Claims Advocacy
“While most industry Claims for Life, Total & Permanent Disablement, (TPD) Critical Illness, (Trauma), or Income Protection, (Salary Continuance) are promptly settled and fully paid, there will always be circumstances where a dispute may arise between an insured party and the insurer.
Causes could vary from the insured party simply failing to provide adequate documentary evidence to support the Claim, through to a complex legal dispute about whether the Claimant’s circumstances match the policy Terms and Conditions. Every insurer provides a Complaints mechanism with access to AFCA, (Australian Financial Complaints Authority), to ensure that such disputes can be equitably resolved. However, no system is perfect:
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AFCA is limited by the dollar amount of the Claim. (It cannot hear a dispute for more than $650,000)
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Some “No Fee – No Win” law firms may charge up to 30% of the sum insured as a Success Fee!
Many Claimants are members of Group Life or Group Salary Continuance Plans where their employer has facilitated membership. They have no direct insurance advisory relationships. We accept referrals from employers, or their professional advisers, to assist their employees, or clients, how best to navigate the Claims process. Our extensive industry experience, together with our broad network of claims management relationships should ensure practical outcomes, reasonably costed.
About Claims Advocacy
Claims Advocacy for an insurance business involves representing and guiding clients throughout the claims process to ensure they receive fair and timely settlements.
Unlike traditional claims handling, claims advocates work on behalf of the policyholder, offering expert advice, clear communication, and proactive support. They help navigate complex policy terms, coordinate with insurers, and address any disputes that may arise.
By prioritizing the client's best interests, claims advocacy aims to simplify the claims experience, minimize stress, and maximize outcomes, building trust and long-term relationships between the business and its clients.
