{"id":85,"date":"2017-03-21T09:54:18","date_gmt":"2017-03-20T23:54:18","guid":{"rendered":"http:\/\/magazine.riskinfo.com.au\/30\/?p=85"},"modified":"2017-05-16T13:14:52","modified_gmt":"2017-05-16T03:14:52","slug":"comminsure-claims-round-table","status":"publish","type":"post","link":"http:\/\/magazine.riskinfo.com.au\/30\/comminsure-claims-round-table\/","title":{"rendered":"CommInsure Claims Round Table"},"content":{"rendered":"<div class=\"fw feature1\">\n<h3>Riskinfo joined forces with CommInsure to conduct a recent Round Table conversation during which a broad spectrum of claims-related issues was discussed \u2013 issues impacting life companies, advisers and their clients.<\/h3>\n<\/div>\n<p><strong id=\"#top\">Table of contents\u00a0<\/strong>(Click these links to move directly to those topics)<\/p>\n<ol>\n<li><a href=\"#01\"> Perception and reality <\/a><\/li>\n<li><a href=\"#02\"> CommInsure staff and adviser responses <\/a><\/li>\n<li><a href=\"#03\"> Advisers and claims <\/a><\/li>\n<li><a href=\"#04\"> The role of insurers <\/a><\/li>\n<li><a href=\"#05\"> Mental health <\/a><\/li>\n<li><a href=\"#06\"> Using technology to improve the claims experience <\/a><\/li>\n<li><a href=\"#07\"> Wrapping up <\/a><\/li>\n<\/ol>\n<hr \/>\n<p>Given the critical role played by claims services and the current-day issues impacting this sector of the life insurance industry, this Round Table discussion demanded an honest, frank and open exchange of dialogue between our life company and adviser panellists.<\/p>\n<p>To this end, we were grateful to CommInsure\u2019s Olivia Sarah-Le Lacheur and Ciaran Curley for their willingness to discuss the issues raised by the media reporting during the first half of 2016.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/magazine.riskinfo.com.au\/30\/wp-content\/uploads\/sites\/19\/2017\/03\/story-feature-01-01.jpg\" alt=\"\" width=\"1200\" height=\"720\" class=\"alignnone size-full wp-image-587\" srcset=\"http:\/\/magazine.riskinfo.com.au\/30\/wp-content\/uploads\/sites\/19\/2017\/03\/story-feature-01-01.jpg 1200w, http:\/\/magazine.riskinfo.com.au\/30\/wp-content\/uploads\/sites\/19\/2017\/03\/story-feature-01-01-300x180.jpg 300w, http:\/\/magazine.riskinfo.com.au\/30\/wp-content\/uploads\/sites\/19\/2017\/03\/story-feature-01-01-768x461.jpg 768w, http:\/\/magazine.riskinfo.com.au\/30\/wp-content\/uploads\/sites\/19\/2017\/03\/story-feature-01-01-1024x614.jpg 1024w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><\/p>\n<p><b>Panelists (L &#8211; R)<\/b><\/p>\n<ul>\n<li><strong>Ciaran Curley,<\/strong>\u00a0Head Of Claims Strategy, CommInsure<\/li>\n<li><strong>Peter Sobels,<\/strong>\u00a0Publisher, Riskinfo<\/li>\n<li><strong>Peita\u00a0Diamantidis,<\/strong>\u00a0Co-Founder &amp; Senior Adviser, Caboodle Financial Services<\/li>\n<li><strong>Diane Bleasdale,<\/strong>\u00a0Senior Adviser, Bridges Financial Services<\/li>\n<li><strong>Olivia Sarah-Le Lacheur,<\/strong>\u00a0Head of Life Distribution, CommInsure<\/li>\n<li><strong>Jason Spits,<\/strong> Senior Journalist, Riskinfo<\/li>\n<li><strong>Nick\u00a0Hatherly,<\/strong>\u00a0Managing Director, AFRM<\/li>\n<\/ul>\n<hr \/>\n<div class=\"fw ad\"><!-- Error, Ad is not available at this time due to schedule\/budgeting\/geolocation\/mobile restrictions! --><\/div>\n<p>&nbsp;<\/p>\n<h3 id=\"01\">Perception and reality <span style=\"font-size: 12pt\"> &#8211; <a href=\"#top\">Back to top<\/a><\/span><\/h3>\n<p>We asked Olivia and Ciaran to share their views on the allegations and criticisms that were directed towards CommInsure by the media and we were also keen to understand the impact this controversy had on the management and staff within CommInsure and on advisers and their clients.<\/p>\n<p>Looking back to the first half of 2016 we started by asking Ciaran his view on which of the media criticisms were fair and which were not:<\/p>\n<p>\u201cThere\u2019s no question about it that we can do things better and we should have done things better, particularly with respect to our definition of heart attack, which we acknowledge was out of step with what the community would expect,\u201d said Ciaran. \u201cSo we\u2019ve rectified this and have passed back that definitional change now to October 2012, which is a great thing for our customers,\u201d he added.<\/p>\n<p>Ciaran also noted that this provided CommInsure with \u201c\u2026a good opportunity to critically examine our processes and procedures to identify where we can improve and how we can engage better with customers and advisers when they need our support most.\u201d<\/p>\n<p>\u201cIt was a really difficult period for us, as an organisation and I think the independent expert Deloitte report that was recently released, and the ASIC investigation into CommInsure reassured us of what we already knew about our business, that it is an ethical business and our people operate with integrity.