Insurance Claims
Life and Critical Illness Insurance – never withhold information as it will invalidate a claim.
November 29, 2010 | Author admin
Withholding information is the single most common cause of a life or critical illness insurance claim being rejected by the insurer. We have a true story to tell you that will effectively highlight this issue, but to preserve the identity of the policyholder, we have changed the name and a few other details.
Mrs C had surgery to remove cancerous lymph nodes from her groin; while recovering from the operation, she fell ill with a secondary infection. At this difficult time, she received some extra bad news. Her claim under her critical illness insurance policy had been rejected, and she could not expect to receive the $200,000 payout. To understand why her claim was rejected, we need to look at the background to these events.
In June 2001, Mrs C discovered a patch of flaky skin on her back, and she went to the doctor thinking it was eczema. Her GP wasn’t sure and referred her to a specialist dermatologist for an expert opinion. However, Mrs C cancelled the appointment with the dermatologist because the flaky skin cleared up before the date of the appointment. Mrs C thought no more about it, especially as the GP did not communicate any particular urgency to her about the matter.
In August 2001, nine weeks after the GP appointment, Mrs C received a routine sales visit from her life insurance company, Standard Life. The sales representative reviewed her situation due to the fact she now had a young family, and recommended she purchase a $200,000 Critical Illness policy. Mrs C signed up to the new policy without hesitation.
The sales representative went through the application form with Mrs C, filling in the answers for her as they progressed through the questions. When asked to provide details of incidences when she had been referred to a specialist for tests or treatments, Mrs C asked the sales representative what Standard Life meant by that. Mrs C alleges that the representative stated that only referrals relating to serious conditions needed to be mentioned. Since Mrs C’s referral related to what she thought was eczema, she didn’t believe it to be a serious condition, so she did not mention it and it did not go on the form. They completed the form together and Mrs C signed the form believing that she had provided all the information that Standard Life had asked for.
Several days later Mrs C’s application was successful and she was issued with a Critical Illness Insurance policy for $200,000.
Two years down the line, Mrs C was diagnosed with skin cancer. She had to undergo major surgery to try and remove the cancer. Mrs C made a claim on her critical illness insurance policy believing that she had a valid claim.
Mrs C’s claim was rejected, Standard Life cited reckless non-disclosure as the cause the insurer’s way of saying that Mrs C purposely withheld information about her referral to a dermatologist.
How did this happen?
It is clear by now that Mrs C should have mentioned the fact that she had been referred to a dermatologist – so why didn’t she?
Two events brought about this unfortunate situation:
1. When Mrs C asked what kind of referrals needed to go on the form, the Standard Life sales representative told her that she only needed to mention serious conditions. This was completely wrong the application form question stated all occasions her GP had referred her for tests or treatments. The key words here are ALL OCCASIONS. ALL means ALL and there is no flexibility for an applicant to consider if the referral is worth mentioning or not. The sales representative provided Mrs C with the wrong advice.
2. Mrs C was not made aware by the GP that the flaky skin was potentially a serious matter. The GP later admitted that this was the case. If Mrs C did not realize that the referral was a potentially serious matter, then surely she cannot be said to have been withholding information when completing the application form. Remember, the sales representative told her that only serious conditions need to be mentioned.
It is our opinion that Mrs C should not be held accountable for what was a genuine mistake. The Standard Life representative provided incorrect advice at a crucial moment, and Mrs C followed it. We think that Standard Life should take these events into account, and validate the claim.
How to avoid the same happening to you
When you are filling out a life or critical illness insurance application form, read each question very carefully and provide an accurate and full answer. Do not consider withholding any information, because if you fail to disclose something that later comes to light, you will be held accountable as withholding that information on purpose. You may think that withholding that information could result in lower premiums, but it’s not a risk worth taking.
We’ve got our fingers crossed that Standard Life will relent and pay out on Mrs C’s policy. She was unfortunate in receiving poor advice, and did not willfully mislead the insurer.
However, people that do withhold information on purpose can expect everything they get on making a claim nothing .
NB : 5% of critical illness claims are rejected by Standard due to non-disclosure. They’re not the highest: Friends Provident rejects 15% of claims for the same reason, and Legal & General rejects 16%. The insurance industry is addressing this situation at the moment by improving the way they obtain the information from applicants, any by providing clear information about the penalties for non-disclosure.
