By risk specialist Lynda Taylor B.B.S and GDipBus (Personal Financial Planning) Licensed Financial Adviser FSP 9752
In 2023 I posted a blog with some tips to ensure that insurance claims are dealt with promptly. Two years on and the number of claims being processed by all health insurers continues to be well in excess of what they had forecasted. This reflects the demands placed on our public system resulting in more people taking out health insurance, and the tough economic climate resulting in clients claiming for low-cost procedures that they may otherwise have paid for. There also appears to be a greater range of tests being recommended to patients. Further impacting turnaround times for claims is the fact that many insurance companies have been running on reduced staffing numbers. Whilst many have addressed the staffing issue, there is a lead time as new people upskill.
To ensure your claim gets the priority you require, it is critical that any claim lodged online has all supporting documentation attached at the outset. Key information for the insurer is the referral letters from GP’s and specialists, the proposed treatment and date of that treatment, and finally a written indication of the costs for the procedure supplied by the health care provider. Any further context that you can add will be helpful. As such, ask these providers or their administration staff to cc you in on any referral emails to other consultants so you have this information to hand.
If you have the misfortune to be claiming under a trauma policy, the claim form has a section that needs to be completed by your specialist, and any supporting documents such as histology reports submitted too. Given the claim is accepted, the insurer sends back an acceptance letter which needs to be signed, and ID such as passport or drivers license needs to be submitted at this time. Generally it takes 5 working days for the funds to appear in your account. If all relevant documents are not attached, it delays the process.
Please note when the form refers to clients, this is the owners of the policy, so if you own a policy jointly with your spouse then you will both need to sign all documents.
Many health insurers have an online portal for lodging a claim. I recommend you label each of the documents with your policy number and a description of the document (for example: policy 12345 Taylor Lynda Estimate of costs to remove wisdom teeth or policy 12345 Taylor Lynda Referral letter to skin specialist). Set up a file on your desktop and save all these documents into this file. It is then easy to upload the documents to the portal when you go to lodge your claim. I also recommend that you lodge your claim as soon as possible as there can be 5 – 10-day turnaround times given the volume of claims being dealt with.
Below is feedback from a couple of clients who have recently gone through significant health ordeals.
“Thanks you both for this, very grateful. I must say that throughout the whole nasty business Lynda and Partners Life have really stepped up and made things easier for me, thank you.”
“Hi Lynda,
Yay! That was unexpected. Do they just credit our account or pay that amount into our bank account?
Feeling better thanks, going back to work next Monday, doing part time first 1-2weeks and see how it goes.
Thanks once again for your help.”
I am always on hand to assist. If you are unsure about lodging a claim, please call me and we can discuss this. There may be other benefits built into your policy that you are not aware of and would be eligible for.