Workspace workflow

Nine steps from stage triage through human review.

1. Symptoms begin
   Health changes; work still attempted or reduced.
2. Work impact
   Material duties start to fail — often the true Date of Absence.
3. Notice
   Employer and/or insurer notified. Not the same as a complete claim.
4. Waiting period
   Continuous incapacity must run; breaks can reset the clock.
5. Assessment
   Insurer applies the policy test to the file they hold.
6. Rejection
   Grounds stated — often dates, duties, or missing specialist evidence.
7. Internal dispute resolution (IDR)
   Issue-by-issue response with a cure plan.
8. AFCA complaint
   External complaint via AFCA.
9. Privacy Act 1988 (Cth) access
   APP 12 access to personal information.

Module detail → · Evidence gaps →

Claim stages

Stage	Focus
Preparing claim	Gathering policy, medical, and employment records before first submission Guided intake · document vault · policy reader · evidence gaps
Waiting-period evidence	Proving continuous incapacity through your policy waiting period Timeline · functional-capacity builder · absence continuity
Insurer assessment	Claim lodged with insurer — awaiting decision or further evidence requests Access requests · further-medical-evidence tracking
Rejected claim	Rejection received — preparing internal review or escalation Rejection explainer · review-ground matrix · record access
Internal dispute resolution (IDR)	Challenging the decision through internal dispute resolution (idr). Review pack · issue matrix · cure evidence plan
AFCA complaint	Escalating to Australian Financial Complaints Authority after internal dispute resolution (idr). Escalation pack · prejudice summary · deadline tracker
Privacy Act 1988 (Cth) access	APP 12 access to personal information — records still missing from insurer or employer. Access-request follow-ups · non-response notices
Professional review	Attorney, OT, doctor, or adviser actively assisting your claim Shared workspace · reviewer routing · export pack

Select your stage in intake →

AFCA complaint

After insurer or trustee Internal dispute resolution (IDR), the Australian Financial Complaints Authority is the free external route for life insurance and super disputes.

AFCA dispute process guide → · Dispute resolution article → · Precedent →