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Types of Life Insurance Riders
November 29, 2010 | Author admin
Insurance riders provide benefits over and above those given by a basic insurance policy. Riders are not free and come at an additional cost, but the cost is relatively less compared to that involved in taking a separate insurance policy to cover the same requirements. Some of the very essential and well known riders include accidental death rider and critical illness rider. Beside these, other important riders (their importance varies from person to person) depending upon one’s age, stage of life and future goals, include accidental death, disability or dismemberment rider, level term rider, waiver of premium rider, guaranteed insurability rider and family income benefit rider.
Accidental Death Rider: The rider provides extra benefits equal to the minimum sum assured while taking the base policy. It is applicable only if the insured dies during the policy term due to accident. Since in most cases the rider benefit promises a sum same as the underlying policy assured amount, it is also called Double Indemnity Rider.
Critical Illness Rider: Also known as Accelerated Death benefit, this rider allows an insured who is diagnosed with terminal illness and may require long term medical care or who requires confinement to medical home permanently; to withdraw part or whole amount of death benefit from the basic insurance policy. The basic insurance policy reduces by the amount withdrawn under rider. The rider helps the insured and his family meet immediate financial needs of medical treatment and loss of regular income generated by the insured. The rider generally specifies the amount available to insured in such cases and can be withdrawn by him during term of policy.
Accidental Death, Disability or Dismemberment Rider: The accidental death rider can be sometimes extended to include any permanent or long term disability lasting at least for 6 months or loss of limbs or sight due to accident.
Level Term Rider: With this rider you can attach a fixed amount of term insurance to your basic permanent life insurance policy for a certain period. The amount of benefit assured can be multiple times the basic death benefit from the original policy.
Waiver of Premium Rider: This rider helps the insured to continue with his insurance policy even if he/ she are unable to pay regular premiums due to long term or permanent disability. By default a life insurance policy can expire if the premium is not regularly paid. In case if the insured suffers from a disability that prevents him from earning a regular source of income, the insurance policy premiums become difficult to bear. This rider allows the insured to take waiver from premium payments until the disability lasts or for the entire policy period in case of permanent disability. The terms of proving disability and its valid duration vary from company to company and across different policies.
Guaranteed Insurability Rider: Also known as Renewal provision, this rider allows you to buy extra insurance at certain periods during the specified term of rider. Without letting your existing policy elapse, you can purchase additional insurance or convert basic term insurance without proving insurability or having to undergo fresh medical examination. The rider is most beneficial to those who may experience major medical illnesses or loss of health due to advancing age, as there is no need for fresh underwriting. It also allows to add more insurance with changing life circumstances like marriage or arrival of newborn.
Family Income Benefit Rider: This rider provides a cushion in case of sudden death of the insured during policy term. While taking the rider, the insured needs to select the time frame for which he wants his family to continue receiving benefits. According to their comfort level, the beneficiaries will have the option of receiving regular monthly income or taking the entire benefit as lump sum after the death of the policy taker. As the insured grows old the duration of rider decreases. This rider is most beneficial to families with single bread winner.
What is Waiver of Premium Insurance Rider?
November 29, 2010 | Author admin
Most people are aware of the advantages and take out some or other form of insurance policy depending on their needs. The most basic situation for which a life insurance policy is generally taken is loss of income due to death of bread winner of the family. But many overlook the possibility of a worse situation arising due to permanent disability that could make regular premium payments difficult and result in the termination of the insurance policy.
Definition – The situation is easily remedied by opting for a Waiver of Premium Insurance Rider that can be easily attached to almost any insurance policy. According to the rider, an insured can claim relief from paying future premiums in case he/she becomes permanently disabled or is unable to earn a living due to disability during the term of the policy and the disability lasts for at least 6 months. With this rider, the insured can continue to enjoy the benefits of the base policy without paying any more premiums till the time the disability lasts. Once the insured recovers, he can start paying premium again.
Benefits and Restrictions – The best part of the rider is that since it attaches only to the security part of the total insurance taken, the extra premium to be paid is quite minimal. The rider can be especially useful in case if the premium payments are quite high and will ensure that the policy continues even in case of debilitating illness or accident. To be able to claim premium waiver, the insured must prove that they have been suffering from the disability for atleast 6 months or any other minimum period as mentioned in their rider terms. Also, the rider benefits are available only until a certain age, generally 60 or 65 years. Post the maximum age limit, the insured cannot opt for this rider. The rider is valid only till the term of policy. Once the policy reached term, the rider is terminated. Thus it is beneficial to opt for the rider right at the time of taking out an insurance policy to safeguard your financial investment planning objective.
