In order to help you understand the process after you have submitted your claim, we have provided some commonly asked questions & answers that you may find useful:
If we hold your policy on our system, we aim to action a fully completed claim form within 3 days of receipt. If all the information has been provided we will write to inform you of our decision. If we are unable to make a decision based on the information supplied, we will send you a written request for any further information required, or advise you of who we have needed to contact to proceed. Either way, you should hear from us within 10 working days of submitting your claim.
2.0 Why would it be necessary to request further information, if I have already sent you a fully completed claim form?
Sometimes we need to obtain more specific information that was not detailed on the claim form, below is an example of when it would be necessary to write for further information;
- Important information is missing e.g. your doctor completes the claim form and states that you have had previous treatment for your condition, although we do ask for exact dates on the claim form your doctor has failed to provide specific dates. In this case we would need to write to your doctor.
- If we require a more detailed explanation of a point contained on the original claim form.
If we do need further information we will let you know what information is required as soon as possible to minimise the delay in processing your claim. If the information we have requested is not immediately forthcoming, we will continue to chase for a response on a regular basis and keep you fully informed of our progress.
3.0 Is it important to check the information provided by any third parties who complete my claim form?
Yes, it is vitally important that you check the information on your claim form provided by third parties e.g. your doctor or your employer, as these details will be used when we assess your claim. Any inaccuracies may result in your claim being declined unnecessarily and although you do have the right to appeal any decisions we make through our appeals procedures this will inevitably delay your claim.
4.0 If I am claiming for unemployment and am registered with the Benefit Agency, why do I need to show I am actively seeking re-employment and provide copies of my job applications each month?
It is a requirement that you are actively seeking re-employment throughout the period of your claim. The Benefit Agency do ask you to provide evidence that you are seeking re-employment and you may feel we are asking for duplicate information, but sending this evidence directly to us as well allows us to ensure this requirement of the policy is being met.
We will therefore on a monthly basis, ask you to provide us with the names and addresses of the companies you have approached for employment, along with copies of the replies you have received from prospective employers regarding the applications you have made.
5.0 I am unemployed, but I am unable to get the employers section of the claim form completed, what do I do?
We would prefer that the claim form is fully completed by your employers, or liquidators, as the questions contained therein are necessary to ascertain the validity of your claim, however, if you are unable to get the form completed, please provide the following:
- A copy of your contract of employment
- Wage slips for 6 months prior to your unemployment
- A copy of your P45
- Your employer's or liquidator's full address details
- Where appropriate, a copy of your termination letter
You will be notified when your claim has been accepted and we will confirm the date your first benefit is due to be paid. Some policies have an initial wait period during which you will not be paid any benefit, if this is the case, we will advise you accordingly. The duration of this wait period will depend on your policy and will be noted in your policy schedule/document, but see the example provided below for further clarification.
- A claim occurs on the 01/06/2008 (if sickness, this will be the date you last worked or your doctor signed you unfit to work. If unemployment this date will be the date you registered as unemployed or the date your wages in lieu of notice expired)
- The initial wait period is 30 days 01/06/08 - 30/06/08
- The first payment will cover the period 01/07/08 - 30/07/08
- The first payment of benefit will be due on or after the 30/07/2008, as payments are made in arrears
If your claim is for unemployment and you received payment in lieu of notice, no benefit will be considered for this period, and your wait period (if applicable) will start from the date your payment in lieu of notice ends. If you have received a redundancy payment, this will not affect the start date of your claim.
- Customer employment ends and they register with the Benefit Office 02/06/08
- Wages in lieu of notice were paid for the period 01/06/08 - 01/07/08
- The initial wait period is 30 days 01/07/08 - 30/7/08
- The first payment of benefit will be due on or after the 29/08/08, as payments are made in arrears
This will depend on the wording of the policy you have. Payments will be made to either you, your lender, or credit card account. You will be informed each time a payment is made of the amount, the period the payment represents and where the payment has been sent to. If you provide us with your mobile number we will text you when a payment is made to keep you fully updated. If payments are made by Direct Credit to your bank account, this can take up to 5 days to clear, depending on your bank.
You will be sent a Continuing Claim Form each month, along with your payment advice letter. This form should be completed on or after the date specified on each form. The Continuing Claim Form should provide sufficient evidence from your doctor or Benefit Office and evidence of your continued job search, for further payments to be considered.
On a sickness or accident claim, depending on your condition, it may be appropriate to offer you a service where it is not necessary for you to complete a form each month. Instead we will call you on a monthly basis prior to your payment being due to get an update on your condition, and to ensure before payment has been released that there has been no change in your circumstances.
Please contact us on 020 8207 9050 and we can either amend your details over the phone or send you a new Direct Debit/Credit Card Mandate.
Most policies specify a maximum number of 12 payments that can be made for any one claim although this can vary, you will need to check your policy document/schedule for details.
Please put your request to cancel your policy in writing, ensuring that it has been signed by all the people named on the policy.
Yes, it is possible. You will need to refer to your policy documentation to check if any exclusions apply to you, but an example of a common exclusion for sickness is "pre-existing medical conditions". This is where treatment has been received before the policy start date. A common unemployment exclusion would be if you resigned rather than were made involuntarily unemployed.
We do allow customers to undertake temporary employment, please contact our offices and we will advise you accordingly.
Yes, this is common to most types of insurance, although some policies do include the premium in the claim payments. Please refer to your policy document for information regarding the ongoing payment of premiums.
It is important to keep us informed if your circumstances change, please contact our offices and we will update your claim immediately.
TABLE OF CONTENTS
- 1.0 How long will I have to wait for a reply after I have returned my claim form?
- 2.0 Why would it be necessary to request further information, if I have already sent you a fully completed claim form?
- 3.0 Is it important to check the information provided by any third parties who complete my claim form?
- 4.0 If I am claiming for unemployment and am registered with the Benefit Agency, why do I need to show I am actively seeking re-employment and provide copies of my job applications each month?
- 5.0 I am unemployed, but I am unable to get the employers section of the claim form completed, what do I do?
- 6.0 If my claim is accepted, when will I receive my first payment?
- 7.0 Here is an example of a typical payment schedule:
- 8.0 Here is an example of a typical payment schedule, where wages in lieu of notice were paid:
- 9.0 Where are the benefit payments sent?
- 10.0 What happens in the months following my first payment?
- 11.0 How do I change the account my payments are coming from?
- 12.0 What is the maximum period I can claim?
- 13.0 Can I cancel the policy?
- 14.0 Is it possible that my claim will not be accepted?
- 15.0 What do I do if I am offered a temporary job during the course of my unemployment claim?
- 16.0 Do I have to keep paying my premium while I am claiming?
- 17.0 What do I need to do when I return to work?