The Combined Insurance Claim Form is an essential document for policyholders looking to file a claim with Combined Insurance, a division of Chubb Insurance New Zealand Limited. It provides detailed instructions on the proper completion of the form and the steps taken by the insurer to assess claims efficiently and fairly. This process ensures that all required information is provided, thereby facilitating a smoother and swifter claims assessment process. To begin filing your claim and to understand the claims process in depth, click the button below.
Navigating the path to filing an insurance claim can be daunting, but understanding the intricacies of the Combined Insurance Claim Form, a division of Chubb Insurance New Zealand Limited, can streamline the process significantly. Designed to provide clear instructions and guidelines for policyholders, this form is essential for those seeking to expedite their claim assessments and ensure a smoother transactions. It emphasizes the importance of prompt and honest communication following an incident, requiring detailed information from both the policyholder and their medical practitioner to accurately assess the claim. Additionally, it outlines specific instructions for claims related to accidents, sickness, and a variety of other covered events, alongside a comprehensive step-by-step guide through the claims process. By adhering to the stipulated timelines, providing all necessary documentation, and understanding the conditions of your policy, policyholders can better navigate the claims process. Furthermore, the form encourages direct contact with Combined Insurance for assistance, ensuring support is available every step of the way. It also details the company's commitment to privacy and explains how personal information is collected, used, and protected in accordance with New Zealand's privacy laws. Ultimately, the Combined Insurance Claim Form is structured to facilitate a straightforward claims process, aiming to alleviate some of the stress and uncertainty that can accompany such situations.
Combined Insurance
Claim Form A division of Chubb Insurance New Zealand Limited
Important Instructions
Important Instructions on how to complete the attached Claim Form and how we assess claims. Please read these important instructions on how to complete the attached Claim Form. This may help us to assess your claim faster.
In this ‘Important Instructions’ section we refer to the Insured or Covered Person as “you” or “your”; and Combined Insurance a division of Chubb Insurance New Zealand Limited (Chubb) as “Combined Insurance”, “we”, “our” or “us”, in the following instructions.
We refer to Chubb Insurance New Zealand Limited (Company No. 104656 Financial Services Provider No 35924) as “Chubb”.
1.It is important that you contact us as soon as possible once you are aware of any circumstance or event giving rise to a claim and provide honest, complete, up-to-date and relevant information when completing this claim form.
2.You should complete Section 1 in full to the extent relevant and attach any relevant invoices and other documents to support your claim. If you do not fully complete the Claim Form this may result in delays processing your claim while we seek missing information. Please see the Important Notes for Particular Benefits.
3.Your Medical Practitioner, and only your Medical Practitioner should complete Section 2 in full to the extent relevant. Your Medical Practitioner must also sign and date the Claim Form in the appropriate place.
4.We normally pay benefits up to the date that your Medical Practitioner has signed the Claim Form. If your disability is ongoing after that date, we will send you a Continuing Claim Form or Progress Form which your Medical Practitioner should sign and complete on your next visit.
Once we have received this completed form, we can make a further payment up to the date your Medical Practitioner has signed the form. The reason we do not pay benefits in advance of when your Medical Practitioner signs a Claim Form, is that the future disability has not yet occurred, and insurance only pays for losses that have already occurred. We follow this procedure even if your Medical Practitioner states an ‘approximate date’ for your disability to end. Of course, all payments depend on your claim falling within the terms and conditions of your Policy.
5.We may ask you or your Medical Practitioner for more information concerning your claim, or we may arrange a further independent assessment by a Specialist of our choosing.
6.Please send this Claim Form together with all supporting documents within 30 days of the commencement of your disability via post to Combined Insurance, Private Bag COMBINED, Remuera, Auckland 1541, via fax to 09-520-9009, or email the form to claims@combined.com. If you do not report your claim within 30 days and we consider the delay has prejudiced our ability to assess your claim, this may affect and/ or delay payment of your claim.
7.Our Claims Process
On receipt of this completed claim form we will take the following steps:
•Acknowledge receipt of your claim within 5 business days.
•Identify your insurance policy, register your matter against it and assign a claim number for reference. Determine whether or not to accept your claim within 10 business days of the date we have all the information we need to determine your claim.
