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Meeting an adviser? How to get the most out of your meeting

When you work with an adviser to get the right insurance in place, we want it to be as easy and accessible as possible. This might mean we come to your place after hours, or that you come to our office – part of what makes working with an adviser so great is our flexibility. If you want to know how to prepare for meeting an insurance adviser there are a few things you can do to get the most out of the meeting, whether you are looking for life insurance, income insurance, trauma protection or just some good insurance advice.

Allow enough time

If you know exactly what you want, half an hour may be okay. However if you are using an adviser because you want to draw on their expertise and experience, you need to allow enough time to for them to get a good understanding of your current situation and how you see your life changing in the future. It is best if neither party feels rushed.

Be open with your disclosure

Disclosure is a key part of making sure we choose the right policy and making sure you really are covered when you come to claim.

Don’t hold back because you are concerned you won’t get cover – chances are it would come out when you try to make a claim and it could be denied. There are lots of different providers and policies available, and when we know the full picture we can choose the best provider, policy or combination of policies to get the most comprehensive cover for your circumstances.

Give us your full attention

Life is busy – and it can be hard to fit everything in. However, if we have a meeting together you need to be able to give us your full attention. You may find insurance boring, but it is important!

This means make sure the kids are in bed, turn the TV off, and put your phone on silent. This is a professional meeting, and even if it is at your kitchen table it needs to be treated as such – otherwise you may miss key information or forget to tell us something critical.

Be prepared

There are a few things you can have ready before we arrive. If you have existing policies, have those details ready for us. Having your personal income details or business accounts ready is good, as is a clear idea of your own medical history and that of your family.

Ask lots of questions

We absolutely love it when you ask questions and are open to learning more! This gives us a great idea of what you already know and what is important to you. We know our stuff inside and out, but we don’t expect you to, so there really are no dumb questions.

Make sure you can both be there

Whether you are getting insurance along with your partner in life or your partner in business, it makes sense for you both to be available, especially for our initial meeting. We need to know what is important to both of you, and we need to know about you as individuals.

After the meeting

After we have met with you, we may need more information or official documentation. Following up on this promptly and partnering with us to chase up third parties, such as your doctor, makes a big difference to how quickly we can get your cover in place.

Relax, we are a team

Lastly, remember that your adviser is on your side.

We are not there to sell you something you don’t want or need, we are there to work with you to put together a plan for your future. It is not about a particular insurance product, it is about the outcome for you if something goes wrong, and insurance is just one of the tools we use to get the best outcome for you. That is why we will likely talk to you about wills, trusts and enduring power of attorney as well.

Are you ready to get an insurance adviser on your team? Get in touch with one of our advisers today.

Prepare for your meeting with an adviser

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Do children need health insurance?

With GP visits free to children under 14 years old, getting medical cover for your healthy, active children may seem unnecessary.

We think it is worth considering, and there are a number of reasons why.

In our previous blog on health insurance (you can read it here) we described health insurance as doing something your future self will thank you for. The same concept stands for insuring your children – you are setting them up for later in life, in a time when our public health system may look very different to what it does today.

Protection against pre-existing conditions

One of the problems adults find when they go to get health insurance is the limits placed on them by pre-existing conditions. A pre-existing condition is a health problem that exists before you apply for a policy – insurance companies are businesses and as such they are concerned about their bottom line. This means if you have a pre-existing condition they are likely to exclude cover for that condition, charge a higher premium or impose a waiting period before that condition is covered.

If you insure your children while they are young, fit and healthy, and they keep the policy when they reach 18 or 21 (depending on the insurer), they will not have any pre-existing conditions as the cover is already in place. This includes big stuff such as cancer or heart problems, but also smaller things such as allergies or asthma.

Pre-existing vs Congenital: An important distinction to be aware of

It is important to understand the distinction between pre-existing conditions and congenital conditions as most insurance policies do not cover congenital conditions.

A congenital condition is something that you are born with, whereas a pre-existing condition is something that you have developed since birth. For example, a tongue-tie correction needed on a baby will generally not be covered, as that is something they were born with. A child that needs grommets inserted (one of the most common procedures for children, which helps prevent persistent ear infections but often has long waiting lists) can be covered.

