Lodging an Insurance Claim

An event takes place; a death or an accident, and life changes. At a time of such extreme stress, we are here for you. Most people would find the prospect of dealing with their first life insurance claim quite daunting but our step-by-step guide below will provide guidance if you choose to benefit from our Claims Assistance Service or if you elect to undertake the claims process on your own.

Benefits Of Our Claims Assistance Service

We are proud to offer our leading Claims Assistance Service to both existing and non-existing customers. Life Insurance Direct has over 9 years of experience in lodging claims and dealing with Life Insurers.

We have handled hundreds of individual claims for our clients with regards to:
claims-assistance-service

At, Life Insurance Direct we are the experts to handle your claim and to stand up for your rights so you can focus on your recovery and looking after your family. Benefits of our service include the following:

Initial Claims Forms Assistance

To ensure your claims process is as smooth as possible we will review your claim forms and documents before they are submitted to the Life Insurance Company. We can answer all your questions prior to completing your forms. Using our knowledge we can explain and provide guidance with the claim forms which is a difficult process for the majority of people. The implications of not completing your claim forms correctly, is significant enough that it can jeopardise or delay your claim being paid.

Central Contact Point

We are your dedicated central contact for you to ask questions and to avoid you having to deal with the prospect of multiple consultants on recorded phone calls within a Life Insurance Company during your claim. This can at times be a stressful, complicated, convoluted and daunting process for many people and we can alleviate these issues by having your own dedicated Claims Contact here at Life Insurance Direct.

Claims Process Follow-Up

Whilst your claim forms are being assessed, we liaise and monitor the progress of your claim with the Life Insurance Company. We will clearly represent you and our aim is to stand up for your rights with the Life Insurance Companies by keeping them accountable to their service level agreements, communicate effectively and ultimately keep them accountable and ensure they act within policy terms. We will promptly contact you during this process and clearly outline the progress of your claim.

Our Claims Service Guarantee

We currently offer our Life Insurance Direct Claims Assistance Service at the discounted rate of $195 for our existing clients. If your initial benefit is not paid by the Life Insurance Company, we will refund your fee.

As mentioned, we also offer our leading Claims Assistance Service to people who have obtained a Life Policy through another Intermediary. We welcome the opportunity to assist you. The fee for non-existing clients is $395. If your initial benefit is not paid by the Life Insurance Company, we will refund your fee.

If you would like to use our service, then please contact us on 1300 135 205 and we will be happy to assist.

Step By Step Instructions On Lodging A Claim With Our Claims Assistance Service

number-1Call Us

  • Call us and speak to our Claims Team, who are fully trained and also sensitive to the event you are facing.
  • Make sure you have the policy number and other details of the event (death or accident).
  • Once you have agreed to proceed with our Claims Assistance Service and we have discussed all the details of the incident, we will contact your insurer and organise the claim forms to be sent to you and us, so we can help you.

number-2Complete the Claim Form

  • We will help you in completing the claim forms and also advise you about the various documents you need to provide along with the claim forms. The claim form has two sections: claimant section & treating doctor’s report.
  • Claimants Section – Kindly complete this section, which will also contain a Medicare form and a Pharmaceutical Benefits Schedule (PBS) form.
  • A Treating Doctors Report – the treating doctor (or the doctor you consulted) needs to complete this form for you, along with relevant test results and reports.

number-3Relevant documents that you need to provide

  • In a life insurance claim, you need to provide certified copies of the death certificate and policy schedule. Death certificates take time and thus it’s best to complete the claims forms and send to us first and then we will lodge the claim with your insurance company, while you wait for the death certificate.
  • In case of an income protection claim, you need to provide financial evidence of your income (if you have not yet provided it) like pay slips, group certificates or tax returns and tax assessments. If you are self-employed you need to submit your business tax returns and profit and loss statements, as well.

number-4Return the Claim Forms back to us

Once we receive your claim forms, we will review all of your forms and documents to ensure we have everything required and that you have completed the forms appropriately prior to your claim documents being sent to the Insurer. We will contact you if we require anything further and also answer your questions.

number-5Assessment of your Claim

  • Once the Insurance Company receives the forms, your claim will be assessed depending on the type of insurance policy you have: life insurance, TPD insurance, trauma insurance or income protection for example.
  • Your claim is assessed according to the outlines in the Insurer’s Product Disclosure Statement (PDS) & Policy Terms.
  • The Insurer will contact us during this process and likewise we will follow up with them to ensure we can keep you up to date during the assessment.

FREQUENTLY ASKED QUESTIONS

Once your life insurance company processes the documents and has assessed your claim as successful, you will receive your benefit.

When you actually start receiving your benefit depends on the type of policy:

In case of life insurance, you generally get the funeral advancement benefit first, as soon as your insurer processes the documents. The balance payment is settled on receiving the death certificate. In case of income protection, you will need to wait till the waiting period stops and your monthly benefit starts to accrue. Your Trauma Insurance / TPD Insurance is paid as a lump sum once the forms are processed along with the Medicare/PBS Assessment, and the event is meeting the definition in Product Disclosure Statement (PDS) of your insurance company.

Before you enter into a contract of insurance, you are legally obliged (under the Insurance Contracts Act 1984) to disclose relevant information to the insurer before a contract is entered into, under the duty of disclosure.

If your policy is more than 3 years old, the process to check your duty of disclosure may not be required and it will depend on your insurer whether they need to conduct any assessments.

Please Note: Here is the actual Duty of Disclosure for your reference.

If you choose not to use our Claims Assistance Service, this is how the process of making a Claim would look like:

Contact the Insurer and ensure you have your policy number available. The claims consultant will organise your claim forms to be sent to you and will ask you some details regarding your claim. Once you have had completed all aspects of the claim forms, you will return these forms along with the requested supporting documentation directly to the Life Insurance Company. The Insurer will then review your claim and contact you as required during the process.

Published: February 25, 2016

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