Making a Claim

What this means

Making a claim is the moment your protection policy does the job it was bought for. Depending on the type of cover, a claim may be made by you, by your family, by your trustees or by your adviser on your behalf.

Every year, UK insurers pay millions of pounds in claims to help individuals and families cope with bereavement, serious illness and loss of earnings. The process is designed to be straightforward, and your adviser can help at every stage.

Why it matters

Knowing how a claim works removes uncertainty at an already difficult time. Families who know a policy exists, know where the documents are and know who to call are able to access money far more quickly.

Delays usually happen for practical reasons — nobody knew about the policy, paperwork couldn't be found, or the information given when the policy started didn't match the medical evidence obtained at claim stage.

What you need to know

Step 1 — Notify the insurer

You, your family, your trustees or your adviser contacts the insurer to inform them of the claim. If you'd rather not deal with the insurer directly, we can make the first contact for you.

Step 2 — Evidence is gathered

The insurer may request:

• Claim forms
• Medical reports
• GP records
• Hospital information
• Proof of identity
• Death certificate (for life insurance claims)

Step 3 — Assessment

The insurer reviews the claim and checks it against:

• The policy terms
• Medical evidence
• Original application information

Step 4 — Claim decision

If the claim meets the policy conditions, payment is made to the policyholder, the beneficiaries or the trustees — depending on how the policy was set up.

Why some claims are delayed or declined

Although each case is assessed individually, the most common reasons are:

• Material information was not disclosed when the policy was taken out.
• Information given at application differed from medical or prescription records.
• Policy terms were not met — for example a condition did not meet the insurer's definition, an exclusion applied, or a deferred period had not been satisfied.
• The policy had lapsed because premiums were no longer being paid.

What to do next

• Keep copies of your policy documents somewhere findable.
• Make sure your family or trustees know the policy exists.
• Check whether your policy is written in trust.
• Understand the additional benefits included with your cover.
• Review your cover as your circumstances change.

Many modern protection policies also include valuable support services that can be used without making a formal claim, such as:

• Virtual GP access
• Mental health support
• Physiotherapy services
• Second medical opinions
• Bereavement support

Common questions

Who should make the claim?

Anyone who knows about the policy can start the process — the policyholder, a family member, a trustee or your adviser. The insurer will confirm who needs to sign the claim forms.

Do insurers check medical records when I claim?

In many cases, insurers may obtain medical evidence from your GP, consultant or hospital to assess a claim.

How long does a claim take?

Straightforward claims with complete paperwork can be settled quickly. Claims needing medical evidence from third parties take longer, because the insurer has to wait for reports to arrive.

Does a trust change how the money is paid?

Yes. A policy written in trust pays to the trustees rather than the estate, which usually means the money reaches the people you intended far more quickly.

Related guidance

• Why Disclosure Matters
• Writing a Policy in Trust
• Choosing Your Beneficiaries
• Why Regular Protection Reviews Matter

This guide is for informational purposes only and was accurate at the date of publication. Please seek personalised advice before making financial decisions.