Understanding exclusions and waiting periods
Exclusions and waiting periods are where claims most often come unstuck. Know them before you need to claim.
When you take out an insurance policy in Australia, the insurer is legally required to give you a Product Disclosure Statement, or PDS. It sets out exactly what you are covered for, what you are not, and the terms and conditions that apply.
What a PDS contains
A PDS is designed to help you compare products and make an informed decision. Most will include the key sections below:
- Cover details — what events or conditions are insured and the benefit amounts.
- Exclusions — situations where a claim will not be paid.
- Waiting periods — how long you must wait before certain benefits apply.
- Premiums — how much you pay and how premiums may change over time.
- How to claim — the process and evidence required to make a claim.
How to read it effectively
Rather than reading cover to cover, start with the exclusions and waiting periods — these are where most surprises occur at claim time. Then confirm the benefit amounts match what you expect, and check whether premiums are stepped (rising with age) or level.
Always keep a copy of the PDS that applied when you took out or last changed your cover. It is the document your claim will be assessed against.
Where to find a PDS
You can download the current PDS for most major Australian insurers directly from our PDS & Documents library. If your policy has changed, ask your insurer for the version that applied on your start date.