Super is a second decision-maker
Group IP and TPD are often held by the fund. The trustee and the insurer can diverge. The file has to name both, and the letters have to go to both.
Forthcoming
Australia
riskatlas.com.au
Based in Melbourne. Same compiler, Australian law and language. Income protection and TPD often sit inside super — which means a trustee and an insurer both decide. ABN 29 203 554 753. We also serve South Africa.
Why this market
An Australian claim is not a South African claim with dollars. Cover inside super has two brains. The PDS, the trustee file, and AFCA after IDR are the local path. Date of disablement is the clock. WorkCover and Centrelink are offsets, not the policy test.
Retail and super are different vehicles
The same person may have cover inside super and a retail policy outside it. Different wording, different complaint path, different holder of the record.
IDR then AFCA
Internal dispute resolution is the named first step. AFCA is the external path. Privacy Act APP 12 is the access basis for the records the claim cannot move without.
How a claim works here
- Cover
- IP and TPD — inside super, and retail / outside super
- Disablement date
- Date of disablement (DOD)
- Privacy / access
- Privacy Act 1988 (Cth), including APP 12
- Internal challenge
- Internal dispute resolution (IDR)
- External complaint
- AFCA
- Clinicians
- AHPRA
- Financial conduct
- ASIC / APRA
- Health overlay
- PBS, private health, state WorkCover
- Currency
- AUD
- Offsets
- WorkCover, Centrelink, sick leave, other IP
What we build here
The tool
Compiler
Same job as the other market: documents in, a file out. Local complaint path, local privacy basis, local cover types.
Open →Alongside it
Library
Language, traps, and IP directories for this jurisdiction. Wired into the compiler when you need it. Not medical schemes.
Open →State social security
Social Security Compass
Government support for this country — conditions and rates. Private insurance is a different contract.
Open →We also serve South Africa
We also serve South Africa — same compiler, South African law and language. Not a skin on this market.
Sentrix Digital, Melbourne.