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 by: Craig Ball
Business: The Carter Group
Client: Male, dentist, eye injury
Claim type: Income protection


In detail

“I stumbled my way through it,” says Craig Ball of his first claim. “I was pretty nervous. I didn’t know what to do. As a young adviser (Craig had set up his financial advice business one year prior), you’re just trying to write as much business as you can. You don’t know anything about dealing with claims until you get your hands on one.”

Not surprisingly, when his first claim came in, a dentist in his late-forties who had suffered an eye injury, Craig had no procedures in place to manage claims. He recalls feeling that the process was out of his control, and he was extremely anxious as he waited for the first cheque to arrive.

“You start to think: ‘Have I done everything right?’ ‘Will there be any non-disclosure issues?’ ‘Did I tick all the boxes?’”

The claim was accepted, providing the client with an ongoing monthly income which meant he could retire comfortably. But the anxiety Craig felt over that first claim led him to develop a comprehensive claims management process.

“We get the clients’ file ‘claims ready’ at application time,” explains Craig. “We request things like Medicare records and financials, and anything else that is usually requested by an insurer upon claim (that we can access already). When a claim comes in, we already have all the documents on file, and can submit everything at once.”

When a claim comes in, we already have all the documents on file, and can submit everything at once

He believes that not only does having documentation on file speed up the claims process, it also minimises disclosure issues because the client is immediately aware their Medicare and doctors’ records will be sourced.

The other change Craig made in his approach to claims was to take a hands-on role with the insurer.

“Our process is a complete 180 degrees from where I started, and potentially from where a lot of advisers are now – we take control of the process.

“Insurers like to think of the claimant as their customer, but the adviser is their customer. We insist on them (the insurers) doing it our way, because ultimately a claim is when the relationship with a client is cemented.”

“If advisers aren’t getting involved in claims they’re not interested in growing their business.”

Craig and his team stipulate that they receive a copy of every piece of correspondence that comes from the insurer to the claimant. They also ask for the cheque to be sent to their office, so it can be hand-delivered to the client. “A cheque or lump sum amount paid into a bank account is a very cold transaction. Wherever possible I believe the adviser should deliver the cheque to the client.”

Not surprisingly, Craig’s advice to advisers (both new and experienced) is to take control of the claims process.

“I attended a conference recently where I presented on claims and I was really surprised to find that only 50% of the advisers present said they were actively involved in claims.

“By getting actively involved in the claims process you’re adding value to your business.”

Craig gives the example of a client who dies leaving a wife and children. “You can set up allocated pension accounts for the claim money to be paid into, instead of paying a lump sum into a bank account.” Craig says this works in a number of ways:

  • It means you are growing the value of your business (through FUM)
  • You have established a relationship with the next generation of the family
  • You avoid your clients becoming targets for bank planners (who often generate leads from large deposits)

“If advisers aren’t getting involved in claims they’re not interested in growing their business.”