The HESTA difference
How we step in if your claim is not approved
1. HESTA insurance specialists reassess the Insurer's decision with a complete and independent review of the claim.
The Insurer will advise HESTA the claim has not been approved and will provide all evidence relied upon in assessing your claim to HESTA for an independent review.
HESTA insurance specialists will then conduct an independent review of the claim through HESTA's formal Claims Review Committee. The Committee will thoroughly review the reasons provided by the Insurer and will make an independent assessment of the reasonableness of the Insurer's decision, taking into account your individual circumstances, the thoroughness of the evidence provided and your ability to return to work.
2. If HESTA disagrees with the Insurer's decision, HESTA insurance specialists will dispute the decision directly with the Insurer on your behalf.
HESTA will refer the claim back to the Insurer for further consideration until we are satisfied with the Insurer's decision.
3. Once a decision is reached, you will be advised directly of the outcome of the claim.
If HESTA successfully challenges the Insurer's decision and the claim is approved, the Insurer will advise you of this and your benefit payment will commence.
If HESTA agrees with the Insurer's decision to decline the claim, HESTA will advise you directly and explain the reasons the claim was declined. If you are not happy with our decision you can lodge a written complaint
with HESTA. If you're not satisfied with the response, you can lodge a complaint with the Superannuation Complaints Tribunal (SCT) on 1300 884 114, for a further independent review.