Access to healthcare, no matter how public funding changes

With New Zealand’s aging demographics the way we are able to access public healthcare may well change in the future. The government currently spends 20% of its budget on healthcare and we have 10 workers (i.e. paying tax to fund the government budget) for every old age dependent, however in the next 20 years that number is going to shift to four workers for every old age dependent. That future healthcare burden raises some questions around the sustainability of our public system.

While we don’t know exactly what the future looks like, it is likely that private medical insurance will play more of a role in getting the healthcare you need when you need it.

Want to talk to someone about insurance for your family?

If you need some help weighing up the pros and cons of having medical insurance for your children, get in touch with one of our advisers today. They can talk you through some of the ins and outs of the policies available and help you find one that best suits your family’s needs.

Do children need health insurance

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Do you need health insurance?

“Do something today that your future self will thank you for.”

Whether or not you are a fan of bite-sized wisdom, this is a great point from which to discuss health insurance.

In New Zealand we are lucky to have a fairly robust public health system which can lead people to think health insurance is a luxury item they can do without.

To a certain extent that may be true but it isn’t the whole story. There are a myriad of benefits to not relying solely on the state to look after you should health problems arise.

Get it before you need it

There are two main reasons you should get health insurance before you think you need it. Firstly the upcoming shift in New Zealand’s demographics, and secondly establishing a relationship with a health insurance provider while you are in good shape.

changing demographics

The government currently spends 20% of its budget on healthcare and we have 10 workers (i.e. paying tax to fund the government budget) for every old age dependent, however in the next 20 years that number is going to shift to four workers for every old age dependent. That is quite a healthcare burden and raises some questions around the sustainability of our public system.

We don’t know how this will be managed, but the government will need to make some changes to fund this and we may not have the level of public coverage we are used to. We may find health insurance is no longer a luxury but a necessity and those with health insurance already in place, with fewer exclusions, will be well placed.

Pre-existing conditions

The second point is that while the fitter and healthier you are, the less likely you are to think about health coverage – however this is exactly when you should be establishing your relationship with a health insurance provider – before you need it. You will then find yourself to be well covered when the need does arise.

Control over your treatment

Another benefit to having health insurance is getting the treatment you want, when you want it. Whether you are treated in the public or private system you may see the very same surgeon – the difference is how quickly you will see them. Through the public system you can end up waiting months for a non-urgent procedure (defined as anything that can wait longer than a week) which you may get as soon as the following week if you are covered by insurance.

What about setting up a savings account for unexpected medical bills instead?

A popular idea, but many people don’t realise how expensive surgery is. And with medical inflation is rising at a rate of 10% annually, it is going up quickly. The current cost of a hip replacement is $22,000; a heart bypass is $45,000. Even a hernia repair will set you back at least $6,000. This doesn’t mean you shouldn’t have an emergency savings account though – this can really help reduce your premiums by having a higher excess on your plan.

can I cancel it if it doesn’t fit the budget?

Many people have seasons when the budget gets a bit tighter, and health insurance can end up being up for discussion. The two biggest downsides to cancelling your policy are finding yourself uncovered when you really need it, and when you do renew your policy finding you are no longer as well covered if any health issues have arisen in the interim. Health insurance should really be a part of your long term plan, and your adviser is well placed to help you make it work.

One last note on pre-existing conditions – don’t make the assumption that you won’t be covered without talking to an adviser – some exclusions expire after a period symptom free and you will still be covered for more than you won’t be – some coverage is better than none.

If you want to discuss more about your health insurance options call one of our friendly advisers for an expert opinion.

do you need health insurance

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Trauma Cover – the best safety net

When we meet with clients we work to help them understand scenarios where they would use the different insurance covers. When everything is going well it can be hard to imagine life any other way. We spoke to a Plus4 client about her experience with trauma insurance to give a real life example of the difference it can make.

In November 2015 Jess and her husband Brian decided to get in touch with Mike Tonks at Plus4 to review their personal insurance. “Brian had met Mike through setting up insurance for the business,” explains Jess. “He was impressed with how thorough Mike was, so thought he might be able to help us with our personal insurance as well.”