Disability – Disability definition as per the waiver of premium rider specifies that the insured must be so disabled that he / she is unable to pursue the profession they were engaged in when they became disabled. It varies from one insurance India company to another whether they consider the person disabled to carry out their particular occupation or unable to pursue any occupation in general. It is thus advisable to expressly clarify the point with the insurance company and read related documents carefully before opting for the rider.
All insurers clearly mention the conditions under which the insured will be considered disabled and eligible for the waiver of premium rider. Where some only accept permanent and irrecoverable disability, others may consider the insured disabled even if they are able to engage in work in some cases. Loss of limbs like hands, legs and eyes generally qualify a person for the rider benefit. Besides, a person who suddenly loses his ability to speak or hear due to illness or accident also sometimes qualifies.
You Don Not Have to Pay Exorbitant Premiums For Life Insurance
November 24, 2010 | Author admin
There are ways of saving money on your life insurance because of the many different types of policies that are available. There is also a wide choice in the types of cover you can have depending on your needs and individual circumstances. The main factors that affect the cost of life insurance are your lifestyle, your age, your medical history, your job and your gender. Some factors affect the cost of the policy more than others.
Smoking is one of the lifestyle factors that does drive up the cost of life insurance. This is because so many health conditions, such as caner and heart disease, are linked to smoking. You have a greater chance of contracting a life-threatening medical condition. Even if you are a reformed smoker, the agent you deal with for the policy will want to know how long ago you gave up smoking. In order to save money, this time frame has to be longer than a year.
You will pay a lower premium if you take out a life insurance policy when you are in your 20’s or 30’s than you will if you are in your 50’s or 60’s. This is because of your life expectancy. You have a greater chance of dying when you are older and so the likelihood of having to pay out the policy to your beneficiary is much higher. The older you are, the more costly a life insurance policy becomes.
If you work in a high-risk industry, such as mining, you will also have to pay a higher premium for your life insurance. This is because there is a greater chance that you will get killed on the job. Your age also plays a part in the cost here because if you are young you may be deemed a high risk because the young are not known to be as cautious as older workers in the same line of work.
When you take out a life insurance policy, you do have to fill out an extensive health questionnaire. You may also be required to have a fill physical check up by the doctor in order for the company to be satisfied that you do not have any pre-existing medical conditions. It is important for you to be truthful when completing this questionnaire, especially if the company does not require any information from your doctor. If you give false information and the company finds out that you do have a pre-existing medical condition, then your policy will be canceled and you will be left without any life insurance.
Improving your diet and exercise is a way of staying healthy. The questionnaire you complete will also ask you questions, such as your exercise habits and your eight and height. If you are overweight, this could affect the cost of your premiums because being overweight is linked to life-threatening disease, such as heart disease. Even if you are overweight when you take out the policy and you change your lifestyle through diet and exercise, you can make changes to your information that will lower your costs.
Shop around when you are looking for life insurance policies. Make sure the company your deal with is financially sound and is not in danger of going bankrupt, taking all your premiums with it. Get a sense of the amount of premiums you are likely to pay by shopping online and requesting free quotes on various types of policies. The life insurance industry is a competitive one, with companies offering various rates and discounts. Make sure you ask about any discounts that you may qualify for because these will lower your costs.
One thing you should be aware of when paying premiums for life insurance is that some companies levy extra charges against you if you choose to pay your premiums on a monthly basis. Compare the rates involved with monthly, quarterly, semi-annual and annual payments to see where you can save the most money. When you’re looking for a term policy, check the renewal guarantees after that term is over. You don’t want to have to start shopping around for a new policy when it is easier just to continue with the one you have for another term. A policy with a guaranteed renewal will allow you to start a new term when the current one ends without having to undergo another doctor’s examination. The premiums will be higher because of your increased age.
