Your clients deserve a specialist in their corner.
So do you.
Claims management is a specialist discipline. How a claim is handled has lasting consequences, for your client financially and for your relationship with them. That's why advisers across Australia refer their TPD, Income Protection, and Trauma claims to us.
The question isn't whether you help clients with claims. It's whether you've made a deliberate, documented decision about how you help, what you charge, and where you draw the line. Most advisers haven't, and that gap is getting harder to ignore.
on appeal. 100% success rate.
unassisted claims
insurance claims management
quality, which we eliminate
A poorly managed claim does not just hurt your client.
When a TPD or IP claim drags out, or gets declined, the fallout is operational, relational, and reputational. Financial advisers who manage claims in-house often absorb costs they never intended to carry.
"Claims are the moment your client needs you most. The way it is handled will define your relationship with them and their family for years."
Time you are not being paid for
A well-managed claim can quietly become a 12–18 month, unpaid commitment.
- Eligibility assessment, pre-vetting, submission preparation, insurer negotiation, and dispute resolution all take real hours.
- Without a fee arrangement, you've committed to work that displaces the new business that grows your practice.
Not charging a fee does not protect you
Your fee structure has no bearing on your liability as the advising planner.
- Litigation lawyers are targeting advisers at both ends of the spectrum: those deeply involved in claims, and those who simply forwarded the pack.
- The common thread is a documented, defensible process, not the invoice.
Client attrition when outcomes disappoint
A slow or declined claim can quietly cost you the relationship, not just the case.
- Clients remember who was managing the process, even when the insurer is at fault.
- A client who ends up with a no-win-no-fee lawyer is a missed opportunity on both sides.
FASEA Standard 5: competence, not just willingness
Being willing to help a client with a claim is not the same as being competent to do so.
- FASEA's Code of Ethics requires you to act with documented competence, not just good intentions.
- A pre-vetting protocol, an eligibility checklist, and a documented scope of service are your evidence of diligence. Their absence is evidence of the opposite.
"Submitting to get the ball rolling" is one of the highest-risk moves in claims
Insurers assess from the date of lodgement, and early mistakes are hard and expensive to undo.
- An incomplete submission can trigger an adverse assessment or flag issues that would not otherwise have been relevant.
- Two to five hours of upfront pre-work can save fifty hours after submission.
The referral model,
from your perspective
A straightforward engagement that protects your client relationship from start to finish.
You identify the claim
Your client has a TPD, IP, Trauma, or Life event. You contact us through the eligibility tool or directly and share the relevant policy and medical context.
We assess and agree scope
We conduct a free eligibility assessment and confirm whether we can take the claim on. We discuss terms with you and your client before any commitment is made.
We manage the claim end-to-end
We build the submission, coordinate all evidence, liaise directly with the insurer, and manage the entire process. You receive regular progress updates throughout.
Claim resolved, client returned
Once the claim is settled, your client returns to you for the advisory work that follows: tax implications, investment of the benefit, insurance review. The relationship remains yours.
What you hand over and what you keep
We handle
- Full claim preparation and submission
- Medical evidence coordination and review
- Direct insurer liaison and follow-up
- Responses to insurer information requests
- Declined claim appeals and AFCA representation
- Tax advice referrals at settlement stage
- Post-settlement compliance to protect ongoing claimability
You retain
- The client relationship at every stage
- Progress visibility throughout the process
- The advisory conversation at settlement
- Your professional reputation for delivering outcomes
- Full oversight if you want it, or hands-off delegation if you prefer
We are authorised to do this. Which means you are protected.
We're authorised to manage claims, which means your practice isn't left carrying the exposure.
- Corporate Authorised Representative under Consilium Advice Pty Ltd (AFSL 424974): a properly licensed framework, not a grey zone.
- The 2022 ASIC reforms formally classified claims handling and settling as a financial service requiring specific AFSL authorisation.
- Your clients' claims are managed with appropriate PI insurance and compliance infrastructure in place. Meet our team.
ASIC's Regulatory Guide INFO 253 requires financial advisers to have a documented claims philosophy. It is not a best-practice recommendation. It is a compliance obligation. If you are assisting clients with insurance claims in any capacity and you do not have a written, auditable claims philosophy, you are not meeting the standard ASIC has set. This applies whether you charge a fee or not, and whether you manage one claim a year or eighty.
Claims handling authorisation
We hold the authorisations needed to provide claims handling and settling services, so you can refer knowing the engagement is properly structured and AFSL-compliant.