Jess and Brian found Mike good to work with and transferred their personal insurance to Plus4. “I really felt like he wasn’t trying to sell to us but was looking at our situation and thinking about which types of insurance would help us. He offered different options, and described what each was there for, and gave examples of how different events could play out for us, which gave us a really clear picture,” says Jess.

As part of the review Jess and Brian got $150,000 of trauma cover, which included a three month stand down after getting the cover in place.

In July 2016, four months after the stand down ended, Jess, aged 43 years old, was diagnosed with breast cancer. The cancer was aggressive but was treatable with chemotherapy, which meant a gruelling year and a half of treatment lay ahead.

Jess sat down with a friend and went through everything she would need, including finding out what insurance she had and how it could be used.

Living in Queenstown, if Jess used the public system for her treatment she would have to travel back and forth from the hospital in Dunedin for treatment, which was a seven hour round trip. Having health insurance meant she could choose where to have her treatment, and so she chose to attend a clinic in Christchurch.

The trip by plane was much shorter, which meant she could fly to Christchurch, have treatment and fly home again in time to be with the children, aged seven and nine, after school.

So what did Jess and Brian use the trauma cover for?

  • Flights – giving her the freedom to choose where to have treatment, and minimise disruption to the children’s lives
  • Hotels – the aftermath of treatment sessions is unpleasant and unpredictable, and while there was family to stay with in Christchurch when she did have to stay overnight, the privacy of staying in a hotel made Jess more comfortable
  • Food – being able to afford quality pre-prepared food for the family took a huge burden off Jess and Brian in a hard time
  • A cleaner and gardener – Jess was unable to use her arm for a while
  • A getaway for the family
  • Keeping the family financially afloat as Jess took a year off work

“While it was great to know we had the money coming, we weren’t initially sure how we would use it,” Jess remembers. “Some of these things were real luxuries, and some of them just allowed us to hunker down and work on me getting well.”

And while it was a significant sum, Jess says they were happy they had as much cover as they did as the expenses added up quickly. “Mike explained it was the best safety net you could have, and I am so glad we listened to the experts, because the premium was very little considering the huge impact it made when we needed to claim,” she explains.

For Jess and Brian, having trauma cover took pressure off the family at a time when things were extremely unsettled, and they were facing a large unknown.

If you want to review your cover or talk to an adviser about trauma cover, get in touch.

trauma cover edit

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How well does your medical insurance cover cancer?

Cancer is a scary diagnosis and it is important to have an accurate understanding of the role health insurance can play in access to different treatments.

The cost of cancer treatment can be high, and not all the medications that are available are currently funded by Pharmac, New Zealand’s Pharmaceutical Management Agency. That means people can be left to pay privately for the medicines that may give them their best chance.

You may have seen, or even contributed to, private campaigns to raise money to help fund cancer treatments not covered by Pharmac. Some of these medicines can buy people a little more time, however others may make the difference in actually beating the cancer.

While we do have good access to cancer screening and treatment in New Zealand, and generally expect treatment to be covered by the public system, the media coverage these fundraising campaigns have received has made us more aware that this may not always be the case. Pharmac, is a government agency that decides which pharmaceuticals to publicly fund. The reality is that they are not going to be able to cover everything for everyone.

When reading these stories and contributing to private campaigns, those among us with medical cover probably feel quietly relieved that, should we find ourselves in this situation, we will not have to rely on donations from strangers to afford the medicine we need.

Unfortunately, it isn’t actually that simple.

Some medical insurance providers do cover cancer treatments that aren’t funded, however many don’t. Whether your insurer will or won’t provide this kind of cover will be in the fine print of your policy. If you are buying your insurance through an adviser, they will know which do and which don’t – here at Plus4 Group we only sell those that do.

Most policies have an upper policy limit of $200,000 per claim per year and will be covered if the treatment is recommended by a specialist.

There are a number of health Insurance policies that have low limits for non Pharmac medications and limits for chemotherapy and radiography. Your Plus4 adviser will be able to identify for you the policies that are available and what will best fit your circumstances.

