If you need to make a serious insurance claim, who's there to help you?
Sapience automatically provides specialty claims assistance to all our personal insurance clients.
If you're our client and you or your family need to make a claim – there's a plan in place to help, and we’re here for you.
Sapience clients are Priority #1 in claims
Our claims assist service is called Priority #1. Our clients call it a promise kept – and it's routinely included in all our insurance advisory services for all our clients.
All personal insurance claims are different
Some insurance claims are straightforward like claiming on a life insurance policy.
- When you need to claim for a medical crisis, terminal illness, a sickness or illness covered by income protection or a longer-term total and permanent disability TPD - this can quickly become a complex and drawn-out process.
- Often numerous medical, psychological and pharmaceutical reports are needed to support a complex claim.
If your health history is one where you’ve seen multiple doctors, perhaps you’ve moved house, maybe the original medical records have been moved to offsite storage and historical documents are held at different medical centres (that have now either moved, combined or sold) – these realities add to the delays and uncertainty of an insurance claim.
A claim is never just about the money — it's also the acknowledgement and respect of the individual, closure, privacy and dignity (often for their family and/or business too) at a very difficult time in life.
If Sapience is already your financial adviser, relax – there's a plan in place for you when needed
We’re automatically here to help you and your family (whether that’s biological or logical) through the claims process should that ever occur so that your case doesn’t stall in some claims managers ‘too hard basket’.
Our claims history to date
We’ve overseen millions of dollars in claims for our clients so we know how to navigate through the life insurance claim systems and skillfully advocate for your best interests.
Pro Tip: Did you know that a Total and Permanent Disability (TPD) claim usually has an initial 6 months waiting period before a claim can be made? and that some claims start as partial payments as some degenerative health conditions like cancers, MS and Leukaemia often result in multiple claims needing to be made on the same policy over time?
Life Insurance companies are in the business of paying claims
Data from the Australian Prudential Regulation Authority (APRA) overseeing life insurance companies, shows for the year ending 30 June 2016, at least $8.2 billion in net policy payments were made by life insurers.
Pro Tip: People often mistakenly confuse general insurance companies with personal insurance companies. We describe the difference this way: general insurance is about things and personal insurance is about, well, people.
What happens if you don’t have a financial adviser and you need to make a claim?
When you need to claim on your personal insurance policy, people without a financial adviser can often feel underrepresented and vulnerable to a corporate system of red tape, delays and uncertain futures.
- To make things worse, if the nature of your claim means you now have limitations on reading, writing or communicating, the DIY process becomes further complicated and delayed. People with major head trauma or mental impairment find this the most difficult process to manage alone.
The solution is Sapience Priority #1 Claims Assistance service
Some people engage a lawyer to try and get their claim processed
Frustrated with the DIY approach, a potential avalanche of paperwork and uncertainty about how to practically manage a difficult personal situation, some people turn to a lawyer to lodge a claim for them.
- A lawyer's costs are often open-ended and usually incur the lawyer's hourly fee – (often charged in 8-minute increments).
What happens when the lawyers get involved?
Everything slows down...
When a lawyer submits an insurance claim on behalf of their client to a life insurance company, the claim routinely leaves the usual claims process and gets diverted to the insurance company’s internal legal team to manage.
These legal teams are usually smaller than their claims team, work slower and well – you can probably guess what this means for the speed of a claim payment.
- The increase in time triggers delays that then trigger more work for the client's lawyers
- which then translates to more expenses for the client and more frustration
- Often without a fair idea of just when the claim assessment might be finalised
This is probably not what you want at this time of life.
What happens when your Sapience Adviser assists with your claim?
First, we find and read the original policy wording to make sure we understand where you stand and what’s needed to prove the claim.
Then we can decide if we want to work together.
- Most people haven’t kept the best records so we then have to collect previously issued product disclosure statements
- We get your written authority to become the servicing adviser on your matter
- We start up an immediate conversation with the relevant insurance company and inform them of our ability to assist and expedite the matter
Our Priority #1 system then takes over the process and our team works with an agreed timeline shared with the relevant claims assessor and your medical professionals.
How do we get paid for the work we do?
If you're not an original Sapience client but would like to use our Claims Assistance Services, we charge a fee-for-service.
- We only get paid after you get paid. Our terms are 7 days.
- Our cost is a fixed percentage of the claims payment or a fixed fee – whatever is agreed to between us in writing.
- Our fees are fixed for completion of the service and we do not charge by the hour (we believe that to be unethical.)
What can people do if they don't have an Advisor?
So what can people who have purchased a policy from an online comparator service and have not advisor, do?
- Contact the relevant life insurance company, DIY and hope for the best, or
- Employ a solicitor to lodge and chase your insurance claim (and be prepared to surrender a third of your payout), or
- Contact the team at Sapience for our Priority Claims Assistance service to pre-assess your claim scenario to see if we have the current capacity to take on that work for you.
Why would you choose the Sapience Priority Claims Assistance Service?
Simple — When you draw upon a legal background and then combine that insight with 20+ years in specialist risk insurance services, you learn what’s needed and how to navigate around the different systems.
An insurance claim is for many of us just a difficult part of life. How we get past that part of life depends upon what we do to prepare for it today.
Put our significant capability into your personal situation and benefit from our expertise.
How we can help
Making a claim with a Life Insurance company is a regular process for an experienced financial advisor. That's why people prefer to have a professional relationship with a financial advisor to navigate the ever-growing complexity of insurance and protect and provide for their families and businesses - and make claims when required.
If you're looking for a personal insurance Claims Assistance Service or if you're a law firm looking to joint venture with a capable practice that understands the legal process, speak with us.
Contact us for a confidential chat about your needs.
Related: Types of Personal Insurance products we work with
Different types of risk protection insurances, provide protection for different life risks.
- Life & Terminal Illness - the basis of all protection strategies
- Income Protection - safeguarding your ability to continue to earn your income
- Total & Permanent Disability (TPD) - protecting against the long-term financial consequences of disability
- Crisis & Trauma Recovery - protecting against specified serious medical conditions (more a 'when' you need to claim than an 'if')
- Severity Based Insurance - designed to pay small claims sooner (Life, Crisis & TPD insurances in one)
