Last month I read with some distress, a story about a terminally ill man with a short time to live having to wait months for his super fund to pay out his claim.
We passionately believe no one in this position should have to deal with the additional stress and anxiety of having to pursue their insurer for payment when confronted with news they have a terminal illness.
While I am not aware of the specifics of the wording in the policies and the exact type of cover in this case, it does highlight to me something we have learned over time.
That is; that good risk advice at the outset results in a good claim outcome, when one is made.
It is a simple fact that if you have the right policies in place to address your specific individual circumstances and the potential risks you may face, then the likelihood is you will get better outcomes, more quickly, when the time comes to make a claim.
When referring a client to us please feel free to emphasise to them that every individual’s circumstances is different and the purpose of our initial review is to ensure we understand the specifics of their circumstances to ensure we put the right risk mitigation strategy in place, with the right policies, definitions, structures and tax outcomes.
We then need to review this strategy regularly. We do this to ensure we give you the best possible chance of a successful claim.
Last year we had a non-client, referred to us by another claimant who knew how passionate we are about helping people win their insurance claims.
For the sake of his privacy, let’s call this non-client “Paul.”
Paul had taken out income protection and total permanent disability insurance as part of his superannuation about 20 years ago, but it was never reviewed. The income protection was not in line with modern contract structures and definitions. It was definitely not the right cover for someone in his circumstances as a self-employed medical practitioner.
Similarly, the TPD definition was inappropriate. He had an “Any” occupation definition, not the preferred “Own” occupation, which is far less onerous to claim on.
It made the process of making the claim far more complex than it really needed to be.
By the time he came to us, Paul was pretty stressed out by the whole thing and anxious for support.
I personally took on his case, working with AFRM’s Group Risk Manager, Bev Murray, and I am pleased to say we were able to achieve the best possible outcome for Paul, given the seriousness of his illness and incapacitation.
Please take a few moments to hear from Paul, in his own words, in the case study below. It is a poignant account of the emotional stress and trauma people suffer when making a claim; and also, what a huge difference it makes to have someone step in on your side and manage the entire claim process for you, knowing they have your best interests at heart.
Until next time, live your life well!
Sincerely,
Nicholas Hatherly
Managing Director AFRM
Case Study
“My name is Paul [name changed to protect client privacy]. About 20 years ago, I took out income protection insurance and total permanent disability insurance as part of my superannuation package with a large Australian insurance company.”
“Two years ago, I was diagnosed with malignant renal cell carcinoma and over the course of two major surgeries I had my left kidney totally removed; then three months later my right kidney was partially removed.”
“Following these surgeries, I found I could not return to work.”
“I commenced the claim process and was quickly overwhelmed by the complexity and scope of the whole process. A friend of mine recommended that I approach AFRM to try and decrease the stress and anxiety these types of claims bring.”
“There was a continual string of correspondence back and forth between me and the insurance company and it became overwhelming.”
“My TPD claim is now completed, and my IP claim is ongoing with the insurers requesting six monthly updates as to my progress, which is simple and easy to administer.”
“My monthly claim payments have allowed me to retire with no financial concerns. I have peace of mind and my future is assured; and I can spend my time recuperating and mending.”
“I definitely recommend both of these insurances for peace of mind - income replacement and total and permanent disability insurance.”
“I will be ever grateful for the support and guidance that I received from Nick Hatherly and Bev Murray who took over the administration of my claim and saw it through to completion.”
“I doubt that I could have stuck the course myself.”
“The other great news is that the cost involved in having them administer my policies was less than half a percent of my total claim. I couldn't be happier.”
AFRM’s Group Risk Manager, Bev Murray, said TPD Claims can be long and tedious and when structured under super, like Paul’s has been. Apart from obtaining insurer approval, it then needs to be signed off by the Trustees.
His claim was lodged in February 2018, and funds were deposited into his account in June 2018.
“Paul was and is still on an ongoing IP claim – that is assessed differently to a lump sum TPD claim – and he said he would have struggled without our help getting this one over the line,” Bev said.
“When we manage a claim for any client, we are always there to help them through the whole process. They need to concentrate on their health, so we try and lighten the load for them; take away the stress.”
“We held Paul’s hand through the whole process, and when there were delays, we assured him that this was normal and that gave him piece of mind and much needed assurance.”
Bev noted that client anxiety levels often increase whenever there is any kind of delay, so it is important to explain all aspects of the process, including the facts that both insurers and AFRM (as an advocate of the claimant) sometimes have to rely on other parties to provide relevant pieces of information to move the claim forward – and the simple fact is that “sometimes things don’t move along as fast as we would like.”
“However, I feel that AFRM being beside Paul through the entire claim process gave him piece of mind; a person to check in with from time to time; and that eased a lot of the stress for him compared to when he had tried to do it himself,” Bev said.
“I do think at times how difficult it must be for a normal run of the mill person to be trying to manage their own claim and look after their health at the same – it would be really difficult.”
“It is always nice when approval finally comes through, to make that call, to give them the good news and you hear the relief and appreciation in their voice. They are so thankful and that we were there to help. I take pride in that.”
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