Claims process

Claims process

We take it as our responsibility that upon notification of a client’s diagnosis of injury or illness that we handle the entire claims process from start to finish. We understand that this time will be stressful for our clients and this is why we take this part of the advisory process so seriously.

Please find an overview of the claims process below:

Step 1 – Pre-assessment of claim

In consultation with the client, we will assess if their injury or illness fits the general definition of their Risk Insurance policy.

Step 2 – Completion of the claim forms

After pre-assessing the injury or illness with the client we will notify the insurance company of the impending claim and request the relevant claim forms. We will then help the client to complete these claim forms and submit them on their behalf to the insurance company.

Step 3 – Completion of medical testing/evidence required by the insurance company

Upon receiving the claim forms the insurance company will request medical evidence which will allow them to make a decision on the payment of the claim. We will liaise between the insurance company, the client and the relevant Doctor(s) to ensure that all requirements and medical evidence is gathered in a timely fashion.

Step 4 – Insurance Payment

After all of the medical evidence has been gathered the insurance company will make a final decision on the payout of the policy.

For Income Protection policies, ongoing medical evidence will be required by the insurance company to ensure continuing payment. This process will continue to be handled by Make A Difference Insurance for the life of the claim.