\u201d<\/p>\n<blockquote><p>trust in a relationship with you guys is the most important thing we have<\/p><\/blockquote>\n<p>Ciaran told the panel that, after assessing all of the work that was completed, there is nothing to support the allegation that CommInsure engaged in \u2018doctor shopping\u2019 for the purpose of securing preferred medical opinions in relation to claims, and nothing to support allegations with respect to an increase in surveillance practices. He said claims case managers are not financially rewarded for declining claims.<\/p>\n<p>\u201cThis isn\u2019t a set and forget approach for us,\u201d continued Ciaran. \u201c\u2026the declined claims review was the largest across the industry and focussed on the end-to-end customer experience in addition to the quality of decision making. We are 100% committed to improving the claims experience and there\u2019s a program in place to make sure that, as a business, we continually look to evolve and improve.\u201d<\/p>\n<p>CommInsure\u2019s Head of Life Distribution, Olivia Sarah-Le Lacheur, shifted the emphasis of the conversation by asking the panel to consider the insurance claim process from the perspective of the claimant. Referring to the self-analysis that has occurred within CommInsure following the 2016 media allegations, Olivia said \u201c\u2026 one thing that\u2019s become evident is the timeliness of communications. So, what we\u2019ve stared into quite deeply at CommInsure was what it really feels like when you\u2019re the person who is submitting a claim.\u201d<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/magazine.riskinfo.com.au\/30\/wp-content\/uploads\/sites\/19\/2017\/03\/story-feature-01-05.jpg\" alt=\"\" width=\"1200\" class=\"alignnone size-full wp-image-587\" \/><\/p>\n<p>Olivia explained, \u201cWe might have a process that takes a defined period of time, and it makes very logical sense to us, but when you\u2019re the person who is having the claim event happen to you, you\u2019re in a very emotional state, and usually you\u2019re involved in something you\u2019ve never done before, which is talking to a life insurance company about the forms you need to complete, the reports that need to be obtained, and to go through a process that\u2019s unfamiliar.<\/p>\n<p>\u201cSo, if I think about the advisers and the licensees that we deal with, one of the emerging conversations out of last year\u2019s media coverage is, what role can I play as an adviser or licensee in identifying our value proposition around the claims experience?<\/p>\n<div class=\"fw ad\"><!-- Error, Ad is not available at this time due to schedule\/budgeting\/geolocation\/mobile restrictions! --><\/div>\n<p>\u201cFor my distribution team, one of the conversations we had very early on was, what do you think your involvement should be in the claims process? What came back very strongly, for us, was that relationships are at the heartbeat of the insurance business, whether it\u2019s a relationship between the adviser and Ciaran\u2019s claims team, or whether it\u2019s the relationship between the adviser and the client. When people talk to each other you get much better outcomes because you can make things clearer, easier to understand, and make them very relevant and specific to the individual. So, what we\u2019ve seen is licensees, who previously didn\u2019t have a licensee standard around the claims engagement, are starting to articulate that in writing and are saying to their advisers, \u2018This is an expectation we have if you\u2019re part of our group. Now we want you to look at what you\u2019re going to do in your own practice.\u2019\u201d<\/p>\n<p>Olivia shared with the panel that another element that was very important for CommInsure last year was the concern amongst the adviser community about the allegations raised in the media. \u201cThey wanted clarification and they wanted confidence so that they could pass it on to their clients, because our brands are intermingled &#8211; the insurer\u2019s brand, the adviser\u2019s brand, and they connect together for the customer. So, as soon as there was any media coverage at all we made a conscious decision that we would proactively reach out to as many advisers as we could to ask them how they were feeling, what they were worried about and what information could be shared to help them retain or restore their confidence in CommInsure.\u201d<\/p>\n<p>The three adviser panellists at our Round Table were asked how they responded to the media reports on CommInsure from the first half of last year and whether this had any impact on their clients.<\/p>\n<p>Peita Diamantidis said her advice business experienced \u201c\u2026an inundation of calls. We even had some clients cancel their policies, so it was that extreme. We were doing a lot to mitigate that because I just don\u2019t believe trial by media is a way to get anything done.