Richard Rugerrio had a heart attack, a triple bypass, a spinal injury, and a mild stroke. Robyn Abrahams, a former nurse, had polio as a four-year-old but carved out a 46-year-long career in critical care at Box Hill and St Vincent's Hospitals before succumbing to muscular atrophy two years before she was due to retire.
Mr Rugerrio has waited more than two years and three months for his life insurance provider to contact him; Ms Abrahams is "too exhausted to fight them any more."
Submissions like these released on Wednesday to a parliamentary inquiry into the life insurance industry have shown elements of the "worst culture and behaviour" of the industry, according to law firm Maurice Blackburn.
Australians pay in excess of $44 billion annually to life insurance companies. Half, or approximately $7 billion, of these payments are paid from superannuation accounts, according to Industry Super Australia.
The inquiry was established following a joint Fairtax Media and Four Corners investigation last year that included allegations raised by the chief medical officers at one of the country's largest insurers, CommInsure, of medical files being tampered with and records being deleted to avoid paying claims.
In his response to CommInsure's submission, the Commonwealth Bank's insurance arm, whistleblower Benjamin Koh rejected the banks claims of an independent investigation after he raised allegations of a "simple alteration [that] could deny a claimant millions of dollars and save the company in the process."
Dr Koh said he was told that anyone with basic IT skills was able to enter the system to alter the medical opinions of the company's doctors after a file he was examining went missing.
"If one file could go missing, and it would not have been detected had I not tried to access it a few days after it was lodged, how many other medical opinions could have been altered without the medical team's knowledge?", he said.
In its submission - CommInsure said it found no evidence to substantiate any of the allegations of wilful misconduct or any systemic issues regarding inappropriate decline of claims.
"Life insurance supports customers and their families at some of the most difficult times in their lives," the bank said. "Commonwealth Bank and CommInsure take that responsibility very seriously."
The inquiry, which began hearings in Melbourne on Wednesday, will examine the use of out-of-date medical conditions, codes of conduct, and insurance conditions for people with a mental illness.
Mr Rugerrio, who has held Total and Permanent Disablement (TPD) Benefit Insurance through his superannuation policy with AMP since 1997, said he feared for his future after he had no contact from the insurer since he lodged a claim in 2014.
"I can no longer use my insurance funds to buy a home to live in and at least have some place to live in my later years," he said.
"I would rather have an overdose than end up living on the street."
In its submission, law firm Maurice Blackburn said the most pervasive change across the industry was the substitution of the legal test of "unlikely" with the more onerous "unable" on the impact of a medical condition on a claimant's ability to work.
"For instance, it is possible to argue that even a quadriplegic is theoretically capable of work and may not satisfy an "unable" definition, notwithstanding that their actual employment prospects in a competitive employment market are negligible," it said.
"As a consequence, the insurance effectively becomes junk insurance"
Geoff Derrick, the National Assistant Secretary of the Finance Sector Union of Australia, said insurance employees have consistently provided feedback on the pressure they are under to see each customer as a sales opportunity to be exploited.
In his submission, John Berrill of Berrill & Watson Lawyers said some of these may constitute systemic problems although it is unclear whether there is evidence of widespread unethical practices to avoid meeting claims.
The hearing will continue in Sydney on Friday.
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