How complicated is the claims process for critical illness insurance?

Hi anon,

The claim process is going to be quite standard regardless of the insurer.

Generally, you will have to submit a claims form and a doctor's statement, with supporting evidence such as relevant medical reports, scans, etc.

If the insurer requires additional information, they will get back to you. However, if the information provided is sufficient, then there is no reason to reject the claim.

I would like to understand what your agent meant by "better known than Aviva for having a smoother claims process". Is there a metric by which insurers are measured yearly for the 'smoothest' of their claims, and that Prudential is consistently ahead of Aviva (or any other insurer for that matter)? I have made claims and either they get paid out (due to being a valid claim) or get thrown out (due to not meeting one or more of the criteria). Claims should be assessed in black and white, and not subject to grey areas.

Also, that statement on "guidance on how to ask the doctor for a diagnosis" is a little ambiguous. What is meant by that statement? The doctor should diagnose based on medically available information and no one else other that another specialist or subject matter expert in the field should challenge the diagnosis. Unless your agent happens to have a M.D. as well, I think we should let the doctors do their job.

And for that matter, I'd like you think about this: what happens if you actually get blessed with good health and never claim (until you pass on)? Would you want to pay more in such a scenario?