Insurance claims (life, health, disability, income cover) and Policywise support

Policywise clients: Contact us for insurance claims support

You don't have to navigate the insurance claim process alone. If you need to make a claim, here's how to get started:

• Check that your policy is with us: You’re eligible for our support only if you took out your policy through Policywise, so if you're not sure, that's the first thing to confirm.
• Have your policy number ready: This helps us find your details quickly and get started without delay.
• Get in touch: Email your adviser directly if you know who they are, or message us at hello@policywise.co.nz if you don't.
• We'll take it from there: We'll walk you through what your policy covers, guide you step by step through the documents and information needed, and liaise directly with the insurer on your behalf.

How Policywise supports you throughout your insurance claim

Having an adviser who supports you when you need to claim makes the process much less stressful. Here's how Policywise helps at each stage:

Before your claim, we'll:

• Explain what your cover includes
• Identify which benefits may be available to you
• Discuss what information the insurer will need.

While your claim is being assessed, we'll:

• Help you complete the paperwork
• Liaise with the insurer on your behalf
• Answer your questions as they come up
• Keep you updated on progress
• Help reduce unnecessary delays.

After your claim, we'll:

• Explain any ongoing benefits you're entitled to
• Review your wider insurance cover
• Help update your cover if your circumstances change.

Real claims story: How Policywise has helped clients

Having a broker or independent adviser in your corner during claim time makes a big difference, particularly when a claim involves more than one policy, additional medical evidence, or a drawn-out back-and-forth with an insurer. The story below illustrates that support in practice.

Health insurance | Declined claim overturned, urgent surgery approved

When their partner urgently needed neck surgery, a Policywise client found their claim declined by nib, leaving them overwhelmed and unsure where to turn. But because they'd arranged their policy through Policywise, they had an adviser already in their corner.

Rather than accepting the decision, the adviser dug into the original application and underwriting process, taking the time to understand what had happened. Policywise listened closely to the couple's concerns and pushed back on nib directly wherever the reasoning didn't hold up, keeping the couple informed and supported at every step.

nib reversed its decision, and the claim was approved. The surgery went ahead without further delay. For the couple, it was proof that having an adviser who doesn't disappear once the policy is signed can make a huge difference at crunch time.

Health insurance | Support through a difficult claim

Not every claim involves a lengthy dispute. Sometimes what matters most is having someone steady on hand throughout. Policywise client Lucy shared the positives of that support when dealing with a difficult health insurance situation.

Her adviser's knowledge and guidance helped Lucy feel confident in achieving a successful outcome. The Policywise adviser was responsive and easy to deal with throughout, turning what could have been a stressful situation into something far more manageable.

Lucy said she wouldn't hesitate to recommend her adviser and the Policywise team to anyone needing support with their insurance needs.

Read more of these stories from this reviews page.

How to make an income protection insurance claim

Income protection claims are usually made once a healthcare provider has confirmed you're unable to work due to illness or injury. The general process looks like this:

1. Check your cover. Review your policy wording to confirm your waiting period and what counts as an eligible claim.
2. Notify your insurer promptly. It's best to get in touch as soon as possible, since your waiting period is generally counted from when you first became unable to work.
3. Complete the claim form. This typically includes sections for you and your doctor to fill in.
4. Provide supporting evidence. Insurers commonly ask for medical reports, specialist notes, and, if relevant, ACC claims information.
5. Get the claim assessed. Once your claim is lodged, most insurers assign a dedicated case manager to assess your claim and support you through recovery, with some insurers aiming to start assessment within five working days.

How long can you claim income protection insurance?

Income protection generally pays out for as long as you remain unable to work, up to the benefit period you chose—commonly two or five years, or through to age 65 or 70. Payments start once your waiting period (often 2 to 26 weeks) has passed. If you relapse into a related condition within a set timeframe, some policies waive a fresh waiting period. Read your specific policy wording, since rules vary by insurer.

How many times can you claim on income protection?

There's generally no fixed limit on how many separate claims you can make, provided each is for a genuine, policy-defined inability to work. A new, unrelated illness or injury usually triggers its own waiting period. If you're re-claiming for a related condition soon after returning to work, many insurers waive the waiting period and treat it as a continuation. Clarify with your adviser, as rules differ between insurers.

How much does income protection insurance pay?

Most New Zealand policies pay a monthly benefit based on a percentage of your pre-disability income—commonly up to around 75%. Your payment may be reduced if you're receiving other support, such as ACC, for the same condition. Some policies use an "agreed value" set at purchase, others an "indemnity" structure based on income at claim time. It's worth reviewing your cover if your income has changed.

How to make a life insurance claim

Life insurance claims are usually made by a beneficiary, executor, or next of kin after the life assured has passed away or been diagnosed with a terminal illness. The exact process varies by insurer, but the general steps are:

1. Check the ownership of the policy. Find the policy documents and check ownership, or contact the insurer or adviser if you're not sure where to start.
2. Contact the insurer promptly. Most insurers ask you to notify them as soon as possible after the event.
3. Gather the required documents. Typically this includes a certified copy of the death certificate, certified ID for the deceased, and, if applicable, a certified copy of the Will or letters of administration.
4. Complete the claim form. The insurer will confirm exactly what's needed based on how the policy is owned.
5. Work with the specialists. You'll be kept in the loop by your claims specialist throughout the claim, and you can get in touch at any point if something comes up.
6. Wait for assessment. The insurer checks that the policy was active and confirms the beneficiary before releasing payment.

How much can I claim for life insurance?

