A carpenter catches their thumb in a table saw and loses it. After surgery they face rehab and time away from tools, plus extra costs to adjust equipment and daily tasks. A one off payment would help them get set up again.

A lump sum may be payable if an accident causes a listed injury, like loss of a thumb and it happens within the required timeframe.

An electrician strains their back lifting cable trays. They are off work for 10 days, then return on half days and light duties for a month. They can work, but their income drops while they rebuild strength and finish physio.

Partial disability may pay a reduced weekly benefit when you return to work on lighter duties after an injury, if you meet the rules.

A café owner catches a bad flu that turns into pneumonia. Their GP tells them to rest at home and they cannot work for three weeks. They miss shifts and lose income, but still need to pay household bills on time.

Weekly Sickness Benefit may pay a weekly amount if illness stops you working, after the waiting period and a doctor’s certificate.

A landscaper slips on wet paving and breaks their wrist. The doctor says no lifting or driving for six weeks. They cannot do paid work and still have rent, groceries, school costs and appointments to cover while they heal.

Weekly Injury Benefit may pay a weekly amount if an accident injury stops you working, after the waiting period and medical evidence.

During a tough period, a person deliberately harms themselves and needs medical treatment. They take time off work and submit an accident and sickness claim for weekly benefits. The doctor notes confirm the injury was self inflicted, not accidental.

Intentional or self inflicted injury, including attempted suicide, is excluded. Because it is deliberate, benefits are not payable.

A sole trader does cash electrical work without the right licence. They get an electric shock and burn their hand, then they cannot work and lodge a weekly injury claim. The insurer investigates and confirms the job was illegal under licensing laws.

Claims linked to criminal or illegal acts are usually excluded. If you are injured while breaking the law, the benefit can be declined.

After a work Christmas party, you decide to drive home. You have a crash and break your collarbone, then you cannot work for a month. Police testing shows your BAC is above the legal driving limit, so your claim for weekly injury payments is declined.

Accidents when you are over the legal alcohol limit or affected by drugs are often excluded. Weekly benefits may not be payable.

Before the policy starts, you have a history of back pain and have seen a physio. Months later the pain flares up again and you cannot work for two weeks. You claim weekly sickness benefits, but your medical history shows it existed before cover began.

Pre existing conditions are usually excluded unless the insurer agrees in writing. So benefits may not be payable for this flare up.