Sunday, May 25, 2025

Case Study – An Unidentified Claim

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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 believe may lead to a claim.

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At a glance

Submitted by: Bill Brown, MDRT member
Business name: Lifestyle Advisers
Licensee: Charter Financial Planning
Clients: Husband and wife, both doctors
Claim type: Income protection – critical conditions benefit

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In detail

About six years ago, a doctor client referred a medical colleague to me for a review of his existing life risk plan.

The referred doctor (Doctor A) visited me, armed with his existing policies and with a question as to the availability of better contracts in the market. After the necessary data collection, we moved to discuss the key features of his “legacy” income protection policy.

I outlined the policy features, and discussed presumptive disability benefits – specifically the crisis/critical conditions benefit, whereby multiples of monthly benefit are payable immediately on diagnosis of certain medical conditions, without the need to prove disability or serve a waiting period. I used a heart attack as an example, noting that insurers were contractually obliged in most quality contracts to pay the benefit (usually six times the monthly benefit) in a lump sum, without evidence of disability. I added that this lump sum was generally not assessable for tax purposes as income, provided the insurer had previously obtained an appropriate tax ruling.

Surprisingly, Doctor A challenged my statement. He related how his wife, also a doctor, and who held an identical policy to him, had suffered a relatively minor heart attack 18 months before. She had been off work for two months and with a 30 day waiting period, had received one month of benefit, totalling about $6,000.

At my invitation, Dr A revisited my office, this time with his wife’s income protection policy document. It was a closed “legacy” contract, now over 10 years old. The policy was now being administered by a different insurer, the second life company to own that book of business.

On examination of the policy and claim documentation, I was able to confirm that the insurer had not paid crisis benefits in accordance with the policy provisions.

There was evidence that there had been minimal involvement by the introducing adviser in the claim process, who apparently had either not read a copy of the insurer’s letter to the insured, detailing the particulars of the claim benefit being paid, or had failed to appreciate the particular provisions of the policy.

I successfully negotiated with the insurer, and the remaining five months of benefit entitlement ($30,000) was paid immediately, accompanied by an apology from the insurer. Both Doctor A and his wife were most appreciative of my professionalism, and have subsequently referred their colleagues to me.

To be fair to the introducing adviser, Doctor A’s wife contacted the insurer direct in the first instance; not the introducing adviser. While advisers are routinely provided with copies of claim correspondence by this particular insurer, it should be noted some insurers do not provide copies of such correspondence unless requested. Sadly, there are also advisers who instruct insurers not to involve the adviser in claims.

What’s to be learned here?

  1. Advisers should instruct clients to contact the adviser in the first instance if they believe they may have a claim.
  2. Advisers must be totally involved in the claim process, and not delegate to untrained staff.
  3. Advisers must understand the provisions of the particular policy.
  4. Advisers should recognise that insurers can always make mistakes in the calculation of claims, particularly those claims involving “legacy” income protection contracts. Accordingly, it is imperative that advisers cross-reference all claims correspondence from insurers to claimants to the appropriate policy document.

I maintain it should be an article-of-faith for true risk advisers to be totally involved in the client’s claim processes. If advisers have no passion for risk, please rebate your renewal (servicing) commission and leave the provision of service and advice on life risk matters to those who really care for their clients.

Case Study – 30 Year Old Stroke Victim

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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 his new wife.

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At a glance

Submitted by: Sam Benjamin (unadvised client)
Claimant: 30 yr-old female, wife of Sam, Business Development Manager
Claim type: Trauma and income protection

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In detail

On Saturday 19 November, 2011, Erin and I woke to go about our day – but something wasn’t quite right. Erin had been feeling out of sorts for the past fortnight, with a consistent headache, for which the local medical centre prescribed antibiotics and Panadol.

I was making coffee when Erin turned to me and said something that made no sense at all. I remembered the same thing happening to my mother years ago. We think Erin suffered a TIA (Trans Ischaemic Attack) or mini stroke.

I wanted to take her to hospital, but Erin insisted she was fine and finally agreed on a visit to our old GP. After a brief physical, we were given the all clear and went on our way. A brief stop for breakfast and we hit the road to suburbia for a dress fitting for a friend’s wedding. Two minutes into the trip, Erin started breathing deeply and feeling nauseous.

