Why is a benefit reduced or refused to be paid? - BUSSQ

Why is a benefit reduced or refused to be paid?

The insurer may reduce or refuse to pay a benefit in the following circumstances:

  • You do not meet the definition of disablement or terminal illness.
  • Your cover was not in place at the time of death or disablement.
  • There has previously been a payment made such as TTD, TPD, or terminal illness.
  • Fraud.
  • While you are imprisoned.
  • If you do not comply with BUSSQ insurance requirements, including compliance with any obligations arising from your duty of disclosure.
  • Where OnePath has not received notice at the time your disability starts, to the extent that their assessment or management of the claim is prejudiced.