Let's Talk Income Protection

Vocational Rehabilitation: The Missing Link in Income Protection - A 7 Claims Story

• Income Protection Task Force • Season 2 • Episode 5

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In this episode, Matt and Stevie take a deep dive into vocational rehabilitation, a crucial but often overlooked part of the claims journey. This episode forms part of the IPTF’s ‘7 Claims Stories’ series and explores how tailored rehab support can transform a person’s recovery after illness or injury. They’re joined by Phil Deacon, who leads the project, alongside vocational rehab consultant Monica Garcia and protection adviser Charlotte Rogers, who each bring a unique perspective on helping people get back to work with confidence and care.

Vocational rehabilitation plays a transformative role in people's lives by supporting individuals with health conditions and disabilities to stay in work, return to work and sustain employment. This missing link in the recovery journey helps bridge the gap between medical treatment and a person's ability to perform their specific job functions.

Listen now to learn more about:

• How vocational rehabilitation consultants assess both physical and cognitive demands of roles to create bespoke return-to-work plans
• Common mental health conditions, musculoskeletal problems and cancer are the top three reasons for income protection claims
• How only 45% of the working population has access to occupational health support
• Why proportional benefit allows claimants to gradually increase working hours while maintaining some financial support
• How self-employed individuals are particularly vulnerable without workplace support structures
• Why the biopsychosocial model helps identify who needs additional support to return to work
• How early intervention significantly increases the chances of a successful return to work
• Why a 12-18 period off work means chances of returning "fall off a cliff"
• How advisers should encourage clients to notify insurers early, even with longer deferred periods
• How claims assessors need better training to identify when vocational rehabilitation could help
• How the industry could learn from countries like the Netherlands, the USA and Australia, where employers play a more active role
• How approximately 300,000 people leave the workplace yearly due to health conditions
• Why over 8.2 million people currently live with work-limiting health conditions in the UK

Links from the episode:

For more information, visit the IPTF website at iptf.co.uk, check the Chartered Institute of Insurers' Guide to Income Protection, or explore the Vocational Rehabilitation Association website.

📣 Send the podcast your questions, thoughts or advice to feature on a future episode via:

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Or email Info@IPTF.co.uk

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IP Task Force on Instagram

Produced and edited by SEA Studios

Speaker 1:

Hello and welcome to let's Talk Income Protection, season 2, episode 5. This is the podcast that breaks down everything you need to know about income protection, whether you're an experienced advisor or just starting out. This podcast will give you actionable insights and advice and, of course, gain valuable unstructured CPD points. I'm Steve O'Noldy, the content associate for the IPTF, and I'm doing the intro and outro solo this week, but fear not, matt will be back for our panel discussion coming right up. So what is in this episode of let's Talk Income Protection? Well, we're diving into a crucial topic that plays a transformative role in people's lives Vocational rehabilitation, which is story two in the IPTF's Seven Claims Stories series.

Speaker 1:

We have an incredible panel of experts, starting with Phil Deacon, the project lead for the IPTF's Seven Claims Stories initiative. We have Monica Garcia, a highly experienced vocational rehabilitation consultant, who has worked closely with individuals going through this process. She'll be sharing her expertise on the challenges and successes of getting people back to work. And finally, charlotte Rogers, a protection specialist at Radcliffe and Co Financial Advisors in Bournemouth, and she'll be shedding a light on the advisors side. So, without further ado, let's get into it. So welcome everyone. Thank you very much for joining us for this episode. Phil, I want to kick things off with you. Could you give us an overview of what the 7 Claims project is all about?

Speaker 2:

Yes, certainly Stevie. So anyone who knows me knows I'm massively passionate about claims, and I don't believe we can talk about protection in any product, but particularly income protection, without talking about claims. It's that critical point of delivery, and so I wanted the ITTF's next project to be about claims and to shine a spotlight on a number of different areas how advisors can help with the claims journey, help support their customers and things like vocational rehabilitation and some of the other topics that we're going to cover, such as misrepresentation and financial assessments and things like that.

Speaker 1:

Fantastic, and we're now discussing the second story from the Seven Claims Stories project, which is all about vocational rehabilitation. So, monica, I want to ask you this what is vocational rehabilitation and why is it such an important part of the claims process and also income protection?

Speaker 3:

Thank you, stevie. So vocational rehabilitation for me is sometimes a missing link, I think, in that recovery journey of customers. But just to give you a sort of general definition vocational rehabilitation is understood as a process, as an intervention, as a way of thinking as well, you know, in terms of policy making around supporting individuals with health conditions and or disabilities to stay in work, return to work and sustain work. So that can mean very various things, you know, to different people, depending on what the health condition is, what the disability is and what the role is Now in the context of income protection. Mostly we tend to see customers that are out of the workplace for three main reasons, and that is usually common mental health conditions, common musculoskeletal conditions and cancer. Now the order of those three varies according to different books, to different providers, but those are the top three.

