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Claims Case Study:

Originally published on 4 December 2019



“The medicos’ latest suspicion is that I’ve had Acute Viral Encephalitis, from which I can make a full recovery. “Fingers crossed. "All my friends joke to me about whether I have good insurance in place and I assure them I have. "After my 30-day waiting period, my income protection policy commenced. "All of a sudden, I was a claimant of AFRM. "And I can honestly say it’s a pretty good feeling.”

My current claim makes what AFRM does very real.


In May 2019, my wife Simone and I were on a long coming (and I’d say well deserved) Europe holiday. We’d already had eight days in Switzerland and were enjoying our eighth night and midpoint of what was a fabulous Scenic river cruise along the Rhine and Moselle rivers.

However, on that eighth night, Simone woke up to find me awake, standing in our cabin, holding my head and cursing fiercely (words that have no place in a communication such as this).


Basically, at the time my “lights were on and nobody was home.” I have no memory at all of the next three days.


When I became “conscious” again I realised I couldn’t tell the time on a clock or use a knife and fork. I knew it was a clock. I knew it was simple maths, but I couldn’t work it out. I slowly became competent again over the next five days but there’s still a piece of that time missing.


This condition, or episode, was a mystery to all. I had the best medical care in Germany. All my doctors on standby when I got home and I am now going through second opinions.


In all, I have been off work for seven months and nobody has been able to come up with a definitive diagnosis. I’ve had a myriad of tests, the latest of which you can see in the images accompanying this case study. It is a 72-hour EEG requiring a set of leads attached to my head for the whole period.


I’d like to think it is actually a really cool bandana and set of beaded dreadlocks, but I am pretty sure no one is going to buy that.


I’m not fully recovered and won’t be coming back to work anytime soon. The medicos’ latest suspicion is that I’ve had Acute Viral Encephalitis, from which I can make a full recovery. Fingers crossed.


All my friends joke to me about whether I have good insurance in place and I assure them I have. After my 30-day waiting period my income protection policy commenced.


All of a sudden, I was a claimant of AFRM. And I can honestly say it’s a pretty good feeling.


Because I’ve had permanent illnesses and injuries in the past, I’ve had no choice but to keep my old Lumley Life (now TAL life) and Aviva (now MLC life) policies from late 1990s.


Fortunately, my team at AFRM are very conversant with the old contracts and it was great that they could check everything. We know what’s happening around the IP claim management and TAL have been great so far. We have good communication with them.


We’ve also had a good look at the MLC “own occupation” TPD and trauma benefit. This story so talks to the need for “own occupation” TPD.


I can do some duties, enough to work, but can I do my own occupation? For the last seven months it’s been a clear “no.”


I have, of course, kept tabs on the business and its communications with our partners and clients, and have been in touch with my fabulous leadership team on management issues but I certainly have not been able to perform my role as full-time Managing Director of AFRM.


And if that continues, I’ll be making a claim for TPD (or maybe a Trauma claim, depending upon a medical diagnosis). That gives me the financial reassurance I need.

What’s been happening to me all this time is that I’m now considering all the same circumstances we, at AFRM, talk to all of you about.


Have I enough cash flow? Will I be able to work again? Is my family going to be financially secure and if I can’t work again, will I have enough to survive comfortably? At the age of 55, these are scary discussions to have with my wife, Simone.


There is always an element of doubt too. They say they can fix me, but after such a serious event, do I want to return to work in the same highly-demanding capacity as I previously worked - or even at all?!


I won’t really know until the Doctors are finished with their tests and diagnosis but you can’t help having these thoughts over and over again. As they say, you’re dead a long time.


AFRM has successfully managed more than $170m in life claims for its clients and there’s no prejudice with the selection of the claimant. I am now one too.


Don’t underestimate the importance of your risk advice.

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