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Making a claim

It’s your responsibility to start a claim within three months of being advised, by your employee, of any critical illness diagnosis or qualifying operation. We know there can be unexpected stresses or strains on a company if an employee needs to make a claim of this kind, so we’ll do everything we can to help.

Starting a claim…

Your employee – their husband, wife, civil partner or child – must have been diagnosed with a critical illness or undergone a specified operation, and have survived for 14 days after the date of diagnosis or operation. For total permanent disability claims, your employee must have been continuously and permanently disabled for six months, so that we can assess the extent of their disablement. A claim can be started by phoning us or emailing us. We'll then send out two claim forms:

  • One will be for you, as the policyholder. We’ll ask you for confirmation of general cover details, and this form will need to be signed by one of the policyholder's officials (often a director of the firm or your company secretary).
  • The other will be for your employee. This asks for more specific information about the nature of the illness or operation and any treatment.

We want to make everything as stress-free as possible, but it’s important to understand that any delays may affect the claim. If we need extra information – such as birth certificates or medical reports – we'll make appropriate contact to get these details.

We’ll be drawing on our experience in Group Risk, as we examine your employee’s circumstances carefully. Our primary aim is always to provide help, support and assistance to your employees. We'll also help families dealing with potential loss of life practically as well as financially. Our claims team is trained to deal with the sometimes sensitive and emotional nature of a Group Critical Illness claim, and we’ll be on hand to answer any queries your employees may have at this difficult time.

Assessing and paying a claim…

When we have all the information we need, we’ll assess the claim. If we need to find out more medical details, we’ll pay for any costs associated with that administration. There may be circumstances in which we ask for an independent medical examination.

When we accept a claim and agree to make a payment, the lump sum will be sent directly to your employee. For claims relating to illness or injury suffered by husbands, wives, civil partners or an employee's child, we'll then cancel cover for those individuals at that point.

For your employees, however, cover continues – but we won't pay any second claims for the same critical illness or operation or any related illness or operation, even if the first payment was from a different insurer of your scheme. We'd treat illness or injury in those circumstances as a pre-existing condition. However, if one of your employees has been paid a lump sum by the scheme and then suffers another critical illness or undergoes a further operation covered by the policy, we may also pay a lump sum.

WC00518 05/2014

Contact us

Talk to us. We’re happy to help. Call:

0845 300 4452

Monday to Friday
9.00am - 5.00pm

Calls to and from Aviva may be monitored and/or recorded

Useful information

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