You've made a successful insurance claim, now what?

In this continuing series on claims we’re now going to look at how modern insurance companies handle the post claim process.  For our example we’ll use one of Australia’s leading insurance companies, AIA Australia who in 2014 paid out $860 million dollars in claims.

In the past for example if your claim for total and permanent disablement, crisis recovery or income protection was successful an insurance company would pay out your claim, and you would receive your funds.  From the industry and the client’s points of view that was where the responsibility from the insurer ended.  The customer had paid their premiums and the company had made good on their promise to honour the policy.

Well for cutting edge companies, like AIA for example, things have changed; it’s a new culture and a new and more positive landscape for the customer.

The reason is that in terms of rehabilitation there is so much more that can be done for clients if the insurance provider is well resourced, proactive and seeking a “win-win” situation.

A couple of facts to get us going:

According to data provided by AIA Australia, in terms of physical conditions, if a person’s off work

then the chance of them ever getting back to work 

• after 20 days is 70%

• after 45 days is 50%

• after 70 days is 35%

One might think that if you have a situation that has you off work and your insurance payout takes care of you financially your worries are over.  You can put your feet up relax and not have to think about work or worry about money.  But that feeling realistically lasts only for the short term.  Multiple studies have shown that busy productive people are happier people.

Additionally you might initially be unable to work due to a musculoskeletal condition, but if that condition is not rehabilitated correctly you might slip into a depressed state and find it harder to return to work even when you’re physically able to.

Progressive insurance companies have recognised that getting involved in their clients rehabilitation process, where appropriate, can mean a more positive outcome for the client and even counting the cost of this service if the client is able to return to work earlier there can be a greater saving to the company in claim payout.  The less a company pays out annually in claims the less they have to charge in premiums, that’s the “win, win” I mentioned earlier.

So what’s the nut’s and bolts of what a company like AIA provides in this area? 

Helping clients get back to work 

AIA Australia says that Return to Work (RTW) plans areconsidered from the moment a claim hits their desks:

  • They have one of the largest rehabilitation teams in the industry, with over 110 + years combined experience.
  • Recruited allied health professionals into their claims teams.
  • Up-skilled their claims assessors to identify suitable rehabilitation claimants.
  • Rehabilitation screening tool embedded in claims processes.
  • Their extensive trials confirm that rehabilitation opportunities identified through early intervention resulted in an increased number of their customers successfully returning to work.

The right partner 

Their rehabilitation team includes rehabilitation counsellors, physiotherapists, occupational therapists and a registered nurse, who work in partnership with medical practitioners to plan and manage client’s recovery and assist them in returning to work.

AIA feels that rehabilitation isn’t just about the physical recovery. Helping claimants, especially those who are self?employed, restores more than their income, it can also help restore their identity and self-esteem. Their RTW programs are holistic, considering each individuals social situation, psychological factors and other health conditions.

Each claimant receives a tailored program which can include modification of work environments, work?related counselling, graded RTW programs, re?skilling/retraining or career advice and redirection.

So what can be the net result in this cultural shift in some sectors of the insurance industry?

Well AIA for instance claim that in 2014 they had a return to work rate of 80% compared to the industry average of 54% (Based on the Swiss Re Rehabilitation Watch 2014).

To find out how a progressive cutting edge insurance company might assist you with more than just money post claim, talk to a friendly Rate Detective consultant today.

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Published on July 7-th, 2015 in Insurance
Damon Rasheed is the CEO of Rate Detective, an Australian financial service comparison sites specialising in Life Insurance, Income Protection Insurance and home loans. Damon holds a Master's Degree in Economics from the University of Melbourne and has been involved in many start-up internet businesses.

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