Four steps to successfully secure a serious illness insurance payout

Discovering that you have a serious illness is a frightening and emotional experience, but claiming from your insurer shouldn’t be.

Successfully navigating the claims process is crucial to ensure financial support during such challenging times. 

Understanding serious illness insurance

Serious illnesses, also known as critical illnesses, include conditions such as cancer, heart attacks, strokes and other severe health issues.

Serious illness insurance usually provides a lump-sum payment if you are diagnosed with a covered illness. This payout can be used to cover lost income or other financial burdens that arise during treatment and recovery.

Policies vary, so it’s essential to understand what illnesses are covered and the specific terms of your policy.

Let’s take a look at the example of Anathi, a 45-year-old mother of two, who was diagnosed with breast cancer. Fortunately, she had a serious illness insurance policy in place and here’s how she successfully claimed her insurance payout:

1. Immediate notification: Upon diagnosis, Anathi promptly notified her insurance company. Early communication helped set the claims process in motion quickly.
   
   
2. Gathering documentation: Anathi collected all the necessary medical records, including her diagnosis report, treatment plan and physician statements. These documents were crucial for substantiating her claim.
   
   
3. Understanding policy terms: Anathi reviewed her policy with her financial adviser to understand the coverage and any waiting periods or exclusions. This knowledge helped her anticipate what to expect from the claims process.
   
   
4. Clear communication: Throughout the process, Anathi maintained clear and consistent communication with her insurer, ensuring all required information was provided promptly.
   
   
5. Receiving the payout: Within a few weeks, Anathi received her lump-sum payout, which she used to cover medical bills and support her family during her treatment.

Steps for success

According to John Kotze, Retail Protection product manager at Old Mutual, an insurer that paid out R14.1bn in claims in 2023 alone, the steps you need to take to secure a successful payout include:

1. Knowing your policy: Speak to your financial adviser or your insurer to fully understand your policy’s specifics including inclusions and exclusions, so that you know what to expect and what is required to make a claim.
   
   
2. Notify your insurer promptly: The sooner you start the process, the sooner you can expect your claim to be processed. This also ensures that you are informed of all the information required and provided with assistance to expedite your claim. 
   
   
3. Comprehensive paperwork: Accurate and complete documentation, such as medical reports, test results and statements from your doctors, will validate your claim more efficiently. 
   
   
4. Keep communicating: Don’t be scared to follow up and communicate with your financial adviser or insurer; this can prevent delays and misunderstandings. 

Successfully claiming insurance for a serious illness requires you to understand your policy, take prompt action, submit thorough documentation and keep communication lines open. Your financial adviser and insurer can help you navigate the claims process more effectively and secure the financial support you need during such critical times.

For more information on Old Mutual’s illness cover solutions, visit the company's website.

This article was sponsored by Old Mutual.