5 Practical tips to help you submit valid long-term insurance claims
Submitting a claim can seem like a big task – especially during an already challenging time. But there’s no need to panic or fret as there are some simple, but helpful steps you can proactively take to help make your claim submission a breeze.
The best first step when handling anything financially is to invest in the support of an accredited financial adviser. When partnering with Old Mutual, you can benefit from the professional and reliable services of their financial advisers; they are there to help you from initiating a policy right through to claim stage and beyond.
Once you have your financial adviser, here are five practical tips that will help you to confidently submit a valid long-term claim.
1. Clarify your financial goals from the get-go
When meeting with your adviser, always be transparent about your needs and goals so they can put together a financial plan that can help you achieve them, while sticking to your budget.
2. Provide all the accurate information in your claims application
It’s important to provide full and accurate information at the application stage. Make sure you disclose all your necessary medical (full and accurate health record), financial, lifestyle (including any risky activities or sports you take part in) and occupational information. The information you provide when you apply for cover will be used to determine your premium, cover amount and the terms and conditions of your policy.
3. Ensure to check your documents after your application is approved/covered
Once your application has been approved and you've received cover, ensure that you check your documents and the summary of the information you provided. If there are any errors or omissions, make sure to correct them with your financial adviser. Make sure you also read and understand the details and terms and conditions of your policy.
4. Review Regularly
Review your cover regularly with your financial adviser to ensure it remains in line with your evolving needs and lifestyle.
5. When claiming submit all the required documents
Remember to submit all the required documents to Old Mutual or speak to your financial adviser to assist. Old Mutual will then validate your policy and assess your claim.
More tips for submitting a claim
If your claim is approved, you will receive a payout.
If your claim is declined, we will explain the reason why your claim is not valid, which may be one of the following:
|
Reasons for decline |
What it means |
Claim savvy tips |
|---|---|---|
|
"Benefit definition not met" |
Failure to meet the criteria of the illness or injury that you are claiming for, as stated in the terms and conditions of your policy. |
Make sure you claim for events that your policy covers you for. Remember, the terms and conditions of each policy are unique. If unsure, speak to your financial adviser about what you are covered for. |
|
"Non-disclosure" |
Misrepresentation of, or failure to disclose important information that is requested when you apply for cover. |
Always be fully transparent when providing the required information at both the application and claim stages. |
|
"Underwriting exclusion" |
When you are not covered for illnesses and/or injuries due to information we discovered about your medical history during the underwriting stage. |
We will notify you of the illnesses and/or injuries which are specifically excluded from your policy when we issue it. If unsure, speak to your financial adviser. |
|
"General exclusion" |
Some claims will not be paid if they are a direct or indirect result of events, activities and conditions that are generally excluded. |
Make sure you are aware of the general exclusions stated in your policy. If unsure, speak to your financial adviser. |
|
"Suicide exclusion" |
Death, as a result of suicide, within a certain period of time as stated in your policy. |
Make sure you are aware of any suicide exclusion periods stated in your policy. If unsure, speak to your financial adviser. |
|
"Fraud" |
If information in support of a claim is found to be manufactured or inauthentic. |
Always be honest when submitting your claim and when providing the supporting information required. |
For more information, speak to your financial adviser, call 0860 60 60 60 or visit www.omclaimstool.co.za to see what people like you claimed for.
To find out more:
- Speak to your financial adviser
The information is not advice. For more information, speak to your financial adviser, call 0860 60 60 60 or visit www.omclaimstool.co.za to see what people like you claimed for.
Old Mutual Life Assurance Company (SA) Limited is a licensed FSP and Life Insurer.
Disclaimer
The material is not intended as and does not constitute financial or any other advice. The material does not take your personal financial circumstances into account. For this reason, it is recommended that you speak to an accredited financial adviser to consider all your options and draw up a plan to achieve your financial goals.
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