The life industry has been contemplating how to optimise the use of rehabilitation resources in a claims environment since back in the previous century when Australian life insurers started to use external rehabilitation providers in the mid-to-late ’90s. These early providers, however, were often more familiar with workers’ compensation and traffic accident compensation systems than with life insurance. In 2001 Mercantile Mutual (now OnePath) brought the first full-time rehabilitation consultant in-house and others followed suit. Soon insurers and reinsurers started seeing how these professionals brought a different type of expertise to the life claims environment, namely skills in disability/injury management, experience assisting individuals to return to work, and the ability to work collaboratively with treating health professionals. While insurers have tried different models of organising their rehabilitation and claims units, most are aligned in their thinking: rehabilitation resources allow claims departments to deliver a superior service proposition to the end customer, positively impact the bottom line, and are likely to play an increasingly vital role especially within the group space (both in tenders and product redesign) with piqued interest in absence management and wellness.
So why then, despite the myriad of benefits rehabilitation resources bring to life insurers, is this resource under such constant scrutiny? What causes it to polarise people, and in comparison to other specialist resources seen as integral to the claims management process, why is it required to prove its ‘worth’ over and over again? Most troublesome of all — why is it that the claims versus rehabilitation divide is emerging within some businesses, and what can be done to avoid it?
This article seeks to unbundle the factors giving rise to, or perpetuating, the division between claims and rehabilitation professionals, who by the very nature of claims management should be close bedfellows. It also encourages readers to consider whether their organisation’s model of rehabilitation is integrated in a way that promotes optimal claims outcomes, and whether current performance metrics for the rehabilitation and claims teams are properly aligned.
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