There may be times that a policy with different limits will work best for you, such as your employer offering cover as part of your salary package. With Plus4 it is all about finding you the right covers.

It isn’t just medical cover that can help out with a cancer diagnosis; trauma cover can pay out a lump sum which can make a big difference with medical expenses and lost income.

As insurance advisers it is our job to know the ins and outs of every policy so we can help you get the very best cover, with no disappointing surprises at claim time. If you want to discuss your medical cover, or any other cover, get in touch with one of our advisers.

Does your health insurance cover cancer

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Do children need insurance?

When putting insurance policies in place, the first point of reference is always the breadwinner. However, it is so important to realise that none of us stand in isolation and that something happening to any member of your family is going to have a financial impact – including your children.

We explain why it could be sensible to consider trauma cover, health insurance and life insurance for your children.

Trauma Cover

Trauma cover pays out a lump sum payment in the event of a diagnosis of certain illnesses or specified injuries (more about trauma cover here.) The main advantage of trauma cover is that the lump sum payment frees you up to spend time with your family and potentially cover some medical costs.

Another advantage is if you have a trauma policy with certain providers, your dependant children are automatically covered.

Looking at Partners Life as an example, their policy provides trauma cover of $50,000 to dependent children, regardless of the parent’s sum insured (note, this doesn’t cover congenital conditions). The children can also keep the policy cover when they become independent. To receive this cover, children don’t need to be listed on the policy, and Partners Life don’t charge a premium for their inclusion.

This is a huge benefit of this provider’s trauma policy for parents of dependent children, and a real example of the value of working with an adviser who understands your family situation.

There are a number of providers that include trauma coverage for children in their policies, to varying degrees, so make sure you speak with your adviser to find the right one for you.

Health Insurance

With GP visits free to children under 13, getting medical cover for your healthy, active children may seem unnecessary. There are a few important reasons we think it is worth considering.

There are two key ways to look at health insurance for children; caring for them now, and thinking about the future.

The main advantage of health insurance for children while they are young is the quick access to specialist services and expertise, without the stress of having to go on a waiting list.

It also offers an advantage as your children grow. Getting health insurance for your children now means you are setting them up for later in life. With an aging population placing more and more pressure on our health systems, public medical care may look very different in the future.

When applying for insurance as an adult many people also find limits placed on their coverage by pre-existing conditions.

If you insure your children while they are young, fit and healthy, and they keep the policy when they reach 18 or 21 years old (depending on the insurer), they will not have any pre-existing conditions as the cover is already in place. This includes any major conditions or illnesses such as cancer or heart problems, but also smaller things such as allergies or asthma.

Life Insurance

Life insurance for children is something that no parent ever wants to think about, but it is worth discussing.

It is uncommon to get life insurance for children, but it is available. How much you can insure children for is very limited but is generally enough to cover funeral costs.

The reason it is worth considering is that insured children can take over the policy when they come of age and will have that cover in place. To increase the cover, they will need to go through the normal application process, but they are assured of the original cover, regardless of any medical conditions that have developed since they were originally insured.

Congenital Conditions

A last note to keep in mind is that most insurance policies don’t cover congenital conditions.

A congenital condition is something that you are born with, whereas a pre-existing condition is something that you have developed since birth. For example, a tongue-tie correction needed on a baby will generally not be covered, as that is something they were born with. A child that needs grommets inserted (one of the most common procedures for children, which helps prevent persistent ear infections, but often has long waiting lists at public hospitals) can be covered.

If you want to know more about the options for insurance cover for children, or check how your current policies provide for your family, get in touch with one of our advisers.

Should you insure your children

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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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6 Insurance Myths – Busted!

Like any industry, there are some persistent myths and misunderstandings around insurance. We are absolutely passionate about what we offer as advisers, and the products that we select for our clients, so we’d like to clear up some common misconceptions.

Myth # 1: Insurance firms don’t pay out

The idea that insurance firms are trying to get out of paying claims is the biggest, baddest myth of them all. It seems to stick around, despite overwhelming evidence to the contrary.

Insurance firms do pay out, and the insurance providers we work with will pay 100% of legitimate claims.

