Your clients deserve a specialist in their corner.
So do you.
Financial advisers across Australia refer their clients' TPD, Income Protection, and Trauma claims to us because claims management is a specialist discipline — and the way a claim is handled has lasting consequences for your client financially and for your relationship with them professionally.
The question is not whether you help clients with claims. It is whether you have made a deliberate, documented decision about how you help, what you charge, and where you draw the line. Most advisers have not. That gap is becoming 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 TPD claim takes dozens of hours across eligibility assessment, pre-vetting, submission preparation, insurer negotiation, and potential dispute resolution. Some TPD claims become complex post-submission. If you have scoped in without a fee arrangement, you have committed to a 12 to 18 month engagement that displaces the new business work that drives your practice forward.
Not charging a fee does not protect you
Many advisers believe that if they did not charge a fee to submit the claim, they cannot be litigated against. That is not correct. Your fee structure has no bearing on 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 the absence of a documented, defensible process. Not the invoice.
Client attrition when outcomes disappoint
A declined claim, or a claim that takes 18 months when it should have taken four, damages trust in a way that is hard to recover. Clients who experience a poor outcome do not always blame the insurer. They remember who was managing the process. If they have ended up with a no-win-no-fee lawyer because you did not offer a clear alternative, that 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 advisers to act with competence, meaning you must only provide claims assistance in areas where you have the relevant knowledge, skill, and documented process. Completing a claim form is not evidence of diligence. A pre-vetting protocol, an eligibility checklist, and a documented scope of service are. Their absence is evidence of the opposite.
"Submitting to get the ball rolling" is one of the highest-risk moves in claims
One of the most common and most dangerous practices is submitting an incomplete or unvetted claim on the basis that you can add to it later. Insurers assess from the date of lodgement. Early mistakes create early impressions that are difficult and expensive to reverse. An incomplete submission can trigger an adverse assessment, alert the insurer to issues that would not otherwise have been relevant, and create a paper trail inconsistent with your client's actual circumstances. 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.
TPD Claim Support operates as a Corporate Authorised Representative under Consilium Advice Pty Ltd (AFSL 424974). Our claims management activities sit within a properly licensed framework, not in a grey zone that could create exposure for you or your licensee.
The 2022 ASIC reforms formally classified claims handling and settling as a financial service requiring specific AFSL authorisation. Working with us means your clients' claims are managed by a firm that meets those obligations, 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 necessary authorisations to provide claims handling and settling services. You can refer with confidence that the engagement is properly structured and compliant with the current AFSL framework.
De-risking your practice
When we manage a claim, the operational and compliance risk of that process transfers to us. Your obligation becomes a referral rather than an ongoing claims management function. Your licensee will appreciate the distinction.
Collaborative, not competitive
We work alongside your practice, not around it. We do not provide financial advice. That stays with you. Our scope is the claims process. The boundary between our roles is clear, documented, and agreed upfront.
Familiar with your legislative framework
Our team understands the regulatory environment you operate in: SIS Act obligations, product disclosure requirements, and the claims standard under the Life Insurance Framework. We speak your language.
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 does not mean abandoning your client. It means recognising where your competence, capacity, or conflict of interest ends and acting accordingly. The failure to scope out at the right moment is one of the most common sources of claims-related complaints against advisers.
There are four natural decision points where scoping in or out should be a deliberate call, 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 also the most important. Many advisers default to not charging because it feels uncomfortable. They assume clients expect it to be covered by ongoing service fees or renewal commissions. But silence is not a policy. It is 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 liability as the advising planner. Not charging does not protect you. It may actually underserve clients by creating invisible pressure to take shortcuts on complex work.
You have four realistic options: charge a fee, no fee, a hybrid model, or a product-type model. None is inherently right or wrong. But each must be a deliberate choice, documented and disclosed before any work commences.
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?
The legal profession has become increasingly active in the TPD and life insurance claims space. Litigation lawyers are targeting advisers at both ends of the spectrum: those deeply involved in claims, and those who simply sent a claim pack. The common thread is not the level of involvement. It is 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 is not a marketing document. It is an operational and ethical framework that governs how your practice approaches claims. It should be clear enough that any staff member could act on it, and specific enough that a regulator or court could assess compliance against it.
