How we're enhancing the claims experience for members

Supporting Australians and their families through the claims we pay is the most important thing we can do. In 2020, we paid $2.7 billion in claims to 37,228 customer and their families. Of the claims we paid, 68% helped our customers continue living their lives while recovering from an illness or injury.

The life insurance industry has experienced a period of significant change over the last few years. However these changes have created a unique opportunity for life insurers to innovate in the ways we deliver experiences for members. Nowhere has that been more apparent than in the way we’re working to transform the claims experience, which is at the heart of a member’s interaction with life insurance.

For several years now, we’ve made investments across our people, systems, procedures and training to ensure every claim is assessed with care and sensitivity and we are continually improving the experience. We’ve also revisited our claims philosophy to ensure we continue to deliver on the promises we make to your members.

TAL’s approach to claims centres on three themes to help us achieve our ambition:

• Digital support and enablement: giving members choice in how they engage with us through simple, transparent and valuable digital solutions that promote engagement, remove complexity and ensure consistency and efficiency in our approach.
• People-led service and support: recognising that each member is different, and the circumstances that surround their claim are unique, Our Claims Consultants support your members every step of the way, tailoring their journey and providing a personal and empathetic experience.
• Embedded health services: Through TAL Health Support we help your members reach their best health following an illness or injury with a comprehensive range of holistic services accessible throughout their claims journey.

Each of these areas is supported by robust governance and risk frameworks, with defined policies, guidelines and processes that support our commitments to members, partners, regulators and the community. A team of 40 people manages this enhanced framework and is overseen by our newly created General Manager, Claims Governance & Risk who reports directly to me. To complement this team, I’m also appointing a General Manager, Group Claims who will be responsible for improving our Group Claims proposition.

Meeting member needs while embracing technology

We’ve been looking at how we can utilise digital transformation to empower members in different ways at different touch points but that does not mean every single process needs to be completely digitised.

Getting digital right means finding the balance between leveraging benefits of technology to streamline a members’ claims experience, while at the same time ensuring human empathy remains a core part of the process.  We can simplify and be more sympathetic in the questions we ask claimants, with improved customer friendly language and product definitions which may decrease the notification delays we often see.

Following extensive member uptake across multiple funds, we’re delighted how our digital claims experience is enabled through Claims Assist. It supports members to track their claim’s progress, submit requirements and, for income protection claims, provide information such as TFN or bank account details. We’ve found this has led to faster submission of requirements, lower inbound calls and increased satisfaction ratings.

Allowing claims consultants to do what they’re best at

When we get the digital equation right, it can help remove much of the admin work from a claims consultant’s role, allowing them to focus their efforts on the most important aspect of their job – supporting claimants during what is often the most difficult time in their life.

Working in collaboration with a member throughout their claim journey, our Claims Consultants provide the care and support needed and ensure a superior experience. They draw on a range of resources and expertise so they can look after each claim in a personal, genuine and empathetic way that reflects each member’s unique circumstances and condition.

Ensuring claims consultants can continue to develop these skills, we provide them with training and coaching, and ensuring they have access to support so they can look after their own wellbeing. One way we do this is through psychology-based training, including motivational interviewing techniques and person-centred communication skills, designed to ensure they’re equipped to understand a member’s situation and work collaboratively with them as they progress their claim.

Helping members reach their best health possible

When your members make a claim, you can be confident TAL provides extra support to help them reach their best health, because we believe a good claims experience offers much more than just paying claims. TAL Health Support has been developed to provide a comprehensive framework that supports the health and wellbeing of your members as they navigate their condition. It provides access to a range of evidence-based services that supports physical, mental and financial health.

Our claims consultants are essential to the process, engaging members with empathy, care and understanding. They aim to provide access to the right services at the right time: from community-based resources before a claim is paid, to targeted support once a claim is underway.

See how we helped Dexter, a TAL customer, to reach his best health following a serious cycling accident that could have left him permanently disabled. Through the help of his claims consultant and recovery and support specialist, TAL developed a personalised rehabilitation plan that utilised the expertise of an exercise physiologist, occupational therapist, and career coaching support to help get his life on track.