•If we are unable to determine whether or not to accept your claim within 10 business days, such as when we request that you provide further information from your doctor or employer, we will advise you of the additional information we require. You must cooperate with us by providing the information we seek to settle your claim.
•If we require information from an independent specialist, or a doctor or other third party which we request directly, then we will advise you of the information required and will provide you with an estimate of how long we expect it will take to determine your claim, once we have this information.
•We will update you once every 20 business days, or another such interval as we may agree with you, until your claim is resolved.
8.With the exception of some circumstances, you have a right to access the information we have relied on in evaluating your claim and you can ask us to correct any mistakes or inaccuracies in that information.
9.If we decline your claim in whole or in part, we will clearly explain the reason or reasons. You have a right to access our Complaints and Disputes Resolution process which is summarised on the back page of this claim form.
10.Should you require any assistance in completing this Claim Form, or have any queries about claiming, or how we assess a claim, please contact us on 0800 COMBINED (266 246) and we will be happy to assist you.
Important Notes for Particular Benefits
11.If your Policy covers you for benefits while you
are hospitalised, please attach a copy of your hospital statement showing the dates of admission and discharge. If you were in intensive care during your period of hospitalisation, the Statement should indicate this.
12.If you are claiming for a Fracture Benefit, please attach a copy of the medical report verifying a fracture.
13.If you are claiming for Covered Cancer please attach a copy of a Pathology, Histology, or Histopathology Report, that medically verifies the diagnosis and a copy of your hospital statement showing any out-patient treatments if you are claiming an Out-patient Treatment benefit.
14.If you are claiming a benefit for Skin Cancer, please attach a medical statement verifying this.
15.If you are claiming a Transportation benefit please attach a receipt for your travel expenses.
16.If you are claiming a Family Lodging benefit please attach a copy of your hotel/motel bill.
17.If you are claiming a Facial Disfigurement benefit, please send a photograph of the relevant scar with your claim form. Please note that we may require you to submit a further photograph of your scar if your injury had not fully healed at the time you first lodged your claim.
18.If you are claiming an Emergency Ambulance benefit, please attach a copy of your ambulance statement or account.
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Fair Insurance Code
Chubb is a member of the Insurance Council of New Zealand (ICNZ) and a signatory to ICNZ’s Fair Insurance Code (the Code). The Code and information about the Code is available at http://www.icnz.org.nz/ and on request.
Privacy Statement
Combined Insurance is a division of Chubb Insurance New Zealand Limited. Chubb collects, uses and retains your personal information in accordance with Chubb’s Privacy Policy, which also applies to Combined Insurance.
This statement is a summary of Our privacy policy and provides an overview of how We collect, disclose and handle Your personal information. Our privacy policy may change from time to time and where this occurs, the updated privacy policy will be posted on Our website.
Chubb is committed to protecting Your privacy. Chubb collects, uses and retains Your personal information in accordance with the requirements of New Zealand’s Privacy Act, as amended or replaced from time to time.
Personal Information Handling Practices
When do We collect Your personal information?
Chubb collects Your personal information (which may include health information) from You when You interact with Us, including when You are applying for, changing or renewing an insurance policy with Us or when We are processing a claim, complaint or dispute. Chubb may also (and You authorise Chubb to) collect Your personal information from other parties such as brokers or service providers, as detailed in Our privacy policy.
Purpose of Collection
We collect and hold the information to offer products and services to You, including to assess applications for insurance, to provide and administer insurance products and services, and to handle any claim, complaint or dispute that may be made under a policy.
If You do not provide Us with this information, We may not be able to provide You or Your organisation with insurance or to respond to any claim, complaint or dispute, or offer other products and services to You or Your organisation.
Sometimes, We may also use Your personal information for Our marketing campaigns and research, to improve Our services or in relation to new products, services or information that may be of interest to You.
Recipients of the Information and Disclosure
We may disclose the information We collect to third parties, including:
•contractors and contracted service providers engaged by Us to deliver Our services or carry out certain business activities on Our behalf (such as actuaries, loss adjusters, claims investigators, claims handlers, professional advisers including lawyers, doctors and other medical service providers, credit reference bureaus and call centres);
•intermediaries and service providers engaged by You (such as current or previous brokers, travel agencies and airlines);
•other companies in the Chubb group;
•the policyholder (where the insured person is not the policyholder);
•insurance and reinsurance intermediaries, other insurers, Our reinsurers, marketing agencies; and
•government agencies or organisations (where We are required to by law or otherwise).
