Making a claim

We’ve signed up to The Protection Distributors Group' (PDG) Claim Charter, reinforcing our dedication to delivering the highest standards to customers throughout their claim experience.

We are passionate about delivering positive customer outcomes and handle each claim with compassion and understanding.

Our experienced claims handlers complete a Samaritans’ training course.

How to make a claim

The claims department can be contacted by telephone, letter or email and the contact details for each type of claim are shown here.

The claims line is open between 9.00am and 5.30pm, Monday to Friday. You or your client can leave a message at any time day or night and we will get back to you.

Our specialist helpline can offer help and advice to your client throughout their claim period. We’ll make sure they have all our contact details.

What happens when a claim is made

We understand that your clients or their family are going through a very difficult time when they make a claim, so we handle each case with sensitivity and understanding.

We have over 60 trained claims assessors and our experienced claims handlers complete the Samaritans‘ conversation with vulnerable people’ course.

We try to keep claiming easy and straightforward, but there are certain things we need to do before making a decision.

  • We check that the plan is in force with all premiums paid to date at the time of the claim. For health claims, premiums should continue until a decision on the claim is made. We suspend premiums on death claims as soon as we are told about the death of a client.
  • Each case is assigned a claims assessor who remains the main point of contact throughout the process. This means you or your client should be able to speak to the same person throughout and they will be familiar with the progress of the case.
  • The claimant can nominate someone else to act on their behalf. We’ll let you know if we need written permission to deal with that person.
  • The assessor will decide on the next step having received the claim form. Please complete the form with as much detail as possible, as this will speed up the claim.

    It’s likely that the majority of health claims will require further medical evidence from the doctors or consultants who are involved in the treatment. Full details of any illness, when it started and treatment given are particularly helpful. We’ll keep you informed every time we ask for information.

    We always apply the Consumer Insurance Act and the ABI Code of Practice when we assess a claim. If we ever decide to reduce the payment, the decision will be ratified by at least two expert members of our team.

  • If your client is making a claim, additional support may be available, details are below.

Rehabilitation Support Service

Our Rehabilitation Support Service – available at no extra cost to clients with Income Protection Benefit – offers qualifying claimants access to a specialist rehabilitation team who will build a structured return to work programme.

The support service includes:

Triage service – to assess your client’s needs if they’ve been absent in the early stages of the claim, due to psychological, musculoskeletal problems or cancer.

Full rehab assessment - more in-depth than a triage and typically done over the phone. If necessary, these assessments can be done face-to-face where appropriate.

Ongoing reviews - helps to support your client’s claim and understand what treatments and/or self-help measures are available.

File reviews – provide direction in the management of your client’s claim as well as monitoring new medical information.

Your client can access these services using the claim contact details for Income Protection Benefit claims.

Nurse Support Services

For clients with Critical Illness Cover and Critical Illness Extra, we’ve partnered with RedArc Assured Limited and their registered nurses, to include a suite of six Nurse Support Services.

These physical and emotional support services are available for your client to access at any point during their policy to help them cope during difficult times.

They include advice and support from trained nurses in six areas:

  • Treatment, coping strategies and bereavement
  • Second medical opinion
  • Mental health support
  • Carer support
  • Help at home after a hospital stay
  • Eldercare

Your client can access these services using the claim contact details for Critical Illness Cover claims.

Second Medical Opinion Service

This is the opportunity for your clients to have a face to face meeting with a Consultant Specialist to get a second medical opinion about their condition, should they need to make a claim.

This service is provided and managed by Healix Health Services Ltd, a UK company with a team of clinically-trained claims assessors who are supported by qualified nurses. Between them, they manage appointments, the transfer of medical records and billing arrangements.

Your clients can be reassured that the service is completely confidential and independent, and no information will be shared between Legal & General and Healix.

The service provides:

  • Access to a database of Consultant Specialists throughout the UK.
  • A face to face or telephone consultation.
  • A supporting report which is sent to your client and their GP.
  • A contribution of up to £300 for the cost of the consultation (average consultation cost is £250).

Your client can access this service using the relevant claim contact details above.

PDF file: Second Medical Opinion – Adviser guide PDF size: 67.8KB  

PDF file: Second Medical Opinion – Client guide PDF size: 294.7KB  

Impact of overseas travel and residency on claims

Overseas travel and residency questions form part of our standard application process.

If the application is accepted by us, then the policy documentation states how we would assess any future overseas travel or change in residency.

The terms and conditions governing residency and travel vary between different products and have changed over time, so any existing customer should refer to their individual policy document for full information.

Any payments from claims can only be made to a UK bank account.

Countries where a claim can be made

Life cover claims

Claims can be made from anywhere in the world. We will pay a claim as long as we can verify that it is valid.

Critical Illness Claims

The life insured, or relevant child is covered if they are resident in the United Kingdom, any part of the countries that form the European Union, USA, Canada, Australia, New Zealand, the Isle of Man or the Channel Islands. We will also accept a claim from other countries if we can confirm the claim is valid. We will act reasonably when reviewing evidence to support the validity of a claim.

Income Protection Benefit

Clients can make a claim on this policy if they reside in or travel to any part of the countries that form part of the European Union, USA, Canada, Australia, New Zealand, the Isle of Man or the Channel Islands, or they reside or travel for up to 12 consecutive months in any other part of the world.

However, the monthly benefit for incapacity provided by this policy will only be payable for up to six calendar months while the client is outside the countries listed above.

Waiver of Premium

The life insured can claim for Waiver of Premium if they reside or travel within the European Union or travel outside of the European Union for no more than three consecutive months in any 12 months.

If the life insured travels outside of the European Union for more than three consecutive months in any 12 months we will act reasonably when assessing whether the life insured meets the definition of incapacity.

Advance payments for funeral costs

We recognise that families having to deal with bereavement can find themselves in situations where they face unexpected financial costs, in what are already upsetting circumstances.

That's why families can receive an advance payment of up to £10,000 on any valid claim to cover the cost of a funeral. We feel this Funeral Pledge is the right thing to do to support our customers and their families at a stressful time.

All Life Insurance policies with a Death Benefit Claim could qualify for an advance payment. Depending on each valid claim and the circumstances, we can pay the Funeral Director directly if we are not already in a position to pay out the full claim value and if the funeral payment is still outstanding.

Policies that don't qualify for advance payments for funeral costs:

  • Policies that are Assigned, Under Trust or subject to bankruptcy.
  • Claims for loss of income (Income Protection Benefit).
  • Claims for a critical illness (Critical Illness Cover).
  • Claims for a terminal illness (Terminal Illness Cover).
  • Claims for Total Permanent Disability (TPD).
  • Claims for Accident, Sickness, Unemployment (ASU).