RESPECT …………..

The anthem of Aretha Franklin, The Queen of Soul was her song Respect “Hey Baby ….. all I’m asking for is a little respect …. R-E-S-P-E-C-T”

In a similar vein, the Life Insurance Code of Practice, Mach 2 at Point 1, requires subscribers to The Code to be “ …. honest, fair, RESPECTFUL, transparent and timely …..”. Whilst each of these could be the subject of its own article, the current will stay with Respect.

Respect is like “good faith” in so far that it is not easy to define but its absence can easily be recognised. How then does Respect translate within the practices of life insurers?

Bearing in mind the limitations of size, this article will only consider a few examples with those being confined to the arena of Claims.

By way of context, when someone is making a claim, generically they will either be sick, injured, grieving or dying. They may have lost their ability to work, their business may be at risk, things on the home front could be under stress, they may feel they have lost some, if not most, of their control over life. For those grieving, they will be feeling the loss of a loved one.

Whatever the reality, the person making a claim will likely be at a very low point.

The icing on the cake is that net of relying on those working for the insurer, they will be forced to navigate solo a World about which they know little.

How crucial therefore the role of those providing informed assistance to the person above.

For financial advisers and/or otherwise third-party representatives, when working with someone making a claim, the obvious thing required is that you are diligent in achieving the desired outcome of not only having the claim paid, assuming it is indeed a valid claim, but also reaching this goal in the least possible time and with the least possible stress and intrusion to the person being assisted

There is, however, another albeit less obvious outcome that is also crucial ie to enable the person claiming to regain some control by helping them to understand what is happening and, where possible make the process inclusive by encouraging them to have input.

The key third-party contribution elements that can be extracted from the above are:

• Minimise stress and intrusion; and
• Enable understanding and encourage inclusion.

Not only should these be personal goals but additionally the person assisting in the claim should use their best endeavours to ensure the insurer is an equivalent and equal contributor.

Within the claims arena, it is these elements when demonstrated by all involved that ultimately create the form of Respect.

Some examples……….

• Assessor Phone Calls

We live in an age of spam which appears in various forms including rogue phone calls that enable voices to be taped and re-engineered via AI potentially leading to identity theft and devastating financial loss. Bearing this in mind, it would be with some trepidation that an unexpected call from an unknown number would be answered.

Even before spam came on the scene, however, it was considered a courtesy that if you wanted to speak to someone in the professional world, you would contact them in advance, for example by email, agree on a mutually convenient time and advise details of what was to be discussed.

The relationship between the claims assessor and the person making the claim should not be one of “two mates informally exchanging pleasantries” it should be prudent, polite and professional. As such, a sign of disrespect is for an assessor to make cold calls whilst a sign of respect is to follow the protocol above.

The relevant request might be made within the claim lodgement email.

Names

For someone making a claim the process is challenging in the extreme as they are providing access to their most personal information to people they do not know.

Whilst over time, assuming consistency of claims assessors, an element of professional trust between the claimant and the assessor may be built up, that trust is unlikely to extend to others within the insurance company.

For this reason, it can be confronting for the person making a claim to be advised that the claim detail is to be discussed or referred to an unknown and impersonal entity such as:

• A senior;
• An external stakeholder; or
• Personalisation should be requested, for example:
• “I am going to speak to Mary, my manager, and I will let you know what we think”; or
• “Part of your cover is insured with a reinsurance company, so I need to speak to them as well.”

Perish the thought that, if necessary, how reinsurance works might even be explained.

• Times and Dates

People are funny beasts in that they can usually deal with the known but less so with the unknown. Thus, advice that involves unknown times and dates is counter-considerate, for example …… “I will get back to you …..

• “As soon as possible”;
• “When I can”; or
• “When my senior comes back to me.”

Better to request that meaningful times and/or dates are provided, for example:

• “Mary’s turnaround time is usually a couple of days, so I will let you know by Thursday how things are progressing”; or
• “I have made an appointment for Friday morning with Dr John, our internal consultant doctor, so I should be able to give you more details that afternoon.”
• Out of Office

It seems to be increasingly common that out-of-the-blue advice is received along the lines of “I am sorry for the delay getting back to you, but I have been away on leave” or “unwell”.

Whether absence is planned or otherwise, a professional protocol is to have an Out of Office posted so that alternate arrangements can be made if a claims assessor is unavailable.

If this does not happen automatically, perhaps the relevant request should be made.

• Email Communication

Whilst the insurer is not responsible for the education of employees prior to their employment, the insurer is responsible for what leaves its office.

