When it comes to life insurance advice, there’s one critical service from advisers that can’t be matched or challenged: claim time.

Sadly, many people who have bought insurance without advice are shocked when something happens to them and they can’t get a claim paid. In the absence of an adviser, they’re often forced to deal with call centre staff (sometimes in another city) during an extremely difficult time.

But with the right advice and support, valid claims get paid.

Experienced advisers have a solid understanding of which insurers (and products) are good and bad, and they know how to effectively prepare claim forms and work with the insurer to get the right outcome. Importantly, they do this quickly and emphatically.

Where there’s injustice, a passionate and experienced adviser doesn’t easily take no for an answer.

The Australian Securities and Investments Commission’s Life Insurance Claims report (October 2016) found higher claim denial rates (12 percent versus 7 percent) with direct and group insurance policies offered by super funds, compared to retail policies established through advisers. This discrepancy is partly linked to the simpler underwriting rules in direct insurance.

There are two key reasons for this. Firstly, at claim time, advised clients and/or their families rarely find themselves alone. In their most vulnerable hour, advisers are there to help them lodge and manage their claim.

If there’s a problem, experienced advisers flex their muscle and leverage relationships with insurers to push for the right outcome. Direct and group insurance customers are unlikely to get equivalent support.

Secondly, advised clients typically do more work when setting up the cover via more rigorous product selection and underwriting. This is an excellent upfront investment to secure a more certain outcome at claim time. Advisers are very good at helping clients gather medical evidence and present it to the insurer to get the cover in place. In return for this additional evidence, the insurer is able to provide the insured with higher quality/more certain cover.

While it may seem like a hassle at the start, the underwriting process avoids nasty surprises because the insurer understands the risk they are taking on. They then don’t need to rely on pre-existing exclusions, or other terms to avoid claims.

Cover granted automatically via super funds also has its coverage limitations because no health evidence is obtained by the insurer upfront from the insured members.

Ultimately, the purpose of an insurance policy is to pay out in the event of a valid claim. Receiving good advice and claim support from an experienced insurance adviser is invaluable in achieving this.

If you would like more information please call 1300 ELSTON or email info@elston.com.au and an adviser will be in touch.