Review of Denied Claims - indclaims
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REVIEW OF DENIED CLAIMS
Assessing acceptability for claim benefits is not always clear cut and oftentimes interpretation of policy terms and conditions is required.
Using ICM’s long-term experience provides an organisation with the ability for an independent consideration of such interpretations.
Using ICM’s long-term experience provides an organisation with the ability for an independent consideration of such interpretations.
In today’s environment more and more declined claims are being referred to the Superannuation Complaints Tribunal and Financial Industry Complaints Board as there is no cost to the insured person to do so.
Most Superannuation Fund Trustees do not see many total and permanent disablement claims so their expertise in this area is not as strong. ICM can provide an expert, impartial opinion.
The Superannuation Complaints Tribunal refers to a Best Practice Paper issued by ASFA which comments on the independent review of declined claims.
It would be an advantage to Trustees to be able to state to members and the SCT that the file had been referred to an independent expert for a second opinion.
This would support the concept that the Trustee acted in a “fair and reasonable” way.
It would be an advantage to Trustees to be able to state to members and the SCT that the file had been referred to an independent expert for a second opinion.
This would support the concept that the Trustee acted in a “fair and reasonable” way.
