The Insurance Claims Process

A policy claim will usually start with a definition.

Let us take as an example “total permanent disability”, which is intended to provide cover for medical conditions not specifically mentioned in the policy.

This usually means that you have a medical condition, caused by an accident or illness, from which you will not recover before the age of 65, and which will prevent you working in either your normal occupation or any occupation (definitions vary from policy to policy).

However, sometimes it is defined as being your ability to carry out certain activities such as getting in to and out of a chair or being able to take a bath or shower unaided.

The effect of the medical condition must be such that you will not be able to work again. On the face of it, that may sound difficult to prove. However, the legal test that is applied is whether it more likely than not that you will not be able to work again.

How can this be proved? The only way that it can be proved is with medical evidence. It is vital that medical evidence is obtained from respected medical consultants who are accepted as having expert knowledge of your particular medical condition. This is where our considerable knowledge and experience of medical experts is vital.

Given the right medical evidence, insurance companies can be compelled to pay your claim.

To start the investigation process, email the Policy Claims Solutions team