\u201d Peita told her peers that \u201c\u2026the actions that big corporates must take after something like this happens is more about perception than it is about reality. I\u2019d prefer to see some sweeping underground change for the industry; not something that\u2019s just reacting to the moment.\u201d<\/p>\n<blockquote><p>Why is there any paperwork? Why isn\u2019t it all electronic?<\/p><\/blockquote>\n<p>Peita said she was more interested in changes that are long standing and fundamental. \u201cSo, I\u2019m interested in how we can change how hard it is for clients to claim and why there is any paperwork. Why is there any paperwork? Why isn\u2019t it all electronic?\u201d she asked; her point being that a totally electronic claims process would help to fundamentally change the claimant experience and help to move it away from being a sometimes traumatic experience.<\/p>\n<p>\u201cI don\u2019t think there\u2019s ever been a time where the public has been more sceptical of institutions,\u201d said Peita. Questioned as to whether she believes this consumer attitude is replicated in other countries, she said \u201cI think it\u2019s a financial industry thing, unfortunately, and generational. So, I think, Gen X and particularly Gen Y have a massive distrust of institutions, and in particular, financial ones. So, I think, unfortunately, these issues are hitting a market that isn\u2019t ready to say, \u2018You guys are the good guys and we know this is an issue, but we believe you\u2019ll get through it.\u2019 They\u2019re like, \u2018Hold on, I\u2019m just never quite sure what you guys are about anyway, and now look what happened.\u2019 So, I think just the angle they come from before they even hear the facts is quite different than it used to be,\u201d she concluded.<\/p>\n<p>Diane Bleasdale, a senior risk-focused financial adviser from Bridges Financial Services, said her first impression of the 2016 media reports was that it wasn\u2019t fair to CommInsure \u201c\u2026 because our experience of claims, with CommInsure, had been very good.\u201d Diane noted CommInsure had recently \u201c\u2026gone outside the box and paid additional benefits to clients.\u201d She said she was surprised when CommInsure twice paid a critical illness benefit in an income protection policy claim because the client didn\u2019t take any sick leave the first time they had cancer, but when he actually did take sick leave it was 18 months later. \u201c\u2026and because it was over 12 months, they paid it again. It was astounding, I couldn\u2019t believe it,\u201d she said.<\/p>\n<p>Unlike Peita, Diane told the panel she did not get questioned by her clients who held CommInsure policies. \u201c\u2026they just checked that their policies were okay.\u201d Diane added, however, that she was contacted by non-CommInsure policyholder clients asking whether their insurance was okay. \u201cSo, we were reassuring clients who weren\u2019t with CommInsure more than we were reassuring clients with CommInsure, which I found quite interesting,\u201d she said.<\/p>\n<div class=\"fw ad\"><!-- Error, Ad is not available at this time due to schedule\/budgeting\/geolocation\/mobile restrictions! --><\/div>\n<p>Offering his own take on the 2016 CommInsure media allegations, Australian Financial Risk Management\u2019s MD, Nick Hatherly, made a very pointed observation. Referring to the age of some of the policies that were the subject of the media reports and the fact that no advisers appeared to be involved, Nick commented<b>: <\/b>\u201cUnadvised claims are a nightmare. Who was acting for that person?\u201d Nick told the panel he thinks all insurers get it wrong: \u201c\u2026you want to build relationships with claimants, but that\u2019s not your job. There should be somebody sitting in the middle who builds that relationship with the trust, and that\u2019s the adviser. It has always been the adviser, [but] unfortunately not all advisers manage this process well.\u201d<\/p>\n<h3 id=\"02\">CommInsure staff and adviser responses<span style=\"font-size: 12pt\"> &#8211; <a href=\"#top\">Back to top<\/a><\/span><\/h3>\n<p>Ciaran and Olivia were asked about the mood inside CommInsure during the height of the controversy. Ciaran: \u201cIt was an incredibly difficult time for people working in the CommInsure business.\u201d Referring in particular to the environment within CommInsure\u2019s claims area, Ciaran said \u201cI have to say, and Diane mentioned it, the support we received from financial advisers was absolutely fantastic. Many personally made a point of contacting us. We heard stories of advisers speaking at conferences describing their experiences with our claims team vastly different to what had been reported in the media. You really need moments like this to help you through difficult times,\u201d said Ciaran.