Insurance & Claims FAQ
Q. What insurance coverage do I have?
Insurance coverage is determined by the contribution payment made by an employer member on a worker’s behalf. For more information, please download the relevant program brochure.
Q: If I am not working am I still covered by insurances
A worker will continue to be covered for a period of nine consecutive months from the last recorded and paid redundancy contribution and/or Apprentice days to Incolink, provided they:
• are unemployed, and
• remain in or are actively seeking work in the commercial building and construction industry, and
• are registered as seeking work with Incolink JobSupport, Centrelink or equivalent.
PLEASE NOTE: The continuation of cover is only provided under Personal Accident Leisure Time Insurance, Funeral Cover, and Discretionary Cover (emergency transport & dental, accident only).
Q. Who will assess my claim?
Total Claims Solutions who have been appointed as claims managers of the insurance company and are responsible for managing all claims
Q. Do I need to get all sections of the claim form completed?
Yes, a claim form cannot be considered until we receive the form accurately completed in FULL. Incomplete answers and vague information will delay the assessment of your claim.
Q. What other information do I need to submit with my claim?
Copies of any medical reports and/or discharge summary, patient notes, radiologist’s reports that you may have been provided with will assist with the assessment of your claim. Proof of dependency will also need to be submitted if requested on the claim form to determine your weekly benefits.
Q. How long does it take for a claim to be considered?
The initial assessment of your claim may take up to 6 weeks, depending on whether we require further information to consider your claim. Delays will occur where the forms have not been completed in full.
Q. Can I fax through my claim form?
Yes, however you will also need to send the original claim form to Total Claims Solutions for the claim to be fully considered.
Q. If I know I will be off work for more than 14 days – do I have to wait 14 days before having to send my claim form in?
No. If it appears that you are going to be off work for more than 14 days, you should complete a claim form and send it to Total Claims Solutions immediately.
Q. Do I need to take all my sick leave and my portable sick leave before claiming?
Yes, if you are off work as a result of an illness, it is a requirement that you must first exhaust all available sick days with your current employer and any portable sick leave days that you may have with Incolink. (You must lodge a Portable Sick Leave claim form).
Q. How can I find out how many PSL days I have accrued?
You will need to contact Incolink on (03) 9639 3000 who will advise you of any days accrued .
Q. What is the maximum benefit period I can claim for?
Weekly benefits are only payable for a maximum period of 156 weeks whilst deemed medically unfit to work as a result of your injury or illness or such lesser period whilst you are unable to return to work, or limited to 104 weeks if aged 65 at time of incapacity.
Q. Can I claim my medical bills?
No, there is no cover available for medical costs. Cover is only for weekly benefits whilst you are medically unfit to work as a result of an injury or illness.
Q. How are my payments made?
Payments are made fortnightly in arrears whilst we have a current medical certificate. Payments can be either made by cheque or Electronic Funds Transfer (EFT).
Q.Where is Total Claims Solutions?
Total Claims Solutions is located in the Incolink Building on Level 1, 151 Rathdowne Street, Carlton, Victoria.
Q. Once my claim is approved how long until benefits are paid?
Payment can be made the same day the claim has been approved provided Total Claims Solutions has a Medical Certificate on file for the applicable periods. Payments are made by cheque or EFT. If payments are made by EFT, funds will appear within 48 hours. If payments are made via cheque, the cheque will be posted within five (5) working days.
Q. What are my obligations when I have made a claim?
You must follow medical advice and treatment from your treating medical practitioner at all times after sustaining your injury/illness; and at our expense, undergo any medical examination by a doctor appointed by Total Claims Solutions, if required. Failure to comply may result in your claim payments ceasing.
Q Who can I talk to if I need help in filling out the form?
A Ask to speak to one of the case managers at Total Claims Solutions, by:
Q. What is IPT and why must I pay it?
IPT (Income Protection and Trauma) is an insurance component which must be paid 100% of the time for an employee unless the employee has been terminated. You may not be required to pay the IPT if you do not have an EBA or your EBA does not stipulate payment of the IPT for your employees. A summary of the benefits payable under this insurance can be viewed by downloading a brochure from here.
Q. Can I pro-rata IPT?
No, IPT cannot be pro-rated. IPT must be paid 100% of the time unless the employee has been terminated. Even, if an employee is employed on a casual basis, you are required to pay IPT 100% of the time unless your EBA states otherwise.
Q. Can I increase the benefits for the Income Protection and Trauma (IPT) Program?
Only if stipulated in your EBA. Please contact Incolink to find out details of how this can occur.
Q. What is Portable Sick Leave?
The Portable Sick Leave scheme (PSL) has been set up to take over the sick days a worker would normally lose when they leave or are terminated by their current employer.
On termination of employment, the employer is required will send to Incolink the number of sick leave credits a worker has remaining. It is important that the employer completes the form at the time of termination.
Q. How do I notify Incolink regarding Portable Sick Leave days when an employee leaves my company?
To manage employees and notify Incolink of Portable Sick Leave Days, please refer to the EmployerLink User Manual.
Q. When can an employee claim his Portable Sick Leave Days?
An employee must first exhaust all their eligible sick days with their current employer before they are able to claim the days held in the Portable Sick Leave Scheme.
Q. What happens to the sick days provided to Incolink if an employee returns to our employment?
If an employee has been terminated by the employer and is re-employed by the same employer within 6 months the sick days provided to Incolink are reversed and the employer takes responsibility for the payment of them.
Q. Can I provide insurance benefits to all my employees including office staff?
Yes, contact Windsor Management Insurance Brokers on (03) 9663 2411 for further information about the Accident and Illness Benefits Program for office employees.