Speaker 3:

So vocational rehabilitation comes into play because you need to understand very early what the functional capacity of the customer is in terms of work, the work they have to perform. So you need to understand what the cognitive demands are, what the physical demands of the role are, what are the emotional demands and environmental context as well of the role, the emotional demands and environmental context as well of the role. So, to give you an example, let's think about a customer who has income protection and has a 52-week deferment period and is a medical professional. So you need to understand why they're still out of work after one year. Was it the condition itself? Was it because the treatment itself takes a long period of time? You need to understand what the support mechanisms are in place for that individual to return to work.

Speaker 3:

Occupational health Now. Interestingly, to give you a fact and a statistic, only 45% of the working population has access to occupational health, you know. So that's quite stark. I think you know, if we think about what support mechanisms are available for the general workforce anyway. So that's that help in terms of setting the scene and what we're talking about when we refer to vocational rehab.

Speaker 1:

help in terms of setting the scene and what we're talking about when we refer to vocational rehab. So it's an incredibly important part of the claims process. This is people that really need help and obviously, monica, as our resident vocational rehabilitation consultant rehabilitation consultant you know you're there helping, supporting these people. So what is your specific role in? When you're helping people, you know getting them back to work.

Speaker 3:

Right. So, coming back again to income protection and why, I think, yeah, work rehab is a little bit different. So you need to understand, first of all, you know, the individual circumstances. So the health condition, injury or disability, is it a fractured leg, for example, and what impact does it have on the individual? So you know, is it like us that today we're in a podcast and we're, you know, sitting, and if we have a fractured leg we can still record this, right? But if our job is to go out there and paint and renovate a new house, you know you might struggle with that and you might be out of the workforce, you know, for a prolonged period of time. Now, not only that. So those are perhaps the physical demands of the role you know for that case. Then you need to understand cognitively is there any impact? What's the functional capacity of the individual at that point?

Speaker 3:

I do see you know on cases particularly where mental health is the main cause. You know people with depression, anxiety, difficulties with concentrating, know memory difficulties, you know. So if you think about an accountant, for example, I do see cases where you know people make mistakes at work and these mistakes can be costly to the business. Right, if you're making a mistake on accounts and payment and that sort of thing. I do see that when support is not in place very early, and unfortunately in income protection, you know we on the individual side, you know because of the product itself and the way it's written, you know we might not have access, you know, to those early prevention mechanisms to support those individuals to stay in work. So you could arrange to have some reasonable adjustments initially if someone is struggling with their mental health, but we might not have the opportunity to intervene at that point. But what we see is that if those issues are not resolved at work in the case of the accountant for example they might go off work. They might have access to, say, nhs support but there are usually long waiting lists for mental health. But there are usually good health and well-being benefits in the income protection sector so they can have access to counselling, psychotherapy, cbt sector. So they can have access to counseling, psychotherapy, cbt, mainly if it's a common health condition.

Speaker 3:

But again, as I said at the beginning, the missing link is the vocational rehab support and if we get there too late we might miss an opportunity to understand what else was happening in the workplace and I think for me the most challenging cases are where there are issues, you know, at work. So work is good for you if it's good, right, and a lot of workplaces you know are contributing to the cause of absence or the main cause of the sickness absence. So that's very difficult because then, as a vocational rehabilitation consultant, you need to work with the individual and the employer. You know, to help resolve whatever issues there might be, you know, to help agree reasonable adjustments, to help agree a phase return to work. Now that's in a case of someone who is employed, open up the conversation about self-employed customers as well, because for me they're a group where you know they need the support the most. You know because they are at risk of losing.

Speaker 3:

You know their clients, you know if they're not in touch with them, they're the ones that are super keen to return to work as soon as possible. You know, because for them it means income. You know on a daily basis in most jobs. So it's really difficult and they definitely don't have access to workplace support. You know, because they work independently so they need someone to give them that guidance around. You know how to sustain work, how to return to work safely. You know, don't do too much too soon. I see that a lot actually with self-employed customers, but with others as well. You know, don't do too much too soon. I see that a lot actually with self-employed customers, but with others as well. You need to guide that journey around, addressing the fears they have, the beliefs they have, you know, and help them lift up that confidence again, which is another barrier. So you see, all of the things I'm talking about now are mainly not related to the health condition itself. You know which is the diagnosis of the injury?

Speaker 1:

most likely, yeah. Do you have any real life case studies where vocational rehab has really made a difference and you know what are those key moments in that journey that you know we need to consider here?