<\/p>\n<p>Ciaran continued, \u201c\u2026as difficult as it was for individuals within the business I\u2019m very proud of how we focussed our attention on the customer. We provide support to customers with serious illnesses, support customers that have lost a loved one or can no longer work due to a disability.\u00a0 Having that perspective tells you that these customers are in a far worse position. So, in effect, this is how we navigated through the difficult times.<\/p>\n<p>\u201cWhat I\u2019d like to think is that for those advisers who were critical it was more on a perception basis. Maybe they hadn\u2019t had a claims experience with us. So, absolutely, there was some criticism [from advisers] and you can understand why, [but] as I said, I\u2019m very proud of the business in terms of how we navigated through that.\u201d<\/p>\n<p>Olivia added the she and her support team continue to speak with advisers and licensees every day \u201c\u2026and what we saw was people always react differently to anything that is quick, shocking or unexpected. Some people look for logic and others need to work through an emotional response. We did have several advisers calling or emailing very upset about the media coverage and wanting to work through that in their own way.\u201d<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/magazine.riskinfo.com.au\/30\/wp-content\/uploads\/sites\/19\/2017\/03\/story-feature-01-02.jpg\" alt=\"\" width=\"1200\" class=\"alignnone size-full wp-image-587\" \/><\/p>\n<p>Olivia told the panel her aim and that of her CommInsure colleagues, was to make themselves both visible and available so they could work through the issues with advisers. She said the fundamental concern held by advisers was the same as it was for CommInsure staff: \u201cOur integrity was being questioned,\u201d Olivia continued, \u201c\u2026so, our focus was to be visible and active in those conversations, and work through as best we could what advisers needed to reach a position of comfort and clarity.\u201d She conceded CommInsure didn\u2019t achieve that outcome with every adviser, and that there are some who will always have residual questions, \u201c\u2026but we felt that being open and transparent was the best way to deal with it.\u201d<\/p>\n<p>Nick also suggested some claims are declined on legally valid reasons but sometimes may not pass a \u2018moral\u2019 test. He told the panel he thinks that sometimes claimants are let down from this perspective and says \u201c\u2026I think insurers need to look at the moral perspective.\u201d<\/p>\n<p>Asked if he was referring to all insurers, Nick said \u201cYes, absolutely. Never let the definition get in the way of a claim that should be paid.\u201d His point here related to the intent of the policy and its wording: \u201cWhat was the intent?\u00a0 Did that happen? \u2026and that\u2019s probably the advocacy we can do as advisers &#8211; get to the intent, and from CommInsure or any insurer we deal with, trust in a relationship with you guys is the most important thing we have.\u201d<\/p>\n<div class=\"fw ad\"><!-- Error, Ad is not available at this time due to schedule\/budgeting\/geolocation\/mobile restrictions! --><\/div>\n<p>Peita added that while she and her support team at Caboodle generally find claims staff to be very compassionate, she says the public has no such insight. \u201c\u2026I think a change we need to be ready to make for large institutions is to start opening the doors a little so the public can see that there are human beings at the end of a process.\u201d Peita continued, \u201cProcesses and machines create fear whereas human beings give a connection. Just like Nick was talking about, the advisers can give that human connection, and I think people see a logo and a building, and they\u2019re not seeing human beings. So I think getting an insight into the fact that claims people have varied personalities and they\u2019re compassionate and interesting, and have wonderful backgrounds, will help better connect the consumer with the claims process.\u201d<\/p>\n<h3 id=\"03\">Advisers and claims<span style=\"font-size: 12pt\"> &#8211; <a href=\"#top\">Back to top<\/a><\/span><\/h3>\n<p>Switching to the topic of the role of an adviser at the time of a claim, the adviser panellists were very much of the view that they are and should be the first point of contact for any of their clients, even ahead of the life insurer who had issued the policy.<\/p>\n<p>Diane said this approach was actually the core of her business which had been built around a claims assistance service which provided clients with information and contact details about what to do if they believed they had a claim.<\/p>\n<p>\u201cWe want to be their first port of call. They should be calling us; not the insurer, and we take it from there. We lodge the claim, we issue the claim forms to them, we ask for the claim forms back. With a good number of our clients, we say to them, \u2018Do you want to talk to the claims manager?