The importance of financial advisers insurance advice to claim outcomes

Bruno Muraca
(AFRM Claims Advocacy)


The importance of financial advisers insurance advice to clients is no more evident than at claim time.

When an event such as an illness or injury occurs with their client, advisers are often the person the client turns to, to seek help, guidance and peace of mind.

Most clients don’t spend the time reading through the detail of their insurance policy, and when a claim occurs, there is often too much happening for clients to have the headspace to consider the detail of their insurance policy.

The role of the adviser to provide clarity and education about the policy is often the start of the process to help clients.

From here, the challenges of working with the insurer to obtain claim forms, help clients complete claim forms, establish who the case manager is and then continually follow up the insurer to the claim completion. For TPD claims this can be up to six months.

“Fortunately, admittance rates of claims continue to be strong, however insurer capacity is being stretched which impacts the end to end value chain.   For advisers, given their competing demands, the timeframes and expertise to manage claims is increasing.  For clients, they are experiencing higher demands from insurers (especially where reinsurers are involved) not to mention the onerous claim forms and medical requirements”, said Bruno Muraca, AFRM Claims Advocacy.

“We are seeing an increasing number of claims being sent to AFRM Claims Advocacy from advisers. It may be because of the time and effort involved in managing the claim, however more and more advisers want their clients to experience the expertise of a claim advocate and to leverage their insurer relationships to deliver clients peace of mind at claim time”.

The Australian Prudential Regulation Authority (APRA) recently released its Life Insurance Claims and Disputes Statistics, for a rolling period from 1 January 2020 to 31 December 2020. What is evident from the statistics is the importance of adviser insurance advice. For example, claim admittance rates for TPD claims, for those clients individually advised (had an adviser involved in advice) was 81% vs 67% for those non-advised.

“A positive claim outcome, is often a reflection of the adviser knowing the clients needs and providing the right advice. It gives us great pleasure to advocate for clients and their adviser. Balancing the client’s financial and health outcomes whilst achieving a positive claim outcome forms part of the clients recovery”, said Bruno



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