Make insurance claims a breeze

January 2016

Advisers can do a lot to speed up and simplify clients' insurance claims, writes Ben Hurley.

Making an insurance claim can be daunting for those who aren’t familiar with the process, especially as they face financial hardship or poor health. Financial advisers can do a lot to ease this intimidating process.

Advisers that know the details of their clients and policies can help demystify the paperwork and ensure all necessary information is provided in advance so the claim can be quickly settled.

They can trim the time between claim and outcome by days or even weeks, says ANZ Wealth national retail claims manager Allen Marinovich.

“For example, sometimes we wait several weeks for the accountant to provide information to us where the adviser may have that already,” Marinovich says.

Ensuring a quick outcome

So what can advisers do to speed up a claim? In brief, they should:

  • know the specific details of their clients’ insurance policies
  • know the exact information the insurer will require
  • know all details related to the claim.

First and foremost: know the specific details of their clients’ insurance policies and the exact information the insurer will require.

When the adviser first calls to notify of a claim, he or she should know the policy number and details including the date of the event causing the claim and the claimant’s current work status.

Using the OnePath claims process as an example, the claims team does a quick assessment to see if the claim qualifies for on-the-phone processing which removes the need for most documentation and can see clients paid within 10 days. Just over a third (34 per cent) of OnePath’s monthly claims fall under this category.

Within 24 hours the claims team sends the adviser the forms to be completed and a checklist of exactly what documentation and details the assessor will need. This varies depending on the claim, but will often include:

  • certified copies of the birth certificate, marriage certificate and death certificate for life-insurance claims (the insurer may also request a copy of the coroner’s report or will)
  • a statement from the treating doctor or specialist for income protection, total and permanent disablement (TPD) or trauma claims
  • an employer’s statement for income protection or TPD claims
  • a report from Medicare Australia on the insured’s Medicare and/or Pharmaceutical Benefits Schedule history
  • a copy of the insured’s current driver licence or passport
  • the fully completed claim form including signatures of the party legally entitled to claim the benefits, authorisations for the insurer to access information relevant to the claim, the privacy statement and memorandum of transfer attached to the claim form and the original policy document.

Room for improvement

But not all advisers make the process as simple as it should be. ANZ’s Marinovich says some send documentation in the post rather than by email, which adds days to the process and has the risk of getting lost along the way.

Others aren’t clear on key pieces of information. “Sometimes advisers ring us up and don’t know when the injury occurred due to waiting periods,” Marinovich says. “They may not know if the client has ceased work or gone back to work.”

Not all policies are the same and some clients are excluded from certain claims due to pre-existing medical conditions. By not knowing enough about the client and specific policy, the adviser may set the client up for disappointment.

Experience counts

Beyond knowing what the insurer will require, the adviser’s familiarity with the process can help speed things up and lessen the burden for the client.

For example, OnePath offers a pre-assessment service where an adviser or claimant can ring in and quickly determine whether they likely have a claim. This can save unnecessary time, stress and disappointment.

An adviser can also help obtain information promptly from third parties, such as advising the client to go to their local doctor to fill out required medical forms rather than chasing busy heart specialists or surgeons at the hospital.

A touch of empathy goes a long way, too. Shane Perez, a Melbourne-based advisor with millennium3 Financial Services, says he tries to put the client’s mind at ease by explaining how the process plays out. Then he assists the client to fill out the paperwork if required and submits the claim once all the documents are completed.

He rings his client regularly while the claim is ongoing to keep abreast of the situation.

“Obviously if things go well it benefits all parties – the client, adviser and insurance provider,” Perez says. “The client could become a good source of referral business for you if they have a good claims experience.”

Awards for OnePath's claims process

OnePath’s focus on customer service and transparency around timeframes paid off at the inaugural AFA and Beddoes Institute 2016 Consumer Choice awards, where the insurer won three categories.

This is significant because the winners were determined by direct feedback from policyholders and claimants of trauma, total and permanent disability, and income protection policies.

In the overall consumer choice category, OnePath won the award for “honouring commitments”, and in the claims category was awarded “best application process” and “best turnaround time”.