In Focus: Vulnerability  

How tech can help your clients to claim

  • To understand the constraints on medical claims processing
  • To ascertain how technology is being developed to help the process
  • To be able to explain how best to approach making a claim
CPD
Approx.30min

It’s also often a role of support during the claims process, and clients, particularly vulnerable clients, look to their advisers for answers on many of their claims’ queries.

When there are delays, advisers can be tempted to chase GP practices. This can be counter-productive and simply adds further pressure onto the GP practice. 

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It’s very difficult when an administration process is going on in the background, to all intents and purposes, invisibly.

Advisers that have recommended a product need to be confident that it will go on cover quickly and they also want their clients to experience a supported, considered and timely payment of the claim. This increases trust, engagement and customer loyalty.

Of course, not only do advisers face calls about claims, but also so do insurers. Greater transparency is better for everyone.

Not only does the eMR technology platform mean that claims are expedited, the process can also be tracked in real time, enabling advisers and insurers to deliver the ultimate customer service and client experience.

Product development

Product development and underwriting go hand in hand. As an example, because getting medical reports can be so onerous, some in the industry have developed products where limited or no medical evidence is needed, but this can be fraught with issues.

It’s better that underwriting is embraced - and made more efficient - than circumnavigated. It’s also vital that products are fit for purpose, so that distributors can be confident in selling them.

Insurers have been tempted to avoid medical underwriting in the past by increasing free cover levels, or increasing non-medical limits.

More recently, greater emphasis has been given to post-issue audit underwriting, which takes place after the individual has been put on cover. 

Not having adequate medical information will also make it more problematical for re-insurers to price and adjust their underwriting philosophies and rules as the effects of the pandemic become clearer and a more accurate picture of the risks are identified.

Consumers want to be confident the product will pay up in the event of a claim – so disclosures and exclusions must be determined at the underwriting stage not at point of claim. This is important, so that advisers feel confident in selling such products. 

A poor claims experience, statistically, is ultimately bad for the client and the whole industry. When medical reports are easier to gather, the underwriting process is more comprehensive and quicker, it’s less tempting to circumnavigate this step, and products are more able to deliver at point of claim.

Medical evidence is also conducive to product development. The more relevant medical evidence that’s available, the more information there is to develop appropriate products that meet the needs of today and the future.