These third parties may be located outside New Zealand. In such circumstances We also take steps to ensure Your personal information remains adequately protected.
From time to time, We may use Your personal information to send You offers or information regarding Our products that may be of interest to You. If You do not wish to receive such information, please contact Our Privacy Officer using the contact details provided below.
Rights of Access to, and Correction of, Information
If You would like to access a copy of Your personal information, or to correct or update Your personal information, want to withdraw Your consent to receiving offers of products or services from Us or persons We have an association with, please contact the Privacy Officer by posting correspondence to Chubb Insurance New Zealand Limited, PO Box 734, Auckland; telephoning:
+64 (9) 3771459; or emailing Privacy.NZ@chubb.com.
How to Make a Complaint
If You have a complaint or would like more information about how We manage Your Personal Information, please review Our Privacy Policy for more details, or contact Our Privacy Officer at the details above.
You also have a right to address Your complaint directly to the Privacy Commissioner by telephoning 0800 803 909, emailing enquiries@privacy.org.nz or using the online form available on the Privacy Commissioner’s website at www.privacy.org.nz.
Complaints and Dispute Resolution
We take the concerns of its customers very seriously and has detailed complaint handling and dispute resolution procedures that you may access, at no cost to you. To assist us with your enquiries, please provide us with your claim or policy number (if applicable) and as much information as you can about the reason for your complaint or dispute.
Our complaints and dispute procedures are as follows:
Stage 1 – Complaint Handling Procedure
If you are dissatisfied with any of our products or services and you wish to lodge a complaint, please contact us via:
Email: Complaints.NZ@chubb.com
Phone: COMBINED (266 246) (call free within NZ)
+64 9 520 9000 (if calling from overseas) Fax: +64 9 520 9009
Post: The Complaints Officer Combined Insurance Private Bag COMBINED Remuera Auckland 1541
Stage 2 –Dispute Resolution Procedure
If you are dissatisfied with our response to your complaint, you can advise that you wish to take your complaint to Stage 2 and referred to our dispute resolution team. Our internal dispute resolution team can be contacted via:
Email: DisputeResolution.NZ@chubb.com
Phone: +64 9 377 1459
Fax +64 9 303 1909
Post: Internal Dispute Resolution Service
Chubb Insurance New Zealand Limited
PO Box 734
Shortland Street
Auckland 1140
Stage 3 – External Dispute Resolution
We are a member of an independent external dispute resolution scheme operated by Financial Services Complaints Limited (FSCL) and approved by the Ministry of Commerce & Consumer Affairs. Subject to FSCL’s Terms of Reference, if you are dissatisfied
with our dispute determination or we are unable to resolve your complaint or dispute to your satisfaction within two months you may contact FSCL via:
Post: PO Box 5967, Lambton Quay, Wellington 6145
Phone: 0800 347 257 (call free for consumers) or +64 4 472 FSCL (472 3725)
Fax: +64 4 472 3728
Email: info@fscl.org.nz
Website: www.fscl.org.nz
Please note if you would like to refer your complaint or dispute to FSCL you must do so within 2 months of the date of our dispute determination.
Further details regarding our complaint handling and dispute resolution procedures are available from our website and on request.
Page 2 of 7
Claimant to complete this page
SECTION 1
(Please print using BLOCK LETTERS)
IMPORTANT. Write your Account Number here
Office Use Only
Claimant’s Details
Mr
Mrs
Ms
Miss
Other:
Claimant's Full Name:
Date of Birth:
/
Height:
Weight:
Residential Address:
Postcode:
Postal Address (If different from above):
Claimant’s Telephone Number: Daytime: (
)
Mobile: (
Claimant’s Email Address :
Occupation:
Employer’s Name:
Employer’s Address:
Employer’s Contact Person:
Employer’s Contact Telephone Number: (
Are you claiming under a Family Policy?
Yes
No
If Yes, please provide Family Policy Account Number:
It is our preference to make claims payments by Electronic Funds Transfer (EFT).
ADo you want us to make payments on this claim by EFT into your account?
Yes No
BIf Yes to ‘A’, is the account that you pay your premium from the Account you want us to pay your claim payments to?