Is it too much to ask that:

• Emails are intelligible both in regard to words used and information layout;
• Emails respond to all questions asked; and,
• Emails follow some reasonable rules of being grammatically correct.

To do otherwise is to send a message to the recipient that they are not sufficiently important to warrant care being taken in the manner of communication.

As an aside, the writer of this article openly confesses to sending “corrections” back to insurers when errors appear in letters they send or intend to send to medical practitioners and even in auto-reply emails.

The above are a few low-tech, simple and practical examples of the type of things that should be in place in order to create a respectful environment for the person making a claim. If it takes encouragement and prodding by those assisting the claimant in order to activate the action, so be it.

There is, however, another action that warrants comment ……….

• Authorities

From a claimant perspective, the authorities requiring their signature give the insurer the power to obtain anything, from anyone, at any time and, notwithstanding when they are used, a text may be sent to advise of same, this only adds to the sense of stress and intrusion because no meaningful detail is provided in the text.

One way of enabling some understanding and inclusion in the claim assessment process is by including wording along the lines of the following when lodging the initial claim documents:

“Notwithstanding the signing of any authority now or in the future, if (INSURER) wishes to obtain information from a third party, prior to requesting the information, could you please advise what is to be requested and why it is required. The specific permission or otherwise of (INSURED) to proceed will then be given. Please note, this includes providing a copy of questions to be asked of the third party.”

In addition, the following may also be added:

“Further, (INSURED) also asks that a copy of requested information be provided as and when it is received.”

The above is also a safety strategy for the adviser. At your peril simply advise the client to give the insurer what they request on the basis that “They know what they are doing, and it will keep the claim moving.”

Firstly, the insurer may not know what it is doing as mistakes happen and/or it may be working on a misunderstanding of the facts, and secondly, if what is requested is unnecessary and/or unreasonable, and the claim is delayed or even denied as a result, the adviser may be exposed.

Some insurers may see requests such as the above as the claim representative making the process “more difficult”. One in fact recently struggled with the concept to the extent of responding:

“You have insisted that our actions be subject to your review and approval. This includes restricting our reasonable requests for information and vetting our requests for medical reports. We will obtain reports and information in accordance with our normal procedures ….. copies of reports and letters of engagement (will be provided) once the reports are received and assessed.”

This response was assessed by the recipient as lying somewhere between the word “empathy” being absent from the insurer’s lexicon to the insurer seeking to give the claimant and/or their representative “the bird” in written form. A gentle suggestion was sent back that if the above represented the insurer’s normal procedures, maybe they needed to be reconsidered.

This insurer’s position was, however, much further off-colour in that it was twice in direct breach of the Life Insurance Code of Practice.

The first breach was to the previously mentioned requirement that the insurer be Respectful and Transparent.

The second was to Section 5.12 of the Code which states in part:

“….. We may ask you to consent to requesting information from more than one source. Unless you tell us you do not want us to, we will tell you each time we use your consent ……  if you do not agree that we need some of this information, we will review our request.”

and Section 5.15 which goes on ……..

“ …. you can ask us to review whether the grounds are reasonable. We will tell you the outcome of our review and, if you are unhappy with the outcome of our review, we will treat this as a complaint.”

Now commonsense dictates that, if someone is to make the necessary informed decision about whether or not they agree to certain information being requested, they must know what is being requested and how it is relevant, and they must know this prior to the information request being made and that includes knowing the questions an insurer is looking to ask a third party.

Net of a fraud investigation, the Cone of Silence has no part in a respectful claims management process. As such, whether requested or no, why wouldn’t an insurer offer to enter into an adult conversation with the person making the claim and/or their representative about matters such as:

• Who might be the best person to contact to obtain additional information about the claim condition; and
• Whether the questions being asked are OK and/or are there other questions that might be asked.

The following was received from a claimant the very day this article was being written “Insurers make you feel like the lowest of low … they make you feel like crap.” Hardly reflective of a Respectful process.

So, what’s the message ………

Is the claim experience universally lacking in respect? Of course not, there are some amazing and brilliant stories being created every day.

Could the claim experience be improved if greater recognition and emphasis was placed on the elements that create respect, i.e.

• Minimise stress and intrusion; and
• Enable understanding and encourage inclusion?

The answer must be Yes.

A key role of the financial adviser and/or otherwise third-party representative is to acknowledge and applaud the elements of respect when they already exist but to identify when they do not, and look to take actions, in turn in a respectful way, to have the missing elements included.

Can it happen? In the paraphrased words of another Aretha Franklin song “Say a Little Prayer” !!!