Insurance claims for mental healthrelated illnesses are more complicated than those for physical injuries. Many of the problems relate to social attitudes toward those with psychiatric disorders. In this gathering of Industry Fund Forum members, legal and mental health experts, and group insurer CommInsure, an attempt is made to identify the extent of mental health-related claims – no easy feat – while steps being taken to improve the process between funds, administrators and insurers are outlined.
Participants at the roundtable were: • Amalia Faba, manager business development and strategy, Superpartners • Nick Galanakis, senior consultant, IFS Insurance Broking • Peter Gebert, operations manager, Cbus • Heather Gray, partner – funds management and superannuation, DLA Phillips Fox • Helen Hewett, executive officer, Industry Funds Forum • Damian Hill, CEO, REST Super • John Mendoza, chair of Superfriend Mental Health Reference Group and chair of National Advisory Council on Mental Health • John Mok, national BDM, CommInsure • Lisa Munsie, executive manager wholesale risk business relationships, CommInsure • John Paul, CEO, ASSET Super • Sean Scallan, BDM, Conexus Financial • Greg Staunton, senior insurance manager, AustralianSuper • Colin Tate, director, Conexus Financial Helen Hewett: From the outset, there were two objectives for the Industry Fund Forum’s insurance reference group, and one of those was to look at the IFSA code of practice because most, if not all, of our insurers have signed up to that.
We wanted to look at whether there were any changes we thought should be made to that, to better reflect the industry fund position, and to then build a process for handling claims which begins when the member first makes contact with either the fund or the funds administrator, and covers the whole engagement with the member rather than just the way the insurer might behave in relation to mental health. The other big project we asked them to look at was in relation to how records are maintained for mental health claims, so that we have a better understanding of what contributions mental health issues have in TPD, death and income protection insurance claims…A number of the insurers talked about how very often, mental health was a contributing factor but the death, disability or lost time was often classified as back injury, a chronic back injury and there was no record of mental health’s contribution. So we want to have a better understanding.