De-risking your practice
When we manage a claim, the operational and compliance risk transfers to us. Your obligation becomes a referral, not an ongoing claims management function.
Collaborative, not competitive
We work alongside your practice, not around it. Financial advice stays with you. Our scope is strictly the claims process, with the boundary agreed upfront.
Familiar with your legislative framework
We understand the regulatory environment you operate in: SIS Act obligations, product disclosure, and the Life Insurance Framework claims standard.
Do you have a
claims philosophy?
The financial advice profession has long championed investment philosophies and risk insurance philosophies. Yet one critical pillar is frequently overlooked. In an increasingly litigious environment, that gap is becoming harder to ignore. TPD entitlements are now firmly in the sights of the legal profession as a targeted asset class.
These are the questions every adviser needs to answer, deliberately, in writing, before the next claim lands on their desk.
When should you scope in and when must you scope out?
Scoping out isn't abandoning your client. It's recognising where your competence, capacity, or conflict of interest ends. Failing to scope out at the right moment is one of the most common sources of claims complaints against advisers.
Four decision points where scoping in or out should be deliberate, not a default:
- At initial enquiry, before any advice or opinion is given
- At the claim pack stage, before the pack is sent
- At submission, before lodgement with the insurer
- At full engagement, if the matter becomes complex or disputed
The full framework for building your scoping decision into a documented claims philosophy is in Trevor's article. Download it below.
Should you charge a fee for claims assistance and if not, why not?
This is the most avoided conversation in claims, and the most important. Many advisers default to not charging because it feels uncomfortable, assuming clients expect it covered by ongoing fees. But silence isn't a policy. It's a liability.
The harsh reality:
- Whether you charge a fee or not, you may be liable for a poor outcome.
- Your fee structure has no bearing on your liability as the advising planner.
- Not charging may underserve clients by creating invisible pressure to cut corners on complex work.
Four realistic options exist: fee, no fee, hybrid, or product-type model. None is inherently right or wrong, but each must be a deliberate, documented, disclosed choice.
The full fee structure analysis, including the ethics question and what each model means for your risk profile, is in the document. Download it below.
What are lawyers targeting and are you in their sights?
Litigation lawyers are increasingly active in TPD and life insurance claims, targeting advisers at both ends of the spectrum: those deeply involved, and those who simply sent a claim pack. The common thread isn't involvement. It's the absence of a documented, defensible process.
What lawyers specifically look for:
- Claims submitted without proper systems and processes
- Submissions that prejudiced the client's entitlement through incomplete or inaccurate information
- Advisers who held themselves out as claims specialists without the competence or systems to back it up
- Advisers who failed to refer to specialists when the matter exceeded their competence
- CPD registers that do not reflect claims-specific training
- Recouping their fees from financial planners on behalf of clients they have taken on
Section 3 of the document covers this in full, including what a defensible process looks like. Download it below.
What does a documented claims philosophy actually need to contain?
A claims philosophy isn't a marketing document. It's an operational and ethical framework governing how your practice approaches claims. Clear enough for any staff member to act on. Specific enough for a regulator to assess.
At minimum it needs to answer five questions:
- Do you charge a fee, and if so, how is it structured?
- What services do you provide and what do you explicitly not provide?
- At what points do you scope in or out, and what triggers a referral?
- What process do you follow to ensure quality and compliance?
- How do you protect your clients and your practice when things get complicated?
Advisers who can answer these confidently, and back it up with documentation, are well placed to deliver good outcomes and manage the risk. Those who can't are exposed, not for doing anything wrong, but for not making the deliberate choices that prove they've done things right.
Part 4 of Trevor's article walks through building this philosophy from scratch. Download it below.
What your clients experience
when you refer to us
You stay their adviser. We handle the hard part.
Faster resolution
Your client's claim benefits from our 11-step triage process and 20 to 25 hours of upfront preparation, eliminating the information gaps that stall claims. Most well-qualified claims resolve in two to four months, not twelve.
Submissions that hold up
92% of TPD claim delays are caused by poor initial submissions. Your client's evidence package is built to anticipate insurer questions before they're asked, reducing back-and-forth and keeping timelines on track.
Transparent, fixed fees
No percentage-based charges. No surprises. Your client's fee arrangement is agreed before we start work and disclosed in writing, so they keep more of their benefit.
Expert medical coordination
Your client's medical evidence is framed against their specific policy definition, not submitted generically and left for the insurer to interpret. We work directly with treating doctors and specialists to make sure of it.
