When trouble hits a colleague, a well-meaning company's first thought is often: let's handle it for them. With group insurance the right role is more precise than that: the company helps – with information, certificates and humanity – while the filing is done by the eligible person towards the insurer, on the insurer's own channel.
- The filing belongs to the eligible person: the insured, or in a death case the beneficiary or a family member – on the insurer's claims line or online portal.
- The company gives three things: information, certificates and human support.
- The medical records tied to a claim are not requested or seen by the employer – they go directly to the insurer. (Data handling arising from the employment relationship and based on law – e.g. a fitness-for-work opinion, a sick-leave certificate, a workplace-accident report – is separate from this.)
- An empathetic internal protocol is prepared in advance, not improvised in trouble.
Why does the eligible person file – and why is that good?
A claim comes with medical records and personal data, and these go directly to the insurer – the employer never learns health data, and that is the safe arrangement for both sides. The eligible person receives the case number and the notifications, sees the case's status, and can make the declarations about their own data. The map of the filing route is in the filing a claim with the insurer article – every colleague should know it before anything happens.
What the company gives: information and administration
The employer's contribution is still very valuable. The first is information: handing over the internal one-pager that shows where to file the claim, what the group contract's ID is, and what records are typically needed. The second is administration: certifying the employment where the insurer asks for it; preparing and handing over the occupational accident report after a workplace accident. The third – in a death case – is tactfully informing the family that the cover exists and where the claim can be filed: families often do not even know about it. Templates and downloadable aids are available on the Resources page. It is good practice, too, for the contact person to ask the colleague a few weeks after the filing: is the case moving, is another certificate needed from the company's side?
The empathetic internal protocol
A good protocol is one that in trouble requires no thinking, only following: who the designated contact is (HR or the office manager), what they hand over, and in what tone. In a death case the order is not a question: first the condolences and the human presence, then – a few days later, offered rather than pushed – the practical help. A model for the process comes from the internal claims workflow article; and for the questions to expect from colleagues, the employee questions and answers collection prepares you.
Where is the line?
The company does not assess the claim, has no access to the case and cannot speed up the assessment – so it should not promise either: "they will surely pay" is a well-meant but risky sentence, since the insurer assesses the claim under its current policy conditions. What the company can responsibly say: "we show you the filing route, we issue the certificates, and we stand by you." And if the case gets stuck or turns disputed, I help the person concerned, as broker, where I can – the framework is in the when the broker steps in article; the company's part is to flag this possibility to the colleague.
A question about your own team? Book a free 20-minute consultation →