I pulled the car over to the kerb and placed it in park. Then I looked over to Erin and was confronted with an image that will remain with me the rest of my life.

My beautiful girl’s face was contorted, her jaw locked open to one side, her tongue spilling out of her mouth, eyes locked in a thousand yard stare. She was shaking violently, her chin seized to her collar bone and hands clawed like talons.

I would recommend anyone contemplating taking out these types of insurance to do so through a qualified financial adviser.

I screamed, threw the car into drive, and pulled a U-turn over the median strip in front of oncoming traffic. I knew the hospital was close (less than 500m). Erin began to turn blue. I rubbed her sternum to try to bring her around, without any luck. I remember hitting her in the chest with all my force to try and get a response… there was none… she was gone.

Screaming at the top of my lungs I pulled into the hospital’s ambulance bay. I remember slapping her across the face, but there was still no response – her body was rigid. I was pushed out of the way by some paramedics who got Erin out of the car and put her on the ground. They manipulated her twisted body into a position where she could breathe again.

Erin had suffered a stroke as a result of a blood clot becoming lodged in a vein inside her brain. She spent ten days in hospital, suffering another stroke whilst there. Fortunately, her physical symptoms disappeared after a few days and we were left with mostly cognitive and emotional issues. With the help of Erin’s doctors (there are a few now), our family and friends, Erin is recuperating well and should eventually make a full recovery.

Having both worked in the financial services industry for some years, Erin and I were well aware of the types of insurance on offer, and the benefits they can provide. I had taken out a trauma policy for myself some five years prior, and had been encouraging Erin to do the same. She finally took my advice in February 2011, which turned out to be extremely lucky, because the policy had a 6-month waiting period and Erin’s strokes occurred just 9 months after taking out the policy.

To date, we have accumulated over $60,000 in medical expenses. These expenses were mainly for Erin, but I also required help to deal with the shock of almost losing my wife. That amount was effectively all of our savings. Due to the existence of the trauma policy, our savings were replenished. We have set aside a portion of the benefit for her ongoing care, and we were able to use some of the proceeds to help buy our first house.

Erin was also fortunate enough to have income protection insurance through her employer, which means we are still receiving 75% of her income and will continue to do so until she returns to work, or reaches age 65. This was something we looked at cancelling when reading her employment contract! We’re so glad we didn’t!

With the benefit of hindsight, I would recommend anyone contemplating taking out these types of insurance to do so through a qualified financial adviser. Erin and I had to arrange for all the paperwork to be completed ourselves, and we faced an anxious five week wait for the claim to be processed. Having an adviser to manage the process would have made the experience significantly less stressful, and allowed us to focus 100% of our energies on Erin’s recovery.

You can read more of Erin’s story at her blog: A Stroke of Genius? http://erinhadastrokeofgenius.wordpress.com

We sincerely thank both Erin and Sam for sharing their story.

Case Study – Pro Bono Advice

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In this claims case study, the adviser shares how he offered his services pro bono to a family dealing with cancer.

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At a glance

Submitted by: Mark O’Leary
Business name:  Eluvia
Licensee: Hillross
Clients: Family who lost husband and father to cancer
Claim type: Death cover, terminal illness benefit

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In detail

“Why do it? It’s a damn good question!” Mark replied, when asked why he regularly offers his services free of charge to people with terminal cancer.

“I genuinely believe we are seriously helping people when they’ve got nowhere else to go, even in some cases where it’s only half an hour’s work, and we just point them in the right direction. We feel that it’s the right thing to do.”

He explained that the type of advice provided in pro-bono cases differed significantly from his regular work.

“To a large degree we become like counsellors. We’re holding their hand and helping people work through issues, keeping creditors from their door, and taking away stress from their lives.

“In these cases, there’s probably more time spent in the back office than in front of the client. We spend quite a number of hours on tracking down lost super and lost insurance – products that a lot of people don’t even know they’ve got.”

