Is your practice focusing on the right outcome when managing a claim?

As the cost-of-living crisis continues in Australia, people are under more financial pressure and need to stay in the workforce longer. When life takes an unexpected turn, such as illness or injury, the stakes become higher. It’s no longer just about managing expenses – it’s about ensuring a sustainable future.

For many, a brighter future lies in returning to work sustainably. By engaging with insurers, individuals can navigate the claims process and tailor recovery plans. This collaboration balances efficient claims management with a path to recovery, helping people regain their footing and thrive.

In response, responsible life insurers are shifting from a narrow focus on minimising claim duration –

often with little regard for whether it leads to a sustainable return to work – toward a more holistic approach prioritising rehabilitation and comprehensive claims management, supporting clients’ well-being.

This approach not only delivers better outcomes for clients but also enables advisers to strengthen relationships, improve case management efficiency, and align with evolving industry best practices.

Here are three ways to align your practice with this wellness-focused shift in claims management and improve client outcomes:

1. Long-term and gradual reintegration

Many professionals fall into a “boom-and-bust” trap – eager to return to work at pre-disability capacity too soon after illness or injury, often leading to setbacks which prolong their recovery. However, advisers can set clients on the right path by connecting them with insurers that prioritise gradual, sustainable recovery.

Take Elena* for example, a general practitioner who developed a psychiatric illness early in her career, leading to several hospitalisations and strain on her family and employment. Following the advice of her treating practitioners, Elena initially took four months away from work to recuperate. Worried about her career, she returned too soon, exacerbating symptoms.

That’s where a holistic, tailored approach truly makes a difference. Elena’s claim manager, along with an experienced rehabilitation counsellor and healthcare team, developed a new recovery plan focusing on a comprehensive wellness strategy and more gradual reintegration. This plan, enabled by her insurer, included wellness programs, psychological support, and ongoing rehabilitation, allowing her to recover at her own pace and steadily resume her duties.

The outcome? Elena is now back at work part-time, maintaining her health. By focusing on long-term recovery, not only has Elena improved her quality of life, but her adviser and insurer have also helped reduce her risk of relapse and the associated costs.

By guiding clients towards providers that emphasise long-term care, advisers not only foster better client outcomes but also build stronger, lasting relationships with their clients.

2. Flexible support strategies

No two clients’ circumstances are identical, so there is no one-size-fits-all approach to claims management. This highlights the importance of insurers adapting their claims processes, ensuring plans meet changing needs.

Consider Gina*, a school psychologist and part-time academic diagnosed with breast cancer shortly after turning 50. During her chemotherapy treatment, her oncologist recommended regular exercise to manage fatigue, but Gina struggled to implement this given her physical and emotional state, as well as the added pressure of caring for her elderly mother and two teenage children.

Recognising these hurdles, her claims manager worked with her oncologist to adjust Gina’s rehab plan, giving her remote exercise physiology support and a cancer coach tailored to her circumstances.

This personalised approach went even further. As she progressed, her claims manager developed a gradual return-to-work plan that helped her reintegrate into her professional life without feeling overwhelmed. The collaborative efforts among Gina, her adviser, and the insurer fostered strong relationships, making the journey supportive and effective.

Advisers can turn a challenging recovery path into an empowering journey by motivating clients to take ownership of their insurance plans, and actively work with providers to customise them. This enhances recovery while nurturing enduring relationships rooted in trust.

3. Advisers role in individualised claims guidance

Advisers are essential partners for clients navigating the often emotionally charged claims process, especially during challenging times of illness or injury. Acting as advocates, advisers streamline communications with insurers and guide clients through each step, ensuring that the claims process is manageable, supportive, and attuned to their needs.

One of the key advantages of having an adviser-led insurance plan, rather than going direct, is the personalised and proactive support advisers provide. Advisers bring expertise and experience that helps clients articulate their needs effectively to insurers and advocate for tailored rehabilitation plans that truly serve the client’s long-term well-being.

By collaborating with insurers, they can help provide access to specific therapies, flexible work arrangements, or mental health resources, which can significantly impact recovery and resilience.

Advisers also alleviate the administrative and emotional burden, handling time-consuming tasks that would otherwise add stress during an already difficult time. This allows clients to focus on their recovery with the confidence that they have an advocate dedicated to their best interests.

By championing custom recovery strategies and maintaining a collaborative approach, advisers enhance recovery outcomes and build trusted, lasting client partnerships. This holistic approach aligns with industry best practices and reinforces advisers’ invaluable role in fostering positive, sustainable outcomes.

Elevate your practice with a holistic Approach

Risk advisers have a unique opportunity to redefine claims management as a path to wellness and recovery. Historically, the focus has often been on getting clients off claims as quickly as possible, often neglecting holistic needs. Such an approach could lead to relapses or clients returning to claims, emphasising the need for a more thoughtful strategy.

By championing insurers prioritising holistic rehabilitation, advisers can guide clients through their recovery journeys with tailored support that goes beyond financial relief.

Claims management isn’t just transactional; it’s a powerful opportunity to empower clients to reclaim their lives, strengthen relationships, and cultivate a supportive claims experience. This comprehensive approach enhances clients’ health and aligns with their long-term financial interests, creating a win-win for everyone involved.

* All names changed to protect privacy.