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

Ben Day was living the dream. Retired before his 40th birthday, the former financial adviser was working part-time at his wife’s family’s winery in north-east Victoria. But just over a year into semi-retirement Ben was diagnosed with leukaemia.

“I didn’t think for one second: ‘What am I going to do?’” he recalls. “I knew I had insurance in place and had managed claims for clients before so I knew the process.”

Ben’s income protection claim was paid quickly, but his trauma policy, held with a different insurer, was initially declined.

“I called for an explanation. The assessor said: ‘You don’t meet the definition for a full payment’. So I asked if they were going to pay the partial payment instead, and she said they weren’t going to pay that either because I was too far gone to qualify for a partial payment. So basically I was too sick for a partial payment but not sick enough for a full payment.”

Because of his experience as an adviser, Ben went back to the insurer and spoke to the Head of Claims. It turned out his claim had been given to a junior assessor who’d been in the job less than two months. The Head of Claims said all that was needed was some further information, after which the insurer paid the full claim immediately.

“If I was a lay-person and had no experience with claims whatsoever, and didn’t have an adviser, I would’ve accepted that and been disappointed, assuming that my policy just didn’t cover my particular illness.

If I was a lay-person and had no experience, I would’ve accepted that and been disappointed, assuming that my policy just didn’t cover my particular illness

“It wasn’t a big issue, more just a frustration, but it highlights the need for people to use advisers.”

With the trauma money safely in the bank, Ben began chemotherapy. “It was a million times worse than I imagined, but what was almost as painful was watching others in the same situation having to work.”

He recalls one particular day in the chemotherapy ward:

“One day, about three months into my treatment, I remember I’d been sitting in the chair for about five hours when a gentleman in a suit walked into the ward. He took off his jacket and tie, and rolled up his sleeve, and sat down next to me and pulled out his laptop. As they put the needle in his vein and hooked up the chemo, he started to work on his laptop. He even took phone calls.

“The nurse spoke to him and asked whether he would be going home after the treatment.  He said ‘No, I’ve got appointments. I’ve got to go to work.’ She told him she didn’t think that was a good idea, but he replied saying ‘No. I have to.’

“I knew exactly why he was doing what he was doing, but I had no comprehension of how. That’s the reality of the underinsurance epidemic. That’s the face of it. Insurance gives you options that you wouldn’t otherwise have.”

When he was an adviser, Ben was often called upon to share his sales process with others. His dealer group even asked him to document his approach so they could pass it on to the rest of their representatives. As he sat in the chemo ward, Ben could not shake the thought that if there were more people doing what he used to, there would be less people having to work through their treatment.

“Once I’d recovered, I met with my brother, who’d also been an adviser and subsequently moved into the world of corporate sales. I said: ‘We’ve got to get out there and start showing advisers how to sell risk insurance’.”

What followed was the creation of a new business, called Risk Sales Tools, a one-on-one coaching service for risk advisers to help them increase sales.

“We’re both passionate and total believers in the importance of risk insurance. And as my brother said to me one day, through our clients we’re going to be able to influence a lot more people to buy risk insurance than we ever could on our own.”