Life & Health Claims Guide
What to do in an event of a claim
In the first instance contact Bay Insurance Brokers to advise of a potential claim so we can assist in making sure the necessary information is collated.
Depending upon the type of claim you are making with depend on what action is necessary to take.
Income Protection Claims
In the event of an income protection claim please contact Bay and we shall notify the insurer and assist in compiling the relevant documents. The insurance company will then contact you directly to process the claim. The most important thing is to provide the insurance company with everything they ask as quickly as possible. This will ensure the insurer has the relevant information to make a quick informed decision on the acceptance of your claim. Once the claim has been accepted the insurance company will require ongoing evidence of disability.
The insurer will require a number of documents initially including:
•A completed Income Protection Claim Form
•Certificate of Medical Attendance
•Any available medical evidence that would support your claim
•Copy of medical history notes
•Copies of any ACC documentation plus final assessment of weekly compensation (if applicable)
•If you are claiming for stress/depression related disorder, you will be required to provide details of your diagnosis from a psychiatrist
If you are self employed you will also be required to provide:
•A completed Income Protection Claim Form
•Certificate of Medical Attendance
If you are a wage or salary earner you will be required to provide:
•Wage Slip
•Copy of employment contract
Once all of the relevant documents have been collected the claim form along with medical and financial details will be passed on to the insurer who will then assess the claim. Should further information be required they will contact you directly.
Health Insurance
Should a claim arise for Health insurance please contact Bay for guidance. Ideally “prior approval” needs to be sort for any procedure. Once approval is received from the insurer you can present the letter with the prior approval claim number to the health provider in lieu of payment. A Claim Form will also need to be completed and return to Bay for processing along with any invoices/receipts relating to the claim.
Life or Trauma Insurance
Again please contact Bay Insurance Brokers and we will arrange for the relevant paperwork to be sent out to you.
For Trauma claims the insurer will require the following:
•Completed Trauma Claim Form
•Any medical evidence that will support your claim
•Copy of your full medical history notes
Once the insurer is in receipt of the relevant documentation they will assess your claim, which may include assessing your medical details against the details given when cover was first applied for. Your insurer may also seek further information from you or your practitioner before making a final decision.
For Life (death) claims the following will be required:
•Registrars Certificate of Death
•A completed Payment Discharge Form
•Certified Birth Certificate
In some circumstances the insurer may also require proof of administration in one of the following forms:
•Letters of Administration
•Copies of Probate
•AnAdministration Act Form
Once the above information has been collated the insurer will assess the claim, which may include assessing medical details against the form completed when the cover was first applied for. The insurer may also seek further information from the Estate of the Life Insured before making a final decision.
Please note that for any policy, the benefit will be paid to the owner of the policy not the person insured unless this is the same person. For death claims, if the insured is the owner, the money will be paid to the executor of the estate and the will be passed to the beneficiaries once probate is issued.
For any further advice or assistance with a Life/Health claim please contact Tracy on 07 579 1064
