paying a claim

The simple art of paying a claim

February 2015

By Olefile Moea, Executive Director, Fairheads Benefit Services

Processing a claim sounds simple enough, but sometimes even simple things can be complicated. Take for instance the payment of a capital claim on money invested in a beneficiary fund. The money has been placed in a beneficiary fund primarily to meet the educational and wellbeing needs of a minor child. It is their money, however the mandate of the administrator is to pay claims in accordance with the trustee approved policy. The trustees have a fiduciary duty to ensure that funds are used for the purpose that they are intended, and as such design policies which protect the minor dependents.

The request needs to be carefully assessed by an experienced trust officer to determine whether there is money available, whether the payment will impact on the longevity of the fund, and whether the purpose of the funds meets the approved policy.

In some cases, the guardian needs help and counselling about paying the claim, proper budgeting or even assistance on making alternative arrangements.

Even once the validity of the claim has been established, in many cases the payment must be made to the third party provider, such as the school or the transport provider.

Getting the balance between making sure that you are not imposing unreasonable barriers for your client, ensuring that the purpose of the product is achieved and keeping processing costs as low as possible, is a complex affair, but in the end is the difference between delivering exceptional service and being just another service provider.