If this is the case then, why do providers not pay out on all claims? Why is there a percentage that are rejected? The key word is legitimate – insurance providers must record all claims made and some will not be covered. The main examples are people trying to claim something that their policy doesn’t cover – either deliberately or through misunderstanding.

We are also guilty of contributing to these statistics. If you are unable to work and have income protection, we may advise you to start processing your claim before the stand-down dictated in your policy. However by the time that stand down has passed, it may have turned out that you are actually ready to return to work. That’s no problem for anyone involved, but statistically this will be categorised as a ‘declined’ claim.

These days there are multiple protections in place for consumers, and insurance is a very transparent industry. One of our insurance providers, Partners Life, even say “If it is grey, we will pay”. We often have the insurance providers give us tips on how to progress a claim so that it will be paid.

Myth # 2: I can’t afford insurance

When finances are tight it can feel like insurance is just another expense. However, what you really need to consider is if you can afford to not have insurance. Ask yourself, if you lost your ability to earn an income, how quickly would you be in trouble? How long would you be able to pay your mortgage?

One of the key advantages of using an insurance adviser is that we can work with you, and your budget, to get you the cover you need the most. Check out our blog here on which insurance you really need.

Myth # 3: If you don’t have an income you don’t need insurance

A common scenario we see is the main income earner has income protection and a non-earning spouse does not. While society sadly undervalues unpaid work, it contributes enormously to a household in different ways. The very real financial ramifications of a non-working spouse being taken out of action is something that should be considered.

Check out our blog, Are you both insured? Here is why you should be, for a breakdown of the whys and hows of insuring a non-income earning spouse.

Myth # 4: I am too healthy to need health insurance

Health insurance can seem unnecessary when you are young, fit, healthy and in the prime of your life.

We have two words for you: Pre-existing conditions. When you take out a new policy the provider will generally not cover you for something you already have. This could be conditions like skin cancers, a heart problem or diabetes. If you take out health insurance when you are in the best shape of your life your premiums will be relatively low. But, more importantly, when things do start to deteriorate you will be covered for them.

Myth # 5: You don’t need health insurance in New Zealand

This can be a tricky topic, and we are really lucky to have the healthcare system that we do in New Zealand.

However, we still believe you are better off with health insurance. The changing nature of our demographics indicates a significant future strain on our public health service. We’ve written more about it here. And, as we mentioned in Myth 4, covering yourself before you have problems sets you up for better coverage in the long term.

Myth # 6: It is easier to have insurance with my bank

All insurance is not created equal, and we are very cautious of policies offered by (and, at times, pushed by) banks. The policies offered by banks often fall short of the standards we expect from the providers we recommend to our clients. This includes non-standard exclusions in the fine print, a lack of transparency, a rushed application and disclosure process, and the sub-standard definitions of covered conditions, making them harder to claim on.

We have written here about the pitfalls of buying insurance based on short term incentives.

As insurance advisers we want the best for our clients, and we know insurance inside and out. If there is any aspect of personal insurance that you have questions about, get in touch with our advisers today.

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Health: The importance of your relationship with your GP

Having a GP (general practitioner) you have a good relationship with is a vital part of your healthcare plan. While having health insurance in place is important, if you become unwell your GP will be your first point of call – so you need someone who understands your healthcare history and that you believe will make good decisions regarding your care.

The relationship you develop with your doctor should be based on trust, clear communication, honesty and respect. For you to get the best possible healthcare, you and your doctor need to work together.

How to find a GP

It is free to enrol with a GP in New Zealand, but you may have to pay for appointments. Doctors’ practices and medical centres are privately owned and set their own fees, but the cost of a visit will be lower if you’re enrolled with the GP, as the government subsidises the fee.

To find a GP you can look at your local district health board website, or the Medical Council of New Zealand to find one near you, but you may prefer to ask around for a recommendation. Many clinics have a number of different GPs working there, so if you don’t connect with one you have the option of trying another. A good tip is to tell the nurses at the clinic what you are looking for in a GP, as they have a good grasp of strengths of each.

Once you have found a GP you like, you may find that they are hard to get an appointment with. If you are able to book in advance and are flexible with times this will increase your chances of seeing the same doctor, but for urgent appointments it may be more difficult.