Speaker 3:

Yes, maybe a couple actually, and in a brief summary, I think you know, just to have a nice mix maybe of someone who's self-employed and someone who is employed, so we can see what the different challenges are between the two. So the first one we're going to call it John, as I changed the name, so we get all anonymised. So John is a self-employed trainer. He's in his 40s and he had been struggling with anxiety for a period of time. Unfortunately, he experienced a series of bereavements, you know, of close relatives, including his father. This all led into, of course, bereavement and unfortunately he developed panic attacks. Now, as a trainer, he will need to deliver face-to-face training to his audience and he would just freeze and have a panic attack. So he couldn't do it. He stopped working. He had a 26-week deferred period policy. He notified the insurer at five months, I think, and he was referred at that point to the health and wellbeing benefits available through his policy. So he had access to counselling at the time. A few weeks later, when the claim was admitted at 26 weeks, he was then referred for vocational rehabilitation support. At the time he was not deemed fit to engage in return to work support just because the symptoms were quite severe, you know. He wasn't leaving the house, he couldn't drive anymore. In addition to that, his partner had suffered an accident, so he had an additional stressor. Counseling was helpful, but he had just seen his GP who had suggested to commence antidepressant medication. So he was going to do that and so we set to revisit his situation in about eight weeks time. After eight weeks he was reviewed and his mood clearly had lifted. You know, he was a bit more brighter. You know, when there's some phone calls, the panic attacks have reduced with the help of counselling and medication and we started to develop a return to work plan. Helpful counselling and medication and we started to develop a return to work plan.

Speaker 3:

I think at the beginning it's about understanding and, for the case of John, what his fears were. He was very worried that he had lost contact with his client. He had obviously the income support via income protection, but obviously that's a replacement ratio and doesn't, you know, doesn't give you your full income. So he was worried about, you know, the household expenditure. He said I need to be able to drive again, you know, to visit the different clients and deliver this training. So we developed a return to work plan with a graduated exposure to driving. He had his brother who was really good and you know, in the first drive he he just sat in his brother's car, you know, for a very quick drive. That was with the support of his counselor, actually, and through vocational rehabilitation.

Speaker 3:

You try and increase those work, hardening activities, and think what is it that he can do at this point? You know, to remain active cognitively and and thinking that, yes, this is a period of time that's going to pass and I'm going to be able to deliver training in a full room of people. He had a really good friend actually who became his buddy and when he was ready to leave the house we said look, how about you go to your friend's training session and you just sit there? Look, how about you go to your friend's training session and you just sit there? You know how do you feel. The first time he still had a panic attack, but the second one he didn't. So you know. So that's how we started to build a graduated return to work for him, because obviously he had no access to occupational health or a face return. Anyway, he was really good with his MailChimp campaigns and you know we turned some of the kind of experiences he had into learnings, you know, messages for those communications to his clients and in the end he felt brave enough to share how he was feeling. And he was surprised at the response of people, you know, because most people will experience at some point a mental health condition, you know, be it anxiety and depression. So you'll be surprised that once you share how you're feeling, you know people would probably have experienced something themselves or know someone very close who has gone through, you know, a difficult time. It's a happy ending for John At the time of this charge, after six months of intervention, he didn't deliver full-time training, so five days a week, but he was given all the tools to continue with self-management and his confidence was way better.

Speaker 3:

No more panic attacks. He benefited from proportional benefit. I think that's a key aspect of income protection, you know, to reassure customers that you're not going to leave them alone, you know, and say, oh, you're fit to work and off you go. People have many fears, you know. Their self-confidence really is very low, you know, and they're scared about the impact of work on their condition. So proportional benefit is a fantastic future of income protection and something actually that I think the government is trying to mirror in the revision they're doing on welfare benefits, you know, and try and introduce a vocational rehabilitation benefit, you know, to the population.

Speaker 3:

Now, an interesting fact about this case story is that at the time of this charge he was still taking antidepressants and the medication was reduced a little bit. But that, I think, tells the story that you know. It's not about, you know, whether you're on medication or not. I think every story is different.

Speaker 3:

Every individual has different challenges and I think that maintenance dose was good for him, was helpful, and he was confident to talk about his GP, about how he was going to win off in the long term. But in the end you have a happy customer. He, by the way, had a two-year claim term period and you know it was important, I think, for him to go back, you know, quickly. But my fear was that, given, you know, the severity of his symptoms initially, had he not had the support, I think those panic attacks would have remained. He would have totally lost all his client base. He would have been stuck at home, you know, not driving, continue feeling depressed and possibly you have a policy lapse there because you know he wouldn't, you know, be able to afford the premiums, you know, after the two year term. So I think it's a really nice story.

Speaker 1:

Monica. That's an incredible story of how someone has been supported through this, matt. It's very interesting stuff, isn't it? I wondered if let's bring Charlotte into the conversation here, but I thought do you have any thoughts off the back of that real life story, matt?

