Claims – the case for applying

Good Returns, last week,  reported on a settlement between an adviser and a client where $30,000 was paid because the client was unhappy with the advice they received. The dispute resolution services FSCL was involved in helping to bring the negotiated settlement about. It underlined one of the less well-known sources of claim failure – where you qualify, but you didn’t claim.

I have some sympathy for both parties in the claim story (click here to read the background). The bare facts seem to be a misunderstanding: the client had a brain tumor, and called their adviser. The adviser thought it was a problem relating to a pre-existing hearing issue because the client did not describe it as a brain tumor - and so said that a claim could not be made.

It was something like two years later before the condition worsened and a trauma claim of $238,000 was paid – a decent sum, compared to most trauma policies, and still a good insurance outcome, so the adviser is to be congratulated on that.

Yet the client still made a complaint based on the fact that they had waited years for a claim they could have made earlier, and that the adviser could have helped to remove the hearing exclusion earlier. They negotiated a settlement of $30,000 under the aegis of FSCL.