The challenges and opportunities of virtual management of medical claims
Prior to 2020, the term ‘telehealth’ was rarely used. Australians were used to travelling extensively for medical care, taking time off work to attend appointments and being restricted to the medical experts they could reasonably access in their local area.
The COVID-19 pandemic saw medical service providers embrace ‘telehealth’ options (appointments conducted using voice or video technology) to ensure Australians still received much-needed medical attention throughout strict lockdowns. As the medical industry pivoted to meet these needs, so did those who assess accident and health claims. While our team at Gallagher Bassett has long used technology to deliver web-based claims management and real-time data insights, there are new challenges we all need to address.
Can virtual medical intervention be effective?
If the service provider is committed to communicating clearly and using technology in the right way, employers should expect to see a return-to-work timeframe that is not unnecessarily extended. One way this happens is through our panel of rehabilitation providers, who have progressed towards remote monitoring technology. Through this, they can remotely monitor claimants exercise adherence, pain levels, notify when claimants reach a set threshold, and support a tailored program for both return-to-work and return-to-wellness. Technology can also deliver better claimant experience through instant video or messaging access to service providers.
What trends are on the horizon for group personal accident (GPA) claims?
For many essential industries, the injury risks to employees did not reduce as a result of the pandemic. In fact, companies across the transport, manufacturing and healthcare industries saw a significant increase in the physical and mental demands of their roles. We expect the demand for GPA policies to remain, however the claiming profile may start to change as a result of these environmental changes.
This trend was mirrored for office-based workers who shifted to a home / remote environment. The work-from-home environment saw an increased demand for mental health support and musculoskeletal issues as a result of poorly set-up home offices. This has a clear impact in terms of Workers Compensation, but the impact has also been felt in the outside-work GPA space.
We expect these trends to continue in 2021 as many businesses accept a more flexible model of working. As such, one of the key areas of concern in the coming year is the potential rise of claims relating to chronic, compounding conditions.
How will chronic conditions impact claim outcomes?
One in five Australians live with a chronic condition – a figure that is only expected to worsen. As Australia’s third most costly health condition, after cardiovascular disease and musculoskeletal conditions, it is an increasingly common trait of Australians who drop out of the workforce. The toll of a claim that cannot be ‘simply’ resolved in the normal fashion can be frustrating for insurers, clients and the claimant. An important relationship building exercise for insurers could include education on chronic pain prevention and management for clients. By sharing your expertise in managing these claim types, you will be able to build a greater understanding with your clients around what to expect if an employee develops a chronic condition.
How can we control and reduce claim costs in a virtual world?
Prevention is key - bring your clients on the journey to understand risks their employees face from their role and adjust their workplace health and safety training to meet these new needs. Make sure to stress to your clients the importance of educating employees on how to prevent an injury, identify and report a potential claim. Insurers must be ready to move quickly on claims to minimise the potential of compounding injuries and reduce investigation timeframes.
Utilising digital platforms to clearly communicate claim requirements and outcomes can help claimants and clients understand a claim’s progression, all at a lower cost due to the nature of the digital space.
Through digital management and data analysis, you can ensure your clients feel informed and protected throughout the entire claim journey. At Gallagher Bassett, we’re helping carriers leverage the virtual claims management model to their advantage through our industry-leading technology.
Find out how we can help you, connect with our team of experts today.
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