CIf No to ‘A’ and/or ‘B’, please provide name of preferred Financial Institution:
Account Name:
Bank
Branch Number
Account Number
Suffix
Complete for Accident only
1.
When did the accident occur?
Date:
at
am / pm
2.
Where did the accident occur?
Street Number:
Street Name:
Suburb:
City/Town:
3.Nature of Injuries: (Please be specific)
4.How did the accident occur? (Please be specific)
5.If it was a motor vehicle accident, please provide a description of the vehicle(s) involved.
(Note: if more than 2 vehicles involved attached details of other vehicles separately)
Your vehicle
Registration No.:
Make:
Model:
The other person’s vehicle
6.
Was the accident reported to the Police?
Police Station:
Was anyone charged by the Police?
If Yes, who was charged?
What was the charge?
(Note: You must provide us with a copy of the Police Report if we request you to)
7.
During the 24 hours before the accident, did you drink any alcohol or take any drugs?
(If Yes, please provide details - state types and quantities)
Did you have a Blood Alcohol Test or Drug Test by the Police?
If Yes, what was the result?
8.
Were you transported to Hospital by Ambulance after the accident?
Name of Hospital you attended:
(Note: You must provide us with a copy of the Ambulance Report if we request you to)
9.
Eye witness details. Please provide details of any eye witness.
Witness 1 - Full Name:
Address:
Email Address:
Telephone Number: (
Daytime
Witness 2 - Full Name:
Witness 3 - Full Name:
Page 3 of 7
Complete for Sickness only
10.Nature of sickness: (Please be specific)
11. When were the symptoms first noticed?
12.Who was the first Medical Practitioner you consulted for this condition? Medical Practitioner’s Name:
Medical Practitioner’s Address:
Medical Practitioner’s Telephone Number: (
When did you first see the Medical Practitioner for this condition?
13. Have you consulted any other Medical Practitioner for this condition?
(If Yes, please provide details)
Medical Practitioner’s Name:
Dates of Consultations:
14. Did you go to Hospital in respect of this sickness?
Hospital Name:
Date of Admission:
Date of Discharge:
Number of Days in Hospital:
15. Have you previously had the same sickness?
Date(s):
Treatment Received:
Name of treating Medical Practitioner/Specialist:
Address of Medical Practitioner/Specialist who treated you:
Complete for Accident and Sickness
16.
Which Medical Practitioner is currently treating you for your injury/illness? (If the same as ‘Q12’ write ‘As above’)
Other Dates of Treatment?
17.
Who is your usual family Medical Practitioner? (If the same as ‘Q16’ write ‘As above’)
18.
What other significant medical
or surgical treatments have you received in the past 5 years? (Please provide details)
Nature of the condition(s) treated:
19.
Are you affected by any other long term or chronic disability?
20.Were you hospitalised?
(If Yes, please state date of hospitalisation) From:
To:
(Please also attach a copy of any hospital statements if you are hospitalised and claiming a confinement benefit)
21. Are you claiming for Transportation and Family Lodging Benefits?
No (Please attach receipts supporting your claim if you are claiming for these)
22. If you are claiming a benefit as the result of the diagnosis of any covered Skin Cancer, please attach proof of diagnosis.
23.
‘Total Disability’. Between what dates were you unable to perform any duties? (Refer to the ‘Definitions’ at the top of ‘Section 2’)
From:
24.
‘Partial Disability’. Between what dates were you able to perform only partial duties? (Refer to the ‘Definitions’ at the top of ‘Section 2’)
25. Date you returned to your normal duties.
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Authority and Declaration
Chubb Insurance New Zealand Limited Claim Privacy Consent, Medical Authority and Declaration
Claim Privacy Consent
I/ we:
i.understand that Chubb Insurance New Zealand Limited CU1-3, Shed 24, Princes Wharf, Auckland (Chubb) requires personal information (which may include Health information) so that Chubb can evaluate this claim and administer the insurance policy and that failure to consent to the collection, use and disclosure of personal information may result in the claim being refused in part or in full;
ii.authorise Chubb to obtain from other parties personal information (which may include Health information) about me/us that Chubb views as relevant to the claim;
iii.agree to Chubb disclosing to other parties, including but not limited to, service providers engaged by Chubb, the insurance broker, the policy holder (if this differs from the claimant) or reinsurers personal information (including Health information) collected in relation to this claim or the insurance policy;
iv.I authorise any person or entity, including but not limited to Medical Practitioners and the Parties referred to in the Privacy Consent, to provide to Chubb such personal information (including health information) as Chubb in its absolute discretion considers relevant for its assessment of my claim or my entitlement to benefit;
v.understand that I/we have rights of access to, and correction of, personal information held by Chubb; and
vi.understand that further information about how Chubb collects, uses, discloses and processes my/our information is set out in Chubb’s Privacy Policy, available at www.chubb.com/nz-en/footer/privacy.html.