You can claim the sum insured stated in your policy document, which is the amount you chose (and paid premiums for) when you took out cover. This is a fixed lump sum rather than a figure calculated at claim time, though some policies include optional extras—such as terminal illness or funeral benefits—that can add to the total payout.

How long after a death can you claim life insurance?

There's usually no strict deadline for lodging a life insurance claim, but insurers generally ask beneficiaries to get in touch as soon as possible. Delaying a claim won't necessarily affect your entitlement, though it can slow things down, particularly if probate or letters of administration are needed for a larger policy. It's best to contact the insurer or your adviser as soon as you're able.

How long does life insurance take to pay out in NZ?

Straightforward claims, where the policy ownership is clear and all documents are provided upfront, can often be processed within days to a few weeks. Claims that require probate, involve multiple beneficiaries, or need further information can take longer. Having your documents ready and responding promptly to any requests will help speed up the process.

How to make a health/medical insurance claim

Health insurance claims are typically for costs such as specialist consultations, diagnostic tests, or surgery. General steps are as follows:

1. Check if you need pre-approval. Many insurers require this for surgery or costs over $1,000, so confirm this before treatment.
2. Keep your invoices and receipts. You'll need these to support your claim.
3. Submit your claim. Most insurers now offer online portals or apps, which tend to be the fastest option, though paper forms are usually still available.
4. Wait for the outcome. The insurer will contact you once your claim has been assessed, or if further information is needed.

Using a healthcare provider within your insurer's approved network can sometimes mean your provider claims directly on your behalf, so you don't need to pay upfront at all.

How long do health insurance claims take?

Online health insurance claims are typically processed within about five to ten working days, though this can vary by insurer and the complexity of your claim. Claims submitted on paper take a little longer. Claims involving surgery or hospital care, and any pre-approval requests beforehand, may take additional time while the insurer confirms cover.

How to make a trauma insurance claim

Trauma (sometimes called critical illness) insurance pays a lump sum if you're diagnosed with a serious illness or injury defined in your policy, such as cancer, a heart attack, or a stroke. To make a claim, you'll likely need to:

• Contact the insurer as soon as you receive a relevant diagnosis
• Provide medical evidence confirming the diagnosis meets your policy's specific definition
• Complete the insurer's claim form, with input from your treating doctor
• Allow time for the insurer to assess the claim against your policy wording.

Because trauma claims depend on meeting an exact medical definition, ask your insurer or adviser early on what evidence will be needed, so nothing holds up your claim later.

How to make a disability insurance claim

Total and permanent disability (TPD) cover pays a lump sum if you become permanently unable to work due to illness or injury. The general process is:

• Notify your insurer of your condition and its impact on your ability to work
• Provide medical evidence supporting your inability to work in your own or any occupation, depending on your policy definition
• Complete the required claim forms, including sections for your treating doctor
• Wait for the insurer's assessment, which may include further medical reviews.

TPD claims can take longer to assess than other claim types, partly because permanent incapacity often can't be confirmed until a reasonable period has passed. Staying in regular contact with your insurer or adviser can help keep the claim moving.

Insurance claims in NZ: What the numbers show

Recent figures from several of Policywise's partner insurers indicate that across life, health, trauma, income protection, and disability cover, claims worth hundreds of millions of dollars are paid to New Zealanders every year.

Recent annual claims figures include:

• $1.706 billion — claims paid by Southern Cross Health Society in the year to 30 June 2025, across a record 3.8 million claims
• $790 million — total claims paid by AIA NZ in the year to 31 December 2025
• $325 million+ — claims paid by Partners Life from 1 April 2024 to 31 March 2025
• $247.7 million — claims paid by Fidelity Life from 1 July 2024 to 30 June 2025
• $117.9 million — claims paid by Asteron Life from 1 July 2024 to 30 June 2025
• $174.1 million — incurred healthcare claims paid by nib NZ in the six months to 31 December 2025.

Note that insurers report claims differently. Some publish figures for claims received, others for claims assessed or new claims accepted, and reporting periods vary. This means the numbers above aren't perfectly comparable, though all point to substantial sums being paid out in eligible claims each year.

Recent claims paid by type of cover

*nib's figure is for incurred healthcare claims during the six months to December 2025, so shouldn't be compared directly with the annual figures above.

Recent insurer data also shows healthy claims acceptance rates:

• Asteron Life reported a 97% combined acceptance rate for FY25
• Partners Life paid 95% of assessed claims
• Fidelity Life accepted 93% of new claims
• AIA NZ accepted 91% of claims received during their respective reporting periods.

Your one-stop platform for insurance claims

Policywise is a 100% free service which tells you which health, life, and disability insurance provider best fits your needs. We offer fast, comprehensive, and easy-to-understand comparisons of all leading providers, and a simple summary clearly recommending which insurer is best for your situation.

Not all insurance policies are the same. Policywise can help you sort out the duds, avoid the lemons, understand the fine print and exclusions, and get the right insurance for you and your family.

We make the important decision of where to buy your insurance super easy. We’ll answer your questions, provide experienced advice and quotes, and manage all the back and forth throughout the application process. Taking out your cover through us means you'll have our lifetime support and claims advocacy, and we'll help you negotiate a positive outcome at claim time. We can also take care of lodging any claims on your behalf and back you up if the going gets tough.

Check out the reviews on our homepage for how other New Zealanders have found our service, because now is the time to get your personal, family, or business insurance sorted. Give your family or someone you love the most outstanding financial support possible. Book a 5-minute callback with Policywise today; our service is fast and free.