What can an insurance adviser help with during a claim?

FMA says some insurance advisers can help with claims. Ask what your adviser can do for this policy, which tasks remain yours, any applicable fee and what authority the insurer needs.

A policyholder receives a claim acknowledgement followed by a request for supporting records. They are unsure whether the request repeats an earlier one. With the agreed authority, the adviser helps list what was requested, what was sent and what still needs clarification. The policyholder checks the factual details; the insurer continues its assessment.

This illustrative scenario combines common enquiry questions and does not correspond to any real client. Actual policies and outcomes depend on personal circumstances, policy terms, underwriting and the insurer’s decision.

Fidelity Life’s published guide allows a nominated support person and explains that an adviser can help gather documents with consent. AIA’s process also offers adviser or direct lodgement. These are examples of those insurers’ processes, not evidence of iCare’s insurer panel or an included service.

The insurer decides the claim initially. An adviser can ask questions or help present relevant information, but cannot make the insurer accept a claim. If the decision is disputed, the provider’s complaint process and the appropriate independent dispute resolution scheme may offer a review route.

This is general information. Personal advice requires current written disclosure and assessment of your circumstances. Claim requirements, amounts and timing remain policy-specific. No medical, legal or claim-outcome assessment is made here.

Use a simple request log to avoid relying on memory. Keep it in your own secure records.

Read forms prepared on your behalf and correct anything inaccurate. If a record is unavailable or you cannot remember a detail, explain that and ask what alternative evidence may be acceptable. An adviser’s assistance does not turn an estimate into a verified fact.

Fidelity Life’s guide explains that additional information may be needed during assessment. A request for more documents does not establish the final outcome. Ask which item remains outstanding and avoid assuming silence means approval.

Ask for the reasons in writing and identify the specific term or fact you want explained. Keep a concise timeline and say what you would like reviewed. Consumer Protection describes contacting the provider and, where needed, its financial dispute resolution scheme for help.

Check which scheme covers the provider involved; the insurer and adviser may belong to different schemes. Confirm the applicable process and deadlines directly. Keep medical, identity, policy and banking records out of the website contact form; arrange an appropriate secure channel.

Q: Must I use an adviser to lodge a claim? A: Check your insurer’s process. The insurer examples cited here include direct lodgement routes.

Q: Does help with paperwork mean the claim is accepted? A: No. Lodgement and document collection are steps before the insurer’s decision.

Q: Can an adviser promise when payment will arrive? A: A general article cannot establish that. Ask the insurer for the current status and any outstanding conditions.

Q: What should my first enquiry contain? A: A brief description of the help you need and your contact details. Arrange document sharing separately after confirming scope and consent.