Good advice limits claims anxiety

We buy insurance to get a claim paid, not to just watch the money go out every month. What happens at claim depends on how you bought the cover.

When you purchase insurance there are two ways to do so. Firstly, direct via the insurer or your bank and secondly through an adviser or broker.

Not wanting to confuse the issue, but some companies only deal directly with customers and some only use a broker/adviser channel.

Purchasing the cover is the easy part. Where the rubber hits the road or the quality of product (s) and/ or service really matters is at claim time.

So why would I most regularly recommend using an intermediary?

Well, in all my experiences in this industry and there have been many of them, I constantly witness where good quality advice reduces the stress and anxiety levels of the client / claimant especially at claim time.

In the health and disability insurance part of my work, in the last 12 months I have managed more client claims than ever before.  

I have come across two particular instances recently where claims were made. The first was by a person who had to work directly with the insurer (not a client of DUX). The second by a client of DUX.   

Let’s focus on the second case.

Our team received a call from the claimant’s spouse to advise that they were in hospital undergoing emergency surgery for suspected cancer. 

As is my philosophy and that of DUX Financial, a claim takes absolute priority.  

So, what is the action plan in these cases.

Reassure the client that their case is now your priority.  Provide them an outline of what is going to happen and when.

Next, check their policy and the wordings that will relate to the condition. Once you have confirmed the cover, contact is made with the client to ascertain the best way to get a claim form completed.

If a drive to their house or the hospital is required to assist them completing the claim form, then that is what you do.  The role here is to minimise any stress or anxiety and get the claim paid as quickly as possible.  

The quickest way to get a claim paid is to provide the insurer all the information relating to the diagnosis, treatment (current and future) and the long-term prognosis, if its related to a claim affecting their working capability and their income.

 If this means knocking on the specialist / surgeon’s door to get the histology report, then that is what you do.

You get regular updates from the insurer to pass back to the client.  Communication with the client is a frequent as they need it.

When all is said and done and the claim is paid, time to close the case file, definitely not.

If it is a monthly benefit claim, then regular follow ups are required to ensure the payments are received.   

Ascertain, does the client require financial advice if it is a lump sum claim. Is budgeting advice required if an income is lost or reduced.  Are the home loan payments still going to be met. Does the family require professional support to manage the stress and trauma.

Only when these things are resolved can we think we have done a complete job.

The time frame on this case was 21 working days to claim payment and advice on going.

So, lets now go back to situation number one. At 40 working days this was still unresolved.

I hope you are still with me. The whole point of this article is to reiterate how important knowledge and advise is at claim time.  A time so often beset by grief, stress or anxiety.

What do you do if you have cover, and its direct to an insurer or via an intermediary you are not sure will be there for you at claim time like I described above? Come and see us for a no obligation 2nd opinion meeting, get some advice, set your cover priorities and we can discuss you becoming a DUX client if you want.

https://www.duxfinancial.co.nz/contact