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I wanted to share this information with you, as you may find it helpful. Earlier this year I successfully made a claim against my life insurance policy. I have metastatic breast cancer and realised that I needed the money now - it wasn't going to be any use to me once I was dead. Here is what I did.
Firstly, I made several attempts to gain correct information. My financial advisor said I would not qualify (for ‘terminal pay-out') and when I rang the Insurance Company, their first response was also the same; neither party was encouraging. On reading my policy document I discovered the information I needed and again contacted the insurance company; I read from the document, asked to speak with a ‘senior' claims assessor from the team and they agreed I had grounds for submitting a claim.
I am not sure whether all life insurance policies have a ‘terminal' payout. I suspect that most will have. There are also some insurance policies that have ‘critical care' clauses that you can also access money through - total/permanent disability on some policies. Superannuation is also another avenue to investigate as this money may well be paid out in circumstances of advanced breast cancer.
The grounds for claiming as stated by my insurance company was that I had to be diagnosed with a ‘terminal' condition - their requirement was also that my medicos considered that I had less than 12 months to live. Having advanced breast cancer placed me in this category.
The next step was to have the forms sent out, and I filled in as much as possible. I provided every bit of information I could. I typed a letter about the difficulties I had with daily living, financial circumstances (ie, that I was on a disability pension) etc. I knew that I needed to provide a lot of information - ‘information overload' is needed here. I also obtained a letter from my GP outlining the difficulties I was experiencing on a day to day basis.
The treating doctor must supply a report and my oncologist did this. At first the insurance company was not satisfied with his report as under their conditions ‘terminal' needed to be less than 12 months to live and this had to be stated by him. Insurance companies don't like parting with money and each request led to another request for information.
My oncologist was prepared to state that I did have less than 12 months so that I could access my benefit - I was very grateful. (But so he should as he does not have a crystal ball and would find it difficult to make a statement otherwise!).
I must say when I read his report, I found it very confronting seeing the facts in black and white, and knowing that what he'd written may be a possibility - but on the other hand I may be around for a long time!
I finally received the cheque after five months. The insurance company rang to say that they were going to grant the claim. On receiving the cheque I did not feel much joy - it was not like winning Tattslotto! It took me three days before I told the family and I just wished I could have had the money some other way!
Once it became imminent that the claim was to be paid I found the Insurance Company most helpful, and understanding.
There are a few important things I think you need to do when making a claim:
- write in diary the day and time you spoke to the insurance person
- always ask for their full name and try to deal with the same person
- ask if they have a direct phone line to make contact easier
- photocopy absolutely everything that you forward to them and write the dates on your copies of when you posted
- if they ring, let the call go through to your message machine so you have a record of what they have said (if available)
- I can't emphasise enough the importance of keeping accurate and concise records of all communication.
I hope my experience may be of help to others living with advanced breast cancer. Gaining access to my life insurance has certainly made some aspects of my life easier. Best wishes.
Judy, Victoria, August 2005
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