Make claims part of your value proposition

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Claim-time is an important time to focus on your clients.

The continued focus on LIF has spawned a number of corollary discussions, with one of the most important being around the concept of the adviser value proposition. Put simply, your value proposition is the total package of value you deliver to your clients, in exchange for the remuneration you receive.

Regardless of whether that remuneration is by a fee or commission, there is little doubt that one of the most important areas an adviser can add value to their clients is at claim time. To the extent that claim time is the ‘moment of truth’ for any type of insurance, many would argue this is the time you can add the most value of all.

Sometimes we take for granted the claims and new business processes because we are so familiar with them, but the reality is to an outsider – even a highly educated one – they can be complex and confusing. In the same way that we use a lawyer as our advocate in a complex legal system, think of yourself as an advocate for your client, helping them navigate the course of a claim.

The extent to which this can result in better claims outcomes was witnessed recently when ASIC released the results of its review into life insurance claims. Notwithstanding the noise around the outliers in some categories, one of the most pleasing findings from an adviser perspective would have been the finding that decline rates for policies sold through the retail advice channel were the lowest of all channels, reinforcing the value of advice.

Recent research by Zurich found that only 5%* of advisers didn’t get involved in the claims process (with the majority of those feeling they lacked the necessary expertise), and whilst there are debates around the pros and cons of charging for this service, there is no doubt that most advisers see this as a key part of their service offering.

Our involvement with the AFA Adviser and Practice of the Year award program brings allows us to spend time with some of Australia’s leading advisers, gaining insights into the drivers of their success. These insights have allowed us to compile the following list of tips for those advisers looking to solidify their claims proposition..

Tip 1: Make yours the first number they call

Constantly reinforce with your client that you are their first port of call should they suffer any change in health (illness, injury, or worse).

Do this through your regular client correspondence and your review meetings. When it comes to claims some clients like the psychological security of a 24/7 contact point (which they are accustomed to from home and car insurance companies), and so you should promote to your client the idea that you can be contacted at any time (even if they don’t actually call you at midnight they will feel better knowing they can).

Rather than giving your client a normal business card, consider giving them an emergency contact card with your mobile number and make it clear that they can call you at any time. 

Tip 2: Be pro-active and talk to the insurer as early as possible

Make yourself familiar with the nature of your client’s policy or policies, including detailed definitions and any optional extras the client may have chosen. Make yourself aware of special conditions (exclusions, waiting periods etc). If you don’t have paper records of all your clients’ policies, some insurers, including Zurich, may provide an online archive of these records.

If it is obvious that the client doesn’t have the right sort of cover (e.g. they only have death cover but want to claim for disablement) then this is a great review opportunity (and will save a lot of wasted time and angst from a rejected claim).

In terms of more complex claims (e.g. trauma, income replacement), it is recommended you speak to the insurer first, not only to clarify any special requirements but also to discuss the nature of the claim and even get a high level ‘pre-assessment’ (again this is to minimise the lodging of claims not covered).

Tip 3: Study the policy in detail

By understanding the applicable policy in depth you may be able to identify any special benefits and/or optional extras the client may be eligible to claim for. Retail risk policies today are generally packed with benefits, such as expense re-imbursement options and early payment facilities, and by helping identify which of these options your client has you can help boost their overall claim benefit.

Try and keep archived copies of policy documents and PDS’s to help ensure you are referring to the right version, (but also remember that some companies automatically pass back upgraded features to some existing customers, meaning your client’s policy may now have more benefits than when it was first issued).

Tip 4: Set expectations for your client around timeframe and process

Put another way, communicate, communicate, and communicate.

The reality is that almost all life insurance claims will involve a degree of stress on the part of the claimant. At one end of the scale they are dealing with the death or serious disablement of a loved one, whilst even a simple income protection claim involves a person who is no longer earning their normal income, and is therefore likely to be suffering some degree of stress or anguish.

You can help your client by communicating regularly and in detail.

Explain to them what is involved in the process so they have a realistic expectation around when a claim might actually be paid. Explain to them the likely timeframes and types of documentation that can be involved for the different types of claim and why it is required (in this respect, draw on your own experience and/or speak to the insurer about why certain documents are required).

Make them aware that delays can often occur with their medical specialist, and so if they see their doctor about the specific condition, they should feel free to stress the urgency of the matter to them.

Each insurer’s process may have subtle differences, so make sure you are familiar with each of them.

Tip 5: Assist your clients with requirements gathering

Even the most complex claims can be dealt with efficiently and sensitively when all the requirements are provided up front. It is not unusual for Zurich to pay a trauma claim within 48 hours of the correct requirements being provided.

For each insurer you deal with, keep on hand a list of the standard requirements for each type of claim, so you can let your client know what they are likely to be and how they can be obtained. Whilst some claims may involve special requests, in reality 90 per cent of the requirements are standard and thus known in advance through standard checklists. Every extra bit of notice your client has about providing a document helps get the money in their account faster, which reflects positively on you.

If you think your client needs help completing paperwork or obtaining requirements then help them as much as you can. If they are hospitalised this could even mean dropping forms off to hospital so they don’t have to wait to return home to do this.

Understanding basics like how to apply for a death certificate or how to get certified copies of documents can prove invaluable for clients who are experiencing the stress associated with a claim.

The relevant Adviser Guide is usually a good source of information on claims processes and requirements.

Tip 6: Know your client and go the extra mile

Show some empathy and understanding with the claimant. If there are ways you think you can add value to the life insured or their loved ones, based on your detailed knowledge of their situation, then do so. Think about dropping around for a cup of tea and keeping them in the loop. Help them by projecting and maintaining a positive mindset, or being a person to confide in so they can ‘unload’ a lot of pent up emotion.

At the end of the day, helping your client successfully resolve a claim – big or small – is the single most important thing you can do to engender long term client loyalty

*Source: Beaton quarterly Pulse survey March 2016

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