Speaker 4:

I certainly do, mate, and it's a great example, monica, of how income protection can provide value way beyond what we naturally assume, because often when we talk about these things, we focus on, as you rightly said, the illness and then the benefit, and we forget that actually, as you quite rightly pointed out, Monica, it's not necessarily the illness itself, but actually the ancillary challenges that someone might experience off the back of it that limits their capacity to go back to work, and you mentioned, obviously he was going through some issues, but it was the cascading effect and the impact that it had on his ability to work and to generate his income and then, even more importantly, return to work. So when I hear stories like this, it reminds me of something I used to say years ago about income protection being what I class as the people's protection. It's very rare in an insurance setting that you'll find a situation where the interests of the provider and the customer align. I'm just being honest, right, we have a commercial product and it's designed to mitigate certain risks, and we pull premium's designed to mitigate certain risks and we pull premiums together to mitigate those risks, and we work on assumptions of claims right In income protection, and I think Monica kind of alluded to this and Phil almost alluded to earlier as well, about this whole idea that, let's be honest, everything we do sales, marketing, advice, coaching process, underwriting, everything it all leads to a focal point in time, and claims is that focal point. It's the point where we get stood up and we get tested and are we actually delivering on all the promises that we're making to our customers, which is why I absolutely love the seven claims initiative.

Speaker 4:

But what I really love about this is, at the point of claim on an income protection contract, you now have a provider paying a monthly benefit to a customer and, quite frankly, take this the right way. They don't particularly want to because it's costing them money. So at this moment in time, you've got a situation where the provider's incentive, their benefit here is if they can support that customer to return to work in a meaningful way where they can be independent and self-sufficient. It benefits the customer, the policyholder and it benefits the insurer. So at that point and it's a very random thing to say this, but this is where I believe Monica's absolutely spot on in what she's saying there's a beautiful benefit to income protection which is unlike other contracts where there's a lump sum benefit paid and off you go.

Speaker 4:

Thank you very much. That's the nature of our relationship. You're done. Now Policy's finished, because income protection is a term-based contract that continues going even whilst that benefit's being paid. There's a lovely, beautiful sweet spot where the customer's interests and the provider's interests align and we can make real meaningful impact in the lives of the customers that have these contracts. So yeah, I find stories like that really great to hear.

Speaker 2:

And if I can just jump in there and answer that because what I really wanted to get across to the industry and for people to be aware of was that we talk about value added benefits and health and well-being benefits, and some propositions are starting to try to include this point of claim delivery of service within those, but generally these services are services that people aren't aware of, are services that people aren't aware of.

Speaker 2:

They aren't aware of what the claims teams are doing, working together with the customer, a vocational rehabilitation specialist to actually get somebody back to work, and I really wanted to shine the spotlight on that so people could understand and see the work that the claims teams are doing, the power of the services that they're providing at the point of claim for the good of everyone. As Matt said, of course there's a commercial benefit for the insurer, but a huge, wonderful benefit for the policyholder, the customer to actually get them back to a place where they want to be, where they're feeling better, where whatever issues that they have are addressed and they're able to eventually get back into the workplace.

Speaker 3:

Yeah, if I can add to that, phil, I think what I've noticed in this last 15 years I've been now in the industry is how the role of assessors has evolved over time. So now it's you know, it's really about being there with the customer throughout their recovery journey. So if they are having an intervention, you know they ask the customer how is it going, how are you feeling? Are you finding this helpful? You know. And then they say well, look, I started working in the case of John. You know I'm delivering one training a week and I'm nervous about it, but I'm doing it, don't worry. You know we've got proportional benefit in place. You know we've. You know we've got three months. So you know, for this, that's your greater return to work. You know we're going to help you with that. And they discuss as well with providers what the progress is.

Speaker 3:

Everyone is involved and I think the message I'm trying to get across is also about best practice. What best practice is? We need to have bespoke interventions. That's when vocational rehabilitation is successful, and for the right case as well. Not everybody needs vocational rehabilitation. Let's say that. You know there are customers who have absolutely all the support mechanisms you know in place at work and everything is well. So they're the ones that have short term claims and off you go, you know. But there are others that are going to need a little bit more support in that journey and they are the ones we need to focus on and the ones we can support.

Speaker 4:

And Monica, if you don't mind me asking. So we talk a lot about the value of short-term income protection versus full-term income protection and naturally I'm a huge advocate of the longer-term option, just given that people generally need the income for the duration of their working lives. But I recognize for a lot of advisors listening, it can be a challenging conversation, particularly when it becomes price-led. And having this discussion around the customer, around value, based on what you're saying here, I think I heard some very interesting statistics about the number of people that once they reach, I say, 24 months off work, the likelihood of being able to return without these kind of vocational support benefits in place. Is there something to be said there around, using these kind of case studies and these examples and the reality of what rehabilitation looks like for the average person, that the full-term option would be far more beneficial, given that it's not always a yes, great, fantastic, I'm fixed, I'm going back to work and there's no issues? What are your thoughts around that?

