The vast majority of claims run smoothly through the insurer’s channel – the broker’s work begins where the routine ends: with stuck and disputed cases. This article describes exactly what I can help with in these situations – and what I cannot.
- The primary route for filing is always the insurer’s phone line – it’s the fastest, and it’s not worth bypassing.
- For a hold-up, the broker asks questions and interprets – for a dispute, the broker helps with the reasoning and the steps of the complaints process, where he can.
- My principal is the family, not the insurer – I help where I can; I do not provide legal representation.
What counts as a hold-up, what counts as a dispute?
A stuck case: the process has come to a halt for no real reason – no answer, it’s unclear what’s missing, repeated requests for additional documents keep coming. A disputed case: the insurer’s decision isn’t acceptable to the family – a rejection, a smaller amount than expected, reference to an exclusion or exemption from liability. The two are a different kind of matter: the first needs momentum, the second needs argument. I have a role in both – but with different tools.
What do I do in a stuck case?
At the client’s request, I help clarify exactly what’s missing – the additional documents and the claim notification go through the insurer’s own channel. Often that’s enough: a case starts moving again simply because someone asks regularly and precisely. What I don’t do: I don’t promise special treatment – no one can honestly promise that. Momentum comes from order, not from volume.
What do I do in a disputed case?
First, I interpret: I compare the reasoning behind the decision with the policy terms – sometimes the decision turns out to be correct, just poorly explained; I say that honestly too. If the reasoning can be challenged, I help put together a request for review: facts, references to the relevant terms, documents. If that doesn’t lead anywhere either, the formal complaints route follows: the insurer’s complaints procedure, then the consumer-protection and arbitration bodies – I give factual information about how these work, and for the stage that requires legal representation, I recommend bringing in a lawyer.
How can help be requested?
My clients’ families simply get in touch – my contact details are in the materials handed over when the policy was taken out, and also on this site. If the policy wasn’t arranged through me, I’ll still review the situation and tell you what I see in it: I don’t charge for that advice either. One request: if you suspect a case is stuck, it’s worth getting in touch soon – the fresher the case, the easier it is to move.
Have a question about your own situation? Let’s talk it through, calmly – 20 minutes, free of charge →
