Understanding claims

When should my client get in touch with you about a claim?

As soon as they feel they may have a possible claim. The earlier they tell us, the quicker we can start to gather any medical/financial information to help us make a decision.

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How does my client tell you about a claim?

The quickest way is by phone. We’ll gather some basic information from them about their illness/condition. They can also write to us, email us or make contact via you. We can then issue a paper claim form or complete a claim form over the phone with them.

0845 6000 493

claims@aegon.co.uk

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When will my client hear about their claim?

We issue new claim forms within 24 hours of request, and handle all correspondence within five working days of receipt or sooner. The dedicated claims assessor handling your client’s claim will maintain regular phone contact to keep them updated with progress.

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How long will my client’s claim take?

The time taken to assess a claim depends on how much medical information we need. For death claims, if we need no medical information other than a death certificate, we can complete a claim as soon as your client returns the paperwork. For a critical illness or death claim requiring medical information, it takes around eight weeks. We are however looking for ways to reduce this. Tele-claims for critical illness take significantly less than eight weeks. Income protection claims are more complex and can take up to 12 weeks. Because of this, we ask people to tell us as soon as they’re unable to work due to ill health, with the hope that a decision will be made before the end of the deferred period. If we can start assessing a claim early, we may be able to offer medical help that will allow them to return to work much sooner. We are currently looking at offering physiotherapy for certain musculoskeletal conditions.

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Is my client covered?

As soon as we’re told about a new claim, one of the first things we do is look at your client’s policy to make sure the condition/illness is covered and the policy is in force. We like to set expectations with your client as early as possible and not put them to the trouble of completing forms unnecessarily.

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How are the benefits paid to my client?

We prefer to make payments by Direct Credit straight to your client’s nominated bank account. This is a quick and safe method of transferring large sums of money. Payment is in your client’s bank account within three working days of a claims decision being made. We can also make payments by cheque if required.

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Why is a claim declined?

The two most common reasons for declining a claim are:

Claimant does not meet the definition

To have a valid claim under a critical illness contract, your client must be suffering with one of the defined critical illnesses covered by their policy at the time they took it out. They may also have to meet certain criteria.

Non-disclosure of information at the application stage

If your client hasn’t completed the application form correctly and we become aware of medical information that would have affected the original underwriting decision, we may not be able to pay a claim.

For more information on claims and non-disclosure, please read our ‘Understanding claims’ guide.

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