Speaker 3:

It really depends, matt. I think I can see that from a financial perspective, maybe a shorter period might be, you know, more attractive for customers. But if we look at sickness absence and statistics in the general population, which usually mirror the insurance world, most people are out of work with common health conditions that are treatable and have a good prognosis. So you should be able to recover and return to work. Treatable and have a good prognosis, so you should be able to recover and return to work. So in theory, a two-year or five-year claim period should be all right because you're going to be better and you're going to go back to work. The problem is you know the NHS has long waiting lists. You know you're unlikely to get. You know that support and vocational rehabilitation is usually not offered as a standard sort of intervention via the NHS or even via PMI private medical insurers. You know so. Also focused on symptom management, which is important. But it's not the full end of the story Now, when I'm thinking about long term IP products that may be suitable, and then there you go, you know.

Speaker 3:

You just never know what's around the corner. It's in really catastrophic cases where you know you have life-changing injuries or health conditions. You know degenerative neurological conditions, for example, where your capacity for work might be permanently impaired. So that's a different story. So that you know luckily doesn't happen very often but it can happen. You know I'm thinking about. You know road traffic accidents. You know brain injury. Depending on the level of the injury, you know you could still work. You know you could have a career redirection, advice and do a different role. But you will need a lot of support.

Speaker 4:

Absolutely advice and do a different role, but you will need a lot of support, absolutely, and I think often we see this, don't we? That even the smallest of impacts on someone's ability to do the job they're ensured to do means they can't do the job that they're ensured to do, and I think that's that's where the real, true value of the full-term contract comes in, in that, yes, okay, we've agreed, you could potentially do another form of work. You know we could do something else. But if someone's got a passion for a particular career, using your example of a medical professional, say a surgeon just even the most minor damage to their, their hands and their ability to perform surgery could significantly impact their ability to sustain that career choice, and that's when something like a full-term contract would be hugely valuable. It doesn't have to be and this is what I'm trying would be hugely valuable. It doesn't have to be and this is what I'm trying to get across to the advisors it doesn't have to be a life changing or life threatening condition that causes it. It could be something that genuinely impacts their ability, at the smallest level, to perform the function that they're insured themselves for, that they chose a career path. These are all really interesting things.

Speaker 4:

I wonder, if you mind, steve, I'd like to just bring Charlotte in, if that's okay, mate, if you don't mind, because I just wanted to ask her a couple of questions around because obviously we've heard from two specialists here. I'm really keen to get it from an advisor's standpoint, in terms of when you're having these kind of conversations with customers, charlotte, and we bring up the subjects of income protection. I mean, firstly, is things like vocational rehab or that claim support something that you discuss? And if you were, what kind of things would you use to create value around that? Because I don't think these are particularly common customer discussion points. Right, but I'm hearing so much value here, both from Phil and from Monica, in terms of how we can add so much more value around income protection and the difference it makes compared to some of the other products we have in our toolkit. So what are your perspectives on sort of how and when to introduce this into a conversation with a customer?

Speaker 5:

Yeah, thanks, matt. It's interesting actually because since I've become an advisor, I'm so much more aware of the level of conversation you've got to have with your clients and the way you position it income protection specifically. I was fortunate enough to work at two major income protection providers before I became an advisor, so I've always been acutely aware of the impact that rehabilitation services and these kind of claims stories that we hear about from my provider life, if you like, I think tying it all together. You know we've spoken about short term income protection versus long term income protection, and I do think there is a place for both, but it's about plugging those conversations in with what's important to the client, what drives them, what motivates them, and trying to get a fully holistic advice package together for a client within a certain budget can be challenging at times.

Speaker 5:

Monica, you've alluded to the fact that when people are on income protection or claiming for an income protection policy, their income is already reduced because it is only a proportion of their gross income, and we all know that we are living more to our means than ever before. So it's really important to encourage a client to get back to work. I think the key from an advisor perspective is to have that constant communication with your clients to encourage early intervention. We've heard that getting people back to work is not only better for the providers it's what helps keep the premiums within the industry more manageable but it's also best for the claimant, as we've discussed.

Speaker 5:

If you're off work, your mental health will suffer and then there's that knock-on effect that monica was talking about earlier. But you've got to encourage that early intervention and clients have to know where to get that early intervention from from outset. They're only going to do that through regular engagement with their advisors. Um, you know how many are aware that values, added support and support services are available for certain things right from day one of the policy. Even if you've got an exclusion on your income protection policy, there could be tools for you to use within your current policies to help manage that exclusion. So if you've got a mental health exclusion on the policy, it's a common one we see as an advisor or from providers but there's many support services that providers offer around counselling and mental health support from day one of the policy.

