In this article, TAL’s head of Claims, Jenny Oliver, sets out the background and rationale behind the development of the TAL Claims Philosophy. Jenny says a claims philosophy is more than just words on a page – at a time when the claims function has emerged from the ‘back office’ to the front line of service functions for insurers…

A positive experience at claim time is at the core of healthy, rewarding, and long-lasting relationships between life insurers and their customers.

While life insurers often have lengthy relationships with our customers, they are by their nature ‘low touch,’ and this can make it challenging to build trust into the customer relationship over time. It is often only when the customer needs to claim that we have an opportunity to fully engage with them and as a result it is often the claims experience that will define a customer’s view of their life insurer.

Getting the claims process and experience right, during a time that is often one of the most difficult in a person’s life, is paramount, and goes directly to the value customers see in the life insurance category as a whole.

Operating within this customer relationship paradigm demands two equally important areas of focus for life insurers. The first is that when thinking about delivery across the entire customer relationship and every customer touchpoint, it’s important to recognise that building those relationships is not a one-stop-shop.

Insurers need to work in an agile way through continuous delivery and continuous improvement to make both their business and their customers stronger. This, in turn, will build trust and confidence that, should a customer need to claim in the future, their insurer will be there to not just pay their claim, but also to support them through that process.

The second area of focus is the actual claims experience itself, which can ultimately be the difference between a positive and negative perception of the entire life insurance industry.

… handling claims effectively is the most important thing we do

At TAL, we recognise that handling claims effectively is the most important thing we do, and we want to provide an outstanding claims experience for our customers, which is where we make the biggest contribution to the people we protect.

Every single claim is different, and every customer brings to this process a different set of circumstances and needs and getting the experience right for each individual customer is critical.

To create that consistency of experience across such diverse circumstances amongst the claims TAL pays to more than 36,000 customers and their families each year requires the right frameworks to be in place, and few are more important than the Claims Philosophy.

At TAL we have developed our most comprehensive Claims Philosophy to date, designed to ensure our customers can feel confident and understand how claims will be handled, and our people understand the ways we are accountable for delivering on those expectations.

A Claims Philosophy is more than just words on a page

… the claims function has come out of the back office and is now regarded as one of the front-line service functions

While claims philosophies are not a new concept, the claims function has come out of the back office and is now regarded as one of the front-line service functions, so it’s essential that life insurers revisit the frameworks and philosophies they have in place to ensure that they remain highly relevant and a true reflection of the work that goes on within the claims team.

In 2020, we took the opportunity at TAL to step back and consider how we make our Claims Philosophy as meaningful as possible and build accountability into it, and the processes and systems that flow from it.

The customer experience is informed by a diverse range of touchpoints, from how life insurers collect the relevant information to support their claim, to what support we’re providing to our customers, how we make decisions, and how we’re looking after our people. No longer is this just about the outcomes that businesses want to deliver. There is now a strong focus on the tangible things in the business – such as processes and accountabilities – that drive those outcomes.

Through the process of revisiting and reimagining our TAL Claims Philosophy, we listened, consulted widely, and worked with our customers, partners, and our people, to articulate the set of beliefs that sit behind the actions we take every day to deliver positive experiences and outcomes for our customers.

By articulating the processes and component parts, our customers and our people know what to expect, and also what is expected of them throughout the claims journey.

When unpacking what our customers and people encountered on the claims journey, we found our processes and accountabilities were comprehensive, but as with anything in a business, there is always room for improvement, and so we set out to develop our most customer-focused and in-depth Claims Philosophy yet.

A values-based approach to delivering customer outcomes

Our approach to that design process began with defining the core beliefs that underpin TAL’s entire approach to delivering a positive claims experience.

The importance of providing guidance and support every step of the way, partnering with our customers and support network to simplify the process where possible, keeping customers’ best health outcomes front of mind and working to help them achieve those, delivering fair outcomes for every customer, and investing in our claims team to ensure we have the right resources in place to meet customer needs, are all core beliefs which underpin TAL’s Claims Philosophy.

These shared values inform the expectations we set for ourselves, and the way we handle claims, interact with claimants as well as their families, make decisions, and provide support along the entire claims journey.

By getting crystal clear on what matters to us, we were able to define a set of positive customer outcomes that every team member can keep front of mind, and ensure our actions are driving against those outcomes.

Clarity and understanding for the customer around both the process and the status of the claim, simplicity, and efficiency where it’s most valuable, and a compassionate approach to supporting every customer and reducing the burden of claiming are all enshrined in our Claims Philosophy, as are the priorities at a business level which will continue to support their delivery.

This framework then serves as a shared ‘north star’ for every member of the claims team, and all those across the wider business who support them. When we are acting in accordance with our TAL Claims Philosophy, we can be confident that we are working to ensure the claims experience for every customer – regardless of the outcome of their claim – is aligned to our values as an organisation and as people.

As new customer needs are identified, the solutions we develop are tested against our Claims Philosophy, to ensure we are continually delivering a more consistent claims experience and remain accountable to our defined and aligned set of performance metrics and measures.

People are at the heart of our claims experience

…technology is most valuable within the claims process when viewed as a platform enabler of the experience, rather than a solution in itself

There is no question that technology has a key role to play in making many aspects of the claims experience easier for our customers, however we believe at TAL that technology is most valuable within the claims process when viewed as a platform enabler of the experience, rather than a solution in itself.

Each of our customers is unique, and when they want to tell their story or share their concerns with another person, we must ensure that our claims consultants are well equipped and feel empowered to support them.

Life insurers should be looking to offer more than just a claim payment, and claims consultants – the way they are trained, their attitude and their approach to work – are key to providing the best possible experience for customers.

A well-developed and rigorously considered claims philosophy is an important part of that equation and sits at the heart of the operational approach an insurer takes to claims.

Our Claims Philosophy helps us identify and act on what we need to do to improve, and that has enabled us to invest more than ever in claims processes, our people, and our technology, with confidence that the investment will drive positive outcomes for our customers, our partners, and our people.

Driving better outcomes for the entire industry

We want our customers to feel confident they will be supported in the best way possible and by our actions throughout the claims experience we seek to alleviate any trepidation they may have felt in approaching us to make a claim.

By reflecting deeply on what we do today and where we want to be tomorrow, we have been able to arrive at a framework which spells out what we are trying to achieve through everything we do and use that to operationalise changes and enhancements for the benefit of everyone making a claim.

We know that if our customers at claim time feel confident as they navigate through the process, then our Claims Philosophy has done its job. Likewise, if our people are crystal clear on what is expected of them, and feel they have the tools and support to deliver against that, there is no limit to what can be achieved.

If our customers are confident in the philosophy underneath the surface, they can be confident in their trust in us as life insurers.

Jenny Oliver is TAL’s Chief Claims Officer


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  1. I wonder why a person in such a position of importance at a leading life company would refer to clients of the company as “customers”? Woolys and Coles have ‘customers’. Advisers have clients. Even the much maligned accountants and lawyers have clients. Maybe the relationship TAL wants to create might go a little better with this seemingly small attitudinal change. Words are powerful and perceptions are quietly accrued. I cannot imagine thinking of my clients a mere customers. I’d feel like a shop assistant in K-Mart or Target looking after our ‘customers’. No real relationship involved . . .

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