Mark shared one example of a pro-bono case he has worked on recently:

“I met Katy* for the first time, with her husband and her kids, in a palliative care hospital. Her husband had been diagnosed as terminal, and had around one month life expectancy. Katy was sitting there with a cheque that had been paid out under terminal illness benefits. It was a $300,000 cheque which she had there waiting for me, because she didn’t know what to do with it. She’d never even opened a bank account.

“Nothing significant happened out of this case from a financial planning perspective. $300,000 wasn’t a lot in terms of this family’s needs. We talked about paying out the mortgage, and what to do about buying cars, because the only car they had was his company vehicle. The husband said he wanted his wife to get a new one, which is an example of the kind of thinking that goes on – he wanted her to have a new car, not a second-hand one, because if it broke down there would be no one there to help her.

“I spoke to her three or four weeks ago, after he had passed away. She said she just wanted to get herself through Christmas, and get the girls started at school. She’s then got to think about the next step. They’re on Centrelink benefits, and she’s got a little bit of money left, but not a lot. All I’ve done so far is point her in the right direction in terms of paying off debt and updating her will.

at the end of the day, we protect families, irrespective of the numbers attached

“So even though there’s been no formal advice, nothing written down, this case sticks in my mind because it’s very, very real.”

While acknowledging that offering pro-bono advice is not for everyone, Mark believes it can be a very rewarding experience, particularly for younger or newer advisers.

“The majority of advisers within our practice are very young – in their late 20s and early 30s. They’re all fully trained, but they don’t necessarily understand the value of insurance and estate planning. We’re using this as a teaching aide of sorts. It’s a way of saying to them: ‘This is seriously what we do! We might sit here and talk about money and shares and the Dow Jones, and that’s all very important. But at the end of the day, we protect families, irrespective of the numbers attached.’

“It isn’t easy, there’s no question about it, but I feel quite good about the difference we’re making. Oddly, I like the sense of responsibility, because I know that we can make a greater difference than most other professionals at this point in their life. A lawyer can tidy up, do a will, and that’s important. An accountant has a role too. But when you meet with them, you get an immediate, heightened sense of responsibility and you’ve just got to get it right.”

Mark had this advice for other professionals looking to offer free services to those in need of financial support:

“With this, there’s no end game. Because the more you look at it, the more people you can bring into the loop to support.

“You have to think about it very carefully in terms of how you manage your time. And if you have a go, you have to do it wholeheartedly, because you don’t want to let people down.

“Choose one organisation that resonates with you, so you can focus your service. And be prepared for difficult conversations.”

*Name has been changed to protect the clients’ privacy

Three years ago, AMP Financial Planning and Hillross embarked on a partnership with the Cancer Council of NSW to provide free financial advice to cancer sufferers. The program has now grown to include support for patients across Australia, with more than 300 advisers volunteering their services in Victoria alone.

Case Study – The Importance of the Date When Diagnosed with Terminal Illness

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In this claims case study, the adviser shares how he was able to secure an additional benefit for his client, based on the date on which their illness was first diagnosed.

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At a glance

Provided by: Robert Bonifacio, MDRT member
Business: Essential Financial Services
Licensee: Charter Financial Planning
Clients: Bob and Mary*
Claim type: Life

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In detail

Bob and Mary* had been clients of Victorian adviser, Robert Bonifacio, since 2005.

In June 2011, Bob, who was aged 68 at the time, approached Robert, asking to reduce the amount of his life insurance cover. He explained that his ill-health meant he was no longer able to work full-time, and as a result could not afford to pay for all the cover he and his wife Mary needed. Robert made the necessary changes to the cover.

Less than a year later, Bob was diagnosed as terminally ill. Robert lodged a claim for Bob on his life cover, which was paid out in advance of his death.

Robert said that Bob and Mary had originally planned to use their life insurance benefit to pay off their mortgage debt. “However, they decided to use the money to do the family things they had always wanted to do before Bob passed away.”

Sadly, Bob died on 19 June 2012.

As part of his advice process, Robert and his team subsequently made enquiries with Bob and Mary’s insurer as to whether they were entitled to an additional life insurance benefit payment. “You see, in our view, Bob was terminally ill before he reduced his life cover. He just didn’t know that at the time,” explained Robert.

After a thorough investigation the insurer, AIA Australia, concurred with this assessment, and agreed to pay out the full benefit for which Bob had originally been insured, before he reduced his cover in 2011.

