An insurance claim for your life insurance can be pretty daunting and tedious. But it can be made simpler and easier if you have all the right information. Here is a list of information that you need before or whilst making an insurance claim.

1. Who should you reach out?

As a rule of thumb, you should first refer to where or whom you bought the insurance through.

  • Insurance Advisor / Insurance Broker

While reaching out to your insurance company directly is a good option, talking to your adviser or broker would save you the stress of going in circles throughout the whole process.

  • Insurer

If you did not acquire the services of a broker or a financial adviser for your insurance then you will have to reach out to the insurance company directly.

  • Superannuation Fund

Reaching out to your superannuation is ideal too if they hold your insurance.

  • Employment Arrangement

If you’ve acquired your insurance through a work arrangement, then it would also best to reach out to your employer first.

Inquire about the whole process and how it works. Then get a list of all forms you need to fill out and acquire copies for you to fill out. You may also seek help and support from your family and friends especially if you are emotionally and physically struggling. Obviously if you have an Adviser they will run through the forms with you and advise you on what to complete, as well as lending a supportive ear to your situation.

2. What information would be asked from you?

The claim would need to be supported by detailed information of your condition. How much and what information would depend on the type of policy that you are claiming for. However, you would more than likely be asked for the following:

  • Medical test results and reports from your physician/ clinic.
  • Physical requirements, number of hours you work each week and other details about your work.
  • If you are self-employed you will be asked for financial statements or payslips and tax returns if you are employed.
  • For death claims, you will need a death certificate or medical report stipulating the cause of death.
  • For other claims generally your GP and possibly another specialist would need to complete a form regarding your insurance.

Often, insurers would need to reach out to your doctor/ clinic to validate the medical information that you have provided. Sometimes you may also have to be assessed by a specialist who reports directly to the insurer.

If your injury or illness is recurring and continues to cause your inability to work, you may need regular tests and continues submission of progress claim forms.

3. How long does a claim process take?

The duration of the whole process would depend on the policy type and circumstance.

  • Income-related concerns

Typically, this is within two months of being notified of your claim, or two months after the waiting period for your policy expires.

  • Other Claims

This is often within 6 months of being notified of your claim or 6 months after the waiting period expires.

All that said, there is a bright side to this complex and daunting process. You are protected by the Life Insurance Code of Practices. This code sets out how insurers handle your claim including timeframes for decision making and how to keep you updated. Failure to meet these standards will give you the power to file a complaint to your insurer. Your Adviser also goes in to bat for you too.

4. How to make a complaint or dispute your claim

If you are dissatisfied about the decision or the claims process itself, you can make a complaint to the insurer or superfund. The sooner you make such a complaint, the better.

If your insurance fails to reach an agreement with you, you may escalate your complaint to the Australian Financial Complaints Authority (AFCA) and get free, independent dispute resolution.

5. Help whilst making a claim

On special cases where the circumstance is really difficult for you, your insurer or superannuation fund may offer help while your claim is ongoing. They can either speed up the assessment process or make an advance payment to help out.

As long as you have adequate documents to support your need for urgent financial help, your insurer or superfund could help you out. These documents could include bank statements or Centrelink statements. Of course, if you were given urgent financial help, this will be taken against the overall claim payout.

Cover obtained through your Adviser

We will point out that the true test of an insurance policy is at claim time. There are many different types of insurance out there, of which many are poor quality. As an Adviser we always act in the best interests of our clients, where two of the criteria is the quality of product we are recommending and the insurers claims history, so that you do not have any issues come claim time. Therefore its very important to consult with us should you choose to review or make changes to your policy. We are always here to help out clients.