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Understanding insurance claims

Insurance is the kind of thing you take out probably hoping that you’ll never need to use it.

But life happens, and every day people around the country need to make a claim on their insurance policies.

Here’s what you can expect when it comes to making a personal insurance claim.

Event happens 

The first step will be something happening that triggers a claim.

Often, this may be obvious – you need to go into hospital for surgery and want to claim on your health insurance, perhaps. But sometimes something may happen and you’re not quite sure whether it qualifies for a claim. In these cases, the help of an adviser can be invaluable to work out what you may be covered for.

Notifying the insurer

If you have an adviser, they will usually help you collect the information you need about the event, to make your claim. Often, they’ll deal with the insurer on your behalf so you can focus on managing the situation at hand. Usually, claims are submitted via an insurer’s online claim form.

Insurer checks

The insurer will then assess the information that is received against your policies and determine what it believes you are entitled to claim. If the insurer reaches a different decision to what you expect, you may be able to call on your adviser to advocate on your behalf.  Sometimes, the insurer will ask for more information.


Provided your claim meets the criteria of your insurance policy, next should be your payout. This may be a one-off lump payment, or a series of payments, depending on the type of policy you have.


If you’re receiving something such as income protection payments that continue over a period of time, your insurer may check in every so often to make sure that you still meet the criteria to qualify.

Want to talk?

Having an adviser can be a big help through the claims process. We know how it works, what to expect and can provide guidance through what is sometimes a stressful time. If you have any insurance questions, drop us a line today.

Disclaimer: Please note that the content provided in this article is intended as an overview and as general information only. While care is taken to ensure accuracy and reliability, the information provided is subject to continuous change and may not reflect current developments or address your situation. Before making any decisions based on the information provided in this article, please use your discretion and seek independent guidance.