If you would like to access a copy of your personal information, or to correct or update your personal information, please contact Chubb’s Privacy Officer on +64 (9) 377 1459 or email Privacy.NZ@chubb.com.
•understand that in evaluating my/our claim or by accepting documents in support of my/our claim, Chubb has made no acceptance of liability, nor waived any of its rights;
•confirm that any information that I/we supply will be true, correct and complete and that I/we will not withhold any information likely to affect the acceptance or handling of my/our claim and understand that if I/we provide untrue information or do not disclose relevant information that it might result in my/our claim being declined in part or in full;
•will give all reasonable assistance to Chubb and co-operate in the assessment of my/our claim; and
•appoint Chubb to do everything necessary to give effect to the consents and authorisations in this document and to execute, on my/our behalf, any documents or to do such acts required to give effect to this Privacy Consent and Authority.
Name of claimant:
Signature of
X
claimant:
Name of
Witness:
Page 5 of 7
Medical Practitioner only to complete this section
SECTION 2
This section must be fully completed by a Legally Qualified Medical Practitioner, at the Claimant’s expense.
Please read carefully before completing this section.
Total Disability
The inability to perform each of the substantial duties of your business or occupation (usual activities if not employed).
Definitions
Partial Disability
The inability to perform one or more, but not all of the substantial duties of your business or occupation (usual activities if not employed).
Medical Practitioner
Means a licenced medical practitioner operating within the scope of his or her New Zealand licence and who is not a member of your immediate family.
Patient’s Full Name:
1. Please tick whether claim is for:
Sickness
Injury
Diagnosis:
Cause:
2. If the patient is suffering from an injury, how did the patient advise you that the injury occurred?
3.
Please Complete for Fractures only. Was the Fracture confirmed by an X-Ray?
No (Please attach a copy of the X-Ray report)
Describe the type of Fracture:
4.
When did the symptoms first appear, or the accident happen?
5.
When did the patient first consult you for this condition?
Did Total Disability begin this day?
If No, please state date total disability began
Has the patient ever had this condition before?
If Yes, please state if the present condition is an aggravation or recurrence of a previous injury or sickness.
Recovery Date:
Has the patient ever had any other disease or infirmity that may be affecting the present condition?
If Yes, what was the disease or infirmity?
To what degree did this contribute to current disability?
Is the patient still under your care for this condition?
If Yes, and the patient has not recovered, what is the expected recovery date?
Please provide details of the Treatment Plan to assist the patient’s recovery:
If No, and the patient has recovered, please write the recovery date.
Has the patient had surgery or is surgery anticipated?
Details of surgery:
10. Has the patient been referred to any other Medical Practitioner or Specialist?
Date Referred:
11.
Are you the patient’s usual Treating Medical Practitioner?
If Yes, for how many years?
If No, please advise the details of the patient’s usual Treating Medical Practitioner/Medical Practice.
Medical Practitioner/Medical Practice’s Name:
Medical Practitioner/Medical Practice’s Address:
Medical Practitioner/Medical Practice’s Telephone Number: (
Page 6 of 7
12.Disability Periods. (Refer to ‘Definitions’ at top of the opposite page)
a) Totally Disabled:
(Inclusive)
b) Partially Disabled
c) Hospitalised as an overnight In-patient
At: (Hospital Name)
d) Hospitalised as an overnight In-patient in Intensive Care
e) Do you expect the patient to remain totally disabled for the next 12 months?
