RIP Tele-Claims -Why Tele-Claims has had its day.

RIP Tele-Claims -Why Tele-Claims has had its day.

We introduced Tele-Claims in 2007, 11 years ago. We worked with the reinsurer SCOR and this has been a great success. Many companies have also built successful Tele-Claims services in house. Indeed Tele-Claims is the predominate claims method for serious condition claims and very few companies are still using traditional claim forms.

However, we think Tele-Claims has had its day and it is time to retire it.

We have replaced Tele-Claims with Crisis Support. Crisis Support combines Tele-Claims, Claims Reviews, Early Intervention and nurse support service into one service. We modestly believe Crisis Support is the next generation of claims processing. In a way we are retiring claims processing and turning into a much more customer focused process.

I am pleased to report that since launching at LUCID last year, most of our customers agree and are moving across. This is due to the many advantages this brings:-

Customer focused service

We have turned the claims process on its head, focusing on the consumer and their condition as the prime concern and then collecting and processing the claim as a secondary process. Claims assessors receive all the data required for their claims assessments. The difference is that this data is collected as a part of an empathetic customer focused nurse support service.

The service can be triggered, at any time when the policy holder is ill, and continues until the consumer is back on their feet and back to work. Watch the video here.

A value add to all policy holders

The service is typically provided to all CI and IP policy holder, with the option of extending to life policy holders. From the consumer’s perspective we deliver a service that looks after them when they are ill regardless of their product, definitions, differed period or small print. I.e. we meet consumer expectations – to be looked after when they are seriously ill. You suffer, we support.

Hence, even if the claim does not meet the definitions for a financial pay out, at least we support the policy holder through their illness and misfortune.

We use proactive Nurse Case Management to manage consumers through their condition ensuring they obtain appropriate treatment. Where required we can arrange for private treatments if private medical insurance is not present and the NHS waiting lists are too long.

To keep costs down we utilise the consumer’s right to obtain a secondary opinion within the NHS.

Simpler customer journey

Combining Claims Processing and Nurse Care Services into one service simplifies the customer journey as consumers are dealing with one service rather than the claim with the claims department and a separate nurse support service..

Reduced Costs

As the nurse collects all the information required for claims while looking after their patient, there is considerable costs saving, as two services are combined.

Overcoming the usage problem of existing added value service

Existing added value services often suffer from low usage. We overcome this by combining the Claims Process with the nurse support service so at least every ill policy holder is provided with empathy and care.

Reduced complaints

While reducing costs is all welcome, the main benefit is in the customer experience, and this leads to lower complaints internally and to the FOS. By providing this caring service first, even if the consumer does not meet the policy conditions and is not entitled to a financial payout, at least we have looked after them and any disappointment is better received and less likely to lead to aggravation.

We transform an existing problem area into a source of promotion. Don’t take our word for it read our heartwarming customer stories.

Working across silo’s

Admittedly one of the challenges of combining the claims processing and added value service is that they typically operate within differing departments, namely claims and marketing and within different budgets. So the introduction of such a service does require some cross departmental collaboration. However introducing innovation is never easy, and we don't shy away from the challenge.

Bespoke by company, product and distribution channel

The service is controlled by our own secure systems. This allows the service to be bespoke for different sales channels, products and company. This also enables us to dovetail to existing Claims Processes, and create bespoke services. Typical variations include the amount of treatments included within the service free to consumers, including:- bereavement counseling, mental health counseling, CBT, physiotherapy, occupation health and secondary opinions.

As we except the value add services provided by companies to increase and become more differential, then we believe being able to bespoke to this level of detail will become important.

Own brand or white label

For those wanting quick and easy set up, we have our own customer brand "Peace of Mind". Alternatively the service can be white labeled to dovetail into existing company values and services.

Tele-Claims was a great step forward 11 years ago, and now its time to become even more customer focused and move on.


Peter McCarthy

Former EY partner now retired

6 年

Good article and very timely for the NSW scheme

Nicola (Nik) Taylor

Care Navigator | Care Funding and Benefits Advice to help you understand your care options, benefit entitlement and ways to pay for care

6 年

Personalisation has received lip service for many years, it's great to some innovative action Andrew

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