Claims

A Claim Declined

Insurance providers pay claims. Obviously - but what makes a claim valid or not is the WORDING of the Contract. Your insurance policy, being a contract, is subject to legal obligations and legal limitations.

Recently a friend – let’s call him Pete - was diagnosed as having a gene mutation that meant he had an 80% chance of developing a hereditary form of stomach cancer that is incredibly difficult to detect, until it is at what is terms “Stage IV”. At that point, death within 12 months is the most usual outcome.

A Claim Delayed

Part of my business involves servicing a number of clients for an older adviser who has retired. I recently reviewed one of these clients – let’s call her Viv. Viv and her husband are in mid & late 50s. Viv earns around $65,000 p.a. but her husband has been in and out of work since being made redundant at age 58. They were under considerable financial pressure.

In the course of our conversation, I asked Viv about an odd blank-like space on her  iris.  She explained that in 2008 she was diagnosed with a melanoma on her iris and it had been surgically removed.

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