ProtectionApr 13 2017

Insurance companies pressed to improve claims experience

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Insurance companies pressed to improve claims experience

Insurance providers are being called on to work harder to improve the claims experience for clients, not just in terms of the process but also in providing the most accurate claims data.

Phil Hull, proposition and portals manager at Holloway Friendly, said the industry must go further to make the claims process fairer, quicker, easier and more transparent for existing clients.

He said Holloway Friendly was a "big advocate of publishing claims statistics" annually, as the claim itself is "the thing our customers buy". 

However, he said it was not so much the claims statistic itself that was what clients bought, but the experience at the point of claim.

Mr Hull explained: "People pay so that they and their family are treated in the way they expect to be treated at any potential point of claim. They pay for the claims experience.

The anguish claimants can go through when trying to make a claim is clear, so anything providers can do to alleviate the stress of the process is important. Andrew Ward

"Rather than talking about changing consumer views, why don't we focus on giving our current consumers a better claims experience instead?"

Andrew Ward, head of protection of advice for Roxburgh, said: "The anguish claimants can go through when trying to make a claim is clear, so anything providers can do to alleviate the stress of the process is important.

"When a policy is underwritten, it is rare that providers will step away from the guidelines and take a human approach to helping someone get cover. A claim can be slightly more rigid in terms of meeting certain criteria and getting the claimant to supply certain information.  

"I've not seen any provider step outside the box and show the client they are trying to make it easier to claim, even if that is the ethos of the provider."

He said he would like to see a provider have certain conditions whereby a claim can be pre-approved to a certain level, or a certain amount can already be pre-approved, so a client can have some money paid out to help with immediate bills while the checks are carried out.

Mr Ward said there were also ways to improve the claims process in getting the necessary information, such as a GP report, so that a claim could be processed more quickly. 

British Medical Association guidelines say these should be completed within 21 days but there is no real law - some GPs can do it in a few days and others can take much longer. 

Mr Ward added: "When helping someone get cover, we spend so much time trying to chase the GP, but do providers spend a similar amount of time chasing the GP at the point of claim, or do they just wait for the report to come in?"

But it is not just the experience and the process but also the way in which claims statistics are published and displayed that needs to be made more transparent, according to Holloway Friendly's Mr Hull.

He highlighted the three methods by which providers calculate their claims statistics: the Association of British Insurers' model, whereby all claims in payment are counted, regardless of which year the claim started; the friendly society model, where only new claims made in the relevant year are counted; and the all claims counted method, which is similar to the friendly society model but includes more types of declined claims, such as where a claim is made for an excluded condition.

Under such models, the headline figure could be different. He pointed to the Holloway 2016 individual protection claims statistics using these three methods. These showed: 

  • ABI method - 98 per cent
  • Friendly society method - 96 per cent
  • All claims counted method - 90 per cent

He said: "It would be easy to simply follow the ABI method and say we paid 98 per cent of all claims in 2016, but this includes all previous claims in payment. 

"My gut feeling tells me this isn't right. Surely this massively skews the previous year's performance?"

Mr Hull suggested it might be better to provide information such as the total of new claims in any one year, the total in force in the previous year, and the total amount of money paid out. 

Phil Nash, product development manager for Active Quote, commented: "Customers depend on the information provided by insurance companies in terms of factors that affect purchase, with claim statistics always being high on the agenda.

"Above all else, clients want to know the investment they make each month is going to result in their claim being paid, should the worst happen."

Although much work in the industry has been carried out in order to rethink the legacy attitude around declined claims, with the principle of transparency supporting this change, he said when claim statistics are not all collated in the same way this "presents a viewpoint for clients that could be deemed as confusing and potentially misleading – thus undoing some of the previous positive changes achieved".

He added: "Claims for excluded conditions and non-disclosure certainly muddy the water – the perfect solution may still evade us but we should still strive to make our statistics as uniform and transparent as possible."

simoney.kyriakou@ft.com