Sentrix Digital riskatlas.com.au Library

A historic diagnosis is not the disablement date. Pulling Date of Absence back into the first twelve months can wrongly switch a pre-existing exclusion on; leaving it on the day duties actually stopped can switch the same clause off (NFO CR356).

Pre-existing condition

Exclusion clocks and causation — look-back, first-year window, what caused disablement

Date of Absence

When policy incapacity / duties-stopped is deemed to have begun

Why this matters for your claim — Insurers may pick an early DOA to fit the first-year window, or treat any old label as look-back proof. NFO CR403 requires contemporaneous notes and causation.

What to capture in ClaimBuddy

Tap a label to open the language-map explainer for that date or concept.

  1. Cover start / entry — Schedule or member certificate.
  2. Look-back notes — Advice, treatment, investigations in the contractual months.
  3. New event if any — Post-cover change that actually altered function.
  4. Duties stopped — Your best candidate for Date of Absence.

Claim tip

Build both clocks: look-back notes versus the day material duties stopped. Do not let a later diagnosis or an earlier ache move DOA without evidence.

Cover 1 Nov 2016. Look-back empty. New left-leg weakness March 2017. Duties stopped 1 July 2017. Historic 2003 injury is background, not the clause.

Sentrix Digital, Melbourne · ABN 29 203 554 753. Not medical, legal, or financial advice. Organisation and drafting only. Verify with treating practitioners, the PDS, and the trustee/insurer. Australian complaints: insurer/trustee IDR, then AFCA. · info@sentrixdigital.com · +61 (03) 9088 1341 · Admin login