Making a personal/business protection claim for your clients

An inquest will be held if the cause of death is still in doubt after a post-mortem examination, or if the death wasn’t from natural causes. There are also certain cases where a coroner has to hold an inquest even if the death was from natural causes (for example if the person was in custody when they died).

It’s a legal document that shows who’s entitled to receive money on behalf of a deceased person’s estate.

If the person who died left a will, the executor(s) of the will are the ones who need to apply for this document. In that case the document would be referred to as a ‘grant of probate’. 

If the person who died didn’t leave a will, their next of kin would need to apply for the document, which would be referred to as a ‘grant of letters of administration’.

In Scotland the equivalent document is known as a ‘certificate of confirmation’

If the life insurance policy wasn’t a joint policy or life of another, we’ll normally need to see one of these documents before we can pay the claim. There may be some occasions where we’ll consider paying a claim without seeing one of them first. You or your client should contact us to discuss the individual circumstances.

Your client can apply for a grant of representation themselves, through a solicitor or any person licensed to provide probate services.

With most types of policy we’ll cancel the direct debit as soon as we’ve been told that one of the people covered has passed away. If too many premiums have been paid, we’ll refund them.

However, for joint life second death whole of life policies, the premiums will still need to be paid up to the passing of the second life.

A trust is a legal document that allows for named persons to benefit from the policy proceeds in the event of a claim. Trustees will be responsible for ensuring the money is dealt with in accordance with the trust. This may involve paying the proceeds straightaway or holding the money for future use (for example, a parent might nominate their children as the recipients of any payout).

The trust can speed up the process of a life insurance policy paying out as it usually does not require a grant of legal representation.

An interim death certificate may be issued if the death is referred to a coroner and an inquest is opened. We can accept them, but we’ll usually need to ask the coroner to give us some more information before we can start to assess your client’s claim. In some cases they’ll need to wait until the inquest has been completed before we can start to assess a claim.

Usually, the money from joint policies goes to the surviving policyholder and the money from single life policies goes to the deceased’s estate. If the policy was set up in trust or assigned to a mortgage lender, the money will go to the trustees of the trust, or the mortgage lender.

Without knowing the details of the claim it’s difficult to say how quickly we’ll be able to make a decision. It depends on what type of claim is being made and how complex it is. However, we’ll be able to give a better idea once we’ve received some details.

We are likely to need the original death certificate (and the original grant of representation if required). We'll return these as soon as we possibly can.

Because it means we’ll be able to deal with their claim more quickly. Once your client has told us they want to make a claim, one of our claims assessors will speak to them and complete the claim form for them over the telephone. If they wish, they can complete the form themselves and post it back to us, but this is likely to slow down how quickly we can deal with their claim.

We explain what conditions your client is covered for in the policy terms and conditions, when they first take out their policy. If they’re still not sure or can’t find their policy terms and conditions, please ask them to get in touch.

For a stand alone critical illness policy the money will be paid to the policyholder. 

If they have a life and critical illness policy this will be paid either to them, or if the policy was set up in trust or assigned to a mortgage lender, the money will go to the trustees of the trust, or to the mortgage lender.

If your client isn't sure who’s entitled to the insurance money from their policy, they will need to contact us.

It depends on what type of cover your client has.

If your client has life and critical illness cover or stand alone critical illness cover, the policy will come to an end.

If they have life with independent critical illness cover, their life cover will continue, so long as they keep paying their premiums.

For additional critical illness claims and children’s benefit claims, the policy will continue.

If your client isn't sure what sort of cover they have, they can find out by checking their policy documents or by contacting us.

Additional critical illness provides cover for less severe conditions at no extra cost. Any claim under this benefit won't affect any future claims they make for critical illness - they'll still be covered for the full amount. Each person covered by the policy can claim a smaller lump sum once for each additional critical illness condition. 

It depends on what type of cover your client has. If your client has life and critical illness cover or stand-alone critical illness cover, the entire policy will come to an end on the first valid claim. If the policy remains in force (where the claim is for independent critical illness or additional critical illness), their partner's cover will be unaffected. If your client isn’t sure what sort of cover they have, they can find out by checking their policy documents or by contacting us.

