Case Studies

Insurance Companies are complex!

Think about your insurance for a minute. What do you know about it? I guess you know how much it is costing, but do you know what type of cover you have got? Do you know how much cover you have? How does this compare to what amount you really need?

We pride ourselves on getting to the bottom of what you are paying for. Sometimes when we put an existing policy under the microscope, we find abnormalities. 

Here’s a couple of examples of where it was totally wrong:-

Over charged premiums refunded

Mr and Mrs Q asked Richard to check several policies they had amassed over the years, and advise on what they needed going forward. One of the policies was with a well known insurance company. It was a savings plan, with a heap of insurance benefits within it. This included life insurance and a “we pay your premium benefit” on Mr Q.

Donna obtained information about the policy, when Richard looked at it the premiums being charged for the “we pay your premiums” benefit he was horrified. They were being charged nearly 10x the true cost for the benefit. Richard wrote back to the Company and asked them to check. They said the premium was correct, but he kept questioning the insurer, even though they were adamant there was no mistake. He argued and argued, and eventually, they realised there was an error and refunded more than $12,000 in overpaid premiums.

Richard helped the couple to identify what was important for them, in terms of insurance cover. He went on to tailor a portfolio that suited their needs. It included some of the existing policies and some new insurance. When Mr Q died a couple of years later, both Richard and Donna helped with the claim settlements, and more than a decade on they still look after insurance for Mrs Q.

Potential claim decline avoided

Richard took over a client who had an existing policy, on which there was income protection. When Richard submitted an application to increase the cover, it was declined. Later, the insurer stated the condition must have been present when the original application was made. The Company was within a hair’s breadth of cancelling the contract, when Richard took up the case on behalf of the Client.It took quite a bit of time and effort, but the Insurance Company eventually conceded that the Condition had developed after the Insurance first started.

Had the problem not have been identified and addressed, the client would have likely been declined a claim ,if he had gone off work due to accident or illness.

Premiums charged for an excluded benefit

While reviewing a Client’s policy, Richard found that one of the benefits had an exclusion. The cover was for Trauma with a Total and Permanent Disablement extension, that the Client paid extra for. However, the insurance, in turn, had an exclusion added excluding payment for Total and Permanent Disability. So the Client had paid for something they were never ever going to be able to claim.

After negotiation with the Insurer, the Client was refunded $1300.

The Clients now pay the correct premium for their policy, for a policy that will work for them.

Sometimes it takes an educated eye to spot those things. Either place your trust in professionals, or take pot luck and hope she’ll be right.


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