Come directly to us at no cost to you!
BUSSQ does not provide legal advice but we are the experts in managing group risk.
We are required to act in the best interest of you, the member and that includes telling you if we cannot assist or appointing our own lawyers to take action against our insurer if necessary.
We want you to receive the claim you are entitled to. At BUSSQ we have trained insurance specialists to assist you with the claims process. By having direct contact with you, it means we have a better understanding of your circumstances and we can service you better. We also understand the building and construction industry and the related difficulties of working when disabled.
How does the claim process work?
Step 1. Call the BUSSQ contact centre and you will be transferred to our insurer OnePath who will discuss your claim with you. This will allow them to get a full view of what you do for work and how your disablement is stopping you from working. There will be a couple of forms to sign to allow OnePath to contact your doctors however most of the claim will be done over the phone with you. As OnePath will then ring your doctor on your behalf you will not have to worry about more paperwork or paying doctors for reports.
In many cases this will be all that is required for you to be paid your benefit.
We understand this is a very stressful time for you, so both BUSSQ and OnePath do our best to make it easy for you.
There is no cost to you for this service. We will also send out one of our Member Services team to sit with you during the process if you need help. It is our job to help you, so call us direct to make your claims process more efficient both in time and cost to you. We want you to have all of your benefit, not loose up to a third in fees for no reason.
It may be that during the call the assessor tells you that you do not meet the definition of disabled. At this stage you have a number of options;
You can request that one of our Member Services team visit so that you can explain your case. They will then report back to BUSSQ who may then ask you to attend an independent specialist paid for by BUSSQ so we can take your case to OnePath, or
You can lodge an objection to the decision. Your declined claim will be reviewed by our claims committee which is made up of people from the building and construction industry, including union representatives. If they feel the insurer has unfairly declined the claim they will make representation back to the insurer on your behalf. Once again there is no cost for this service. Or,
You can appoint a lawyer to act on your behalf. You will have to pay the lawyer for this service. If you use a lawyer make sure the fee that you will be charged is fair in relation to the work required. We do not make payments to third parties unless directed by a court so we will pay you the benefit and you will then have to pay the lawyer.
Step 3. If you are still unsatisfied with the result you can:
Take your case to the Australian Financial Complaints Authority (AFCA). AFCA is an independent body who will review your claim and has the power to direct a payment from BUSSQ or OnePath if they feel you have been unfairly treated. You do not need a lawyer to access this service and we are required by law to provide you with the details on how to lodge a complaint with the AFCA. You can also have a relative or friend assist in making the AFCA complaint. This service is free so if you are successful you still have 100% of your money.
Have your lawyer take court action against BUSSQ or OnePath. In many cases this will be done by your lawyer as no win no fee. However if you do loose in court you will have to pay some of our lawyers costs which may include a barrister. Of course if you win we will have to pay some of your costs. Remember that any costs awarded against you will have to be paid by you. The no win no fee is usually only in regard to your lawyers costs.
This communication is not giving you legal advice just outlining your options. If you think you need legal advice see a lawyer as we cannot and will not provide legal advice.
Be aware you can start the process with us and if at any time you feel you need legal advice you can appoint a lawyer. Just because you start with lodging directly to save costs does not mean you are locked into the process.
Don’t forget, we’re here to help you, so call us on 1800 MY BUSSQ (1800 692 877) for assistance. As an industry fund our reason for being is for you, the member, not to make money out of you for shareholders.
To make a claim contact BUSSQ on 1800 MY BUSSQ (1800 692 877).
See changes to insurance effective 1 March 2017
Please note: In the event of a dispute, the insurance policy document will override the relevant Product Disclosure Statement and the information contained within this website.