What to look for in a GP

You should feel like your doctor listens to you, explains things clearly and respectfully, and follows through on referrals and relaying test results.

To have an effective relationship with your GP you have to be absolutely open and honest with them – if you don’t feel comfortable with someone it is a good idea to try someone else.

If you have any ongoing health concerns or pre-existing conditions it is a good idea to ask your GP how much experience they have had with that condition and what their preferred treatments are. GPs are people too, and there can be conflicting opinions on some treatments and conditions, so you need to find a GP whose values align with yours.

GPs are generalists, so a good GP should be relatively quick to refer you to a specialist for anything out of the ordinary. Having a GP you like and trust means you can probably trust their recommendations of specialists as well, which can take some of the stress out of the next stage of the journey.

How to get the most out of your GP appointments

Unfortunately, GPs are stretched, so you need to get straight to the point – this isn’t the place to have a chat about the weather or the match last night! Sometimes you may have a few things to cover, in which case mention it when you make the booking as you may need to book back to back appointments.

You need to be honest about what you came for and not expect the doctor to read between the lines, or mention the real reason you came as you head out the door. No matter how awkward or embarrassing your situation may seem, they really have seen it all before. You also need to be honest about any medications, how much you drink or any recreational drugs – you can’t expect quality treatment if your doctor doesn’t know the full story.

Your medical records

Your medical record is kept with the GP you’re enrolled with, but any health professional involved in your care can look at it.

Did you know you can as well? When you apply for insurance the provider may want to look at your records. While you should always be open with your GP, you may not be aware of what they are writing down and how much emphasis they are putting on what you have said. You may find it worth checking, and if you feel you have been misrepresented you can ask if they will amend it. This can be particularly relevant with regards to stress being seen as a pre-existing condition – make sure your vent about the kids, the spouse and the mortgage hasn’t been misconstrued.

If you want to know more about health insurance and why we think you need it, even in New Zealand, read our blog here. We’ve also touched on our thoughts on getting health cover for children here.

If you want to talk to one of our advisers about getting the best health insurance cover, call us.

How to find a GP

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The Four Pillars of Plus4 Insurance Solutions

At Plus4 we have a promise we make to our customers: “Choosing the best of the best for you”. This promise represents our point of difference, is the statement that we live by, and has remained unchanged since Plus4 was founded.

In addition, our practice is founded on four core principles or pillars, Best for You, Advocacy, Local but National, and Relationships. These principles four pillars guide us in choosing the best personal and business insurance cover for each individual client.

Best for You

We select the best for you – by using independent research combined with the collective experience of Plus4 Advisers. We believe this gives us a level of transparency, which means you can trust our advisers to give you independent advice.

We start by assessing the independent product rating. This gives us an indication of how the different policies stack up against each other, by looking at their policy wording at an in-depth level. Insurance is only as good as the fine print that it is written with, which is why we use independent research to qualify the products we use. It means our selections are not based on our opinion, or the relationship we have with providers.

We use independent research houses, including QPR, Iress, and Plantech, which research all the products on the market and give an unbiased analysis of the features of each.

It is worth noting that while insurance houses open their products to these independent reviews, there are a number of banks who provide insurance, that do not. In our view, this is because ‘in-house’ bank insurance products often rate very poorly in these independent reviews.

The second element we examine is the provider’s financial strength rating. This is rated by A.M Best, and Standard & Poor’s (Australia) Pty Ltd, and gives an indication of an insurance provider’s solvency and ability to pay out on claims. There is no point in us helping you get good coverage if the provider can’t pay out at claim time! It’s worth noting that there is also legislation ensuring insurance providers are able to cover their claims, and this was tightened after the Christchurch earthquakes.

Lastly, we look at the claims rating of a provider, which means how many claims they have approved versus how many they have turned down. For example, Sovereign pay 96% of all claims, which is considered a very high rating. It is most likely that the bulk of the 4% they didn’t accept were claims that shouldn’t have been made.

If a provider has a low claims rating, it is an indication that they may have non-industry standard clauses in their fine print, or less-than-stellar business practices. We want the best coverage for our clients, so this means we will avoid these providers.

