Claims – What do we do well and what can we improve?

“Our key focus is on customer outcomes. That’s what our focus is. It’s not about getting better outcomes for us as advisors, but obviously by delivering better customer outcomes that does sometimes make our lives a little bit easier as well.”

“One of the key things that we were challenged by when we first launched the Charter was actually insurers not notifying advisers of claims, which then affected our ability to be able to then support our clients. So that was one of the key drivers for the Charter. When we launched the Charter, we only had, you know, 6-7 insurers actually meeting the criteria that we set out at that time. Over the years, though,  we were delighted that more and more insurers were getting there to the point at which we have pretty much every single firm signed up to the six points that we’ve outlined, which has included things like making sure that the advisor was notified, but also elements such as making sure that claimants can be turned away by anybody that wasn’t actually a claims professional.”

“We sent out a very comprehensive survey which we do each year now just to make sure that those who have previously signed up to the Charter are still actually adhering to that. So we send out a very robust survey, lots of questions for the insurers to come back with. And we analysed the time that it was taking them to assess claims forms and the time that it was taken to assess medical evidence. Now we can’t hold insurance to account for things that are outside of their controls, such as probate. After assessing what all the insurers did, we came up with two new criteria, which was that we would expect insurers to assess a claims form within three days and medical evidence within 5.”

“I’m really pleased to say actually that that we’ve had some really positive conversations with insurers that haven’t made Charter status this year. We are fully expecting a number to meet the status before we do the evaluation again in quarter one next year.”
 

“They need the people skills to be able to deal with claimants, you know, vulnerable people, so we know it takes time for them to recruit and train.”

 
“One of the reasons for years I’ve encouraged advisors to get involved in claims is because I know the power of advisors when it comes to things like  getting involved, challenging the insurers either  themselves that even probably even involving the claimant, you can absolutely get some claims overturned.”

“The vast majority of occasions the insurer will get that assessment absolutely spot on. But mistakes do make get made and there are some situations where it is a grey area and the first decision is on one side and then it could be that somebody more experienced looks at the case and then actually feels that a different decision could be made.”

“It’s quite a good year for Guardian in terms of this conversation because we launched the market back in 2018 and we’ve had five years of trading under our belts now. And that means that this year you should expect to see our first ever claims report. So I think you’re going to see some interesting insights in there.  If you think about the design of Guardians proposition, when we came to market 5-6 years ago now, there’s some interesting aspects there which are really we’re starting to see the evidence now of how that.”

“We talk about trying to pay as many claims as we can as quickly as we can, and to do that we have to start from a place of ‘we want to pay this, how can we do it?’ And I think we do that quite well and we can see that through the claims stats that come out.”

“I think as an industry we’re pretty good at trying to find ways to pay those claims nice and quickly and learning from our claims experience, analysing our claims end to end and using that information to feedback in to how we can do things better.”

“I think there’s room for us to improve for sure. I’m really reassured by the fact that it’s something that we’re already getting some real weight behind. And as an industry, as a company, we’re spending a lot more time looking at those things and developing mechanisms and creative solutions to help us get as many claims paid quickly as possible.”

“Like you said yourself there, Adam, when we’re declining a claim it has to be the last resort. It can only happen where it’s absolutely undisputedly the right thing to do. We have to be so careful. And if somebody gets in touch to make a claim, we need to make sure we’re doing everything we possibly can to pay it.”

“I think it’s fair to say that we’re open to those challenges and those appeals to make sure that the correct decisions are being made and those borderline claims are getting, you know, on the right desks, so to speak.”

“I think as time goes on, we should really make sure that we’re saving those really in depth investigations for the right claims and for all of the rest, we’re looking at the most efficient way to pay it.”