Everything you need to know about making a protection claim

Everything you need to know about making a protection claim

If illness or death strikes your family, a protection payout could mean the difference between living in a debt-free house and having to sell the home you grew up in. But what does a protection claim really involve? And how do you prevent delays? Read on to discover everything you need to know about making a protection claim.

 

How do I make a claim?

If you think you qualify for a protection claim, your first step is to call the insurer. If you're unsure who the insurer is, the Association of British Insurers can help you track them down.

You’ll need to provide your policy number and personal details, including your full name and date of birth. If you’re making a Critical Illness or Income Protection claim, you’ll also be asked about your illness or condition. For a life insurance claim, you’ll need to provide details about the deceased.

The insurer will guide you on your next steps, which will include filling in a claims form and submitting supporting evidence.

Which documents do I need to provide?

The insurer will ask you to provide evidence that supports your claim. The type of evidence required will vary depending on the policy you’re claiming under.

For a life insurance claim, you'll need to send the deceased person's death certificate. The insurer might also ask for a document proving your legal entitlement to deal with their estate.

If you’re claiming on a Critical Illness policy, the insurer will usually ask for copies of medical reports from your doctors. They’ll also request a signed consent form that allows them to obtain additional medical information if necessary.

Income Protection providers will ask for medical reports and financial information, such as your P60 and payslips or, if you’re self-employed, your tax returns.

How long does the average claim take?

The length of time between making a claim and receiving a payout varies enormously.

If you’re making a life insurance claim and the policy was written in trust, you could receive a payout in a matter of days. If it wasn’t written in trust, you may need to wait until probate is granted, which could take around six months. It could take even longer if the deceased died without a will.

According to LV=, a Critical Illness claim typically takes between four and six weeks from start to finish. If there’s a delay in getting medical information from your consultant or you’re still undergoing tests, your claim could take longer.

Income Protection policies are more complex and, according to Aegon, can take up to 12 weeks to assess. Bear in mind that Income Protection policies usually have a deferred period - between 13 and 52 weeks is common. Once your claim is accepted, you might need to wait up to a year before your policy starts to pay out.

It’s really important to keep paying your premiums until the insurer tells you whether your claim has been accepted.

What can I do to speed up the claims process?

There are a few things you can do to try to speed up the claims process. These include:

  • Filing your claim as soon as possible
  • Providing all the supporting documents requested by the insurer
  • Giving clear and honest details
  • Documenting the claims process, including noting down calls and retaining correspondence.

Some insurers operate a tele-claims service, which enables you to submit a claim over the phone without completing lengthy paperwork.


Why might my claim be declined?

The latest figures from the Association of British Insurers reveal 97.6% of protection claims are accepted, including 88.1% of Income Protection claims, 91.6% of Critical Illness claims, and 97.4% of term life insurance claims.

One of the main reasons for insurers rejecting claims is non-disclosure. This is where the policyholder withheld details or gave the wrong information during the application stage. For example, not disclosing a pre-existing medical condition or substance misuse.

A Critical Illness claim will only be accepted if you meet the insurer’s precise illness definition. Critical Illness policies only cover the most severe conditions. So, if you’re deaf in one ear, this won’t meet the definition of deafness, which stipulates you must have permanent and irreversible loss of hearing in both ears.

For an Income Protection claim to be accepted, you must prove that your illness or injury prevents you from working and that you’ve lost your income. Most insurers use an 'own occupation' definition of incapacity, where they pay out if you can't do the job you hold at the point of claim. However, some apply a 'suited occupation' definition, where they only pay out if you can’t do your own job or a similar one that suits your qualifications and experience.


Once my claim is paid, is that it?

With a life insurance or Critical Illness claim, your dealings with the insurer will usually end once you receive the payout. You can only claim once, so the policy will terminate. The only exception is if you qualify for a ‘partial payment’ under a Critical Illness policy.

There’s no limit on the number of claims you can make on an Income Protection policy. If you recover from your illness and return to work, you might be able to claim again in the future.

Some Income Protection providers offer services that aim to help you get back to work as quickly as possible. These include physiotherapy, counselling, complementary therapies, and access to legal and career helplines. It’s always worth asking your insurer whether they offer support services.


Get in touch

If you have any questions about the protection claims process or need help finding the right policy, please get in touch. Request a callback or call us on 03300 583 859.