What is the claims process?02 December 2014
We realise that making a claim can seem complicated. So we’ve produced a claims guide(Opens new window) to explain the whole process and answer any questions you might have. We also offer a tele-claims service, which helps remove the complication of making a claim.
When you make a claim, we aim to:
- allocate a claims assessor who’ll deal with the claim from start to finish
- provide a personalised, professional, supportive and sympathetic service, right from first notification
- make sure all payments are made accurately and on time
- look for ways to help you get back into work
- make sure you get the best and most appropriate advice and treatment
Using the new Association of British Insurers (ABI) guidelines, we’ve implemented a ‘tailored evidence’ approach. This means that we assess each claim individually, and only ask for the medical evidence that we need to assess each claim accurately.
We’re keen to make you feel as comfortable as possible and let you submit a claim with the minimum amount of stress, which is why we offer a tele-claims service.
With this service, a claims assessor collects information from you over the phone, rather than using a claims form. All our claims assessors have a good understanding of insurance products and medical conditions/claims handling.
How it works
Our assessor will contact you to arrange a convenient time to call back. They’ll also tell you what information you need to have to hand.
During the call, the assessor will gather all the information that would normally be submitted on a claim form. This generally takes around 40 minutes for a critical illness or terminal illness claim and 60 minutes for all other benefits.
If you feel, at any time, unable to continue the call because you're tired or distressed, the assessor can call you back another time.
Once the call is complete, you will receive a copy of your answers for checking and to make any amendments where necessary. In the meantime, we’ll request medical information from your GP/Consultant.
With tele-claims, you will benefit from:
- a better all-round experience
- a more personal approach
- set expectations upfront
- reduced time from claim notification to decision
- invalid claims being identified earlier on in the process
- having to provide less medical evidence
Under Treating Customers Fairly, we’ve introduced client phone calls on claims. A fully qualified claims assessor will contact you to get extra information about any misrepresentation before we make a claims decision.
It's important we get your their side of the story - as this helps us make the right decision first time, reducing the number of complaints. It also makes the process a little easier for you, helping you to give the best quality of information possible.