Anthony Clough

SPONSORED CONTENT | Conventional wisdom says that employees who are sick shouldn’t go to work, and in the case of infectious diseases this wisdom is sound. But when it comes to chronic mental and physical health conditions, work can play a crucial role in recovery.

A wide body of research shows staying at work and maintaining healthy routines are an important part of managing difficult health conditions. And employers and their insurers have an integral role to play in holistically supporting employees in their journey back to health.

Speeding up the claims process is one part of the picture, and insurers have come up with a range of ways to help claimants promptly obtain the payments they deserve. But greater gains are being made through early intervention with targeted recovery programs that begin before a claim has even been lodged.

Traditionally, the insurance industry has engaged rehabilitation services after a claim has been lodged and accepted – a process often taking more than three months. The problem with this approach is it delays or even misses the opportunity to engage the right support that can hasten an employee’s return to health, and prevent chronic secondary conditions from developing such as depression.

This early window of time is extremely important. Research by The Royal Australasian College of Physicians in   found the longer an employee is away from work, the more difficult it became for that employee to return. An employee absent for 20 days had a 70 per cent chance of returning to work, but for a 45-day absence the return rate fell to 50 per cent. After a 70-day absence the return rate was just 35 per cent.

Recognising the importance of early intervention, insurers have been looking at ways they can identify risks to employees’ health and intervene before chronic health problems develop. The result has been an increased focus on absences due to injuries or illnesses that occur outside the workplace, and promptly establishing a framework and support network to assist with recovery.

And this focus is already drastically reducing claim rates, benefiting both the employee and the organisation and reducing the employers’ premium rates. Insurer AIA in partnership with Mercer Marsh Benefits found employer clients who adopted an absence management approach had an average claim duration rate of 31.7 months over five years, which was 50 per cent lower than AIA’s corporate average of 46.5 months.

The right support at the earliest time

Extensive literature supports the benefits of early intervention, which is simply about implementing the right support at the earliest and most appropriate time for the employee. But while financial benefits of insurance are almost always claimed, employers and employees aren’t always aware of non-financial benefits that are available, such as rehabilitation and mental health tools such as resilience training.

The World Health Organisation has labelled stress as the ‘health epidemic of the 21st Century’, and resilience training can help individuals adjust and maintain equilibrium during periods of stress and adversity. By increasing the awareness of mental health conditions in the workplace and providing tools and strategies to address them, employers can foster a mentally healthy workplace.

AIA has been working closely with employers undertaking early intervention, offering rehabilitation services prior to a claim being lodged since 2012.

Absence management takes early intervention a step further, by reducing or preventing employee absence by recognising that staying at work can be one of the best forms of treatment. And it is being driven by the need to address more complex and chronic health conditions including mental health diseases.

“The focus is on early identification of risk, and prevention where possible,” says AIA rehabilitation consultant Catherine Zaman: “Employees, where appropriate, are encouraged and supported to remain at work while engaging in treatment or linked in with tailored wellness programs to assist in managing their health condition holistically.”

Insurers work with employers to identify and prevent risks as early as possible. This involves educating the human resources team about best-practice disability management and the array of wellness programs and vocational programs that are offered. Team leaders are also educated to ensure they know how to support the re-integration of their team members.

“By engaging a specialist occupational provider, we can support the employee with access to wellness services, contributing to shorter recovery timeframes and improved prognosis,” Zaman says.

AIA’s programs are designed to help both wellness and work-readiness. In the area of mental health, AIA offers wellbeing coaching and its RESTORE™ program, which was developed to focus on recovery outside of the medical treatment regime through exercise, activity planning and engagement, stress management techniques and community engagement.

The insurer also supports employees navigating the health system to support better outcomes, as well as resilience coaching, work readiness programs, return-to-work support and work coaching.

The benefits of early intervention apply not just to the employees who experience faster recovery, but also to the entire workplace which experiences less disruption to its workforce.

“For the employer it minimises the impact of an employee absence on the business and promotes wellbeing in the workplace,” says Anthony Clough, AIA head of corporate and master trust clients.

“Early intervention also has indirect benefits on the workplace such as reducing the training and integrating temporary employees and even the impact on morale and the psychological burden on employees who have picked up a heavier workload.”

The challenges of early intervention

While the benefits are clear, early intervention can be challenging to implement. Secondary mental health conditions in particular are difficult to record as they can occur at any time from any condition. A good partnership between the insurer and employer is crucial.

For AIA, this begins with understanding the specific needs of the employer and its employees. Setting up an early intervention framework and communicating this to the business is an involved exercise. Both the insurer and employer need to be committed to providing this service to employees.

Effective reporting strategies need to be in place so that HR identifies abnormal periods of absence, and there needs to be clear processes defining how and when this information is shared with the insurer. Line managers need to be able to recognise when an employee needs support and who to contact to facilitate that support.

Regular feedback from the managers and case conferences with stakeholders such as the treating doctors are important to ensure the goals are aligned and any risks are mitigated early.

Mercer Marsh Benefits is a key partner for AIA in the provision of Group Salary Continuance Insurance and support programs designed specifically for employers. Mercer Marsh and AIA provide early intervention and absence management programs that promote return to life goals and organisational health.

These programs are designed and driven by data analytics that capture key risk areas for employers and help with the development of focussed solutions.

Benefits for the workplace

Mercer Marsh Benefits works with over 350 employers to provide Salary Continuance Insurance, implementing early intervention frameworks and illness specific solutions for each unique employer across the portfolio.

Chris Sinclair, head of group life at Mercer Marsh Benefits, says effective absence management can maximise recovery and return to work opportunities with positive outcomes for all involved.

“The key problem it addresses is the delayed notification of a claim, which in turn reduces effectiveness of being able to intervene and deliver services which assist with the individuals’ recovery, return to life, and return to work.”

Implementing an “Early Advice/Early Engage” framework has a range of benefits for the workplace, Sinclair says.

It fosters conversations with employees focussed on ability rather than disability, supporting the recovery of an organisation’s key asset–its people–and reducing indirect costs such as lost productivity, recruitment and training.

It reduces claim duration rates, lowering insurance premiums and allowing the provision of more attractive employee benefits and employer risk management tools. And it allows employers to outsource people risk management to specialists, saving the employer time and money and allowing the organisation to focus on what it does best.

“Whilst an individual who is suffering from an illness or injury will likely have a personal support network including family, friends and medical professionals, it is often support from the employer that is the most important, but equally the most challenging aspect to get right particularly when the illness is mental health related,” Sinclair says.

A new paradigm

Mental health, like any illness, is complex, but the insurance industry is beginning to realise the role good work plays in recovery.

The days are gone of insurance companies simply assessing claims, with the industry moving towards wholistic support of an individual’s recovery journey.

And on the other side of the equation, forward-thinking employers are looking beyond traditional frameworks responding to workplace illness and injury and building frameworks for problems that occur outside the workplace.

Insurers and employers alike are recognising that applying an appropriate claims strategy from the outset has a direct correlation to the health outcome of the individual, the duration of the claim and ultimately the employer’s premium.

“It is typically simple action that delivers the best outcomes,” Sinclair says. “It could be sitting down with an employer to understand and address barriers they face to knowing when employees are absent and developing a solution to address that barrier.”

As the industry moves from being claims assessor to claims manager, it is now a new paradigm to lead all claims conversations with a focus on ability rather than disability.


Copyright © 2019 AIA Australia Limited (ABN 79 004 837 861 AFSL 230043). This is general information only, without taking into account factors like the objectives, financial situation, needs or personal circumstances of any individual and is not intended to be financial, legal, tax, medical, nutritional, health, fitness or other advice.

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