Without knowing the details of your client’s claim it’s difficult to say how quickly we’ll be able to make a decision on it. It depends on what type of claim they’re making and how complex it is. However, we should be able to give your client a better idea once we’ve received some details from them.

One way your or your client can make sure their claim is paid as quickly as possible is to allow us to complete the claim form over the telephone with them, rather than filling it in themselves and posting it back to us.

Yes, as long as they give us their permission to do so. However, it is easier if we deal with you or your client directly because this gives us the best chance of getting the information we need need right from the start.

Any biological, legally adopted and/or step-children your client has. For details of ages of children covered, please refer to your client's policy booklet.

No. Their policy – including their own critical illness cover – will carry on as normal so long as they keep paying their premiums.

The amount of money they will receive is detailed in their policy booklet. If they're not sure, or can’t find their policy booklet, please ask them to get in touch.

Because it means we’ll be able to deal with their claim more quickly. Once you or your client have told us they want to make a claim, one of our claims assessors will speak to them/you and complete the claim form  over the telephone. If they wish, you/your client can complete the form and post it back to us, but this is likely to slow down how quickly we can deal with the claim.

The money goes to whoever’s entitled to it according to how your client’s policy was set up. Usually this will be the person(s) covered by the policy. If the policy was set up in trust or assigned to a mortgage lender, the money will go to the trustees of the trust, or to the mortgage lender.

Yes, as long as they give us their permission to do so. However, it is easier if we deal with your client directly because this gives us the best chance of getting the information we need right from the start.

Without knowing the details of your client’s claim it’s difficult to say how quickly we’ll be able to make a decision on it. It depends on what type of claim they’re making and how complex it is. However, we should be able to give your client a better idea once we’ve received some details from them.

One way your or your client can make sure their claim is paid as quickly as possible is to allow us to complete the claim form over the telephone with them, rather than filling it in themselves and posting it back to us.

Total permanent disability benefit pays out if your client suffers a ‘total and permanent disability’ due to illness or injury. 

We have two different definitions of what qualifies as total permanent disability: own occupation and activities of daily living. Whether your client qualifies for a payout will depend on the nature of their disability and which definition applies to their policy. Your client can find this information in their policy booklet, or by contacting us.

This helps us to confirm that your client has suffered a total permanent disability. Doing this helps us confirm that all the necessary medical investigations have taken place, that all treatment options have been exhausted and that your client has co-operated fully with the treatment given.

Yes, if the type of incapacity they’re covered for relates to them not being able to perform an occupation (ie if they’re covered on an ‘own occupation’ basis).

Yes, they should pay their premiums until we have made a decision. If any premiums have been overpaid we will refund these. If we have to reject their claim, we'll contact your client to tell them why.

We'll pay the money into their bank account electronically by BACS. We pay each benefit payment monthly in arrears.

If their policy includes a back to work benefit this will be shown in their policy conditions. So if your client goes back to work part-time, they'll get a proportion of the full benefit as long as their earnings are less than they were before.

You or your client needs to tell us within two months of the start of their incapacity, or before the end of their deferred period if sooner.

Yes, as long as they give us permission to do so. However, it's easier if we deal with your client directly because this gives us the best chance of getting the information we need right from the start.

When your client has this option, we may be able to waive their insurance premiums after they’re incapacitated for a certain length of time.

Whether or not we can waive your client’s premiums will depend on what type of incapacity their policy covers. Your client can find out what they’re covered for by reading the policy schedule in their policy booklet or by contacting us.

No, we will only waive the premiums of their policy.

Your client will have to continue to make premium payments until we have made a decision about their claim. If any premiums have been overpaid, we will be able to refund these. Your client can find this information in their policy booklet, or by contacting us.

Yes, if the type of incapacity they’re covered for relates to them not being able to perform an occupation (ie if they’re covered on an ‘own occupation’ basis).