New claim intake — Risk Atlas

1. Policy wording & schedule

Start by choosing whether your cover is through an employer group scheme or a private individual policy. ClaimBuddy will scan your upload and link clauses to the rest of this form. Core policy terms →

What type of income protection cover is this?

2. Claim stage

Choose where you are right now — Risk Atlas tailors evidence gaps, trap warnings, and checklist priorities to your stage.

Where are you in the process?

3. Parties & references

Upload your policy in section 1 first — policyholder, policy number, and insurer auto-fill when found. Also capture cover start and waiting period from your schedule here.

Claimant name

Employer

Start typing for SA employer suggestions — or enter any employer not listed.

Insurer

Full list of NFO Life Insurance Division participants — select yours, or choose Other if not listed.

Policyholder

Policy number

Claim reference

Cover start

From policy schedule or HR benefits pack — check commencement of cover wording.

Waiting period

From your policy schedule — auto-fills when detected on upload.

Also called deferred period or elimination period in policy wording.

4. Occupation & material duties

Your job title and core tasks — the health story builder and functional-capacity module are on the next screen.

Language map → Insurers test whether illness stops you performing material duties, not just your job title.

Job title / occupation functional lane

Start typing — suggestions from ESCO (EU standard occupation database). Select one to optionally auto-fill duties.

Material duties (core tasks your job actually requires) not just title

Type your own summary below or upload a job spec on the right — both together is best.

Job specification / job ad upload

Job specification, position profile, HR job description, or the job ad for your exact role.

PDF, Word, text, or image · max 32 MB each

No files selected yet.

Note on upload (optional)

Press Next → for the health story builder and functional-capacity module link.

5. Health story

Everyday health story → medical record → review. Map symptoms to material duties in the functional-capacity module (synced with this profile). Language map →

Save your claim workspace first — then open the functional-capacity builder from the dashboard or this screen.

Health story builder guided · 4 steps

Story strength

0%

Language map →

1 What happened Your words — onset, symptoms, story

2 Medical record Diagnosis, treatment, certificates

3 Work impact Which duties became impossible?

4 Policy test Incapacity / disability — insurer decision

💡

Pick the narrative frame first — gradual illness, sudden injury, and mental health claims need different timelines and evidence.

Choose your story shape

Pick the frame that best matches your situation — it guides timelines, evidence, and the questions in the next steps.

Which sounds most like you?

Illness ≠ Incapacity

You can feel ill before policy incapacity begins — capture when duties became impossible, not just first symptoms.

Learn more → Diagnosis ≠ Disability

A label on a form is not the claim — pair every diagnosis with duty impact evidence.

Learn more → Symptom ≠ Functional limitation

Translate each symptom into a material duty it blocks — that is what insurers argue about.

Learn more →

See example story openings (not your claim — inspiration only)

Select a story shape above to see tailored examples.

Onset & symptoms

Tap symptoms that apply, then open prompt cards to add detail with your own words.

Physical & pain

Cognitive

Emotional & mental

Sleep & arousal

Work-facing signs

Quick timeline

These three dates are often different — capture each separately. Pick an exact date when you know it, or month / year (approx) when you are unsure.

Symptom onset

Stopped performing duties

First medical certificate

Medical record layer

Structured medical facts — diagnosis with ICD-10, medications, and Medicare / private health insurance history. Keeps clinical language separate from your everyday symptom story.

My Health Record AU · forthcoming

Placeholder — possibility of linking My Health Record (Australian Digital Health Agency) so diagnoses, prescriptions, and certificates can be pulled into this step instead of typed. Recorded on Core AU and the development work-in-progress list. Not connected yet.

Diagnoses ICD-10 auto-fill

Start typing a diagnosis — ICD-10 code fills automatically. Add every working and confirmed diagnosis from certificates or specialist letters.

Medications & treatment tap to add

Select from common SA prescriptions or search — then pick the strength on your script, how often you take it, and an optional comment. Manual strength entry is available if yours is not listed.

Search medications

Your income-protection or group disability policy is separate from Medicare and any private health cover. Capture that history here when a claim, waiting period, or gap payment affects your evidence pack — but the incapacity test still comes from your policy wording.

Medicare / private health insurance history upload or type

PDF, Excel, CSV, or screenshot export · max 32 MB each

Manual summary (optional)

Guided prompt cards (onset, certificates, side effects)

Date ladder

Capture these in Key dates — they are rarely the same day.

Symptom onset When you first noticed symptoms — often weeks or months before you stopped work. Insurers use this to test whether illness predates cover or waiting periods.
Stopped performing duties When you could no longer perform core material duties — your Date of Absence (DOA). This is the main policy test date and may differ from your first sick note.
First medical certificate Date on your first GP or specialist sick note. Employers and insurers sometimes treat this as the ‘official’ start even if symptoms began earlier.
First notice When employer or insurer was first formally notified.

Live preview

Your story preview will appear here as you build.

Functional areas

Open the functional-capacity module to map duty impact per area.

💪 Physical & stamina Fatigue, pain, medication sedation, reduced stamina.
🧠 Cognitive & focus Brain fog, anxiety, depression, sleep disruption, slowed thinking.
⚙️ Technical & specialist Cannot sustain technical accuracy, side effects, vision or coordination issues.
🤝 Interpersonal & client-facing Social anxiety, emotional overload, cannot face clients or lead teams.
⏱️ Reliability, safety & pace Unpredictable attendance, missed deadlines, safety risk if impaired.
📋 Administrative & processing Cannot keep up with admin load, errors in routine tasks.

Medical evidence signals optional

Tick only what applies to this claim. ClaimBuddy uses these to prioritise documents on your evidence list and surface relevant insurer traps on your dashboard.

Hospital admission during this claim

Adds hospital admission and discharge summaries to your evidence pack.

Specialist evidence requested or likely needed

Covers insurer requests, IME referrals, and consultant reports — not routine GP sick notes alone.

6. Salary, deductions & payslips

Earnings and deductions affect benefit calculations, tax, and offsets. Enter what you know or upload payslips (6–12 months is ideal).

Gross earnings

Net pay (take-home)

Pay frequency

Earnings basis

Insured benefit %

Monthly deductions (if known)

Amounts use $ + commas — e.g. $85,000. Type digits only; formatting applies as you type.

PAYG / tax

Super contributions

Health insurance

WorkCover / Centrelink offsets

Other deductions

Deduction / earnings notes

Payslips upload

Upload recent payslips or payroll statements — ideally 6–12 months before and during absence.

PDF, Word, text, or image · max 32 MB each

No payslips selected yet.

Payslip note (optional)

7. Key dates

Symptom onset

Date of Absence (your understanding)

Insurer-stated DOA (if different)

First medical certificate

First notice to employer/insurer

Form submission

Complete claim confirmed

Rejection date

Review deadline

Ombud deadline

8. Notes

Record-access status / other notes

Record access status

Claim readiness intake