Working directly with customers to ensure a timely return to meaningful work is one of the most high-impact ways an insurer can reduce claims durations and increase customer satisfaction
The FINEOS Care Plan for Life Insurance
As automation and self-service digital channels reduce time-consuming administrative claims functions and phone enquiries, claims assessors have more time to focus on these important, value-added activities. FINEOS supports claims assessors in every aspect of customer-centric planning with its contemporary care plan capability which has been designed in collaboration with FINEOS clients.
To engage a customer in their plan, the claims assessor must understand the things that are important to the claimant and what their world looks like outside of the claim. The FINEOS Care Plan “About Me” feature prompts the claims assessor to delve into the aspects of a customer’s life that will help in personalising the planning process, such as family and work life, interests, education, training and experience. This information helps develop goals that are important to the customer as opposed to focusing solely on the medical aspects arising from the injury. The claims assessor may also pick up on biopsychosocial factors requiring proactive management.
Customer circumstances change over time, as do their needs, and the supports required to help them achieve their goals. The FINEOS Care Plan is designed to be responsive to these changes by scheduling periodic reviews. Outcomes are collected from multiple sources to ensure the customer is achieving goals and the plan is progressing in the right direction. Changing circumstances that may require additional supports can trigger alerts, for example, the customer relocating, experiencing a relationship change, or the onset of secondary conditions. Early intervention by all participants is key and the claims assessor is equipped to manage these changes and provide the additional supports to avoid long-term impact.
Collaboration via Digital Channels
Collaboration is key to achieving better return-to-work outcomes for the customer. Swiss Re’s Rehabilitation Watch 2022 states, “In-house RCs (rehabilitation consultants) have collaborated with rehabilitation providers to develop tailored programs
for life customers. This has led to innovative service delivery, improving recovery and return to work outcomes for customers with conditions commonly seen on claim.” The FINEOS Care Plan is digital by design, and it has the APIs required to support secure digital collaboration among employers, providers, and external rehabilitation providers. Each authorised stakeholder can actively participate in the plan with access to the relevant components to update the elements that are assigned to them.
When care planning is managed on external systems, there is an inherent missed opportunity to learn from successful plans and report on customer outcomes. The FINEOS Care Plan is fully integrated into the core claims platform, making the data available for reporting and learning. Rehabilitation-specific data can be mapped to claim outcomes to measure the effectiveness of rehabilitation intervention. In addition, customer feedback on both internal and external rehabilitation services can also be captured in the FINEOS Care Plan to share with the providers to improve service delivery. The predicted rehabilitation cost to support the plan, as well as the actual cost incurred, are captured against the plan to quantify its value and effectiveness.
Additional reading: The FINEOS Care Plan for Social Insurance APAC