• AFRM

Case Study



“The speed in having the claim processed by AFRM has been a huge relief, given I had surgery one day after the initial consultation with the doctor.”
“Knowing that there was someone able manage and support the claim, given the bigger health concerns I was facing, was extremely reassuring.”

Thousands of Australians have been forced to re-examine their financial risk management plans and even pivot careers during the past two years because of the COVID-19 pandemic.


And many of those people have chosen to reduce or even cancel outright their life insurance covers as means of taking pressure off their family budgets during these challenging economic times.


At the same time, other people have taken the long view, examined their options and decided to keep their financial safety net in place to ensure financial security into the future.


One of the latter is Estate Agent, Michael Edwards, [actual client name used with Michael’s permission] who is thankful for that foresight now, having just had a serious melanoma surgically removed from his leg.


During the pandemic, Michael said he and his partner were in the same boat as many others and had considered reducing their cover.


“But having seen friends and family having to call on insurance in critical times, we knew the importance of maintaining it,” Michael said.


“Having seen the positive impact it can have when needed is what convinced us to keep our financial risk management plan in place.”


Michael counts himself fortunate because during a routine doctor’s visit in April 2022, a lesion on his thigh was diagnosed as melanoma and excised the very next day.


And in May, he had had follow up surgery under general anaesthetic to widen the margins around the excision, to scan and remove lymph node scans, to apply a keystone flap repair, and have a drain inserted.


Back in April, after the initial diagnosis Michael immediately contacted AFRM to let us know about it.


AFRM immediately set to work examining Michael’s Trauma with Total and Permanent Disability (TPD) Policy to determine if he had a valid claim.


This case also illustrates one of the key reasons AFRM recommends Trauma cover to our clients when it is appropriate to their individual circumstances. The benefit payment delivers flexibility to the claimant in terms of how the funds can be applied.


This is because Trauma cover pays you a lump sum in the event of suffering certain specified types of serious illness or injury that is listed in the Product Disclosure Statement (PDS).


It provides you with a pre-selected amount of money (your sum insured benefit) that you can use to pay out-of-pocket medical expenses, home and/or transport modifications, support your ongoing day-to-day financial needs and take care of your dependents as you recover.


Quantifying how much cover you need is dependent upon your preferences for funding the various potential financial commitments detailed above.


Importantly, Trauma insurance pays the benefit regardless of whether or not the trauma you suffer requires you to take time off work.


Our initial assessment of Michael’s case found there was certainly a valid claim. Michael’s policy PDS included an ‘Advancement benefit’ to be paid if the policyholder suffers “a specified medical event” – in this case, as defined by the policy, ‘Early-Stage Melanoma.’


The ‘Advancement benefit’ provided for a benefit of 25 per cent of the insured benefit up to a maximum of $100,000 for ‘Early-Stage Melanoma.’


AFRM immediately commenced the claim process, working with Michael, to submit all relevant medical documentation with the claim.


Within one month of Michael notifying AFRM of the potential claim, the insurer confirmed it had accepted the claim.


Michael was very appreciative of receiving the lump sum Advancement Benefit payment.


Needless to say, today, Michael is pleased with the financial peace of mind that came with the news of the claim outcome.


He was also thankful for having AFRM in his corner managing every aspect if the claim.


“The speed in having the claim processed by AFRM has been a huge relief, given I had surgery one day after the initial consultation with the doctor,” Michael said.


“Knowing that there was someone able manage and support the claim, given the bigger health concerns I was facing, was extremely reassuring.”


“I have had to take some time off work due to surgery. Knowing that there are funds to help cover the cost of the medical bills and my time away from work has been a huge relief, while I focus on my health, treatment and recovery.”


 

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