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Term Life Insurance | Term Life Insurance Can Help Your Loved Ones In Future
November 24, 2010 | Author admin
There are many rules and regulations in life insurance policy, people just do not have the time to read about the policy and they just sign on the dotted line and accept the policy, however if you can give some time to read the policy properly and take complete knowledge about the policy, you can save make the right choice and save a good amount of money for you. Term life insurance is a confusing policy at first. There are many companies that offer term life insurance. If you simply believe in your agent and book your policy then my suggestion to you is that you are doing a mistake. That’s because you may not be getting the best deal for your term life insurance coverage. Insurance agents generally stick to their favorite companies, that’s because they get their commission from that particular companies. And because of this reason you do not get the best prices that you can get. And above all if you have health related issues then it is advisable for you to take complete knowledge about the market and to compare prices and to see what companies are less aggressive with quotes. Once you have found the company that offers you the best prices then you can decide onto what type of insurance coverage you want.
Generally a term life insurance is taken to take care of any debts or any other financial burden that your family might have to bear in case you pass away. Term life insurance is basically a type of security cover that you provide to your loved ones whom you leave behind. It is practically for this reason that people generally are not sure as to what exactly is the time frame that they should apply for the policy. I would suggest a few things here, if you have a huge retirement fund coming your way, then it is ok to apply for a short time cover, because you may not need as much as far as life insurance is concerned. But that is not the case with all of us, and due to this they do not understand how much is needed and they undercut their insurance and wind up with a life insurance plan that cannot cover everything in the event of an untoward happening.
I remember when one of my friends had spoke to me about this issue and I had recommended him to go for a large plan, but he said that the large plan would cost him more and that he would just go with a small plan. Then one day he met with an accident and he died due to that. Later on his family suffered because he had lots of credit card debt and also his home is mortgage. His wife was not able to support the family properly and they had to leave their home simply because they were not able to pay the monthly payments of their home. His children were removed from the school and were admitted to a local community school because his wife was not able to pay the school fees. If only my friend had taken a large cover for his term life insurance, this kind of situation would have been avoided. So my advice to all is to always try to pay more for your insurance because that is an important matter when it comes to the safety of you and your loved ones for their future.
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What provides safety for the future?
November 8, 2010 | Author admin
Have you ever thought of how to live a secure life in the future? No one can predict the future and now we may be having all wealth, but future cannot be predicted “Stop acting as if life is a rehearsal. Live this day as if it were your last. The past is over and gone. The future is not guaranteed”. This is one of the beautiful quotes from Wayne Dyer and always thinks for the future of you and your family members. You are going to live your life and you are the responsible person for the loss in your life. Investment is the one that provides safety for your life and investing your money in insurance provides the complete safety for your future. Are you still unaware about the benefits of insurance and its types? Don’t worry my friends we will see a detailed overview about it.
What is insurance?
Insurance is an amendment or policy that gives protection against an undesirable event or risk and it ensures that we are protected from financial loss or harm. The insurer is a person who insure and the insurance agent is a person who acts as a representative between the insurer and the insurance companies and he may be either an independent representative or a dedicated one. Independent representative means, the agent represents the insurance products of many companies and dedicated one is who represent only for a particular company.
Varieties of insurance:
Different types of insurance are available and each type provides some safety and security. Life insurance, property insurance, health insurance, auto insurance, liability insurance, credit insurance, casualty insurance, home insurance and there are other types of insurance locked fund insurance, pet insurance and more. Whatever the insurance type it may be, the theme behind the insurance is safety and security for the future. The first insurance company in USA was started in 1732 in Carolina and Benjamin Franklin was the one who helped to popularize the insurance.
Premium:
Premium is the sum of money paid, usually at regular intervals for an insurance policy. As said above, you need to invest in order to gain profit and before selecting the insurance decide your budget and select a premium that you can afford. Insurance companies in general have different premium options for the benefit of customers and you can pay the premium quarterly, half yearly, annually and monthly. Either you can pay in hand or there is an option to deduct the premium from your salary. Each and every company has different premium plans and the least amount of premium starts from hundreds and continues to the most; depending upon your budget you can decide the premium amount of your own. If you are busy and if you can’t find time to pay the premium, better you can call your agent and can pay the premium to the agent.
The companies usually remind about the premium thorough email or through letters. Find the best insurance companies through internet and there are many good health quotes companies who provide you the valuable information regarding insurance.
Life Insurance – Getting it Right
November 8, 2010 | Author admin
Life insurance is sought by people for a variety of reasons. You may feel that because you’re getting on in life and feel that life insurance could give you the security of knowing your family will be taken care of after your passing. Another popular reason is that you are purchasing a home or thinking about starting a family. Whether life insurance is a luxury or a necessity in your case, you are probably asking yourself how do I pick the best life insurance scheme for me?
