Full claim paid after initially being declined
Claimant: 40-year-old male
Condition: Cerebellar haemorrhage requiring surgery
Insurance Claim: Trauma Insurance
Mr E, a 40-year-old dentist, was watching TV with his wife when he suffered a cerebellar haemorrhage late at night. Mr E had trauma insurance, but there were issues with his condition matching the definition of the insurer.
When an injury or illness doesn’t fit the insurer’s definition of the event, the claim is usually declined, leaving the claimant without a leg to stand on. This was the case with Mr E’s Trauma claim. His claim was rejected due to technical details of the definition of his condition. We stepped in to argue with the complaints resolution team to successfully have the claim paid in full.
