With Big-T and Little-T underwriting now common and significantly reducing non-disclosure issues, do you feel the industry is ready for a tele-claims service? Is there a demand for this, and is it necessary?
Chris Hulme, Clayton Hulme Partnership
Non-disclosure has long been an issue faced by insurers and the insured across the land, spanning all forms of insurance resulting in bad feeling and clients’ views of “they won’t pay out if they can help it.”
It stands to reason then with advances in technology and medical science that underwriting can be streamlined and significant cost savings achieved for insurer and the insured.
The demise of the GPR with its increasing costs and delays in such reports being sent to insurers to Big-T and Little-T scenarios of tele-underwriting brings about speed and cost efficiency. At the same time it transfers completion of medical history and lifestyle information outside of the sales process.
Within one insurer, a team of 14 is undertaking 1500 tele-interviews a month. The subsequent reduction in the requests for and costs of GPRs has the benefit of significantly reducing non-disclosure, in some organisations to zero.
Tele-claims, or End-T as I will call it, being a natural progression from Big-T, Little-T, is expected to bring about speed of claims processing and payment, which, in conjunction with the greater accuracy of initial underwriting should bring the claims to payment ratio up considerably.
The adviser community has still to be persuaded of the benefits of Big-T, Little-T and End-T, although with tele-claims support functions such as those recently launched by Medicals Direct, aimed to reduce costs and improve time efficiencies in assessing claims, the industry is certainly ready for this enhancement.
Roy McLoughlin, Master Adviser
I think the simple answer here is that it depends on the individual adviser and their relationship with the client.
Historically, we have been the first port of call when a client is in a situation where a potential claim has arisen. You sometimes find clients are unaware that conditions are potential claims. It is I believe the advisers responsibility to certainly make the first enquiries to the respective insurance company. We have the advantage of being able to discuss a prospective claim in a calm and knowledgeable manner.
This is vital as unfortunately we have experienced claims handling from some that has been discourteous and rude and it is important that we protect our clients at such a delicate time.
That said, some clients may wish to go directly to an insurance company and this is a situation where a tele-claim service would clearly work.
A client may have a sensitive medical condition which they do not wish to initially discuss with the adviser. Under these circumstances talking to a qualified medical person has obvious advantages providing they are also trained to deal with the sensitivities of such life changing events.
As is the case with Big-T and Little-T there is no ‘one size fits all’ and it is vital that the dialogue is opened and maintained on this subject. Insurance companies sometimes look for absolute solutions which in the ever changing world that we live in simply do not exist.
Kevin Carr, Kevin Carr Consulting
I suspect this will follow a very similar path of progression to that of tele-underwriting, where more and more companies offer the service until it becomes the norm.
Some companies already provide tele-claims of course, either in-house or outsourced, however, as was also the case with tele-underwriting the type and level of service that could fall under the generic heading of ‘tele-claims’ can vary from merely reading out a claim form over the phone to a more empathetic service provided by an independent nurse, which could also look to provide rehabilitation services as well as assessing the claim itself.
The benefits include quicker decision times, a better experience for the claimant and reduced medical evidence at claims stage – and as with other phone-based services, calls can be recorded and used to improve future service as well as detect potential non-disclosure. It is just a bit more human isn’t it?
While it is likely that claimants would prefer to speak to someone than fill out a form, I have always been a big believer in consumer choice and if someone would prefer to fill out a form that should always remain an option, especially if they are too ill to speak.
When it comes to claims the outcome will always be more important than the process, but if we want our customers to trust and promote our industry then the better the overall experience is the more this will happen.
Roger Edwards, Bright Grey and Scottish Provident
“Tele-underwriting is now available from most protection providers. As an enhancement to the proposition it has the advantage of bringing benefits to customers and providers alike.
Over the last few years technology has enhanced most of the protection application process with more efficient ways of getting clients on risk faster, and of course, the quicker they are on risk the quicker they start paying their premiums.
But the main reason people take out protection policies isn’t to marvel at the effectiveness of the application process, but to be guaranteed a lump sum when it is needed. The problem is that while we have continually enhanced the front end, the claims process remains predominantly paper based as if the service at this point doesn’t really matter anymore.
This is perhaps the last link in the process that is crying out for a refresh. Claimants are often going through emotional and physical hardship and need the claims process to be as easy as possible. Tele-claims would be able to use the same medically knowledgeable people as the underwriting process and speed the process up considerably. It would also be useful as a filter to ensure conditions that are not eligible as claims will go no further and end up being recorded as declines. However, we also need to work on what aspects of the claims process could equally fit in a web environment rather than simply assuming that the telephone is the utopian answer.
And whatever we do let’s not call it Big-C and Little-C tele-claims!”
