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The Truth About the Insurance Process

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Insurance comes in several different forms, with a particular kind tailored for different types of situations. There are hundreds of forms of insurance available to cover any need that may arise.

When it comes to insurance, it will usually be divided into two main categories: personal and business. And under those two categories can be found multiple branches of insurance, related to the parent variety.

We’ve listed them down below:

Personal Insurance

      Life Insurance

      Accident and Critical Illness Insurance

      Home and Content Insurance

      Income Protection Insurance

      Tenant Insurance

      Landlord Insurance

      Lender’s Mortgage Insurance

      Travel Insurance

      Motor Vehicle Insurance

Business Insurance

      Public Liability

      Professional Indemnity

      Management Liability

      Farm Insurance

      Cyber Insurance

      Key Person Insurance

      Business Interruptions

Now that you have a better idea of the many several kinds of insurance, let’s dive into a more comprehensive insight into the workings behind them.

The Insurance Process

For most people, claiming insurance is usually a long and winding battle. Though the process may take a few twists and turns, generally, the process is divided into five stages.

First Stage: The Incident

The incident is what will be referred to as an insurable event. Take for instance, if you own an insured home, the insurable event would be if your house becomes flooded, or if it catches on fire. It can even be as simple as your window getting broken.

Second Stage: The Claiming Process

Basically, the claims process is the beginning step of recovering the insurance, right after the insurable event. In this regard, the very first thing that you should do is to get into contact with an insurance company.

But that’s not to say that you should be rushing things in this step. Take the proper time to gather composure and make sure that you’re in the right mind before talking to anyone.

To ensure that the call you make goes smoothly, keep these few simple tips in mind:

      Remain calm throughout the duration of the call.

      Prepare a short chronology of the events leading up to the incident and the nature of the incident itself.

      Provide only the hard facts.

      Avoid mentioning any irrelevant information that won’t benefit your case.

      If you can, ideally you should contact a lawyer first before talking to the insurance company. A lawyer can help you smoothen out all the statements before you make them.

However, not everyone can afford a lawyer and sometimes, you are mandated by the insurance company to make the call immediately after the incident. With this, the best thing that you can do for your case is to remember that your call is probably going to be recorded, and that any statement you make can be used against you.

Once the call is over, the insurance company will begin to identify which claims can be denied. They may also start an official investigation to prove or deny any claims you made.

Third Stage: The Internal Review

Autsralian law requires that the insurance company perform an internal review process. It is actually absolutely necessary, especially in the case that they denied your claim.

The review process may be conducted by an employee of the same company, but to avoid bias, it should not be the same person that originally took over your case.

Unless it’s proven that the decision to deny your claim was evidently wrong, insurance companies rarely ever waive their first decision.

Fourth Stage: The External Review

If the second decision has been made and you’re still not happy with the outcome, you can proceed to the fourth stage. Here, the Australian Financial Complaints Authority will intervene and try to resolve the issue between you and the insurance company.

Normally what happens is that they will try to facilitate a negotiation that could result in a compromised agreement between the two parties involved.

If the AFCA rules that the company should in fact, cover your insurance, then the company must comply. But if the AFCA decides that the insurance company doesn’t have to cover you, then you will not be held bound by that decision. If you wish, you can proceed to stage 5.

Fifth Stage: The Court Process

Because you have a contract with the insurance company, you can bring this issue to the court on the grounds that the company breached said contract by failing to compensate you.

For you to win your case, you may need a legal team to back you up. For more information regarding this, you can read more at www.gibbswrightlawyers.com.au.

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