The group insurance industry had a wake-up call at the 4th annual Group Insurance Summit yesterday, hearing from claimants about the slow, drawn out, and impersonal claims process and the debilitating experience it can prove to be.

At age 32 Jay Allen, a former TWU Super member, was diagnosed with melanoma. An initial claim in 2008 was rejected and then finally in 2011 he was paid a fraction of the assets he felt he was entitled to.

“It wasn’t really worth it, but I wanted to prove a point,” he said. “Not once did I feel like anyone understood, on a human level, that they knew what I was going through. There was no empathy.”

Allen said that one obvious way to improve the process would be for the super fund to have one point of contact so information did not need to be repeated, and the claimant felt a better sense of connectedness with the claims process.

“This would have made it so much easier. I didn’t know who to call or what to do,” he said.

This was an experience echoed by UniSuper member, Paula Dawson, who has made two claims in the last 10 years.

“I was in a situation where I was so wiped out, I had been in hospital for three months, and [the claims process] was difficult and incomprehensible,” she said.

One of the main difficulties was that the super fund only wanted to communicate via email.

“I didn’t know who to contact, there was not one person or contact,” she said. “And I was in a situation where it was really hard to get the information together. Simple information for me wasn’t obvious. I was anxious.”

Head of insurance and claims manager at UniSuper, Amalia Faba, says the fund has spent a lot of time re-orienting its practices towards a service culture, and now has a mantra of “making a difference in a member’s greatest time of need”.

She detailed four key improvements made to the claims process.

Firstly enabling a service culture required introducing one point of contact for each member and increased resources. In addition, UniSuper worked closely with its insurance provider, TAL, to enable information sharing.

The fund now uses the phone as the primary tool for contacting members, not emails, and is working on a flexible claims including face to face.

It is also investing in education of members and employers about the claims process and is making sure that staff are in roles which play to their strengths.

Corrine Boyle, information centre co-ordinator of the NSW branch of the Distributive and Allied Employees’ Association, who also sat on the panel, said the chief complaint she hears about the claims process is the amount of time it takes and the lack of continuity so that claimants have to tell the same story over and over to different team members.

In opening the conference, Damien Mu, chief executive of AIA said the insurance industry shouldn’t forget it plays an important role in making a difference in people’s lives.

He said most Australians get their insurance coverage from the superannuation industry, and the conversation has shifted to being about under-insurance to adequate insurance cover.




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