Speaker 5:

So, yeah, you might not be able to claim on a policy for that specific condition. You might not even be off work as a result of that condition again in the future by using the support services that providers offer. And it's about engaging the clients, engaging with their contract right from day one so that when a claim comes in, we're getting those early intervention processes in built early so that they don't have three months without income, six months without income, a year without income before their waiting period kicks in. And actually, if we're pragmatic about it, how often as advisors do we update the sum assured on an income protection policy following a change in income, following a salary increase? So we could be in a position where a client's claiming on an income protection benefit and they're getting 60 percent of their gross income, but they're based on their gross income 10 years ago and it's not reflective of actually what they need. They need to get back to work quick and they need to get back to work in an efficient manner to maintain that longevity.

Speaker 5:

Matt, we appreciate that not everybody's going to be in a back to work position Myself. My father claimed for 12 years on his income protection policy before he retired. Thankfully he had an income protection policy and I'm aware of a claim going through at the moment with my family friend. She's only young, she may never return to work following an RTA, but she had an element of income protection and the additional support she's had from the provider has been absolutely phenomenal in adapting her home, talking about her mental health and her mental resilience and how they can help get her back into some form of work, even if it's not the job that she was doing before. Because she's so young, she cannot not work for the rest of her life. So I think, to sum it up from an advisor perspective, what would be great is more engagement between the three parties, between the provider, between the claimant and between the advisor, so that we can all support that client in returning to work as the best customer outcome.

Speaker 1:

Charlotte, I think you've just touched a bit about our next question, which is all about the importance of collaboration within the industry. You mentioned about how everyone can come together to support, you know, the insurers, rehabilitation consultants and financial advisors, all working together to better serve an individual. Monica, from your point of view, how can the industry collaborate better?

Speaker 3:

Communication, definitely. I think some of the points Matt and Charlotte made around notifying the insurer but actually accompanying, you know, being in that journey with your customer, you know that claim journey, understanding what is the process, that is really important. I mean some of the things, matt, you said about that. Early notification of absence is really key and goes back to the point I was making around identifying customers that need that additional support. So there is this theoretical framework called the biopsychosocial model of health, which is something I take to insurers, you know, in the work I do to equip their claims teams, you know, to understand what are those risk factors. You know who is likely to remain out of work, you know. But what are the things, what are the questions they need to ask customers to identify the ones that are going to need that initial support to return to work. So it's really key that early notification.

Speaker 3:

Again, use of evidence-based interventions I think insurers could be at risk, you know, of maybe putting in place interventions that are, you know, not endorsed by NICE guidelines, for example, and you know you need to be very careful in that. You need to make sure that any support that is put in place, you know it's gone through the right, you know, governance process. That's really important and sometimes that's tough. That's tough because there's so much out there on the internet and the things you see that people are googling, you know in terms of what's going to help their condition and you just think, fair enough, that's their beliefs, but that's probably not what's going to help them to get better and recover enough to get back to work.

Speaker 1:

Phil, what about the best practices here in integrating vocational rehab into the claims process? Can you shine a light on this at all?

Speaker 2:

I think, firstly, we need training. We need claims assessors to have a better understanding of vocational rehabilitation and the role it plays. We need insurers to be supported in terms of, I guess, bringing that into the proposition and shouting about it. And again, I want to make a distinction between value added services or health and well-being services and these additional claims services, between value-added services or health and wellbeing services and these additional claims services. You could argue that they're all part of the same thing, but, generally speaking, these services at the point of claim are something that aren't advertised at all. They're not on the website. They're something that the claims assessor will have access to. You know they'll have a panel of providers or sometimes one provider that they will work with. So I think insurers and claims teams need to shout more about those services, about the work they do, share the case studies, speak about it, put it on the website and just make more people aware that these things and just make more people aware that these things are available to people.

Speaker 2:

Stevie, there's a couple of points, if I may, that I just want to pick up upon, because the early notification that we talked about, that Matt and I think we've all mentioned, is so, so important. And my advice to advisors is that, even if your customer has a six or 12 month deferred period, if you have a client who is is ill and there's no foreseeable return to work date, you know that they don't know how long they're going to be off, let your advisor know, let your insurer know, because it may be that the insurer can do something, can identify a need and can support that return to work. I think Monica mentioned that maybe after a year, 18 months, if somebody's still out of work, the chances of them returning fall off a cliff. So getting that support early, identifying the need for that support early, is so, so important. You can even design your product to try and encourage that early notification, which is which is something that I've been involved in in the past. So so that's that's the first thing I wanted to say.