Declined claim recovery
If your client has already received a rejection, don't let them accept it as final. We've overturned 71 from 71 declined claims through appeal; a decline is rarely the last word when it is properly challenged.
Post-settlement protection
Your client's future claimability is protected after a successful claim, so they don't inadvertently compromise ongoing entitlements. It's the step most advisers and claimants miss.
Run a client eligibility check in five minutes.
Get a structured read on your client's situation before you refer: policy type, disability status, employment history, and the key factors that determine claim viability.
No cost. No obligation. No need to have all the information at hand. The tool guides you through what is needed.
Speak With Our TeamChoose your path
Both assessment tools are free, confidential, and carry no obligation to proceed.
What advisers ask us
Most advisers frame it as specialist support, the same way you'd refer a client to a tax specialist for a complex trust. You're not stepping away from the relationship; you're bringing in the right expertise for this phase of it. We can provide adviser-facing briefing materials to help you explain the referral clearly and confidently.
No. Our scope is strictly the claims process: preparation, submission, insurer management, and appeals where necessary. We don't provide financial advice or encroach on your advisory relationship. Advice on the benefit proceeds, investments, or insurance restructuring stays with you.
TPD is our primary focus, but we also manage Income Protection, Trauma, and Life insurance claims, coordinating across multiple policies where needed. Tell us your client's situation and we'll tell you clearly whether we're the right fit.
- Fees are paid by the client, not by you or your practice.
- It's a fixed-fee arrangement, agreed and disclosed in writing before any work begins, with no hidden costs and no percentage-based charges.
- The initial eligibility assessment is completely free, whether or not your client proceeds with us.
Yes. Contact us before your client accepts the decision as final. We've overturned 71 from 71 declined TPD claims. A decline often comes down to submission deficiencies that can be fixed on appeal through AFCA or resubmission with stronger evidence. The sooner we're engaged, the more options we have, and there's no cost to finding out if an appeal is viable.
The question is often misframed. The real question is whether it's ethical not to charge, and be financially incentivised to minimise the time and care you invest.
- TPD claims are among the most time-intensive matters an adviser will handle: a well-managed claim takes dozens of hours.
- A no-fee model can underserve clients by creating invisible pressure to cut corners on complex work.
- Your time has value. A transparent, documented fee is professional, not unethical.
- What's genuinely risky is the alternative: undefined scope, no fee arrangement, no documentation.
There are clear moments where managing a claim in-house becomes the higher-risk choice. Refer when you see:
- A procedural fairness letter or formal decline from the insurer
- Disputed medical evidence
- Legal advice to your client that conflicts with yours
- A claim running past six months without resolution
- Any mental health claim, now a specialist area in its own right
- A business owner claim, where the employee vs. business-owner distinction needs specific expertise
At any of these points, document your decision, and if you refer, document the referral and its basis. Knowing when to refer is a sign of competence, not weakness.
You'll get regular updates throughout the claim: milestones, insurer responses, material developments. Some advisers want full oversight and every piece of correspondence; others prefer a summary at key stages. We adapt to what works for your practice.
Yes. We work with individual advisers, small practices, and larger dealer groups seeking a consistent claims solution across their network. If your licensee wants to formalise a referral arrangement, contact us to discuss a structured partnership.
Safeguarding
Your Practice
A Claims Philosophy for Financial Advisers
Trevor Battersby, Founder of TPD Claim Support, on why a documented claims philosophy is no longer optional. It's essential. A practical framework for the deliberate decisions that protect your practice, your clients, and your licence.
Sending a claim pack to your client is not the same as scoping out. It is still an act of service and it carries risk whether or not you charged a fee. Not charging does not protect you from litigation. It may actually increase your exposure.
Litigation lawyers are targeting advisers at both ends of the spectrum. The common thread is not the level of involvement. It is the absence of a documented, defensible process. Your CPD register, your eligibility checklist, your pre-vetting protocol: these are your defence.
FASEA Standard 5 requires competence, not just willingness. Your documented systems and processes are evidence of diligence. Their absence is evidence of the opposite. In the event of a complaint or audit, it is the difference between a manageable situation and a serious exposure.
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Let's talk about your next referral.
Whether you have a client with an active claim, a declined claim to appeal, or simply want to understand how the referral model would work for your practice, we are ready to have that conversation.
Or call us directly on 07 3187 6112. Brisbane-based, Australia-wide.