The additional payment (which doubled the original pay-out) was hand-delivered by Robert to Mary: “It was our pleasure to meet with Mary and deliver a cheque she was not expecting.”

“In this day and age we don’t often hear all the good things that happen above and beyond the call of duty,” said Robert.

*Clients’ names have been changed to protect their privacy

Case Study – Any Occupation TPD

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In this claims case study, the adviser tells how she stepped in to help the client receive the TPD benefit they were entitled to through an industry super fund. It highlights the complexity of claims for group insurance inside superannuation, particularly when looking at the ‘any’ versus ‘own’ occupation definition.

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At a glance

Provided by: Bev Carlyon, MDRT member
Business name: Integrated Professional Services
Licensee: Matrix
Client: Barbara*
Claim type: TPD inside superannuation

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In detail

In 2009 I met with a husband and wife for a financial planning meeting in my office. During the meeting, Barbara, a school teacher, advised that she was severely injured in a tour bus accident in Italy five years previously. As a result of the accident, Barbara required continuous ongoing treatment and had only been able to teach on a casual basis. Recently, her condition had worsened and she had developed a serious, debilitating form of arthritis, to the point where she could no longer work.

In that meeting I learnt that, at the time of the accident, Barbara had ‘any occupation’ TPD cover under an industry superannuation fund. Naturally, I enquired whether the industry fund had offered her any assistance during the previous five-year period.

Barbara advised that she had originally made enquiries through the fund’s Customer Service department about what her options were, and had been told the insurance would stay in place even if her employer was not paying into her super fund. There was no mention of how to claim, or indeed if they could refer her to someone who could assist.

After hearing her story in our first meeting, I commenced enquiries with the fund as to how I could assist with what looked like a TPD claim.

The industry fund had changed insurers three times since Barbara’s accident, and this potential claim became a ‘hot potato’ – a  little like musical chairs with all the insurers hoping the claim would not ‘land on them’. You can imagine the questions each claims manager asked in an attempt to determine when Barbara had in fact finished work, and whether she had returned to work at any time over their responsibility period.

This claim was also hampered by the fact that Barbara had not ‘thrown in the towel’ when she was first injured; she had kept trying to return to work due to her strong work ethic and her need to feel she was not disabled.

We had to obtain a statutory declaration from her school’s Principal (now retired), confirming Barbara had eventually transitioned from full-time to part-time, and then to casual employment. It was managed this way because the school did not want to lose an excellent, dedicated teacher. (Sometimes the evidence for claim is not just about the physical health of the client!)

The three-year struggle came to an end with the industry fund recently agreeing to pay her claim.

I believe our credibility as financial advisers stands or falls at claim time. Over the last three years the professional relationship I have built with Barbara’s husband, an accountant, has generated many referrals; not the least of which was his own cover, including the buy sell insurance of the partnership he was in.

Whilst the claim work has been ‘gratis’, I was able to retain Barbara and her husband as clients, and have built a long-term relationship.

As an aside, when I visited the specialist with this client for her ‘independent medical assessment’ I was told that in the 30 plus years he had been in practice, the specialist had not seen another financial adviser attend a claimant’s meeting. I have also been told by claims managers that less than 20% of advisers are involved in the claims process. How can this be?

I believe turning people from prospects to clients is not just a sales transaction – we must be there when they need us. Our integrity is at stake!

*The client’s name has been changed to protect their privacy

Case Study – My Own Claims Experience (Ben Day)

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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.

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At a glance

Provided by: Ben Day
Business name: Risk Sales Tools
Date of claim: November 2010
Claim type: Income protection and trauma

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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.”

Case Study – My Own Claims Experience (Mark McNeany)

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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.

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At a glance

Provided by: Mark McNeany
Business name:  Vertex Group
Licensee: Garvan
Date of claim: July 2010
Claim type: Income protection

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In detail

Mark McNeany has been advising for more than 20 years. He and fellow adviser Chris Steiger have their own advice business, which opened in 2002, called  Vertex Group. Together Mark and Chris deliver a range of holistic advice services to self-employed business owners and medical professionals, specialising in risk insurance advice.

