..... to ensure users have accurately filled out forms and applied for adequate cover.

Centric Wealth’s joint head of risk, Jon Pillemer, said financial advisers were increasingly helping consumers who had bought insurance policies online with the claims management process after claims had been rejected.

He said the complexity of life insurance policies could result in a claim being rejected, even if the smallest of details are incorrect at the time the policy was purchased.

“Many people wrongly assume that purchasing insurance is as simple as going online, selecting the cover they want, filling in the relevant forms and paying the premiums. In reality, insurance is a lot more complex, which is why an increasing number of people end up not being covered even when they should be,” he said.

“Due to the complexity and amount of jargon, one of the biggest risks associated with buying life insurance online or on the phone is overlooking important details and not fully understanding exactly what is covered.”

Pillemer said a number of clients had come to Centric Wealth in the last few years seeking help with claims. He cited Client X who was referred to the firm in November 2010 after having difficulty getting his total and permanent disability claim paid.

Client X suffered a stroke in April 2009. He satisfied the stroke definition and was paid under the trauma component by the insurer. The client was also unable to work and was paid income protection benefits.

However Client X did not receive the permanent disability payment of approximately $2 million under an own occupation total and permanent disability benefit. The requirement of that component was that Client X not work for three months, with no likelihood of ever returning to work in his own occupation again.

Before coming to Centric, Client X had been assessed by around six independent medical specialists at the insurer’s request and deemed to be able to return to work in the future.

Centric intervened in November 2010 and was successful in March 2011 in proving Client X would not be able to secure employment as his previous job required cognitive skills that he do not possess and would not regain over time.

“This outcome would have been highly unlikely within the time frame achieved, or may not have been successful at all, without intervention from an experienced adviser,” Pillemer said.

11/10/2013
Leng Yeow
Source:  Professional Planner    www.professionalplanner.com.au