One fund executive in strong agreement with that sentiment is Kelly Cantwell, executive manager of administration for the 925,000-member HostPlus, which recently took the momentous decision to bring the claims management process entirely inhouse. Each claims manager in the HostPlus team now has sole responsibility for a number of current claims ‘files’, although of course the ultimate claims assessment is still the province of its outsourced group insurer. After only a few weeks of operation, Cantwell said recently that the fund was already getting overwhelmingly positive feedback from members and their beneficiaries. “They are just so relieved to hear that they will only be dealing with one person. Members or their beneficiaries making a claim are invariably going through a traumatic period in their lives. The last thing they need is to have to repeat details over and over again, or wait while follow-up to their questions progresses through a queue,” Cantwell says. She added the “re-engineered” claims management process aimed to “get back to basics”, and question whether “we really need every piece of paper we have now”.
Her team aims to provide members with customised claim forms rather than the “one size fits all” forms that currently prevail, Cantwell added at the time. The same sort of flexible, multidimensional approach is important when it comes to the processing of claims, Mu says. The executive is all for the ability of members to lodge claims on-line, and indeed AIA Australia is gearing up for the launch of eClaims (a complement to its new LIFEApp tool for on-line applications), which aims to streamline the collection of information from the claimant, and third parties such as doctors. However, Mu says the electronic world must be overlaid with telephony and a manual or automated ‘triage’ process, to catch the majority of claims which unfortunately are not quite as simple as that aforementioned broken arm and to engage the claimant early on to assist streamline information requirements.
The key to making these more complex claims a hassle-free experience is a “tele-collect” – a claims manager’s telephone call with the claimant – which gets it right the first time. “Where claims get held up is this back-and-forth with forms to fill out and documents to collect,” Mu says. “We know ourselves from personal experience of dealing with everyday transactions in our personal life, if a particular task is not something we can do on-line or phone somebody about, how long does it take us to do? Who knows what drawer or even bin we’ll file the forms in. So why should we expect the members of the super funds we deal with to be any different?” Standard practice at AIA will be to book in the “tele-collect” call with the claimant a few days in advance, making sure they know every document and piece of information they need for the interview. Mu also thinks that AIA and its competitors can do more to standardise elements of the claims process. “You can see a classic example in many TPD claims, where there has often been a claim through Workcover first.”