In July 2010, business was good and the partnership strong, when Mark was struck down with a mysterious illness. Hospitalised and severely jaundiced, Mark was subjected to numerous tests, as doctors tried to identify the cause of his symptoms. His liver function was 40 times above normal, and he was in very real danger of liver failure.

With no diagnosis and no clear picture of where this acute illness was heading, Mark lodged a claim on his income protection policy. He expressed his relief at having the claim accepted almost immediately, with only minimal paperwork required to receive his first payment. “I wouldn’t have had the mental or physical capability to deal with a problematic claim,” he said. “I was lucky I knew who to call and how the claims process worked, otherwise I would have definitely wanted an adviser to step in and take care of it.”

It was nearly seven weeks later, after seeing a number of specialists and participating in a variety of tests, that a diagnosis was made – acute hepatitis acquired through a ‘mystery’ virus. By this time Mark’s liver function had started to improve. By Christmas he had returned to work part-time, and by March 2011 had made a full recovery.

just as importantly, review your own levels of cover and get them right.

The experience crystalised the importance of insurance in his mind, especially as he was unable to work at all during the illness. “I was probably kidding myself initially thinking I would work from home, because I didn’t feel particularly unwell, I just felt very tired and was quite jaundice,” said Mark, recalling the first few days of his illness.

“I thought maybe I could take care of  a few quick emails each day, but I didn’t even have the energy to spend a minute in front of the screen.”

Mark says his own situation also demonstrates the importance of personal insurance for small business owners. Without a regular monthly payment coming in from his insurer, Mark and his family would have had to look to his business for support.

“If you are a small business owner without insurance and you suffer an illness or injury that stops you working, what do you do for income? It could mean drawing down on borrowed funds, if you have access to them, selling off assets, or drawing cash out of the business. Or, if it’s a business where you are one of two owners who participate equally, how can you make a decision to  keep paying a salary to someone who is generating no revenue for the business, while the other is running the show? It  becomes a moral issue, not just a financial one. Yes, there are alternatives to income protection insurance, but they’re not good ones.”

Mark says he has used his own claim experience with clients to help illustrate not just the value of income protection but the value of holding different types of insurance.

“Initially we find that a lot of our clients don’t quite see where trauma insurance fits in, so my example helps to illustrate that. I was sick, I couldn’t work, so my income protection paid straight away. But if I had taken a turn for the worse, if for example I had required a liver transplant, I had a trauma policy there backing me up which would pay a lump sum to both myself and to my business. And if the worst had happened, I had a substantial amount of terminal illness and death cover.”

Having avoided what could have been a significant trauma event, Mark also believes that insurance plays a valuable role in aiding recovery.

“I was running the numbers every month, and it was tighter than you expect. Going on an income protection claim is an immediate 25% pay cut! I think that if I’d had some insurance but not enough, then it would have felt like having none. I had to focus on getting better, and being with my wife and kids. If I’d had to worry about how they were coping financially, and how my business was going to pay me, my recovery would have been a lot tougher to get through!”

Mark’s message to advisers? Review your clients’ needs regularly and, just as importantly, review your own levels of cover and get them right. “Because when you call on it, you need every cent of it.”

Case Study – Young Life Cut Short

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In this claims case study, financial adviser, Ted Zappara, shares the heartbreaking story of how he lost his daughter at the age of just 22. As an adviser, he had previously insisted all his children take out life insurance, and he shares how this approach means his granddaughter will be provided for well into her future.

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At a glance

Provided by: Ted Zappara and OnePath
Business name: Cygnet Financial Group
Licensee: Financial Wisdom
Client: Lauren Zappara
Claim type: Death

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In detail

Lauren was 22 and had been out celebrating a birthday. She was the mother of our first beautiful grandchild, Ava Rose. It was a very, very hot evening so when she came home – she was staying at our place that night because we were looking after Ava – she decided to go for a swim. She simply got in the water, went to the spa side, put her head back, and fell asleep, unfortunately in the water.

We were all having breakfast the next morning and didn’t know where she was. I went outside to put the spa cover back down and found Lauren at the bottom of the pool, and had to retrieve her.

Circumstances change your life in an instant. When something happens, the best thing you can ever have is the support of everyone, including your adviser, around you.