\u2019 and they respond, \u2018No, we\u2019re happy that you are dealing with this for us\u2019,\u201d Diane said.<\/p>\n<p>\u201cI think because they know that we know them and they trust us, they\u2019re not talking to a third person and trying to explain all that they\u2019re going through at the time. So, it\u2019s a very integral part our offering and probably the thing I get the most satisfaction from &#8211; that I\u2019m helping them and that ultimately what we put in force for them has paid out and has helped them at their greatest time of need.\u201d<\/p>\n<p>For Peita, the professional risk adviser should be a central figure, supplying guidance and stability during and after a difficult and often traumatic time for a client, as well as an advocate promoting their cause with the life insurer to produce the best outcome. Yet, this work is often caught up in the mechanics of making a claim.<\/p>\n<p>\u201cMy only frustration in terms of what the adviser\u2019s role can be is when I\u2019m helping to talk between departments in the same institution &#8211; that drives me nuts when I\u2019m the connector between silos. That\u2019s not all insurers, but it\u2019s happened for us previously where I needed to almost provide the file notes to say, \u2018This is what this person said. Can you please go and speak to your boss who will go and speak to their boss to advance the claim.\u2019 Advisers shouldn\u2019t need to do this because it takes us away from our singular focus which should be the client,\u201d Peita said.<\/p>\n<p>Building on those views, Nick reaffirmed his belief that clients seek trust and a relationship with an adviser which obligates them to provide assistance at claim time and a failure to do that is to fail at being a risk adviser.<\/p>\n<p>\u201cI\u2019m going to keep harping on about trust and relationship, and the trust and relationship sits with the adviser. We deal with the insurer but somebody has got to be that advocate. Somebody has got to settle that client down. I believe every time the insurer talks to the client, the client\u2019s first thought is, \u2018They\u2019re trying to get me off claim\u2019 and no matter how hard you\u2019re going to try that is always going to be the perception, and we put ourselves right in front of that. And, on the other side, the adviser is the expert. We\u2019re the ones who wrote those policies. We\u2019re the ones who study those definitions. We put those sums insured in place. It\u2019s up to the adviser to make sure that\u2019s interpreted correctly,\u201d Nick said.<\/p>\n<div class=\"fw ad\"><!-- Error, Ad is not available at this time due to schedule\/budgeting\/geolocation\/mobile restrictions! --><\/div>\n<p>Nick added that advisers who assist clients with claims usually see first-hand the emotional toll its takes on people, something both Peita and Diane agreed was a reality as well, with Nick adding that adviser assistance was more than just handling claims processes but helping to deliver on the promise inherent in the insurance product. As such, he questions why an adviser who does not assist at claims time would even consider offering advice on insurance in the first place.<\/p>\n<p>Adding to Nick\u2019 comments, Diane and Peita also questioned why an adviser would step back from assisting a client with a claim if they were involved with securing insurance for that same client, with Diane regarding it as part of the trust relationship between an adviser and a client. \u201cIn fact,\u201d Diane said, \u201cbeing asked to help with a claim demonstrates the client does trust the adviser and this is shown in the type of personal information clients often share with advisers within that relationship.\u201d<\/p>\n<h3 id=\"04\">The role of insurers<span style=\"font-size: 12pt\"> &#8211; <a href=\"#top\">Back to top<\/a><\/span><\/h3>\n<p>In examining the role of life insurers in assisting advisers during a claim Olivia pointed out that for some advisers, particularly those new to life insurance and the claims process, it can be as daunting and confusing for them as it is for their customers. The remedy to this, according to Olivia, is education and story-telling, that is telling advisers how it can and should be done and then illustrating that with real world cases studies from peers within the profession.<\/p>\n<p>\u201cWe have got to do more education and to build more capability around all aspects of life insurance, particularly with the claims piece because advisers already have their own personal experiences to talk about the power of delivering on a promise, the emotion of being involved with a client and how they demonstrate the value of the advice given. Our model is to be able to support advisers regardless of whether they\u2019re in a specialist environment or if they\u2019re in a generalist environment.