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Tag Archives | Income Protection

Case Study – Ward v MetLife

In this legal case, the plaintiff sued his insurer after his group salary continuance claim was discontinued because he was deemed to be no longer disabled. The case highlights the difficulties insurers and the courts can experience when dealing with mental health claims. At a Glance Source: Judges’ decision notes, with commentary by Terry Ward, claimant Topics covered: mental […]

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Case Study – FOS Determination – Income Protection Offset

This case looks at a dispute between a claimant and their insurer, which was resolved by the Financial Ombudsman Service in June 2014. The insurer applied an offset clause to the claimant’s income protection benefit, reducing the payments. FOS overruled the insurer, ordering them to pay compensation. The case has implications for advisers recommending key […]

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Case Study – Insurance For Miners

This case study, provided by AMP, looks at some of the issues insurers need to address when considering the insurance cases of mining employees.   At a glance Submitted by: AMP Client name: Tony Client occupation: Mining engineer Cover applied for: AMP Elevate income insurance benefit of $11,250 per month In detail The client Tony* […]

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Case Study – An Unidentified Claim

In this claims case study, a couple, both medical practitioners, who were referred to the adviser for a review of their insurances discovered they were entitled to an additional claim payment. It demonstrates the value an adviser can bring at time of claim, and why clients need to notify their adviser of any occurrence they […]

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Case Study – 30 Year Old Stroke Victim

This claims case study is told from the point of view of the customer, Sam Benjamin. His wife, Erin, suffered a stroke shortly after her 30th birthday. Sam and Erin did not have a financial adviser, and Sam was left to manage the claim process alone, while dealing with the emotional stress of nearly losing […]

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Case Study – My Own Claims Experience (Ben Day)

In this claims case study, an ex-adviser shares his experience of having to make his own insurance claim, and the impact this had on his view of the advice industry. At a glance Provided by: Ben Day Business name: Risk Sales Tools Date of claim: November 2010 Claim type: Income protection and trauma In detail […]

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Case Study – My Own Claims Experience (Mark McNeany)

In this claims case study, adviser Mark McNeany shares his experience of having to make his own insurance claim, and the impact this had on his view of the advice industry. At a glance Provided by: Mark McNeany Business name:  Vertex Group Licensee: Garvan Date of claim: July 2010 Claim type: Income protection In detail […]

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Case Study – My First Claim (Craig Ball)

In this claims case study, succession and estate planning specialist, Craig Ball talks about how nervous he was when faced with his first claim, just one year after setting up his own business. He highlights the importance of developing a comprehensive claims process and engaging with the insurer during the claim. At a glance Submitted […]

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Case Study – Insuring Your Friends

In this claims case study, an accident left the client totally disabled. He later died from the condition. The claimant in this case study was a close friend of the adviser, 2010 AFA Adviser of the Year, Steve Salvia. He highlights the importance of ‘doing the right thing’ for those close to you, whether they […]

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Case Study – Interpreting the Policy Intent (Example 1)

In this claims case study, the adviser was able to negotiate an overturn of the insurer’s original decision to decline the claim by looking closely at the original intent of the policy, as well as its literal wording. It demonstrates the importance of building strong relationships between advisers, dealer group management and claims managers. At a […]

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