The events of Lauren’s passing have absolutely crystalized in my mind that everybody, at some point, may have an event that will necessitate our support. I cannot be more confident of the success of our industry if we maintain the focus on being there for our clients, not just through the good times but, more importantly, through the bad times. And I believe it’s our role, in the advisory service, to not only facilitate our clients’ investments, but make sure their security, and the security of their family, is paramount.

Insurance within itself may be intangible, but it is absolutely, without any question, one of the most important facilities that any family should have.

Insurance within itself may be intangible, but it is absolutely, without any question, one of the most important facilities that any family should have.

I insisted with all my children that they had their insurance in place. We know now that our granddaughter will have financial security, basically for the rest of her life. The insurance is going to allow Ava to go to private school, and to have all of the comforts that she may want in her later life.

I would imagine that in the event that we did not have the insurance in place, the burden of financial support would have rested on her new mother, or guardian, Kelly, our eldest daughter, who was only 24 years old at that point. It’s not Ava who would have suffered, because we would have made sure that didn’t happen. But individually my daughter Kelly would have really struggled, and indeed it would have been another burden upon Eileen (my wife) and I, albeit one which we would have gladly accepted.

The knowledge and the comfort and the security of having those funds have enabled Kelly to maintain a lifestyle for Ava that would not have been possible without her insurance.

For more video testimonials to use with your clients, visit the OnePath Life Risk Tool Box on Adviser Advantage (www.onepath.com.au/adviser).

Case Study – Social Media in an Advice Business

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Two-time AFA Adviser of the Year finalist, Nick Sinclair, has successfully integrated a range of social media channels into his business marketing strategy. Nick shares the challenges he faced as a ‘social sceptic’ and how, using channels like Twitter and Facebook, he has transformed his Wealthfarm business.

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At a glance

Provided by: Nick Sinclair
Business name: Wealthfarm
Licensee: Synchron
Business start date: 2004
Head Office location: Southport, Queensland
Number of staff: 24
Social media partner: White Echo (whiteecho.com)

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In detail

Background

Nick Sinclair is not afraid to admit that he was a social media sceptic. It wasn’t until one of his clients opened his own consulting business that Nick became interested in using social media in his own firm.

“We were having a beer one afternoon and chatting about how his business was going. To be perfectly honest I didn’t believe that anyone would pay for social media consulting.

“My client said to me: ‘This is how powerful it is, Nick, watch this,’ and sent out a tweet via his mobile phone. It said: I’m having a beer with my financial adviser. He’s changed my financial situation, so happy that I moved to the coast and met him. Within minutes he had three friends who were well within my client profile tweeting back saying they’d been looking for an adviser and asked him to send through my details.

“I picked up on those leads straight away, and it made me think that maybe social media did have some merit.”

Implementation

Nick worked with White Echo (his client’s consultancy firm) to set up a business Twitter and Facebook account, and develop a social media strategy for Wealthfarm. The strategy was two-fold:

  • Generate leads by leveraging the reach of social media
  • Build deeper relationships with existing clients, leading to retention and referrals

Content which is relevant to clients – news on interest rates, economic updates, business and marketing strategies – is posted daily on Twitter and Facebook. Clients can click on the accompanying links to read the full story, or choose to share it with their own followers.

“If you want to increase your profile, and engage more clients, the most cost effective way is through social media. The reach that you have is significant,” says Nick.

By way of example, he tells how in the first few weeks of establishing Wealthfarm’s Facebook page it received 50 ‘likes’. “But those 50 people have their own networks, so that’s the equivalent of 15,000 people who you have reached with your brand.”

Social media also allows Nick to engage with clients on a deeper level than can be achieved through annual client meetings.

“Part of our fact-find process is to determine which social media our clients are active on. We’ll then ask if they’re happy for us to follow them.

“It gives you a deeper level of understanding about your clients. I can see what they’re doing on the weekend, the places they like to eat, what interests them. Most advisers have a certain level of relationship with their clients. They’re never going to increase that unless they engage with social media.”

Measuring success

Wealthfarm receives a report from White Echo each month, tracking how many comments have been received, which articles were the most widely read, and what clicks from social media have flowed through to the Wealthfarm website. This enables both parties to determine which content is engaging clients or prospects, and whether it has resulted in a direct lead.

