Panellists at the Zurich Sustainability Round Table have called for change to address the contradictory agendas of supporting claimants in returning to wellness while many of those claimants also seek to successfully claim for Total Disability or TPD benefits.
In the fifth and final part of the Zurich Sustainability Round Table, this dilemma was dissected by the panel, where senior Zurich execs expressed their concern that delayed notification of claims is one of the elements which contributes to undermining both customer health outcomes and sustainability.
Zurich’s Head of Retail, Tim Kane, noted frustration among some of his colleagues when claims notifications are received up to five years after customers have stopped working, thereby limiting insurers’ ability to intervene earlier in the process.
David Creaven – Head of Client Partnerships, SCOR Australia & New Zealand, echoed similar thinking in emphasising the importance of early intervention in large corporate schemes, where employer-funded premiums create strong alignment around affordability and return-to-work outcomes.
Supporting the proposition that insurers could or should do more to assist claimants return to wellness, Kane’s colleague, Ioana Logan (Product Owner, Zurich Propositions), noted medical research revealed people have worse return-to-health outcomes when in an ‘insurance’ or ‘compensatable’ setting.
Kane noted that Zurich would be open to law reform allowing insurers to fund treatment for claimants if it were in their best interests, particularly where this could support a return to good health.
…insurers should focus on helping customers return to work rather than remaining on prolonged claims
He said the act of working and being employed is beneficial for clients’ long-term health and insurers should focus on helping customers return to work rather than remaining on prolonged claims.
From the adviser perspective, Sydney-based risk specialist adviser, Kristen Agius, said clients would likely welcome insurers funding rehabilitation costs, particularly given the significant out-of-pocket expenses many face when seeking newer treatments.
She said access to alternative therapies and structured rehabilitation programs would be viewed positively if it improved recovery prospects.
In terms of the likelihood of any movement from the law makers to accommodate the future prospect of insurers funding rehabilitation costs for claimants, CALI’s GM Corporate Affairs and Strategy, Keely O’Brien, said the industry has strengthened its advocacy presence in Canberra. She reported a more constructive stance from Treasury and ministers has been developed over the past three years, and expressed optimism about achieving legislative change, although she noted this was particularly with regard to advice reform.
While APRA data confirms the vast majority of claims submitted to life insurers are paid, insurers such as Zurich appear to be open to exploring better ‘return to wellness’ solutions for claimants, particularly those suffering from episodic rather than permanent disability conditions, which also includes the rising number of claimants where the assessment of the permanency of the condition is more subjective than objective.
Click the video image link above or the link below to review the fifth and final part of the Zurich Sustainability Round Table series:
Zurich Sustainability Round Table Part 5: Returning to Wellness or Remaining Disabled – The Dilemma
