Income Protection dont trust insurance companies

Talking to a very good friend this morning who works for an insurance company as an assessor.
After the junior assessor assess's the claim whether it be travel or income protection it gets sent to him to assess again.
He specialises in travel and income protection.

He gets bonus's on denying claims.
However if someone has been a good customer over the years eg, paying insurance and not making claims they will usually accept their claim.


Well... He was telling me today already last week he had refused 2 income protectin claims even though one had been a customer for 5 years paying premiiums.

Because once you put in for a claim they will do a medical investigation history check and if you lied on your application when u first applied and you ticked the boxes to say you never went to the doctor for high blood pressure, or pain somewhere and you didnt declare it.. Well he knocks back your claim.

"You failed to tell us 5 years ago when you took out the Income protection insurance that you had already a sore bum and didnt write it on your application"
"We believe your sore bum may have contributed to your heart attack"
Therefore at this time your claim is denied until we receive medical evidence to the contrary"

He was saying when he was doing travel insurance most claims are knocked back so people usually just give up.

Example , " you have failed to provide enough information for us to make a decision"

"Your Travel Insurance Claim for injury due to ridng a motor scooter in Thailand has been denied as you have failed to provide us with a signed copy of your Thai motorbike licence which must be translated into english using a qualified translator accepted by the WTTS"

Most people dont read the fine print and dont have a Thai motrbike licence .

"Your Travel Insurance Claim for injury when riding a motorscooter in Bali has been denied as we have not received a Police report that you were not under the influence of drugs or alcohol whilst riding"
"Furthermore a copy of the motorscooters insurance policy translated into english and signed by a JP must also be submitted when making a claim"

"Your Police report is not in the english language and not signed by the Chief Commander of Africa therefore we cannot at this time accept your travel insuance claim"

Its ok for them to TAKE your money on application BUT when you go to make a claim suddenly they look for excuses !

 

My advice when applying for insurance is declare everything that is documented somewhere .

Every so often we are approached by insurance company for information on one of our patient , but , they've never been here . Answer , it's a fishing trip . Insurance company seeing if someone is seeing another doctor for undeclared problems .

If you have missed stuff on your application , they can use it as grounds to decline

Cliff

 

A lot of this is regarding income protection. There's plenty of options out there that ask a few basic questions but never really assess your previous medical history. They tend to be quite cheap and they're often available online or over the phone.

Then there's the more expensive options where they get a full medical and they adjust the premiums based on your medical history and lifestyle (try getting cheap life insurance when you go wreck diving every second weekend).

The cheaper versions verify your medical history when you claim, hence they deny claims a lot more often than the ones that cost more but do everything up front.

In essence, you get what you pay for.


I'm also constantly approached by various insurers (most from banks I have mortgages with), offering over the phone discounted insurance with no medicals required. This isn't something that should be done over the phone, people need to get good advice on personal insurances.

 

Wow, an insurer knocking back a claim because the insured withheld information on the application that may have resulted in a denial of cover or exclusions. Imagine that!

Anyone that applies for insurance cover undertakes a Duty of Disclosure, which means you have to provide all details required that may determine whether the insurer will accept your application or not.

 

Friends daughter had a motor bike accident in Thailand. Her travel insurance said it would cover her if she had an Australian motor bike licence. She didn't (and they didn't. )
Marg