Insurance Claims Assistance

Insurance Claims Assistance

Insurance Claims ManagementWhen you need to make a personal insurance claim, we're there to help.

Sapience automatically provides speciality claims assistance to all its personal insurance clients

If you're our client and you or your family needs to make a claim – relax, there's a plan in place to help and we’re here for you- Drew Browne - Director Sapience

Sapience Claims Assist is automatically available for all its insurance clients

Sapience clients are Priority #1 in claims

Our claims assist service is called Priority #1 Our clients call it a promise kept - and it's routinely included in all our insurance advisory services for all our clients.

All personal insurance claims are different

Some insurance claims are straightforward like claiming on a Life Insurance policy.

But when you need to claim for a Medical Crisis, Terminal Illnesses, a sickness or injury covered by Income Protection or a longer-term Total and Permanent Disability (TPD)  - this can quickly become a complex and drawn-out process.

Often numerous medical, psychological and pharmaceutical reports are needed to support a complex claim. Now if you’ve seen multiple doctors, perhaps you’ve moved house, maybe the original medical records have been moved to offsite storage and perhaps historical documents are held at different medical centres (that have now either moved, combined or sold) – these realities add to the delays and uncertainty.

A claim is never just about the money—it's also the acknowledgement and respect of the individual, closure, privacy and dignity (often for their family and or business too) at a very difficult time in their life.

If Sapience is already your financial adviser, relax there's a plan in place.

We’re automatically here to help you and your family (whether that’s biological or logical) through the claims process should that ever occur so that your case doesn’t stall in some claims managers ‘too hard basket’.

Tip: People often mistakenly confuse general insurance companies with personal insurance companies. We describe the difference this way: general insurance is about things and personal insurance is about, well, people.

Our claims history to date

We’ve overseen millions of dollars in claims for our clients so we know how to navigate through the life insurance claim systems and skillfully advocate for your best interests.

Tip: Did you know that a Total and Permanent Disability (TPD) claims usually have an initial 6 months waiting period before a claim can be made?

Tip: Did you know that some claims result in partial payments and degenerative health conditions like cancers, MS and Leukaemia often result in multiple claims needing to be made on the same policy over time?

The truth is Life insurance companies are in the business of paying claims

Data from the Australian Prudential Regulation Authority (APRA) shows that, for the year ending 30 June 2016, at least $8.2 billion in net policy payments were made by life insurers.

But what happens if you don’t have a financial adviser and you need to make a claim?

When you need to claim on your personal insurance policy, people without a financial adviser can often feel underrepresented and vulnerable to a corporate system of red tape, delays and uncertain futures. 

  • To make things worse, if the nature of your claim means you now have limitations on reading, writing or communicating, the DIY claims process becomes further complicated and delayed.
  • People with major head trauma or mental impairment find this the most difficult process to manage.

Our solution - Sapience Priority Claims Assistance Service

So what are the options available?

  • Take a DIY approach and hope for the best, or
  • Employ a solicitor to lodge and chase your insurance claim, or
  • Engage the team at Sapience for our Priority Claims Assistance Service (PCAS) to get your claim completely sorted.

Some people engage a lawyer to try and get their claim processed

Frustrated with the DIY approach, a potential avalanche of paperwork and uncertainty about how to practically manage a difficult personal situation, some people turn to a lawyer to lodge a claim for them.

  • A lawyer's costs are often open-ended and usually incur the lawyers hourly fee – (often charged in 8-minute increments).

What happens when the lawyers get involved?

Everything slows down...

When a lawyer submits an insurance claim on behalf of their client to a life insurance company, the claim routinely leaves the usually claims process and gets diverted to the insurance company’s internal legal team to manage.

These legal teams are usually smaller than their claims team, work slower and well – you can probably guess what this means for the speed of a claim payment.

  • The increase in time triggers delays that then trigger more work for the client's lawyers
  • which then translates to more expenses for the client and more frustration
  • Often without a fair idea of just when the claim assessment might be finalised

This is probably not what you want at this time of life.

What happens when your Sapience Adviser gets involved

First, we read the relevant policy wording to make sure we understand where you stand and what’s needed to prove the claim.

Then, we can decide if we want to work together.

  • Most people haven’t kept the best records so we then have to collect previously issued product disclosure statements
  • We get your written authority to become the servicing adviser on your matter
  • We start up an immediate conversation with the relevant insurance company and inform them of our ability to assist expedite the matter

Our Priority #1 system then takes over the process and our team works with an agreed timeline shared with the relevant claims assessor and your medical professionals.

How we get paid for the work we do?

If you're not an original Sapience client but would like to use our Claims Assistance Services, our fee is simple

  • We only get paid after you get paid. Our terms are 7 days
  • Our cost is a fixed percentage of the claims payment or a fixed fee – whatever is agreed to between us in writing.
  • Our fees are fixed for completion of the service and we do not charge by the hour (we believe that to be unethical)

Why would you choose the Sapience team and our Priority Claims Assistance Service?


When you’ve spent 10 years in courts presenting and winning cases and then combine that legal insight with 18+ years in specialist risk insurance services, you learn what’s needed and how to navigate around the different systems.

Put our significant capability into your personal situation and benefit from our expertise.

An insurance claim is for many of us a difficult part of life. How we get past that part of life depends upon what we do today to prepare for it tomorrow.

If you're looking for a Claims Assistance Service (or if you're a legal firm looking to joint venture with a particularly capable Claims Assistance Service who understands the legal process, please Contact Us Today here to see if we can help you get certainty about your situation.

Contact us today here to see if we're the type of people you'd like to work with.

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