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The enigma of person-centred claims management

Life insurance claims workers are most satisfied when they see and feel they’ve contributed to a person on claims recovery. And yet the performance of these workers is often measured by vastly different things: volume and speed of claims processed, depth of product knowledge, and other compliance-related tasks.

This disconnect is one of the many dichotomies faced by life insurers and reinsurers, highlighted through recent research by mental health organisation SuperFriend.

Life insurance has simple origins. Contributions were collected from Roman troops to help pay burial expenses for the fallen. Fast forward more than 2,000 years, and 'simple' is an adjective rarely used in the insurance world.

Life insurers have navigated sustained scrutiny throughout the financial services royal commission, followed by complex legislative changes driven by Protecting Your Super, a contracting and increasingly competitive market, and downward pricing pressure.

Is a person-centred approach to claims management even possible in today's environment? The research says yes.

Despite the many and varied challenges of their working and regulatory environments, many claims workers are finding ways of applying a person-centred approach, and reaping its many benefits.

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Person-centred claims management takes the 'whole person' claiming into consideration. The approach empowers the claims manager and person on claim to collaborate and consider the person's unique circumstances to help navigate the claims process and overcome potential challenges faced during rehabilitation or recovery.

SuperFriend's research also highlighted certain workplace factors that support person-centred claims management, making it more likely to succeed. These include providing a psychologically safe and mentally healthy workplace, supportive managers, a 'safe to fail' environment, peer coaching, and the underlying workplace culture including what the organisation tangibly and visibly values and rewards.

If a person-centred approach to claims management is better for people claiming and claims managers, why is it not more widespread here in Australia? Several factors seem to be at play. The first is that measuring claims manager success under this model requires a shift from quantity of claims processed to quality of customer service and outcomes. It may mean approaching initial conversations with the person claiming quite differently, getting to know and build trust with the person claiming. Done well, this can also glean required information and be done just as efficiently as a traditional 'check the box' approach.

It also means shifting from a multi-person, on-call customer servicing model to a single point claims management approach where the person claiming can deal with one person (or a limited number of people) where possible throughout their journey. This requires both a change to the claims handling model and investing in staff capability and confidence-building.

A person-centred approach to claims management can be a gradual transition. It doesn't have to happen overnight to deliver benefits. This may translate to training people leaders in person-centred communications, or even simply harnessing those team members naturally working this way and equipping them to mentor their colleagues. In the longer term, it could look like celebrating quality relationships with customers and celebrating their successes, or retiring volume-related quotas in exchange for metrics related to quality and positive outcomes.


Sandy MacLeod, general manager of insurance solutions, SuperFriend

The enigma of person-centred claims management
Sandy Macleod
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Adrian Flores

Adrian Flores

Adrian Flores is a features editor at Momentum Media, focusing mainly on banking, wealth management and financial services. He has also written for Public Accountant, Accountants Daily and The CEO Magazine.

You can contact him on [email protected].

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