How to make an insurance claim

Once insurance cover is in place it is something we rarely think about – until it is time to make a claim. The circumstances around making a claim are likely to be stressful, to make the process as smooth as possible, we have put together our best practice tips.

Contact your adviser

The first step is to call your insurance adviser, and this is a time when the decision to purchase your insurance policy through an adviser will really come into its own.

The relationship you have with your adviser means that they know you, your circumstances, and your policy details. This means you don’t need to find and decipher your policy at a worrying time. Your insurance adviser will immediately have a good idea if your event is claimable and can give you a quick answer before starting the claims process.

While the call centre staff at insurance providers are great people, and good at what they do, they don’t have the relationship with you that your adviser does. Your adviser also works with the insurance provider every day. This means they have a good relationship with them and understand the way they, and the claim process, work. That alone will make the process smoother, and therefore less stressful.

Filling out the claims forms

After you speak with your adviser they will send you the claims form and provide you with any support you need to have them accurately filled out. There will be a section for your personal details, and a section for any relevant professionals (such as a medical specialist).

They will also alert the insurance company that a claim is coming.

You need to get the completed form back to your insurance adviser as quickly as you can. They will check to make sure it is complete, and then deliver it to the insurance provider. The length of time the assessment takes depends on how much information is needed and how quickly the completed claim form gets back to the insurance company. In the case of a death event the insurer aims to have it approved within seven days. Once a claim has been approved, payment will be made overnight.

Medical insurance claims

In the case of medical insurance, there are two ways of going about making a claim; pre-approval or post-approval.

If you are having a health scare and have scans or other diagnostics booked in, you can get the claim process started with your insurance provider and apply for a pre-approval claim before the appointment. This means that everything is ready to go when you get your results back. If everything is okay you don’t need to make the claim, if not, the claim is already under way and is one less thing for you to think about.

If you are unable to process a pre-approval claim, you can make a post-approval claim, and this process is the same as claiming on other types of cover.

Claim approval

Once the claim is with the insurance provider they will get in touch with you directly, however your insurance adviser will be kept updated on how your claim is progressing and will be available to support you with any concerns you have. If need be, they will also advocate for you.

It is very rare for a claim to be declined. Legislation is in place to make it very difficult for insurance providers to “get out of” paying on an insurance claim.

Claims that are denied are usually the result of a non-disclosure by the client – even if the non-disclosure was accidental. This is one of the advantages of purchasing your insurance policy through an adviser – our process is so thorough that it is unlikely you would forget to disclose anything. Answering all those questions may seem tedious at the time, but it means come claim time there shouldn’t be any problems.

Our clients also have access to the Plus4 Claims Advocacy Team, and if we believe a claim has been unjustly denied, this team will get together and take a closer look.

When to make a claim

It is always best to make a claim as soon as possible. Depending on the policy and provider there can be a varying window of opportunity to make a claim, and some of our clients have successfully made retrospective claims. Read more about it in our blog post Is it too late to claim?

At Plus4 we work for you and we value our relationship with you. If you have any questions about a potential claim, do not hesitate to get in touch with your adviser.

How to make an insurance claim

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