An expert’s advice: He is a coach and consultant, Steve Tan has been coaching insurance planning and agency management for over 3 decades. We are blessed to have him on a special interview series to share on proper insurance planning.
He’ll cover these questions in Part 4 of this series
- How to ensure your claims gets approved?
- Types of claim available.
- Procedures of a claim process that you should be aware of.
For those who love reading, here’s subtitles for you to read through if you don’t want to go through the whole video.
How to ensure your claims gets approved?
Q: Welcome back to Finposts.com. Next, we will discuss on a popular topic which is CLAIM. Many people are afraid of buying insurance and not being able to claim when the need arise. Some will say that it is hard to claim, even though they’ve been paying for insurance for a long time. What’s Shifu’s opinion on this topic?
A: Insurance companies will not run away from their responsibility (claim). A claim will only be rejected if material facts was not declared at the time of application to be insured. Material facts has to be declared as it will affect the underwriting decision. Decisions such as premium loading, exclusions or other conditions applied will be imposed onto a policy on a case to case basis. If all facts was honestly declared, companies will approve your claim, as they are governed by the law to do so.
Types of claim available.
Q: What are the types of insurance claims available?
A: Very good question. There are a few types of claim.
- Firstly will be death claim. Insurance covers death benefit.
- Second type of claim is total permanent disability.
- Thirdly, hospitalisation and medical expenses.
- Fourth type of claim is survival benefit. If no claim is made until the maturity of the plan,
company will pay out a sum of money as survival benefit.
Procedures of a claim process that you should be aware of.
Q: So, what are the procedures that we should be aware of, when making a claim?
Death & Total Permanent Disability (TPD) claims
A: We will talk about death and total permanent disability (TPD) claims first. In terms of death claim, the company needs to verify 3 things. Firstly, we need to submit the death certificate or other documents for verification. Secondly, we need to verify the appointed nominees or the appointed trustee appointed to manage the estate. Thirdly, we need to verify the age of deceased. Why so? It is because insurance premium is determined by age upon application. Certain companies don’t verify the age upon application to avoid delay but upon death claim, the company will surely verify their age.
For example, if Mr A is 28 years old. However, during application, he lied that he is only 20 years old. So, this means that he has been paying a lower premium all these while. In this situation, company will usually request him to pay back the total premium difference with interest charged or the company can reduce the coverage to compensate the difference.
Another example, 28 years old Mr A said that he is 30 years old instead. Conversely, he has been paying more over the years. The company will then refund him the excess of premium paid.
So this is regarding the age verification upon death claim. In summary, company need to verify 3 things – Death, Nominee and Age. As for TPD, company surely need to verify if claimant is TPD. Similarly, we need to verify the age and nominees/trustees as well. So, the only difference is one is death, another is TPD.
Hospitalisation & Medical Expenses claims
A: Moving on, for hospitalisation and medical claim. We need to submit the original receipts and invoices. Duplicate copy is not allowed. Even if you’d bought medical insurance from 10 companies, you can only claim from 1. In other words, you don’t have to buy so many medical cards. Plus if your hospitalisation bill is 10K, you can only claim 10K. Insurance companies will only payout base on approved amount of the hospitalisation bill. Nobody is allowed to make money from insurance payout.
Otherwise, this is not the essence of insurance. It is gambling.
Survival benefit claims
A: Lastly, for survival benefit claim upon maturity, claimant has to be alive and makes the claim by himself. Making the claim by himself is one way to prove his survival. When making the claim he can then decide who will receive the money. So that’s it. Generally, there are 4 types of claim.
Host: That’s it for today’s topic on claim. If you have further questions, you can read on the relevant articles at FINPOSTS.COM. Okay! That’s all for today. Thank you Shifu!
Benefits are meant to be claimed. To ensure that a claim will be processed smoothly, we have to do our part. Be honest and give full disclosure upon the application to be insured so that when it comes to claim, there’s no hiccups. Do drop us a comment if you have further questions!
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