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 questions confidently, and back them up with documentation, are well-placed to deliver excellent client outcomes and manage the risks that come with claims work. Those who cannot are exposed, not because they have done anything wrong, but because they have not made the deliberate choices that demonstrate they have 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
Our 11-step triage process and 20 to 25 hours of upfront preparation eliminate the information gaps that stall claims. Most well-qualified claims we manage resolve in two to four months, not twelve.
Submissions that hold up
92% of TPD claim delays are caused by poor initial submissions. We build evidence packages that anticipate insurer questions before they are asked, reducing back-and-forth and keeping timelines on track.
Transparent, fixed fees
No percentage-based charges. No surprises. Our fee arrangement is agreed with your client before we start work and disclosed in writing. Your client keeps more of their benefit.
Expert medical coordination
We work directly with treating doctors and specialists to ensure medical evidence is framed against your client's specific policy definition, not submitted generically and left for the insurer to interpret.
Declined claim recovery
We have overturned 71 from 71 declined claims through appeals. If your client has already received a rejection, contact us before they accept it as final. A decline is rarely the last word when it is properly challenged.
Post-settlement protection
We advise on how to protect future claimability after a successful claim, ensuring your client does not inadvertently compromise ongoing entitlements. This is the step most advisers and claimants miss.
Run a client eligibility check in five minutes.
Before you refer a client, or simply when you want a quick read on whether they have a viable claim, our eligibility assessment gives you a structured picture of their situation. It covers 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 would refer a client to a tax specialist for a complex trust structure. You are not stepping away from the relationship. You are bringing in the right expertise for this phase of it. We can provide adviser-facing briefing materials that help you explain the referral arrangement clearly and confidently to your client.
No. Our scope is strictly the claims process: preparation, submission, insurer management, and where necessary, appeals. We do not provide financial advice and we do not encroach on your advisory relationship. Any advice about what to do with the benefit proceeds, investment decisions, or insurance restructuring remains with you.
Our primary focus is TPD, but we also manage Income Protection, Trauma, and Life insurance claims. If a client has multiple policies or policy types involved in the same claim event, we coordinate across all of them. Speak to us about your client's specific situation and we will tell you clearly whether we are the right fit.
Our fees are paid by the client, not by you or your practice. The arrangement is fixed-fee, agreed and disclosed in writing before any work begins. There are no hidden costs and no percentage-based charges that erode the benefit. The initial eligibility assessment is completely free for your client, regardless of whether they proceed with us.
Yes. Contact us before your client accepts the insurer's decision as final. We have overturned 71 from 71 declined TPD claims. A decline is often the result of submission deficiencies that can be addressed on appeal through AFCA or by resubmission with stronger evidence. The sooner we are engaged after a decline, the more options we have. There is no cost to finding out whether an appeal is viable.
The question is often misframed. The real question is whether it is ethical not to charge a fee, and therefore be financially incentivised to minimise the time and care you invest in the process. A no-fee model for complex TPD work can actually underserve clients by creating invisible pressure to take shortcuts. TPD claims are among the most time-intensive matters an adviser will handle. A well-managed claim takes dozens of hours. Your time has value, and acknowledging that through a transparent, documented fee arrangement is not unethical. It is professional. What is genuinely risky is the alternative: undefined scope, no fee arrangement, and no documentation of what was agreed.
There are clear situations where continuing to manage a claim in-house becomes the higher-risk choice: a procedural fairness letter or formal decline from the insurer; a claim involving disputed medical evidence; a matter where the client has received legal advice that conflicts with yours; a claim ongoing for more than six months without resolution; any mental health claim, which has become a specialist area; and any situation involving a business owner, where the employee versus business owner distinction requires specific expertise. At any of these trigger points, document your decision and, if referring, document the referral and the basis for it. Knowing when to refer is a sign of competence, not weakness.
You receive regular progress updates throughout the claim: milestone notifications, insurer responses, and any material developments. The level of involvement is up to you. Some advisers prefer full oversight and a copy of all correspondence. Others prefer a summary update 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 management solution across their adviser network. If your licensee is looking to formalise a referral arrangement or provide claims support as a firm-wide capability, contact us to discuss a structured partnership.
Safeguarding
Your Practice
Trevor Battersby, Founder of TPD Claim Support, examines why a clearly defined claims philosophy is no longer optional for financial advisers. It is essential. This is not a marketing document. It is a practical framework for making 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.