Niki Ellis | A best practice framework for the Management of Psychological Claims: But where are we up to in practice?


A best practice framework for the Management of Psychological Claims: But where are we up to in practice?

28 Oct 2016, Posted by Professor Niki Ellis in WHS

Congratulations Howard Williams, one of the organisers of this year’s ALUCA conference, on a great conference. Held in Adelaide, numbers were up this year to 400. The opening address by futurist Gihan Perera was terrific.

I spoke in one of the parallel sessions on 20 October. Recently, I was a judge on the Swiss Re, ALUCA and Insurance Council of Australia awards for innovation in return to work. As always, this was a worthwhile experience as it gave me insight into the state of best practice across the industry.

In my presentation, I compared current practice in the life insurance industry, as evidenced by submissions for the awards, to best practice as described in the framework for the management of psychological injury, which was developed for SuperFriend by Anne-Marie Feyer, Jane Palmer and myself. I concluded that the life insurance industry is off and running in innovation of claims management at the micro level (that is, making claims processes client-centric and outcomes focused), and was in the early stages of exploration of partnership with superannuation funds and employers to get earlier intervention (macro level) but was neglecting meso level interventions. Meso level interventions are things the industry could be doing themselves, such as using product design to get better client outcomes and better use of analytics to manage claims (not just triage claims). Also, there is plenty more potential in bringing evidence to medical treatment and rehabilitation. Finally I concluded that there was scope to bring more rigour to the evaluation and continuous improvement processes underpinning current innovations. EML’s winning submission in workers compensation was a good example of what can be achieved with partnership with a university.  You can view my presentation here.

Watch out workers compensation, I am finding the life insurance sector is taking a more innovative approach to their work these days. In conversations I have had with the workers compensation sector, too often a lack of innovative thought is excused by the constraints of regulation.