ALUCA’s Medical Forum events were held in Sydney and Melbourne last month. Thank you to all the CMO’s and ’Medical Consultants who attended and provided some rich insights into the current challenges the industry is facing.
Themes from NSW Medical Forum discussion
- Mental health – Issues with life insurance products covering subjective conditions, justifying exclusions for disability in insurance products and the need to work with community on this. Given the subjective nature of mental health conditions, and their assessment, there is a need to focus on function e. how does the condition affect them in their lives and how they function rather than how they feel which is more subjective.
- Restoring trust – Need to re-build the trust with customers and treating doctors, especially GP’s. They are mistrustful about how the information they provide to a life insurance company might be used against their patients. A call out to Assessors is the need to provide support to GP’s as many have lost confidence in insurers post Royal Commission (RC) findings. CMO’s are spending time providing reassurance about what claims and underwriting teams are doing. Acknowledgement that CMO’s have an obligation to build trust and work to common goals. Encouragement for CMO’s to engage more with their colleagues including treating doctors – and a need to help Doctors to understand what CMO’s need (the focus should be on the patient’s condition not life insurance)
- Health records – the quality of many health records is poor, and perceived to be deteriorating. This is likely due to many factors, including the pressures treating doctors are under, and potential mistrust in the insurance (life and non-life) industry. The PJC enquiry and RC will likely impact access to health records further. These factors are expected to have flow on impact to underwriting and claim assessments.
- Staying informed – Rapid advances in medical research and technology change – and ensuring Insurance Medicine advances with these developments. Onus on medical professionals to keep up-to-date with these advances and information – i.e. latest heart attack definitions.
- LICOP 2.0, Royal Commission, PJC enquiry into rehabilitation services – will impact all areas of the life industry – again there is a need for individuals and organisations to remain up-to-date and involved in progressing outputs.
- Time pressures – Would like more time to be able to deliver quality work – but constant time pressures impacts on this.
- Drug & alcohol – increasing usage is seen as a hot topic. Legalisation of medicinal marijuana and what will this mean?
Simplification & access to return to work (RTW) support – general feeling that there are too many people involved in RTW – insurer-employer- broker- customer – lawyer- Rehab – the customer can be lost in this process. Often customers need urgent access to treatment rather than going through many channels/ layers. There is a need to simplify and provide clarity on processes such as this (any many other processes in life insurance). Lastly, there is a degree of mistrust about RTW language and so the focus is moving towards health support, wellness and recovery.