With so many different life insurance companies out there, finding the right life insurance policy for your needs can seem like a nightmare. Where should you begin? Some life insurance policies look good but end up costing more than you can afford when calculated on a day to day basis, and you may find that if you cancel a life insurance scheme you lose all the money you’ve paid into it so far. Some life insurance policies are flexible, allowing you to adjust them to suit your changing needs and budget, whereas others which don’t give you that advantage may offer higher returns. Remember that life insurance is not just there in case you die – most life insurance schemes also pay out in the event of serious illness or disability, meaning that you’ll have extra money to help you get by if you find yourself struggling.
As some people can not guarantee that they will always be earning an income, the idea of getting a life insurance policy can be very intimidating. If this is your fear then find a company that will allow it’s policy holders to take a contribution break of up to three years to cover you in preiods where you are unemployed or are unable to contribute for other difficulties. If you are considering taking out a similar life insurance policy your bank may be a good source of free financial advice. This type of policy won’t have such a large payout, but it offers the security in the short term. Life insurance may not be out of your reach even if you are struggling financially. Policies are available where your initial contributions are very low, like a step rate plan. The disadvantage of policies like this is you may be required to pay contributions for several years before your policy is valid and offers benefits. If you have been turned down in the past for life insurance due to illness, be aware that some life insurance companies specialize in offering solutions for people in this type of situation. These types of policies may be customized to your needs and income, while being mindful to the specifics of your present condition. So no matter what your situation may be, life insurance can be available to anyone. It’s never too late to consider taking out a life insurance policy. Always shop around and pay particular attention to the fine print. You’ll soon see that there is a policy out there made just for you.
Can Your Insurance Company Afford Your Claim?
November 6, 2010 | Author admin
Choosing an auto insurance policy is often considered to be all about the price of the policy. Sure you want the best coverage you can, and you want to be sure that you will get reimbursed for the types of accidents that are likely to happen to you, and absolutely you want to have the cheapest policy you can get, but what about choosing an auto insurance company that can actually afford to pay your claims?
Filing Auto Insurance Claims
November 6, 2010 | Author admin
The auto insurance policy that you have purchased is useful only if you are familiar with the auto insurance claims. Filing an auto insurance claim is essential to cover the financial loses caused by accident, theft, vandalism, etc. People who are completely familiar with the auto insurance claims can deal with such situations in a better way. Here are some points that are essential to be considered while filing an auto insurance claim:
Personal Injury Insurance Claims Process – Article Blast! Free Articles And Content For Reprint On Your Website, Newsletters and Ezines. Submit Your Articles For Free!
November 6, 2010 | Author admin
You don’t need an attorney to settle an insurance claim for personal injury. In most cases, these settle without any attorney present. This happens because there are large costs and legal fees associated with situations like these. If you learn how to go through the process and handle the claim, you might save a bit of money, while getting bigger injury compensation.
Your first meeting with the doctor is when the claim process starts for your case of personal injury. Once you get treatment, you are officially known as injured. If someone says that you have an injury similar to a headache, he will usually not get any type of payment, unless they see a very clear proof of the injury.
In most cases, an insurance company will attempt the settlement of the claim for injury insurance. This happens when they offer you a sum of money, in exchange for the signature on a document stating that you will not make any type of claim against the company.
Plenty of insurance adjusters will try to get the settlement right from the beginning, when they first talk with you. Over the phone, they can record the conversation and use the agreement you give them.
You can choose not to settle, in which case your claim process will go on. The treatment you get and the medical bills which show up will be paid by the insurance. You will receive a form for medical authorization from both companies, asking you to give permission for them to get the records and medical bills. If you don’t sign this form, your medical bills don’t get paid.
They need to see the records since they pay the bills, so it’s only logical that they know what they pay for. The defender’s insurance company doesn’t need this form signed, at least not until they settle.
After the medical bills get paid, your insurance company will get their money back from the insurance company of the party that was responsible. This only happens when you reach a settlement agreement. This entire process can take three years, but it depends on the limitations statute of your state.
The claim process for the personal injury is mostly focused on the medical treatment that you’ll get. You will receive letters from the carrier of the insurance, asking for medical condition reports. If they think that you get too much treatment, they might send letters to the company where you have your insurance, saying that they don’t want to reimburse the medical bills
