Claims professionals rely on employability assessment to help decide total and permanent disability (TPD) life insurance claims. TPD insurance is set in a unique multi-billion-dollar market and is available to all working Australians, usually through their superannuation. The TPD stakes are high and claiming a predetermined lump sum amount in a win/lose decision is challenging from the outset. Employability assessment emerged as a new vocational assessment model in the mid-2000s and was developed by rehabilitation counsellors to accommodate TPD policy and legal requirements. Employability assessment within the TPD context has not been empirically evaluated despite growing legal scrutiny. The aim of this thesis, therefore, was to contribute formative knowledge about this burgeoning area of Australian disability insurance from claimant, rehabilitation advisor, and claims professional perspectives. Five exploratory studies examined specific research questions using a multiphase mixed methods design.
Study 1 was a scoping review of literature related to forensic employability or vocational assessment and to life insurance TPD claims or claimants. Thirty-four items were eligible for inclusion in the study and they comprised three domains: (1) forensic vocational assessment, (2) TPD in superannuation insurance, and (3) legal aspects of the second limb of TPD policy. Only one item pertained directly to employability assessment and TPD. The findings indicated that the new employability assessment model and forensic vocational assessment were similar in origin, purpose, and methodology, although employability assessment lacked psychosocial components commonplace in other forensic models. Australian TPD in superannuation has grown exponentially in recent years in response to consumer and market forces. In the final domain, legal interpretation of vocational areas within the second TPD policy limb, such as retraining, type of work, date of assessment, and realistic assessment of work options, were shown to inform employability assessment practice.
Study 2 sought claimants’ perspectives of the TPD process. Analysis of data from in-depth interviews of 12 claimants whose TPD superannuation claims had been finalised, found that they lacked information about having a claim and claiming TPD. Nearly all interviewees reported that the process was unclear and complicated, which caused them anxiety and frustration. Communication was often ineffective and frustrating at a highly stressful time of disablement; the complex and lengthy TPD process undermined their health and wellbeing. Three-quarters of interviewees wanted to return to some form of work but were uncertain how to proceed. Interviewees described unexpected consequences following their lump sum payouts and all contributed suggestions for system improvement.
Study 3 explored the views of 10 employability assessment experts in a qualitative focus group discussion. They were rehabilitation advisors employed by national insurance companies whose primary responsibility was management of employability assessment within the TPD claims setting. Findings from this focus group confirmed the forensic underpinnings of this model, the need for independent training and accreditation of employability assessment providers and called for realistic information about a claimant’s work potential.
Study 4 applied a novel adaptation of the Delphi process to generate 21 survey items for inclusion in the final study (Study 5). The rehabilitation advisor experts from Study 3 participated in a three-round Delphi, the last two rounds of which were real-time and in-person. This adapted Delphi process was anonymous and was completed in four weeks with 100% response rate and 75% consensus on items to be included in the survey.
Study 5 was an inaugural nation-wide survey on the view of life insurance claims professionals on employability assessment. Survey respondents were claims assessors and technical advisors (N = 104) representing approximately half of all insurance professionals making TPD claims decisions. Respondents found that employability assessment was extremely important in enabling a clear picture of a claimant’s work potential and in deciding the claim. Transferable skills analysis, objective rationale for job options identified, and labour market analysis with employer contact were deemed essential components of an employability assessment. Rehabilitation counsellors were regarded as best qualified to conduct these assessments by 56% of respondents.
The five studies provide new information about employability assessment as part of the TPD claims decision-making process. Providers who conduct employability assessment should have independent training and credentials in forensic vocational assessment; provider qualifications are inherent to core competencies of the rehabilitation counselling profession. Studies focused on employability assessment expose a tension between lack of psychosocial information about the claimant and consistent calls for “real life” evaluations of a claimant’s situation. The claimants who were interviewed wanted to be treated as real people and their claim experience to be informative and supportive.
An inevitable outcome of establishing a new body of knowledge is recommendations for further research. The findings call for research in employability assessment methodology to validate omission of psychosocial components. Collaborative research between the legal and rehabilitation sectors would deepen knowledge of the second TPD policy limb and its impact on employability assessment practice. Recent changes to TPD policy, rehabilitation, and claims management practice indicate that updated data on claims professionals and claimant perspectives would provide current and comparative insights.
The need for independently delivered and standardised forensic training, and formal accreditation of TPD employability assessment providers is identified in several studies. Information gained from this thesis provides scope for forensic practitioners to further refine employability assessment into an objective evidence-based methodology that contributes to just and fair TPD decisions.
See Margaret’s complete 266 page PhD Thesis here
Margaret Elizabeth Black
Margaret has worked as a rehabilitation advisor within life claims since 2000. She was a founding member of the Life Rehab Forum, which is now incorporated into the ALUCA rehabilitation subgroup. Margaret’s passion for TPD and the assessment of employability was clear as the inaugural winner of the ALUCA research award in 2007 and throughout her work as a TPD employability assessor, trainer, and presenter. Accepted as a full-time researcher into employability assessment in TPD, Margaret was granted a Commonwealth Postgraduate Award in early 2015 and studied full-time at the University of Sydney. Three international academics examined her doctoral thesis and in September 2018 she was awarded her PhD, to be conferred in April next year. A keynote presenter at the American Board of Vocational Experts conference in Savannah, Georgia in 2017, Margaret is a fellow of the Australian Society of Rehabilitation Counsellors, affiliated with rehabilitation counselling and forensic rehabilitation organisations in Australia and USA.