Losing a loved one is a challenging and emotional time for any family, without having to deal with a rejected funeral cover claim. To help ensure a smooth claims process, we've created this comprehensive guide to why 1Life Funeral Cover claims might be rejected and provide tips on how to ensure your claim is approved. As a 1Life Insurance policyholder or beneficiary, understanding the claims process can make all the difference in ensuring that your family receives the financial support they need when it’s time to make a funeral cover claim.
Top 8 reasons why 1Life Insurance might decline funeral cover claims
The first step in avoiding rejected funeral cover claims is understanding why they happen. Here are some of the top reasons why 1Life might decline your claim.
1. Waiting periods
Waiting periods represent the time between when a policy commences and when funeral cover claims for certain events can be made. Be sure to familiarise yourself with the waiting periods applicable to your policy as claims made during this time will be declined.
For example, 1Life Funeral Cover policies have a six-month waiting period for death due to natural causes. If you submit a claim for a natural death that occurred during this waiting period, it will be declined.
2. Lapsed policies
To process a funeral cover claim, the policy must be up-to-date with all premiums paid.
Missing premium payments could result in a policy being suspended or cancelled. When a policy is no longer active, any claims made on it will be declined. To prevent this from happening, ensure that your premiums are paid regularly and on time. Set up automatic payments, if possible, to avoid missing any due dates.
3. Information mismatch
Ensuring that your details on the policy document align with the information provided at the claim stage is crucial if you want to avoid a rejected funeral policy claim. Insurers go to great lengths to verify the accuracy of these details to guarantee that the right person receives the rightful benefits. If there are inconsistencies between the names and ID numbers of the life assured, beneficiaries or members on your policy document and the information on ID documents or the details provided at claims stage, it could result in a rejected claim.
Regularly review your policy documents to ensure that all information, including names and ID numbers is correct. If you notice any errors or discrepancies, contact your insurer immediately to update your records.
4. Unclear relationships
1Life allows you to cover additional members on your funeral policy. However, the relationship of these additional members must be clearly defined and meet 1Life’s criteria. This is especially important when the additional member is not a relative by blood or marriage.
By ensuring that the exact relationship is clearly defined, you can help prevent any complications and ensure a smooth claims process.
At 1Life, our goal is to provide you with the utmost support during difficult times, and by being transparent about the relationships covered by your funeral policy, we can ensure that your claim is handled efficiently and with the care it deserves.
5. Age limitations for child members
Children under the age of 21 can be covered on a funeral policy, or up to age 25 if they are full-time, dependent students. Children over these age limits cannot be covered on their parent's 1Life funeral policy. If a funeral cover claim is made for a child who is over the age limit, it will be denied. To avoid this, encourage your children to take out their own funeral policy once they exceed the age limit for cover on your policy.
If a policyholder or covered family member dies due to suicide within the first 12 months from inception date, the funeral cover claim may be denied. Be aware of this exclusion when applying for funeral cover and ensure that you understand the terms and conditions of your policy.
7. Illegal activity
Funeral cover claims may be rejected if a policyholder or covered family member dies while engaging in illegal activities.
8. Residing outside South Africa
If the principal policyholder resides outside South Africa for longer than 60 consecutive days without notifying the insurer, the claim may be denied. If you plan to travel or live abroad for an extended period, inform your insurer to avoid any issues with your claim.
Tips for a smooth claims process
Knowing how to claim on funeral insurance policies ensures a hassle-free claims process. Here are 4 tips:
1. Claim in time
Submit your claim within the specified time frame. For 1Life Insurance, funeral cover claims must be made within six months of the death. If a claim isn't submitted in time, it could be declined.
2. Provide the required documents
Upon notifying 1Life of your funeral cover claim, they will advise you which documents are needed, such as a death certificate. Submit these within three months of the request to avoid delays or rejections.
3. Lodge disputes promptly
If you are unhappy with a claim decision, you have 90 days to lodge a dispute with 1Life. If you're still unhappy with the response, you can contact the Ombudsman for Long-term Insurance within six months of their response to your dispute.
4. Keep your contact information updated
Ensure that 1Life Insurance has the correct contact details for the life assured, beneficiary and policy members. This will allow them to contact the appropriate person for any outstanding documentation or information.
By following these tips and keeping your policy up-to-date, you'll be better prepared to navigate the funeral cover claims process and ensure that your family receives the financial support they need during a difficult time.
The views and opinions expressed in this article are those of the authors and do not necessarily represent or reflect the views of 1Life Insurance or its employees.