Alan Knowles has praised insurers for paying out on retrospective claims and urged advisers to do a little extra probing of customers about existing protection policies they may have in place.
The co-managing director at Cura Financial Services spoke to Health & Protection about examples involving a client who had a benign brain tumour, another who had rheumatoid arthritis and one with bowel cancer.
The first case was from 10 years ago and involved a customer who had a benign brain tumour where they did not take any time off work. Two years on from the tumour being removed, insurers Friends Life and Legal & General both subsequently paid out onto the claim due to Cura’s involvement.
The second case involved a Vitality customer who did not make a claim for her rheumatoid arthritis as she did not think it was covered by her serious illness policy. Again, a retrospective claim was made, and Vitality paid out.
These examples follow on from a LinkedIn post from Knowles over last week about a client who had been referred to him who had had bowel cancer two years ago and was interested in taking out life cover.
Knowles explained that upon speaking to his client he established she had an existing life and critical illness plan with Legal & General.
However the client had not claimed as someone, who Knowles believes to be the original agent and not the one who made the referral, told her that she had the wrong type of cancer, and it was not serious enough to claim.
But upon being sent the detail of the cancer, Knowles became suspicious so contacted Legal & General who transferred the policy over to Cura.
He revealed the insurer helped “massively” in establishing that no claim had been made resulting in Cura making a retrospective claim for the cancer she was diagnosed with two years prior.
Knowles added that Legal & General said not only was it paying the claim, but as it was decreasing cover it was paying at the higher value it should have been in 2020, and it was refunding the premiums paid over the last two years.
The end result was just over £127,000 was paid to the client for something she did not think she could claim on.
Asking the right questions of clients
Knowles (pictured) told Health & Protection all of these cases underlined the importance of advisers probing customers properly and always asking the right sort of questions.
“Any good adviser should be asking about medical background and existing policies,” Knowles said.
“This is where the real benefit of advice comes in. An adviser will do a fact find, they will run through these sorts of questions and find out about existing policies and so on.
“If someone is just buying a policy online or if they’re not receiving advice, the agent is probably not going to find out enough information to do that.”
Knowles added advisers should also ensure they do not overpromise to clients but rather probe that little bit extra.
“They should say: ‘So, I see you have this condition – you have this existing policy, have you ever tried making a claim on that existing policy?’ – and then see what their response is,” he said.
“If it’s ‘no, I didn’t think I could’ or ‘yes, but it got turned down,’ you can decide whether you speak to the insurance company and try and find out that little bit more from them.”
Having a good knowledge of the products and what they cover should help advisers decide whether to do that, Knowles concluded.
