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  • Writer's pictureNicholas Hatherly

AFRM Client Newsletter Q1 2020

Originally published 18 March 2020

As much as we are all probably well over news associated with the spread of coronavirus (COVID-19), the fact is there has been confusion around media reporting of COVID-19's potential impacts on your insurance cover. We have also had many questions from clients enquiring about their policies and what they cover. Am I covered? Can I claim? In terms of whether you can claim on your retail life insurance serviced by AFRM, there are two important scenarios to note:

  1. Retail life insurance policies cover the insured individual for their death, disability or illness, even if they have contracted a pandemic virus such COVID-19. As long as the other policy definitions are met, then a claim can be paid. In terms of the conflicting media reporting, we can clarify some of those issues (discussed below) related to  whether or not official “government travel advice” can affect your policies.

  2. Disruption to income caused by external factors related to coronavirus are not covered. These external factors, for example, may be being unable to work due to enforced self-isolation; or if the current government prohibitions prevent you from working. For example, if you work in event management and are unable to work because all large events are currently banned. This is because the reason for the loss would not be related to the insured’s death, disability or illness.

Employees of businesses / corporations who are unable to work due to current COVID-19 prohibitions, should seek clarification from their employer about the status of your ongoing remuneration. Business owners / self-employed individuals experiencing financial loss in their business due to external factors would need to check to see if any of their general business policies provides coverage. If you are self-employed and you’re a not sure about this, we recommend that you talk to your general insurance broker to see if your policy includes business interruption and whether or not there are any clauses or exclusions that may prohibit you from claiming. AFRM are specialists only in the life insurance market and we defer to the experts on general insurance matters. COVID-19 and Government Travel Advice A report by RiskInfo on 10 March led to some industry debate because it featured part of a Financial Services Council (FSC) statement which said:

“There are no exclusions in existing life insurance policies that would prevent the policy paying out for a claim related to coronavirus if you follow Government travel advice."

Since this statement was published, the FSC has clarified and issued a further statement that reassures our industry and clients of the security of retail life insurance policies – the type that AFRM uses for our clients’ risk protection strategies. No existing retail individual life insurance policy applies any restriction on policyholders in relation to their travel activities. AFRM is therefore keen to confirm to our clients that benefits would not be jeopardised under any circumstance where an individual retail policyholder contracted and died from COVID-19, regardless of how or where contracted. Policies such as income protection and business expenses protection will, likewise, offer benefits if the contraction of COVID-19 led to the policyholder being disabled to the extent required under the policy definitions.  While total and permanent disablement policies are similar, in the fact that there is nothing to exclude a legitimate claim for COVID-19, the prospect of never being able to work again due to COVID-19 is unlikely given the nature of the virus. It is good to be covered in any event. That said, we do expect that new policy applications will be subject to scrutiny of your travel plans, as this would be normal underwriting activity by the insurer: to assess all known risks at the time of application. For example, the RiskInfo 10 March report includes a comment attributed to a spokesperson from AIA Insurance that states:

“For any new insurance applications we receive, we will take into account in our assessment any recent and proposed travel to countries where the Federal Government has raised its advice level to Do Not Travel as a result of COVID-19.”

We are, of course, happy to assist if you have any other queries in relation to COVID-19 and your insurance protection. The Federal Department of Health provides detailed information about COVID-19 here and also regular updates about the current status of the pandemic here. This quarter’s case study is an example of how AFRM’s reputation for claims management expertise often results in us being referred clients purely to manage their claims. It also demonstrates the positive outcomes we can achieve. Until next time, live your life well! Nicholas Hatherly, AFRM Managing Director


Case Study

“I’m really glad I ended up going with someone that knows what they are doing.”

It is not uncommon for people to simply stop pursuing an insurance claim because the administrative hurdles and paperwork gets to be all too much.

That was the situation when 61-year-old, James [name changed to protect client privacy], requested Total and Permanent Disability claim forms from his insurer back in 2015.

Suffering mental health and heart problems, James tried managing his own claims twice and was ultimately overwhelmed by the process each time.

Then in April 2018, James was referred to AFRM.

Amanda Anstess acted as his Claim Advocate. Over the past 18 years Ms Anstess has gained extensive experience working with insurance products, terms and conditions and has been actively involved in filing many successful insurance claims.

Ms Anstess investigated the circumstances and liaised with medical practitioners and the insurer on James’ behalf. The final medical reports to support the claim were produced after a Cardiologist appointment in August 2018.

With all the appropriate documentation put in place with Ms Anstess’ support, a Total and Permanent Disability (TPD) claim was approved and ready for payment early November 2018.

James’ total benefit was more than $200,000. This included a TPD benefit of more than $155,000 and a refund of the TPD portion of his insurance premiums going all the way back to Feb 2008, the date from which his disability was deemed to be permanent, totalling about $45,000.

"I’m really glad I ended up going with someone that knows what they are doing,” James said.

Ms Anstess said ensuring you have all the correct documentation on hand at the time you file a claim makes all the difference.

“We followed up the GP for his report and then had to await the report from the Cardiologist following James’ set appointment,” Ms Anstess said.

“Once we had the documentation everything then took care of itself. Knowing what information is required and then systematically obtaining all the information - speeds up the process. By providing as much information as you can at the same time as the claim is submitted really does improve the chances of a quick outcome,” she added.


Business NSW lauds AFRM for supporting #BackingTheBush campaign

Business NSW Chief Executive Officer, Stephen Cartwright, formally thanked AFRM this month for our support of the Business NSW’s Backing The Bush campaign.

At the height of the bushfire crisis earlier this year, Business NSW called on city-based businesses, not for profits, government agencies and sporting clubs to publicly commit to taking one meeting that would normally be held in the city to an affected regional area.

AFRM was among the first companies to pledge to hold its annual planning meeting in one of the bushfire affected communities. On 10 March, Mr Cartwright contacted AFRM to thank us for our support and to also provide an update. “With over 110 companies already taking the pledge, and the first meetings already taking place, much-needed cash is beginning to flow into affected areas.,” Mr Cartwright said. “But there is more to do. That’s why Business NSW has partnered with Destination NSW to match companies like yours who have taken the pledge with affected local businesses.” “Whether you are seeking a picturesque rural retreat for a team-building exercise, a 5,000-seat venue in Regional NSW or a suitable space for a board meeting, the Destination Team is equipped help. They can provide you with unique destination options, contact venues on your behalf, source proposals for your requirements and support you in creating a memorable event experience.” Mr Cartwright said businesses that have made a pledge can take advantage of Destination NSW’s service by visiting the Meet In NSW website for more information, or email their regional NSW Business Events Specialists, or call them on (02) 9931 1145. He also urged everyone who is interested to help build more support for those in need, by helping Business NSW spread the word by using #BackingTheBush on your social media and to share the Backing The Bush website with your contacts, clients and colleagues.


Claims Paid Update

Amazing to think that we have already reached the end of the first quarter of 2020!

We are pleased to report that AFRM is continuing to achieve positive claims results for its clients.

In just three months since our Q4 update, we have achieved another $5.5m in claims paid out to our clients, taking the total AFRM client claims paid figure to $177.7m.

This total represents 642 total claims managed for 470 individual clients.

It’s good to know we continue to be there for our clients when they need us most.

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