Claims time needs collective approach

The experience of insurance at claims time is enhanced only through a collaborative and multitude approach between the financial adviser, claims manager, health professionals and customers, Association of Financial Advisers (AFA) delegates heard.

TAL head of retail claims, Sandra Hill, told the 2017 AFA National Adviser Conference at the Gold Coast last week advisers needed to have an open dialogue with all parties, be aware of who the case manager was and share information that was appropriate to win the claim for the customer.

“The industry itself is morphing. You’re seeing a lot more partnerships between the adviser, between the claims manager, between the customer and between the health professionals,” she said.

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“And the idea of that is that you end up with an optimum outcome for your client.”

Hill said 70 per cent of claims were notified by advisers in the industry, and added it was possible to reach the 100 per cent mark.

“[Clients] can access their own records up to three years, if you’re not aware of that. And that will help to fast track what we’re looking at the claim itself. I think you need to identify your case manager and make yourself known to them and the role that you intend to play,” she said.

Henderson Ross & Co Financial Group senior partner, Tim Ross said advisers need to pre-empt what could occur during claims time for a client and recommend products accordingly.

“Because rather than simply focusing on something simple that would be the cost, we start to focus on what’s going to happen at claims time. We really do need to help our clients be prepared for the worst,” Ross said.

“It’s almost like an assumption from us. Even to ask that question to the client, when we make product recommendations, we need to ask what’s going to happen at claims time.”

Ross emphasised this discussion was more pertinent than even given the different channels of insurance available to customers.

According to Ross, $9.2 billion of total life insurance claims were paid in 2016, which comprised of 108,000 individual claims. There were $26 million paid every day to claimants, 44 per cent paid out in term death benefits, 18.5 per cent in total and permanent disability (TPD), 8.5 per cent paid out in trauma claims, and 29 per cent paid out in income protection business expenses insurance claims.

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