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Accident & Health

Comprehensive Management of Injury and Health-Related Insurance Claims

At Quartz Claims, we recognise that Accident & Health (A&H) claims represent more than administrative processes — they involve real people experiencing unexpected disruptions to their lives, health, and livelihoods. Whether the incident occurred at work, during travel, or in day-to-day life, our role is to support a fair, timely, and respectful resolution process from start to finish.
Through a combination of structured workflows, secure digital systems, and experienced claims professionals, we deliver a service that is both operationally robust and deeply human.
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Expertise Across the Accident & Health Spectrum

Quartz Claims manages a broad portfolio of A&H claim types, including:

  • Personal Accident & Illness Claims – Covering accidental injury, temporary incapacity, and illness under standalone or embedded policies
  • Workplace Accident Claims – Where an employee is injured under group risk or corporate cover
  • Corporate Travel Claims – Including overseas medical incidents, trip cancellations due to injury, or emergency repatriation
  • Disability Benefits (Temporary or Permanent) – Assessment and administration of claims relating to partial or total incapacity
  • Out-of-Pocket Medical Expenses – Reimbursement processing for covered medical treatment costs
  • Group Scheme Claims – Managed under employer-sponsored or affinity programs with specific benefit frameworks
Our systems are flexible enough to handle complex benefit structures while ensuring a smooth experience for policyholders and stakeholders.

A Balanced Approach: Efficiency Meets Empathy

The nature of A&H claims demands an approach that is both methodical and compassionate. At Quartz Claims, we’ve built our service model around five core principles:
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Timely and Accurate Triage
Claims are assessed immediately upon lodgement using automated workflows that prioritise urgency and complexity — ensuring fast action for time-sensitive cases.
Clear Policy Interpretation
Every claim is reviewed against the policy wording, benefit schedule, and relevant exclusions, providing early clarity and reducing avoidable delays or miscommunication.
Secure, Confidential Handling
We maintain strict controls around the handling of medical documents and personal information, with full compliance to Australian privacy standards.
Human-Centred Communication
Our claims professionals communicate with claimants and intermediaries with respect, clarity, and empathy — particularly in challenging or sensitive cases.
Escalation and Oversight
High-value, long-term, or disputed claims are escalated through structured decision pathways, with oversight built in to ensure transparency and defensibility.

Scalable Solutions for Individual and Group Claims

Our A&H claims capabilities are equally suited to:

  • Individual Retail Policies – Offering fast, efficient claims outcomes for direct clients
  • Employer-Funded Group Policies – With tailored service models and SLA tracking
  • Affinity and Member-Based Programs – Where brand protection and policyholder satisfaction are paramount
By embedding AI into our workflows and maintaining a disciplined approach to process design, we’re able to scale rapidly while delivering high-quality outcomes — whether handling a single event or supporting thousands of scheme members.

Independence That Strengthens Trust

Quartz Claims is wholly focused on claims management. We are not affiliated with any legal, loss adjusting, or ancillary service providers. This independence allows us to deliver truly objective, policy-based claims decisions without conflicts of interest — building trust with insurers, brokers, Coverholders, and policyholders alike.

Why Partner with Quartz Claims for A&H Claims?

  • Independent Third Party Administrator focused exclusively on claims
  • Experience across a wide range of A&H claim types and policy structures
  • Technology-led infrastructure for faster turnaround and lower costs
  • Empathetic service model that values the claimant experience
  • Scalable operations that can flex to support growth or surge events
  • Transparent communication and reporting for all stakeholders

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frequently asked questions

These claims generally relate to injury, illness, or medical costs arising under personal, workplace, or group insurance policies. They may include temporary disability, hospitalisation, or reimbursement for approved treatments.


Yes. We manage both individual and group schemes, including employer-sponsored plans, membership programs, and affinity groups. Our systems are built to accommodate bulk claims, batch processing, and multi-level benefit structures.


All medical and personal documentation is stored in secure, encrypted environments with strict access controls. Our systems are fully compliant with Australian privacy regulations and offer full auditability.


These cases are escalated within our structured decision-making framework and are managed with heightened oversight to ensure fair treatment and alignment with policy terms.


We engage directly with claimants when authorised to do so, and always in a respectful, compassionate manner. We also maintain clear communication lines with brokers, employers, and insurers throughout the claim.


To explore our A&H services, contact us at info@quartzclaims.com. We’ll work with you to understand your portfolio structure, claims volume, and preferred service model before tailoring a solution that meets your objectives.

+61 2 7245 8910