Improving Psychological Claims Management

1 in 5 adult Australians experience a mental health condition every year. The complexities of mental health make it a difficult field to navigate for partners, friends, family. It is even more challenging for the claims assessor who is further removed from the individual’s life and often doesn’t have the best grasp on the intricacies of the claimant's mental health condition. Stirling Andersen hosted a Breakfast Seminar last Wednesday which focused on methods to improve psychological claims management.

The Breakfast kicked off with Pieter Breytenbach, Head of Claims Customer Service at CommInsure. His experience across South Africa, New Zealand (NZ), USA, Canada and now Australia, puts him in a perfect position to tell the room full of Heads of Claims and Claim Leaders what Australia could be doing differently.

Here’s what we learnt:

1.       Streamline...
Firstly, how you can streamline your point of entry into your claims team. Do you have 15 inboxes? Do you have a hot line and a direct line? By streamlining your point of entry you’re allowing your assessors to talk to claimants as soon as possible. Simple.

2.       Quality Contact…
Pieter spoke about how assessors in NZ fly across the country within 48 hours to have meaningful, face-to-face interactions with claimants living in remote areas.

By getting in front of the claimant and having a quality conversation with them and their family, we can understand the root cause and the motivations moving forward. With the code of conduct being implemented across the industry, emphasis has been placed on contact and communication with the claimant. But, what is the benefit touching base regularly if the quality of that contact is poor? An assessor should be ascertaining what information the claimant has been exposed to; are they on a month-long GP waiting list? do they have access to online support? By digging deeper, assessors will do a greater service to those most in need.

3.       Throw away the cookie cutter…
There is no ‘one size fits all’ model for mental illness, think outside the box and make sure your assessors can creatively think of solutions.

4.       Going ‘off claim’ is important too….
Our attitude cannot be “good luck, goodbye”. Use technology to your advantage. With Skype, why don't we consider online community services? Investing more time into “off-claims” will increase sustainability in the long term. It’s not a pipe dream, it is achievable and being done elsewhere in the world.

These longer-term strategies may take some time before seeing the of your efforts so in the meantime, Pieter encourages us all to start telling the stories of amazing things organisations are doing for people in their time of need and fingers-crossed the rest will follow.

If you're interested in attending one of our next Life Insurance events or keen to talk further about the market, please contact Pippa Morris on or 0282 565 000

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