{"id":75638,"date":"2025-02-07T09:51:18","date_gmt":"2025-02-06T22:51:18","guid":{"rendered":"https:\/\/riskinfo.com.au\/news\/?p=75638"},"modified":"2025-02-13T10:05:25","modified_gmt":"2025-02-12T23:05:25","slug":"advisers-challenged-to-step-up-at-claim-time","status":"publish","type":"post","link":"https:\/\/riskinfo.com.au\/news\/2025\/02\/07\/advisers-challenged-to-step-up-at-claim-time\/","title":{"rendered":"Advisers Challenged to Step up at Claim Time"},"content":{"rendered":"

A key industry service provider has called on advisers and advice businesses to exercise greater diligence when preparing and submitting claims on behalf of their clients.<\/p>\n

Trevor Battersby<\/strong>, Director and Founder of TPD Claims Support<\/a>, has told Riskinfo that sub-standard work by either advisers or their support team members when preparing clients\u2019 claims is causing needless delays or declined payments in some instances.<\/p>\n

He says while “insurer bashing\u201d is a popular sport, companies can only assess what has been submitted to them.<\/p>\n

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Trevor Battersby… advisers need to up their game at claim time.<\/figcaption><\/figure>\n

\u201cThere is minimal to no training in writing claims, and it is the most critical part of the process,\u201d he says. \u201cQuality in quality out, garbage in, garbage out.<\/p>\n

\u201cAs professionals we are in control of the claim submission and we simply need to raise our standards in this area.\u201d<\/p>\n

Battersby says a well-researched and comprehensive claim can make the process easier for everyone.<\/p>\n

\u201cA defined research and submission methodology will reduce claim time frames and eliminate ineligible claims quite quickly,\u201d he says. \u201cIt\u2019s up to us to complete a quality submission.\u201d<\/p>\n

Battersby says the most significant error he sees is lack of\u00a0medical evidence.<\/p>\n

He says advisers should check the product disclosure statement and know the difference between a medical specialist, medical practitioner, and health professional.<\/p>\n

You simply cannot submit a claim and hope…<\/p><\/blockquote>\n

“A psychologist is not a medical specialist, and we constantly see claims being submitted with a GP and a psychologist, not a psychiatrist.”<\/p>\n

He says advisers charged with completing a claim form are \u201cfuture forecasting\u201d what an insurer will look for.<\/p>\n

\u201cRemoving hurdles before they become a problem will avoid those numerous one and two-week delays on each email from the insurer requesting more information,\u201d he says.<\/p>\n

\u201cEven more pertinent is that if a client is not eligible, call it now. You simply cannot submit a claim and hope, and then blame the insurer when a claim is declined.\u201d<\/p>\n

Battersby says most of the claims his firm has been asked to take over have lacked clear evidence or the expected and necessary information required by the insurer.<\/p>\n

\u201cIf you focus on great systems and process you will minimise any litigation threat when things go wrong,” he says. “In the absence of these key submission processes you are again flying blind if you can\u2019t produce this evidence should your client seek legal advice.<\/p>\n

\u201cDo not let the insurer control the process,\u201d he says. \u201cWork hard at the start and the rest will flow.\u201d<\/p>\n

Battersby says a good claim submission should include:<\/p>\n