ClearView’s vision is to support Australians to achieve their financial and wellbeing goals while being a positive force for our staff, our community, and the environment.
As part of this, our Claims Philosophy outlines our values as to how we will work with you, your family or estate at claim time, so you know that your claim will be handled expertly, sensitively and with compassion and care.
We are committed to supporting you, to help you identify your eligible benefits and to pay them as quickly as possible.
At ClearView, our Claims Philosophy has four core values.
1. Supporting you and your family
We know that it can be difficult for you dealing with a sickness, injury or death. This is a time when your day to day life is disrupted, and you may find it overwhelming to complete paperwork and contact health professionals.
That is why we assign you a Claims Consultant who will assist you or your family at each step of the claim. Our Claims Consultants are trained professionals who are here to help and support you. They will take time to understand you and will advise you as to our process from the beginning.
Where possible, our Claims Consultants will seek to minimise the amount of information that ClearView requests from you and explain to you the impact of any information we obtain in relation to the claim. This allows you to focus on your recovery, and where appropriate, your return to work.
We also have a claims guide that can help you identify the sort of information that you may need at claim time.
We will be in contact to update you on the progress of the claim at least every 20 business days, or according to your needs.
2. Fair, consistent and responsible
When you contact us about a potential claim, we will look to help you rather than discourage you from claiming.
Our Claims Consultants are committed to assist and help you identify which benefits you may be eligible to claim under your insurance cover.
We assess all claims on their individual merits and we are committed to providing a consistent and fair approach when making our claims decisions. ClearView also has a comprehensive review process, so you can be assured that if you disagree with our original decision, an independent reviewer will listen to your concerns. If the matter has not been resolved to your satisfaction, you can lodge a complaint with the Australian Financial Complaints Authority, (AFCA). AFCA provides fair and independent financial services complaint resolution that is free to consumers.
AFCA’s contact details are as follows:
| Website: |
www.afca.org.au |
| Email: |
[email protected] |
| Postal: |
Australian Financial Complaints Authority
GPO Box 3
Melbourne VIC 3001 |
| Phone: |
1800 931 678 (free call) |
Customers experiencing vulnerability may have additional needs at claim time. We recognise that some people may have specific needs, for example people from diverse cultural backgrounds, people from non-English speaking backgrounds, people who experience family violence, people with low levels of literacy, people in financial distress and Indigenous people. Where additional assistance is required, we will provide support to the best of our ability.
The
Life Insurance Code of Practice set out obligations for insurers on how to engage appropriately with their customers, handle claims appropriately and fairly and to carry through with any expectations that have been set. When we say we will write to you or call you, that is exactly what we’ll do. ClearView is a signatory to and bound by the Code, and supportive of the principles outlined in the Guidance Notes relating to insurance in superannuation. Our Claims Consultants adhere to the Code’s requirements when assessing your claim.
In the event we make an error, we will take action to correct it as soon as possible while keeping you informed.
3. The health benefits of returning to work.
We understand how important work is to your overall wellbeing. It plays an important role in recovery after any sickness or injury.
ClearView is a proud signatory to the ‘Realising the Health Benefits of Good Work Consensus Statement’, an initiative of the Australasian Faculty of Occupational and Environmental Medicine (AFOEM) of The Royal Australasian College of Physicians (RACP). Some of the key principles from this consensus statement are:
- Good work is important in the health and wellbeing of employees, their families and broader society.
- Long term work absence, work disability and unemployment may have a negative impact on health and wellbeing.
- Providing access to good work is an effective way to reduce poverty and social exclusion.
- With active assistance, many of those who have the potential to work, but are not currently working, can return to work and enjoy its benefits.
There are a number of people with different skills involved in a successful return to work, and we can help bring them together as we work with you and your health and other relevant professionals during the course of your claim. These could include various health professionals, return to work specialists, your current employer, and/or a prospective employer. Our aim is to help you recover your health and return to work, where it is appropriate.
At ClearView, we see our role as helping both customers on claim and the community. We have a firm belief that a partnership with the community as well as customers during the claims journey can have a positive impact on people’s lives.
Whether it is paying a benefit or assisting you with occupational rehabilitation, financial health coaching, business coaching, or improving your qualifications, we always have you at the centre when managing your claim.
4. Paying claims
ClearView is in the business of paying valid claims as smooth and promptly as possible. This is the reason we are here and forms part of our vision now and into the future.
In the 2021 financial year, we paid out $93.8 million in claims. These benefit payments provided financial support and peace of mind to over 833 customers and their families at a difficult time in their lives.
Wherever we can, we will help you and your family in the aftermath of a sickness, injury, or death.
“We are proud to see ourselves as partners in your recovery. We aim to holistically care for people, and we have a will to do the right thing.” - Lee-Ann Barnard, Head of Claims
Need more information
If you need more information about our claims process, please refer to your Product Disclosure Statement (PDS) or call us on 132 979.
Disclaimer
All claims are accepted, and benefits paid in accordance with the terms of the policy. This information is intended to provide general information only and the information has been prepared without taking into account any particular person's objectives, financial situation or needs. Before acting on such information, you should consider the appropriateness of the information having regard to your personal objectives, financial situation or needs. In particular, you should seek independent financial advice and you should read the relevant PDS before making any decision about a product. A copy of the relevant PDS can be obtained from 132 977 or on our website clearview.com.au/tools/pds-and-brochures. You can find the target market determination(s) for the product(s) at clearview.com.au/tmd.