National new claim field assessments

The process and objective

• The Insured makes initial contact with the Insurer to advise of the likelihood of a claim
• The Insurer obtains brief details during this initial contact and a standard letter is issued; the letter provides the Insured with an overview of the initial claims requirements and advises of the appointment of a representative to assist them through the assessment process
• A brief field assessment request is prepared by the Insurer and issued to The Factual Group via email
• Factual then make contact with the Insured to arrange an appointment to assist the Insured through the initial claims assessment procedure

During the field assessment interview we collect / undertake / provide:

• The Initial Claim Form
• Medical Statement signed by relevant doctor
• Privacy Consent Form
• Health Insurance Commission Authority
• Pharmaceutical Benefits Authority
• Proof of Age with photo ID
• Employment history
• Financial documentation
• Assessment Questionnaire
• Assessor Preliminary Report

While assisting the Insured through the process the Insured is informed about the claims process and the likelihood of reasonable medical and financial disclosures being required.  This understanding of the Insurers requirements and the likelihood of reasonable disclosures being requested lessen the likelihood of misinformed or fraudulent claims from the outset.

• We then prepare and submit a Full Field Assessment Report

Operatives

Through our considerable life industry background we have recruited assessors Nationally from the Life Insurance Industry. As a result our assessors are experienced in the field underwriting and/or claims management process.

Cost centres

We have one fee for all matters within a return journey of 100 kilometres from a cost centre. Given the national spread of the Cost Centres over 95% of the assessments completed to date have been based on the fixed fee arrangement. Our cost centres are as follows:

We also service the Australian Capital Territory with Canberra as the base, as well as Tasmania with Hobart as the base.