13. Is there any further medical information relevant to this claim?
Medical Attendant Authority and Declaration
Chubb Insurance New Zealand Limited Privacy Consent and Declaration
Privacy Consent
i.understand that Chubb Insurance New Zealand Limited CU1-3, Shed 24 Princes Wharf, Auckland requires personal information (which may include my/our personal information and the patient’s health information) so that Chubb can evaluate the patient’s claim and administer their insurance policy;
ii.agree to Chubb disclosing to other parties, including but not limited to, service providers engaged by Chubb, the insurance broker, the policy holder or reinsurers personal information collected in relation to this claim or the insurance policy;
iii.understand that I/we have rights of access to, and correction of, personal information held by Chubb; and
iv.understand that further information about how Chubb collects, uses, discloses and processes my/our information is set out in Chubb’s Privacy Policy, available at www.chubb.com/nz-en/footer/privacy.html.
Declaration
I/we confirm that to the extent I/we am/are aware, the information supplied in this form is true and correct.
Medical Practitioner’s Declaration
WE RECOMMEND THAT A COPY OF THIS FORM IS TAKEN FOR YOUR FILES.
Provider Number:
Qualifications:
Address: (If not on stamp)
Telephone Number: (If not on stamp) (
MEDICAL PRACTITIONER’S
Email Address: (If not on stamp)
STAMP REQUIRED
Full Name of the
Medical Practitioner’s:
Signature of the
Medical Practitioner’s: X
A division of Chubb Insurance New Zealand Limited
Combined Insurance is a division of Chubb Insurance New Zealand Limited Chubb Insurance New Zealand Limited | Company No. 104656 | FSP No. 35924
Customer Service Phone 0800 COMBINED (266 246) Email claims@combined.com
Website www.combinedinsurance.co.nz Postal Address Private Bag COMBINED Remuera Auckland 1541
Form Number: NZ00010 / ChubbNZ11-22-0721
Page 7 of 7
Filing a Combined Insurance Claim form effectively is a key step in receiving insurance benefits after an unforeseen event. This process requires careful attention to detail and accuracy to ensure that all information provided is correct and complete. Following the step-by-step instructions below will help streamline the process and assist in submitting a claim efficiently. The goal is to facilitate a smooth and swift claim review and reimbursement process, minimizing delays and potential roadblocks. By adhering to these steps and providing all necessary documentation promptly, claimants can navigate the claims process with greater ease and confidence.
Following these detailed steps and providing accurate, complete, and honest information will assist Combined Insurance in processing your claim as swiftly as possible. Remember, completeness not only expedites the review process but also helps avoid potential delays arising from the need to seek additional information or clarification.
To submit a Combined Insurance Claim Form, complete the form with honest, complete, up-to-date, and relevant information. Ensure Section 1 is filled out in full and attach any relevant invoices and documents needed to support your claim. Your Medical Practitioner must complete Section 2 in full and sign and date the Claim Form. Then, send the completed form and all supporting documents within 30 days of your disability's commencement. You can submit it via post to Combined Insurance, Private Bag COMBINED, Remuera, Auckland 1541, via fax to 09-520-9009, or email it to claims@combined.com.
Once your Combined Insurance Claim Form is received, the following steps occur:
If you cannot submit your claim form within the 30-day period, it's crucial to inform Combined Insurance as soon as possible. A delay might prejudice Combined Insurance’s ability to assess your claim, potentially affecting and/or delaying payment of your claim. The circumstances around your delay may be taken into consideration, so it's important to communicate any issues as quickly as possible.
If you need help completing the Combined Insurance Claim Form or have any queries about claiming or how claims are assessed, you are encouraged to contact Combined Insurance directly. Assistance is available by calling 0800 COMBINED (266 246). Their team is ready to provide the support and answers you need to navigate the claims process effectively.
Not contacting Combined Insurance as soon as possible after becoming aware of a claim-worthy event can result in unnecessary delays. It's crucial for individuals to inform the insurer immediately to streamline the process.
Failing to provide complete and honest information when filling out the claim form may lead to delays or even the rejection of the claim. Accuracy and transparency are key to a smooth claim process.
Leaving sections of the form blank, especially Section 1, which requires detailed personal and incident-related information, can significantly slow down the claims process. It's important to fill out every relevant section thoroughly.
Not attaching necessary supporting documents, such as invoices, medical reports, and receipts, can hinder the claim's progress. These documents are essential for verifying the details of the claim.
Allowing someone other than the medical practitioner to complete Section 2 can lead to issues with the claim. This section needs to be filled out by a licensed medical professional for accuracy and validity.
