Claims

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Process.
Evidence.
Payments.
Fraud.
Claim mitigation services.

Claims process

Mortgage protection insurance claim can involve the benefits being paid over a long period of time. Therefore the claims process needs to allow for a regular reassessment method to ensure that the customer is still unable to work.

The process can be split as follows.

Notifying the claim to the insurer.
Registering the claim by the insurer.
Verifying cover.
Assessing the claim. E.g. covered or not covered.
Planning how the claim will be handled.
Payment.
Review.

Notifying the claim to the insurer

There are two basic options.

The customer completes a claim form obtained from the lender or insurer direct. The form is completed by the customer and then either sent directly back to the insurer or sent first to the lender, who confirms the cover and the insurer then passes it to the insurer.
The alternative is for the matter to be completed by phone. This is more customer friendly and quicker. The customer phones the insurer direct and the form is completed on the phone. The insurer checks cover with the lender if the insurer does not have that information, and then the completed form is sent to the customer to sign.

Registering the claim

If the written format is used, then the claim form is entered onto the computer system when it is received and a claim number allocated. If the claim is notified by phone, then the information is entered directly into the computer system, which then generates the claim form.

Verify cover

This verification is to make certain that the insurance certificate is valid and current for the date of loss, getting the loan details and checking any premium payments. This is usually all now done by computer. There may be separate computer systems holding the different data, and these may have to collate together for full verification.