- Yes (72%)
- No (25%)
- Not sure (3%)
Advisers have delivered a clear verdict in responding to our latest poll question on whether there needs to be more clarity around the respective roles of advisers and insurers at claim time.
So far, 78% of those voting in our poll say they want better definition around the respective roles of insurers and advisers at claim time, while 22% are ok with current arrangements. Interestingly for a Riskinfo poll, there is not one adviser to date who has remained on the fence with a ‘Not sure’ vote. This suggests all advisers already hold a clear view on this question.
This poll stems from new research findings released by the Beddoes Institute, which makes the point that engagement with policyholders can be made difficult due to what it calls the multidimensional relationships that exist between policyholders, claimants, life companies and advisers, particularly when the roles of each party are not well defined. This argument implies that if industry roles were better defined (at claim time and also during the life of the policy) this would lead to better overall engagement with the client.
One adviser comment supports the contention that nothing needs to change:
“The role of the Adviser is clear. Their responsibility is to support their client at the time of their greatest need. As such there is no need to define their role further.”
This same adviser also noted, however, that he believes this client support at claim time will become more problematic to deliver in future, due to the remuneration changes included in the Life Insurance Framework Reforms.
We’re asking this question at the same time as the industry is witnessing the emergence of other interested parties seeking to serve claimants. These new players include legal firms looking to expand the range of their services, new consulting firms created by former claims staff and management and existing licensee firms who are developing new advocacy services for both existing clients as well as ‘external’ clients, for example, who are seeking help with a group insurance claim.
The emergence of more advocacy options for claimants would suggest that life companies, in particular, need to have in place a system that will accommodate a range of third-party advocates supporting their client through the claims process.
Our poll remains open for another week and we will welcome your further contributions to this conversation…
Completely agree with the comment that the role of the adviser is clear and so to see 75% of poll respondents requiring clarity as to their role really is a concern. There can be no confusion whatsoever between the roles of the adviser and the insurer, they each do completely different things and fulfil different needs for the customer.
When it comes to the eventuality of a claim, the advice role does not change. At underwriting the adviser plays the role of facilitator, securing insurance for the client at the best possible terms and securing premium for the insurer at an acceptable level of risk. The relationship at claim time is no different.
There is no requirement whatsoever for the adviser to get involved with a claim, however where involvement is sought, the role is again that of facilitator. How do I get my client’s claim assessed and paid smoothly and promptly? By working together with the parties to ensure that any requirements are managed quickly. It’s naive to think that insurers are in the business of making billions of dollars of claims payments a year without the need for minimum proofs and claims management. Prudent claims management and assessment is a fact of life and a requirement of the shareholders and regulators. The aim is to make this process as efficient and simple as possible. By being there to answer any questions of the client and to help them to source and compile the claims requirements, the adviser helps the client to navigate a process during a difficult time. This has the secondary payoff of getting the required information to the insurer sooner which allows them to progress the claim and a decision/support for the client in the fastest possible time.
At the end of the day, the contract of insurance is between two parties, the insured and the insurer. The role of the adviser is clear, to support the functions of each to ensure that the contract that was put in place is executed efficiently.
Excellent and accurate comment Andrew. We could not have put it better. It is a real worry if advisers are struggling to understand their role and responsibilities with their clients at claim time.
I also agree with Andrew and well said.
Recently I raised this question in pure frustration for an insurer going direct to the client demanding information (for a terminal ill client who is on an ongoing claim).
Don’t get me wrong, I respect information is required, it’s the way they go about it.
As the adviser and “facilitator”, I believe we seek for greater clarity due to the insurers claims department following an administration “process” rather than delivering on the promise, in an appropriate manner.
I was absolutely gobsmacked and disgusted with their actions in this particular case and I couldn’t believe such a significant insurer (not naming names), could lose focus on basic human decency.
Because of this, I’m not shocked at all with the stats – I’m hoping it relates to the fact of the insurer over (or under) stepping the mark against clients and advisers, rather than advisers not knowing how to facilitate, or action claims.
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