Speaker 2:

The other point and sorry, this just straight away a little bit from your question, stevie, but the other, the other point I wanted to make we talked about mental health exclusions and the value of income protection. Let's say, if there is an exclusion on the policy, but if you have a mental health problem or have had one in the past, that's excluded, you're more likely to suffer a comorbidity, a coexisting illness. It may be because you have a mental health problem, that you don't exercise well, or your nutrition isn't in the right place, and the chances are that you you're more likely to suffer uh and a comorbidity, a co-existing illness, than somebody who doesn't have a history of a mental health problem. So actually, even if something is excluded, there's more value in income protection than somebody who potentially doesn't have a pre-existing medical history.

Speaker 1:

Yeah, I mean there's certainly a lot to consider, especially as there's such a wide range of different injuries mental and physical to factor and think about here. But I want to now move on to the future of vocational rehabilitation and where we might see some emerging trends or some insights. Monica, I want to touch upon some research that has been done which might help us think about this future, which was done by the Health Foundation titled Action for Healthier Working Lives, which was released in March. We will provide a link in the episode description for listeners to go and check that out. But, monica, what does this research tell us and what trends can we see for the future based on this research?

Speaker 3:

Thank you, steve, and yeah, really a milestone publication. You probably heard in the news. You know there's so much talk about, you know personal independent payments, you know through government, but you know the need to have a welfare reform. But the Action for Healthier Working Lives final report sets a really interesting, I guess, precedent about the state of the health of the nation here in the UK so 300,000 people currently leave the workplace every year due to health conditions. Over 8.2 million people now live with work-limited health conditions and these are people who are in work right Now. The report also highlights that a focus on a medical model of health where the importance is given only to diagnosis and symptom management is not the answer. And they put vocational rehabilitation left front and center of the report, which for me was really interesting because we need to be learning from other countries.

Speaker 3:

You know, if you are in the Netherlands, if you're in the USA, in Australia, you know employers have a lot more accountability and play a key role in providing that early support. You know, to support individuals at work initially, you know so preventing them from falling out of work and early intervention, so quickly helping them to get back to work. So we can learn a lot, I think you know in the income protection space, again, early intervention is the key. I think in the group income protection space there is more scope. You know from those preventative measures. You know you're dealing with large employer schemes. You know you can work on wellness initiatives, support employers. You know to work on even job design culture. You know when we talked about good work versus work, that is the actual cause of the sickness absence. So it's not a single ballot solution, it's a multifactorial, you know issue. But again, going back to the retail side of things and individual IP, I think I can't stress enough the importance of a bespoke, personalized approach and the role of claims assessors. So claims assessors, understanding those risk factors and what the needs are of that individual person, you know again, think about teachers, medical professionals. You know who are the ones who tend to access those one-year deferment periods, for example, but equally those professions are under a lot of stress. So you know you need to understand. You know try and encourage that early notification. You know can you do anything? You know to help that return to work journey before you know they reach that one-year landmark.

Speaker 3:

Another point is learning about what goes wrong if you don't put early support in place. One, it's more costly. If someone has been out of the workplace for six months or one year, you know the intervention is going to be more complex. You know you're going to need more sessions of vocational rehabilitation or physical therapy or mental health therapy. Second, you might already be dealing with an even lower self-efficacy, low self-confidence.

Speaker 3:

I see the number of times I see people with failed return to works in. Income protection is massive. These are people who at the beginning, of course they're desperate to go back to work and they might go back to work too soon. You know people with a fractured leg. You know the case of the self-employed. You know climbing up ladders and then falling again, you know, because they didn't have guidance.

Speaker 3:

Or recently I saw a case of a gentleman, an air traffic controller, with panic attacks that tried to return to work after three months but couldn't. He was let go. Eventually, at nine months he found a different job but he couldn't drive and a relative was driving him to the workplace and he was still going up to work with panic attacks and eventually he just couldn't cope, you know. So by the time he was referred for intervention, you know, after 18 months of sick leave. His self-confidence was totally on the floor and fair enough, you know. He said I've tried and I failed, I can't work, you know. So that journey is a lot longer and, I think, more complex, you know, than doing it very early.

Speaker 3:

So those, I think, are my key points around, yeah, the ins and outs of vocational rehabilitation. And then I think a final point is, I think, industry best practice. I think we need to understand evidence base. How do we implement vocational rehabilitation? I think having a common understanding, a common framework and everyone, you know, delivering the same quality of services. So there are different models, you know. Some instruct third party providers, some large insurers have their own in-house vocational rehabilitation teams which are very effective as well. So I think, going forward, potentially, that might be a good model, you know, if you have the investment, you know, in that type of support.