Advocacy

Through the strength of Plus4, we are able to help achieve the best possible policy terms during the application process and deliver the most successful outcome at claim time.

If we believe a claim has been unjustly denied, our Claims Advocacy Team will get together and take a closer look at the wording of the policy, the circumstances of the claim and appeal to the insurance provider on your behalf, at no cost to the client. We have had tremendous success in this space, in the rare event that we do experience claims issues.

Read more about our Claims Advocacy Team in our article here.

Local but National

From Whangarei to Invercargill we have 44 advisers, working from 28 locations. This means not only is there is an adviser near you, but that adviser is also supported by our head office and the entire national team.

Relationships

Of utmost importance to the way we operate is developing trusted relationships that last. Providing you with confidence in your choices and at claim time, we are your personal insurance advisor and are with you to help throughout every stage of your life. This means when your circumstances change we are there to make sure you still have the best coverage, and should need to make a claim we are there to help you through it.

Lastly, overarching and supporting our four pillars is the independent best practice review process. We engage a company to conduct an annual review of Plus4 advisers to ensure we are complying with legislations, regulations and codes of conduct. This is not a requirement of the industry, but something we take on voluntarily because we believe it provides another layer of transparency and assurance to our clients.

To make sure you are getting the best insurance coverage, from a passionate and professional adviser, contact one of our team today.

The circumstances of every claim are unique, so always talk to your adviser about your circumstances and your policies when making a claim – we are here to support you through this process. 

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Do you know about our Claims Advocacy Team?

When you get your life insurance, trauma cover, income protection insurance or health insurance though a Plus4 adviser, you automatically have access to the Plus4 Claims Advocacy Team. This is a great benefit, let us explain why.

If we believe a claim has been unjustly denied, this team will get together and take a closer look at the wording of the policy, the circumstances of the claim and appeal to the insurance provider on your behalf.

While this isn’t a legal service, it provides another layer of accountability to the insurance providers, and is a good first step before escalating a claim dispute to the ombudsman (the Insurance and Financial Services Ombudsman Scheme resolves complaints about insurance and financial services.)

Our Claims Advocacy team are rarely assembled, as we find our customers seldom have claims denied. There are a few reasons for this:

  • Insurance providers pay out
    It might sound a bit simple, but it is true. If everything in your application is in order, and the event is covered in your policy, insurance providers pay 100% of all legitimate claims.
  • Our customers have bought their policies through an adviser
    A simple way to increase your chances of having a claim covered is by buying insurance through an adviser – just like Plus4. We read the fine print, so we always confirm that what you are buying covers your circumstances. This means you are unlikely to have a nasty surprise at claim time.
  • Our customers didn’t buy their policies through a bank
    If you have bought your insurance through an adviser, it means you didn’t buy it through a bank. We have written before about our reservations regarding buying insurance from banks, including non-industry standard exclusions, which can lead to claims being denied when they may have been otherwise covered.
  • The importance of full disclosure
    On the rare occasions claims are denied, it is usually the result of a lack of disclosure. When we help clients choose a policy, we also guide them through the paperwork for the application. The paperwork can seem like a hassle at the time, but the effort pays off when it comes to making a claim.

If you want to know more about our Claims Advocacy Team, or talk about making sure you are covered come claim time, get in touch with one of our advisers.

Plus4 Claims Advocacy team

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7 steps to getting the best insurance cover

Want to get the best insurance cover for you and your family? Here is how you do it:

Using an adviser is always going to get you the best life insurance, income protection and health insurance to suit your budget, lifestyle and life stage. However, some people can be put off by thinking it is a service they pay for, or just not understanding how it works.

The first thing to note is that you don’t pay us for our services. We don’t want getting the best cover to cost our clients so we don’t charge you. Instead, we are paid by the insurers.

Here is our process to break it down for you.

  1. Find an adviser

We get most of our clients through word of mouth. Finding someone who is local makes it easier for you – it is good to be able to meet in person. We have advisers all over New Zealand, check here and find an adviser near you.

  1. The first meeting – Relationship Building

This usually takes under an hour and is a “Getting to know you” session. We want to have a really good understanding of your situation to ensure we can give you the best advice. This includes your budget, your lifestyle and what you want to happen should a crisis arise.

