In The Event Of A Claim
How Can We Help
You purchase insurance to protect against the unforeseen. The last thing you want to do is make a claim.
There are 3 general claims categories:
- Death
- Disability
- Critical Illness
When you make a claim for Disability or Critical Illness you enter unchartered territory. We are there for you to guide you through the process efficiently from:
- Discussing your circumstances
- Reporting your claim
- Assisting you with forms
- Assisting you with gathering information
- Being with you on calls with the assigned insurance company claims adjudicator
- Being with you throughout the claims process as verification and updates are required
- Working with you through appeals, if necessary
The most unfortunate circumstance in our view is that a legitimate claim ends up with having to seek legal advice. We are not here to replace a critical illness lawyer however we are here so that if you do need one in the end you have a partner there as well.
You are in a unique field serving others everyday with the highest degree of integrity. You deserve the same and at Johnston Shaw we committed to standing by you the way do for others.
Case Studies
We were approached by a 33 year old physician who had purchased insurance within the preceding 12 months to advise us that he had terminal cancer and had perhaps 24 months to live.
He described his diagnosis and how it came to manifest and it turns out that on hos application he omitted the precipitating factor. He had a young family and they were clearly facing what their life would be without him. We explained to him that the families needs were paramount and that they needed to be able to rely on the insurance he purchased and the way we things were going it looked like they would have a difficult time collecting re the innocent omission. We advised him to allow us to disclose what had come to light his diagnosis and his precipitating non disclosed event and deal with whatever problems arose while he could influence the outcome and speak for himself.
Rolling the dice was not an option. He passed away 18 months later after he received a full acknowledgment of his disclosure comforted that the insurance was in full force and effect. This situation is a clear indication of how our experience impacted an otherwise uncertain result. Without the insurance the family's lives would have been impacted greatly and their ability to go on and strive for a new normal would have been compromised.
Was introduced to a 40 year old dentist who had just had his critical illness claim denied for a qualifying condition because of a technicality on the delivery amendments.
Further his disability increase option that he exercised was denied at claim time based on another technicality despite accepting payment. What was clear was that the delivery of both his Critical Illness policy and his increase option were flawed. The agent of record on the file stopped returning calls on the declines. Simply what happened was a perfect storm of events that could not be anticipated.
The client was dealing in good faith on both transactions. In the end we put a compelling case together for appeal which was denied as we suspected it would be but same formed the basis for an action which was commenced through lawyers we interviewed and recommended. The result was that the full critical Illness claim was paid out an the disability payments missed were paid out after his death. We were there all through the process.
Met a dentist at his age of 57 struggling with severe shoulder pain in both shoulders as a result of a torn rotator cuff. Both shoulders as the good shoulder was compensating for the injured one.
Was looking to sell his practice with Roi Corp and Roi Corp referred us to assist with a potential claim. He was suffering and worried about devaluing his practice by going off on claim. We came up with a strategy that worked for everyone. The value of his practice was maintained. His income could continue in part through disability benefits which bolstered his spirits and created a light at the end of the tunnel.
In addition prior to the claim being made we were able to secure Long Term Care coverage which may have been otherwise difficult had he been on claim. Insurance is a financial instrument. The security in knowing it was there if needed allowed this dentist to properly plan and keep everything in order to maximize his opportunities.