Sending the claim form beyond the 30-day deadline after the commencement of disability may affect or delay the payment. Timeliness is crucial in reporting the claim to ensure prompt processing.
Failure to cooperate with Combined Insurance’s requests for additional information or assessments might not only delay but also negatively impact the outcome of the claim. Being responsive and cooperative facilitates the evaluation process.
Choosing not to specify if payments should be made via Electronic Funds Transfer (EFT) can complicate the payment process. Indicating a preference for EFT can lead to faster and more secure payments.
Not utilizing the claimant’s rights to access, correct information, or engage in the dispute resolution process if unsatisfied with the claim outcome can leave possible benefits unclaimed. It’s beneficial to be aware of and use these rights when necessary.
Addressing these common mistakes can drastically improve the experience of filing a claim with Combined Insurance. Being thorough, timely, and cooperative plays a significant role in ensuring a claim is processed efficiently and satisfactorily.
When submitting a Combined Insurance Claim Form, understanding the supporting documentation required can simplify the process and ensure a swift response from the insurance provider. Besides the claim form itself, several other forms and documents frequently play a crucial role in the evaluation and processing of a claim. Described below are some of these essential documents.
Supplying the right documents alongside the Combined Insurance Claim Form can significantly streamline the processing time by providing a comprehensive view of the claim at the outset. It's not merely about submitting a claim but doing so with the diligence that facilitates a smooth and efficient review, ultimately leading to a fair assessment of the claim submitted.
Health Insurance Claim Form: Similar to the Combined Insurance Claim Form, health insurance claim forms require the insured to provide comprehensive personal details, medical history, and the specifics of the medical claim. Both forms might necessitate supporting documentation, such as medical reports, invoices for treatments, and possibly a doctor's certification of illness or injury, to process the claim efficiently.
Disability Insurance Claim Form: This document bears similarity to the Combined Insurance Claim Form in that it asks for detailed information about the claimant’s condition and how it affects their ability to work. Both forms typically require a medical practitioner’s statement and might request further evidence or follow-up through progress reports to continue receiving benefits, especially for ongoing disabilities.
Automobile Insurance Claim Form: Although focused on vehicle-related incidents, automobile insurance claim forms share features with the Combined Insurance Claim Form, including the provision of detailed incident descriptions, police reports if applicable, and information on any other parties involved. Both forms aim to collect all relevant information to assess and determine the claim’s validity and settlement amount.
Property Insurance Claim Form: Similar to combined insurance claims, property insurance claim forms are used to report damage or loss of property, requiring the insured to document the circumstances, extent of damage, and any third-party assessments or repair estimates. Both forms serve the purpose of evaluating the claim to provide compensation as per the policy's terms and conditions.
Travel Insurance Claim Form: This form and the Combined Insurance Claim Form both require the insured to detail the events leading to the claim—whether it’s for medical reasons, lost luggage, or trip cancellations. Supporting documentation such as receipts, medical certificates, and possibly police reports are commonly required to substantiate the claim, similar to the need for detailed and supported documentation in combined insurance claims.
When you're filing a Combined Insurance Claim form, careful attention to your actions can significantly impact the processing of your claim. It's essential to know what you should and shouldn't do to ensure a smoother experience.
Do:
Don't:
Many people encounter misconceptions when dealing with the Combined Insurance Claim form. Being aware of these misunderstandings can facilitate a smoother claim process. Here are eight common misconceptions explained:
Understanding these aspects ensures a smoother interaction with the claim process, aiding in setting realistic expectations and leading to better outcomes for all involved.
Understanding how to properly fill out and use the Combined Insurance Claim form is crucial for ensuring your claim is processed efficiently and correctly. Here are five key takeaways:
Moreover, ensuring your privacy and understanding your rights concerning the information you provide on your claim form is fundamental. Combined Insurance adheres to privacy laws and has procedures in place to protect your information.
Finally, assistance is available if you have questions or need help filling out your claim form. Contacting Combined Insurance directly can provide you with additional support and guidance through the claim process.
Home Health Documentation Checklist Tool - Physician-signed plans of care are verified for timeliness, an essential step for starting or continuing home health services.
Minnesota Accident Report - If more than two vehicles are involved, additional forms for Section "C" are required, ensuring all information is captured.