<\/p>\n<blockquote><p>The claim is five minutes of filling in forms and 55 minutes of being a psychologist, a counsellor, a social worker<\/p><\/blockquote>\n<h3 id=\"05\">Mental health<span style=\"font-size: 12pt\"> &#8211; <a href=\"#top\">Back to top<\/a><\/span><\/h3>\n<p>One of the areas of recent focus has been on increasing TPD claims related to mental illness which impacts the work of advisers and life insurers, some of whom are struggling to deal with an issue that seems to be affecting more people. For advisers, this includes being able to secure client cover for mental health and for insurers being able to assess claims and provide ongoing support.<\/p>\n<p>Diane said that in her experience more clients are struggling to secure cover as they have been considered at some time in the past to have suffered some form of anxiety or stress, regardless of its length or severity, which has since been recorded on their medical records.\u00a0 She added that this either makes getting cover very difficult or creates exclusions when cover is in force. As a result, clients are wary of the insurer and feel claims managers are trying to get them off claim each time they contact the client. \u201cI have that with the income protection claims we\u2019ve got going. They don\u2019t want to talk to the claims manager.\u201d Diane said. While she was aware of insurers trying to reduce costs \u201c\u2026from the adviser point of view I think clients need to be covered. If insurers are going to cover them for cancer why won\u2019t they cover them for potentially something going really wrong in their lives and they are mentally ill for a time.\u201d<\/p>\n<p>Diane\u2019s comments touch upon how she believes medical records need to be more explicit and exact around the issue of the definition of mental illness, particularly as they may impact an insurance application or claim further down the track.<\/p>\n<p>Peita said mental health professionals, who are familiar with the issues, are not being helpful either. She related that her practice has encountered distrust from these professionals who do not want to share information. \u201cWe were told \u2018Surely there\u2019s a privacy issue here\u2019, and I had to sit down with that person and to talk them through why they were actually hurting the client,\u201d Peita said, adding that poor mental health data impacted the entire insurance and advice process. \u201cThe community needs to get together on this because none of us is handling this well. The medical profession is playing catch up with data on it. Therefore insurers are playing catch up on how to price it, and that puts us all behind the eight ball.\u00a0 I think there\u2019s so much more work to do and until we start talking more across some of the silos it\u2019s not going to get better.\u201d<\/p>\n<div class=\"fw ad\"><!-- Error, Ad is not available at this time due to schedule\/budgeting\/geolocation\/mobile restrictions! --><\/div>\n<p>As part of CommInsure\u2019s efforts to tackle the issue of mental health, the insurer has created a Back to Wellness program which is intended to work on improving the mental health of claimants first, before focusing on getting them back to work, according to Olivia, who said any discussion around mental health opens up a number of key issues. \u201cOne of those questions is: What does it feel like for the person who is trying to go on claim? How do they navigate through all of the claims experience when they\u2019re really struggling with their mental health condition but also with a loss of identity?\u201d Olivia said the program was born out of answering the question of \u2018How can people be made to feel like themselves again?\u2019 instead of \u2018How can we get them back to work?\u2019<\/p>\n<p>Reinforcing Olivia\u2019s comments, Ciaran said, \u201cWe have a fundamental belief that work is good and it\u2019s a critical part of the recovery process\u2026There\u2019s an avalanche of research now available with respect to the health benefits of good work. What we\u2019re trying to do around mental health is listen more and be more flexible. For example, customers participating in the Back to Wellness program do not need to fill in the claim form every month. Our primary objective is not to get them back to work. The objective is to get them back out into the community &#8211; back engaging with friends and family doing the things they previously enjoyed and perhaps doing some voluntary work.\u201d<\/p>\n<p>From the adviser\u2019s perspective, this type of approach reflects both current thinking and research around mental health treatment and their own experience with Peita rejecting the cynical notion that these programs are just more sophisticated ways of getting clients off claims. She said \u201cI understand the cynical adviser, but I\u2019m calling them out and saying, if we can actually get people feeling good about themselves and getting back to work, I\u2019m all for that.