This initial meeting can take place at our offices, at your workplace, or we can come to your home – we’re even happy to come by in the evening after you have put the children to bed!

  1. The Research Phase

After the initial meeting, we have a good idea of what you are after, and we go into research mode.

This means we look at the offerings of a range of different providers, to find the one that best suits your and your circumstances. The independent research we carry out is a key way that we add value to our clients. We then drill down into the fine print to make sure it all stacks up and that we can substantiate our recommendations to you.

  1. The second meeting – Presenting the Plan

We get back with the client and present the plan we have put together.

We need to allow at least an hour for this meeting (and again we can meet wherever suits you best), as we present the plan and then go through the application process. The time it takes to fill out the application can vary – for example, if you have any health issues that need to be considered.

We also fill out payment forms at this meeting, so everything is ready to go once your application is approved.

  1. Approval

If everything is clear-cut, we hear back from the provider and give you a call to say it is all ready to go. Sometimes, as a result of the information provided in the application, the provider may come back with questions or variations to the policy. This is something that your adviser will talk you through.

  1. Claim time

While we all take out insurance hoping to never use it, at some stage you may need to make a claim. We have written a blog on what happens at claim time (you can read it here), but what you really need to know is that if you have your insurance through an adviser, when it comes time to make a claim we will be there to support you, walk you through it and advocate for you.

  1. Follow up

So, we have set up the best policy for your current circumstances, allowing you to get on with life knowing you are covered. However, life changes. To make sure your policies keep up with your life, we check in with you to find out if anything has changed and make sure you still have the best policies to meet your needs. (Here are some of the life changes that might lead to policy changes).

Are you ready to get the best insurance cover? Or do you have questions about how it works? Give one of our advisers a call today.

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Should you get health cover for your children?

With GP visits free to children under 13, getting medical cover for your healthy, active children may seem unnecessary.

There are a number of reasons we think it is worth considering.

In our previous blog on health insurance (you can read it here) we described health insurance as doing something your future self will thank you for. The same concept stands for insuring your children – you are setting them up for later in life, in a time when our public health system may look very different to what it does today.

Protection against pre-existing conditions

One of the problems adults find when they go to get health insurance is the limits placed on them by pre-existing conditions. A pre-existing condition is a health problem that exists before you apply for a policy – insurance companies are businesses and as such they are concerned about their bottom line. This means if you have a pre-existing condition they are likely to exclude cover for that condition, charge a higher premium or impose a waiting period before that condition is covered.

If you insure your children while they are young, fit and healthy, and they keep the policy when they reach 18 or 21 (depending on the insurer), they will not have any pre-existing conditions as the cover is already in place. This includes big stuff such as cancer or heart problems, but also smaller things such as allergies or asthma.

Pre-existing vs Congenital: An important distinction to be aware of

It is important to understand the distinction between pre-existing conditions and congenital conditions as most insurance policies do not cover congenital conditions.

A congenital condition is something that you are born with, whereas a pre-existing condition is something that you have developed since birth. For example, a tongue-tie correction needed on a baby will generally not be covered, as that is something they were born with. A child that needs grommets inserted (one of the most common procedures for children, which helps prevent persistent ear infections but often has long waiting lists) can be covered.

Access to healthcare, no matter how public funding changes

With New Zealand’s aging demographics the way we are able to access public healthcare may well change in the future. The government currently spends 20% of its budget on healthcare and we have 10 workers (i.e. paying tax to fund the government budget) for every old age dependent, however in the next 20 years that number is going to shift to four workers for every old age dependent. That future healthcare burden raises some questions around the sustainability of our public system.

While we don’t know exactly what the future looks like, it is likely that private medical insurance will play more of a role in getting the healthcare you need when you need it.

Want to talk to someone about insurance for your family?

If you need some help weighing up the pros and cons of having medical insurance for your children, get in touch with one of our brokers today. They can talk you through some of the ins and outs of the policies available and help you find one that best suits your family’s needs.

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Our Clients Agree

Here are a few reviews from some of our existing clients around New Zealand

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