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Claims Case Study:

Originally published in 3 July 2019


“Thanks for convincing me to take out this Trauma cover for Julie back in the day.”

“I honestly never ever thought we would claim on it, but geez, I’m happy about it now.” “I can’t thank you guys enough!”


A number of years ago, when Paul [names changed to protect client privacy] was in discussions with AFRM about recommendations for appropriate risk mitigation measures, Paul was not entirely convinced he needed to take out Trauma cover for his wife, Julie.


The only reason he was reticent was that Julie is the family homemaker. Therefore, he perceived the family’s financial position to be more at risk if he; as the family’s breadwinner; suffered from Trauma rather than his wife.

His AFRM adviser talked him through a scenario in which his wife suffered a trauma and was unable to look after the household and their children. How might that affect Paul’s ability to continue earning an income for the family?

That was when ‘the penny dropped’ and Paul agreed that Trauma cover for Julie would be a good idea.


The above scenario is of interest because Paul is financially savvy and works in the financial sector. The point being, that even financially educated people sometimes don’t see every possible risk scenario they may face into the future.


And even when that scenario comes to pass, they are not always sure what circumstances constitute a claim.


Earlier this year, Julie was diagnosed with skin cancer and surgery was required to remove a mole and surrounding affected skin. Scans of the rest of her body were also required to ensure they had caught the cancer early enough. Fortunately, the procedure was a success.


Even with his industry knowledge, after reading through his insurance PDS, Paul was not sure if Julie’s skin cancer and treatment merited a claim under the family Trauma cover, so he contacted his AFRM adviser for a second opinion.

AFRM confirmed the circumstances merited a full claim and within a month, Julie and Paul received a payment well in excess of $500,000 from their insurer.


When his AFRM adviser contacted him to let him know Julie’s claim had been approved Paul was, at first, speechless. After taking a moment to compose himself, Paul thanked everyone in the AFRM team for the work done in managing the claim.


To his adviser, he then said:

“Thanks for convincing me to take out this Trauma cover for Julie back in the day. I honestly never ever thought we would claim on it, but geez, I’m happy about it now. I can’t thank you guys enough!”

Needless to say, the large financial payment has significantly changed the family’s financial position.


Accordingly, Paul is now re-assessing the family’s circumstances, reviewing all remaining insurances, closely considering risk mitigation requirements appropriate for their ‘new’ financial position.

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