\u00a0 I think there would be some instances where maybe that proves to be a disadvantage. In most instances, done well, it\u2019s very powerful.\u201d<\/p>\n<blockquote><p>There\u2019s got to be so much more you can do with technology<\/p><\/blockquote>\n<p>Nick said this reflects his experience as well but he asked who should be delivering these services and who should be funding them. \u201cI think the insurer should be helping financially to get that done, but who should be delivering that service so it is seen as non-conflicting? I want all my clients off claim. I never want them on claim, but where does the trust and relationship come from? We are dealing with people\u2019s money and their health and they are not going to ring somebody and open up and reveal everything that\u2019s going on in their life.\u00a0 They do for me. It\u2019s amazing. The claim is five minutes of filling in forms and 55 minutes of being a psychologist, a counsellor, a social worker and whatever else, or just a listener.\u00a0 People need someone to talk to.\u201d<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/magazine.riskinfo.com.au\/30\/wp-content\/uploads\/sites\/19\/2017\/03\/story-feature-01-03.jpg\" alt=\"\" width=\"1200\" class=\"alignnone size-full wp-image-587\" \/><\/p>\n<h3 id=\"06\">Using technology to improve the claims experience<span style=\"font-size: 12pt\"> &#8211; <a href=\"#top\">Back to top<\/a><\/span><\/h3>\n<p>Given the complex nature of life insurance policies and the claims process our adviser panellists did not want better or greater systems offered to them through the use of technology but preferred simplicity and convenience for themselves and their clients. Both Peita and Diane expressed frustration at the piecemeal approach advisers and clients have to go through in submitting information and the literal paper trail that has to be created to take out a policy or lodge a claim.<\/p>\n<p>\u201cIt has got to be able to be done better. It\u2019s just all paper forms at present that are being sent out by most insurers. There are a few at present that when you lodge a claim will take initial details and then say, \u2018Well, can we ring your client and get a bit of a history over the phone for the income protection?\u2019 The client is still sent a form to complete.\u00a0 And, every month and every three months they\u2019ve got to complete these forms again. Why? There\u2019s got to be so much more\u00a0you can do with technology,\u201d Diane said.<\/p>\n<p>According to Peita, much has been done in the way of technology but this type of change is slow and time consuming for large institutions who typically look to fix major issues instead of addressing smaller processes which can also create problems. On the issue of paper based forms and process Peita questioned the difference between scanning returned paper forms and having clients sign and submit documents electronically through the insurer\u2019s website. \u201cHow is that not exactly the same thing and only adding a little piece of technology at the front to solve the problem?\u00a0 I think, unfortunately, institutions look for these sweeping fixes when, in reality, it\u2019s the smallest little things that could start to be solved,\u201d Peita concluded.<\/p>\n<p>Both Olivia and Ciaran said they have received similar feedback in the past and are keen to maintain the range of choices available to advisers and clients because \u201c\u2026what Diane will want may be different to what Peita wants\u2026 and\u2026 if a customer wants to go and spend time with Nick completing a claim form we have got to give the customer that choice,\u201d Ciaran said, adding that choice would extend to tele-claims and online claim lodgement as well as using existing systems to make the process easier.<\/p>\n<p>\u201cWhere I see tremendous opportunities is leveraging off what we\u2019ve built with the online underwriting systems including the rules engines. We\u2019re currently building a digital prototype that will enable customers to lodge claims seamlessly online. With the potential for claims to be lodged online, making a decision and payment faster, establishing a relationship faster, intervening earlier and talking about wellness and other support services, there are great opportunities here to improve the customer experience,\u201d Ciaran said.<\/p>\n<div class=\"fw ad\"><!-- Error, Ad is not available at this time due to schedule\/budgeting\/geolocation\/mobile restrictions! --><\/div>\n<p>Olivia added that some of the easiest changes are not related to technology at all but processes that engage with clients and are about the \u2018personalisation of the experience\u2019 when people don\u2019t want to go online but talk directly with an insurer. Pointing to CommInsure\u2019s own processes of handling calls related to claims, Olivia said the tele-claims service tries to figure out in a single call the complexity of the claim and what action to take. \u201cIf we can have one phone call with them, get the information we need and pay that claim we will do that now.