• AFRM

Claims Case Study:

Originally published on 7 August 2019


“…a huge thank you for being my advocate and all your help with processing my claim but most importantly asking if I was OK all those months ago when I contacted you to talk about my policy options.
“If you had not asked me if I was OK, I would still be suffering in silence and wouldn’t have sought the medical help I need.”

In January this year, AFRM adviser Dan Musumeci met with client Emma [name changed to protect client privacy] and her husband to discuss cutting back their insurance cover in the wake of their finances taking a hit over the previous 12 months. Her husband was not working and income from Emma’s own consulting business was down significantly because she had not been actively pursuing new business for quite a while. Dan cautioned that cutting all insurance cover may not be the best option to protect the client’s long-term best interests. That said; the meeting concluded with Dan agreeing to obtain alternative quotations for the sake of the couple making some comparisons before finalising a decision on what they would do next.

Dan followed up with a phone call to Emma in February with the promised information and it was during that conversation that Dan suspected a deeper undercurrent needed investigation. “I asked her if there was anything that was wrong,” said Dan.

“And at this point, she broke down and advised that she had been dealing with a lot of stress and anxiety lately.
“They had more than $1.5m in debt, husband wasn’t working and with her income being almost non-existent, they were looking to put the home on the market.”

Through the course of the conversation a light was gradually shed on a much larger landscape of circumstances that had cumulatively led to that point in time. A friend of Emma’s had suffered an accident while helping Emma move business premises back in 2018. The accident had led to Emma becoming sad and anxious. As a result, the business suffered because Emma started putting off new work and only doing the bare minimum of what needed to be done. This, in turn, led to the loss of a major client and the drastic reduction in Emma’s income. Discovering this broad range of contributing factors convinced Dan that Emma needed more help than he could provide alone.

“I asked if she had spoken to her GP and she said she hadn’t. So, I asked her; as soon as we finished the call; to call her GP and talk to them about what had been going on in her life,” Dan said.

Dan kept checking in with Emma over the following months and learned that not only had Emma been formally diagnosed with depression, but she had also commenced counselling sessions with a psychologist to treat the condition.

Fortunately, because of the advice received earlier from Dan, Emma still had her Income Protection (IP) insurance in place and now Dan flagged to Emma that her current circumstances merited a claim. A subsequent claim on Emma’s IP insurance was approved ‒ and by mid-June Emma received her first payment in excess of $30,000. The terms of Emma’s policy mean that she will continue to receive payments until either she goes back to work at normal capacity, or until the age of 65. Upon hearing that her claim had been approved, Emma sent the following note to Dan:

“Thank you, thank you, thank you!! You are an angel.” “I received an SMS message last night from [the insurer] advising of the processing of the payment.”
“Many tears have been shed since - tears of utter relief. The processing of the claim couldn’t have come at a more needed time.” "I wouldn’t have been able to make the mortgage payment next month, so a huge thank you for being my advocate and all your help with processing my claim but most importantly asking if I was OK all those months ago when I contacted you to talk about my policy options.” “If you had not asked me if I was OK, I would still be suffering in silence and wouldn’t have sought the medical help I need."
“I cannot thank you enough.”
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