An overview of Victoria’s workers compensation death benefit system

This article explains how death benefit claims operate under WorkCover, what to do if WorkSafe has denied your claim, a brief overview of how life insurance policies work, whether you qualify as a beneficiary for a death benefit claim, why the insurer may have delayed your claim and your options for compensation through the deceased’s superannuation fund.

Losing a loved one is incredibly difficult. Therefore, it is essential to know what kind of legal avenues may be available to you in the tragic instance that their death is work-related. At Gordon Legal, our expert team handles these kinds of compensation claims compassionately, ensuring you do not have to interact with these complicated legal processes during this time. If you have any questions about how this compensation system operates in Victoria, you can contact a member of our empathetic workers compensation team on (03) 9603 3000 or by completing an online enquiry form.

What is a death benefit claim under WorkCover?

In Victoria, WorkSafe manages death benefit claims through its WorkCover scheme. When a worker passes away as the result of a work-related injury or illness, their dependents may be entitled to a death benefit.

This claim usually includes:

• A lump sum death benefit payment.
• A weekly pension.
• Coverage for funeral expenses.

These claims fall within the authority of the Workplace Injury Rehabilitation and Compensation Act 2013.

How can I contest a denied death benefit claim in Australia?

If your death benefit claim is denied, you do have legal options available to you. WorkSafe and the insurer may deny your claim because:

• They do not believe the death was work-related.
• They do not think you qualify as a dependent or beneficiary of the worker.
• They believe the death was related to a pre-existing condition or other non-work-related factors.

If your claim is denied, you can request an internal review of the decision by WorkSafe within 60 days. If this review results in the denial being maintained, you can lodge a further review request with the Workplace Injury Commission, resulting in a conciliation process between yourself, WorkCover, and the insurer.

If the claim remains rejected after this conciliation process, you may be able to escalate the dispute to the Magistrates Court of Victoria.

These processes can be incredibly complex, so it is essential that you receive legal advice if you plan to dispute a rejected claim. Our team at Gordon Legal is ready to assist with this appeal process, so we urge you to contact us on (03) 9603 3000.

Do all life insurance policies include a death benefit?

Most life insurance policies do include a death benefit. This compensation is paid to the nominated beneficiary upon the insured person’s death. Therefore, it is important that you:

• Check if the policy was active at the time of death.
• Check if the policy covers death due to work-related illness or injury.
• Confirm that the insurer has not excluded specific causes of death.

Navigating the insurance claim process can be confusing, especially if you are managing multiple claims through multiple insurers. Our expert team is experienced in managing multiple claims like this, and they will be able to help streamline this process for you.

How do I know if I’m a beneficiary for a death benefit claim?

For your death benefit claim to be successful through WorkCover, you must show that you were a dependent of the deceased worker. A dependent is usually defined as:

• The spouse or de facto partner of the worker.
• A child of the worker. This can include stepchildren or adopted children.
• A financially dependent family member of the worker.

If you are pursuing a death benefit claim through an insurer or a superannuation fund, they will make their own assessment as to whether you qualify as a beneficiary under the policy.

Our team at Gordon Legal is ready to assist you with managing these various death benefit claims. If you want to begin investigating whether you have a viable claim, our compassionate legal team is ready to listen.

What happens if a death benefit claim is delayed in Australia?

Delays in death benefit claims are common. This is because WorkSafe or insurers will often require extended periods to reach their decision. They may:

• Need to access extensive amounts of documentation to reach a decision.
• Need to identify the precise cause of death.
• Need to determine if you can be classified as a dependent under their policies.

These delays can cause immense hardship, especially if you are relying on the death benefit payout to help cover funeral expenses and other ongoing costs. At Gordon Legal, we offer dedicated support with the entirety of WorkSafe’s death benefit payout process and can ensure that your claim is resolved as quickly as possible.

Can I claim a death benefit through a superannuation fund?

Yes. Most superannuation funds have a default death benefit paid to eligible dependents or other nominated beneficiaries. This is separate from the WorkCover death benefit, and it may be possible for you to advance both claims.

If you qualify as a dependent of the deceased worker, you will need to:

• Contact the deceased worker’s superannuation fund.
• Notify them of the death.
• Provide them with the necessary documentation, which will usually include the Death Certificate.
• Provide evidence of your relationship to the deceased, if requested.

The superannuation fund will then distribute the benefit to dependents and nominated beneficiaries. At Gordon Legal, we have both a workers compensation team and a superannuation claim team, and both teams are committed to assisting you through this difficult time.

Need assistance managing a death benefit WorkCover claim for a deceased loved one? Our firm is highly experienced in all aspects of Victoria’s workers compensation scheme, including its death benefit systems. We approach these claims with empathy and compassion and promise to advocate on your behalf to ensure you receive the entitlements you deserve. Contact us on (03) 9603 3000 to arrange a free consultation with one of our workers compensation lawyers.