\u00a0 So, we are not anchored in to the approach of \u2018You must fill out our forms.\u2019\u00a0 We\u2019re trying to figure out what can we do quickly, what can we do in the format that they want, and that takes no technology change. That\u2019s just saying, \u2018We\u2019ve got an intention to have a conversation\u2019, and reduce the amount of content that we need to validate that claim to pay it.\u201d<\/p>\n<h3 id=\"07\">Wrapping up<span style=\"font-size: 12pt\"> &#8211; <a href=\"#top\">Back to top<\/a><\/span><\/h3>\n<p>While the conversation covered much ground in the area of improving claims, including the better use of technology, processes and systems the Round Table panellists closed the discussion by focusing on the message advisers and insurers send to the public when acting on claims and how that message can be improved. Ciaran said this meant listening to what customers were telling CommInsure and \u201c\u2026designing an experience around what the customer wants as opposed to what suits us,\u201d so that it was of value to the customer first. \u201cWe\u2019ve heard from three very experienced people today around how forms don\u2019t work and we\u2019ve got to find a way around this.\u201d<\/p>\n<p>For the advisers at the table telling the stories about the benefits of life insurance still remains key, with Diane seeing the need to engage with media while Peita sees the need to engage with consumers at a grass roots level through direct experience. \u201cWe need to get more good news stories out there &#8211; that the insurers are paying the claims and that we are honouring our promises. The media are having a field day at pushing the wrong impression about insurers,\u201d Diane said.<\/p>\n<p>Adding to this, Peita said any good news stories have to also go out to the public as people were seeing the mass media as becoming less relevant and that engagement via social media and through communities provided a better opportunity to embed these stories in people\u2019s minds. \u201cI think we should go grass roots and we go hard, and I think that\u2019s where people will instantly just dismiss a bad customer experience story that they see because they will have heard and seen somebody who\u2019s gone through the process and it\u2019s worked for them.\u00a0 So, I think that\u2019s where some effort could really be applied,\u201d Peita said.<\/p>\n<p>Like his peers, Nick also sees the usefulness of promoting the value of advised life insurance, urging that the story should be that claims are paid. \u201cAbsolutely, we pay claims.\u00a0 What was the figure for last year? $7 billion plus in paid claims for the industry. Good client relationships belong there and how we create that trust and relationship is the question,\u201d he concluded.<\/p>\n<script type=\"text\/javascript\">if (typeof(addthis_share) == \"undefined\"){ addthis_share = {\"passthrough\":{\"twitter\":{\"via\":\"riskinfonews\"}}};}\n\nvar addthis_config = {\"data_track_clickback\":false,\"data_track_addressbar\":true,\"data_track_textcopy\":true,\"ui_atversion\":\"300\"};\nvar addthis_product = 'wpp-3.5.9';\n<\/script><script type=\"text\/javascript\" src=\"\/\/s7.addthis.com\/js\/300\/addthis_widget.js#pubid=ra-53a3668b19172d69\"><\/script>","protected":false},"excerpt":{"rendered":"<p>Riskinfo joined forces with CommInsure to conduct a recent Round Table conversation during which a broad spectrum of claims-related issues was discussed\u2026<\/p>\n","protected":false},"author":1,"featured_media":610,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-85","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-feature"],"_links":{"self":[{"href":"http:\/\/magazine.riskinfo.com.au\/30\/wp-json\/wp\/v2\/posts\/85","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/magazine.riskinfo.com.au\/30\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/magazine.riskinfo.com.au\/30\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/magazine.riskinfo.com.au\/30\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/magazine.riskinfo.com.au\/30\/wp-json\/wp\/v2\/comments?post=85"}],"version-history":[{"count":0,"href":"http:\/\/magazine.riskinfo.com.au\/30\/wp-json\/wp\/v2\/posts\/85\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/magazine.riskinfo.com.au\/30\/wp-json\/wp\/v2\/media\/610"}],"wp:attachment":[{"href":"http:\/\/magazine.riskinfo.com.au\/30\/wp-json\/wp\/v2\/media?parent=85"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/magazine.riskinfo.com.au\/30\/wp-json\/wp\/v2\/categories?post=85"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/magazine.riskinfo.com.au\/30\/wp-json\/wp\/v2\/tags?post=85"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}