Nick also receives feedback directly from clients: “They’re telling us in meetings about how they saw a particular article we posted. In fact, some clients that we’ve traditionally serviced over the phone or via email are now only using social media to contact us.”

Wealthfarm has now expanded its social media channels to include Linkedin and YouTube, and is even running workshops on leveraging social media for its small business clients.

Key learnings

With around 3 leads each month attributable to social media, Nick has gone from sceptic to advocate. His advice to others looking to implement a social media strategy for their business is:

  1. Use it consistently and regularly – “People are on social media 24 hours a day. You can miss opportunities if you are not monitoring it regularly. The same goes for negative commentary. If you’re not there to respond it can get out of hand quickly.”
  2. Leverage others’ expertise – “When we broke down the cost to do it in-house versus the cost to outsource it, it was chalk and cheese. It’s a lot easier to outsource it; our partner can monitor our brand across multiple channels 24/7 and notify us immediately if there is a challenge/opportunity.”
  3. Show your personality – “People don’t follow businesses so they can be ‘flogged product’. Share information about people within the business, or if you work with a charity, ask your followers to support it.”
  4. Get involved – “You can be sceptical and not do it, but if you’re trying to market and grow your business you don’t really have a choice. Social media is the new way forward. It’s only going to get bigger.”

Case Study – My First Claim (Karyn Hilton)

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Before becoming an adviser, Karyn Hilton worked as a nurse. In this claims case study, Karyn shares how this previous experience helped her identify a potential trauma claim on behalf of her client. The claim also happened to be the first she processed for a client. This case highlights the importance of researching your client’s claimable condition and also working closely with insurance BDMs to leverage their product knowledge.

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At a glance

Submitted by: Karyn Hilton
Business: William Buck Wealth Advisors
Client: Male, sole income earner, suffering from rare nervous system condition
Claim type: Trauma

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 In detail

It was Karyn’s prior experience as a nurse that led to her lodging her first claim on behalf of a client who technically was not covered for his particular condition.

Karyn recalls the event: “The client was a married father of two and the sole-income earner. He was diagnosed with a rare condition called chronic inflammatory demyelinating polyneuropathy (CIDP). I was a nurse for a long time and had heard of the condition and knew it would affect his nervous system, resulting in him being confined to a wheelchair. He had trauma cover, and even though CIDP wasn’t a listed event I figured we could try to make a claim.”

After contacting the claims department, who agreed the claim was worth investigating, Karyn got to work collecting paperwork, liaising with the insurer and a number of medical professionals, and keeping her client informed every step of the way.

“With this particular claim, I felt everything from frustration to a sense of satisfaction, that in the end I made a difference. I can still remember that phone call. I asked my client if he was sitting down. He was at work at the time, just trying to go back part-time because he had to earn an income. I said: ‘The company is going to pay you $160,000’. I heard a grown man cry at the other end of the phone. I will never forget that.”

Of particular help to Karyn during her claim was her Business Development Manager (BDM), and she recommends new advisers leverage their relationships for more than just new business.

I heard a grown man cry at the other end of the phone. I will never forget that

“What advisers need to remember is that these BDMs know their own PDS and policy terms, so they can help you determine if the condition is covered, or what benefits could be paid. With my particular claim the client’s policy had a financial planning benefit attached. I was green in the industry and didn’t know what a financial planning benefit was. I gave advice to my client, I billed my client, and, thanks to the advice from my BDM, the client got reimbursed the benefit for my services.”

Karyn was also grateful for her medical knowledge, and believes the first thing advisers should do when they receive ‘that phone call’ is to research the clients’ condition.

“Find out as much about the condition as you possibly can; if that’s on the internet, the library, or by speaking to a friend who is a doctor. I think it’s really important to put yourself in the clients’ shoes, and to get some idea what they’re going through, or about to go through.

“I would also look at a prognosis, because I’ve had to have really tough conversations with clients who haven’t approached their doctor about a prognosis and I’ve had to bring it up. To get claims paid and to guide the client in the right direction you need to know what they’re dealing with.

“Knowledge is power.”

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