Speaker 4:

Can I just interject for a second and ask a little question, because we're talking about the future of vocational rehabilitation and, obviously, within income protection, and there's two things that I've touched on here. Firstly, something that Phil said at the beginning, which is around the role that we play. So the important point when it comes to claims and a lot of these things we're talking about, as Phil has mentioned, are not available when you look at the contractual documents. They're not things that are advertised or publicly discussed. They're things that come into play once a customer reaches that claim point, and so, naturally, the point of claim is that pivotal moment in the industry where we stand up and get counted or we let our customers down and produce these bad outcomes. And then, further on to that, what you said, monica, around the claims assessors being absolutely pivotal in this in terms of being able to provide meaningful support to the individual on these bespoke personalized support infrastructures and frameworks that deliver the better outcomes.

Speaker 4:

And we see from what you've just said, where it's not delivered properly, the outcomes end up being pretty poor for everyone, provider included. Are we then suggesting that for the future of this to work properly, given that we've seen a huge increase in the number of income protection recommendations in the market over the last couple of years, and it's a trend that continues to be growing, and we're seeing income protection really coming to the fore in terms of what advisors are prioritizing above all else. For me, this has become a really important point. Do we need to, then, see more investment in claims assessors, in claims departments, in that side of the industry? Because we see a lot at the front end, and what I'm concerned about listening to you both speak, phil and monica, is, if we don't get this right, if we don't invest enough in bringing the correct people and the correct resources into this part of the industry, we could be setting ourselves up for failure.

Speaker 2:

I think I'll answer that, matt, if I may.

Speaker 2:

I think you're absolutely right and quite often in my experience claims departments are underfunded.

Speaker 2:

You know, and there's been a debate around in the industry for a little while now, you know I mean resources will be thrown at new business underwriting because obviously there's that commercial aspect, whereas I think claims is often seen as a back office function that perhaps isn't so important.

Speaker 2:

But again, you know, at a time when customer outcomes has never been more in more in the spotlight, um, and where, certainly with income protection, actually there is a commerciality from the insurance point of view in terms of getting people back to work, um, and and therefore not continuing to pay benefit in the longer term, yeah, absolutely, I think it's essential that claims fees get funded and it's it's always been a disappointment to me as a claims person for 30 years, that actually claims is often seen as an easy target in terms of underfunding and that's really disappointing. So it would be great to see insurers actually recognising the important role that claims has to play, not just in terms of delivering great customer outcomes play not just in terms of delivering great customer outcomes, but in terms of actually that commercial aspect Managing a book of income protection claims is a bit like managing a profit and loss account. How you manage it will have a direct impact on the amount of money that needs to be reserved against those enforced claims. And yeah, it's a really, really important aspect.

Speaker 3:

I think it's the competencies of claims assessors and how they've evolved, and technical and non-technical. I think the complexities of assessing and managing a disability claim are really complex and you need to equip your team to be able to provide that best customer support but equally conduct, you know, a robust assessment. You know there is the financial side of things. You know Phil can tell you all about it. You know I focus on the non-technical side of things, but I think we can definitely learn. You know, more from other countries. You know in Australia the workers' compensation market are really really interesting in how much effort they put in.

Speaker 5:

The competences of claims teams are much easier from an advisor perspective to have because of a client's awareness that the state won't look after them, that there's long waiting lists, that there's likely to be a prolonged time off work. And I only see income protection uptake increasing, a with increased awareness, with all the work that IPTF and other bodies are doing, but, b because of consumer awareness, they're much more aware of a loss of income for a prolonged period of time whilst they're sat on these NHS waiting lists awaiting referrals, which will then delay treatment, which Monica's already alluded to. The treatment is going to be more lengthy, more invasive, et cetera, et cetera. So, phil, from a provider perspective, do, do you see?

Speaker 5:

I know that a bit. It's not quite the same now, but do you see more investment in the claims? Are providers looking at this as we are, as consumers or as advisors, or are they?

Speaker 2:

are we just going to have to wait and see yeah so is the question our providers looking at and recognising that they need to invest more in their claims teams? And if that is the question, I'm not sure they are. If I'm perfectly honest with you, I still think in too many cases claims teams are seen as easy targets in terms of resource, in terms of salaries, and you know they've traditionally always been a bit behind underwriting. So I'm not sure that providers do recognise that at the moment. But of course, all too often they only recognise that there's an issue with the claims team once the claims experience becomes really bad, once complaints go up and things like that. And yeah, it's a difficult one. But I mean, all we can do is continue to kind of shout about it and kind of bring people's attention and focus to the work that claims teams do and how that they can make such a difference to customers. But also within the proposition.

Speaker 2:

You know, as a claims person I've been involved. You know I've kind of looked back along the customer journey right to the point of new business underwriting. I see when products work and when products don't work. I hear firsthand the problems that occur and the things that work really well from customers. I've spent my whole career doing that, and so claims teams are so important.

Speaker 2:

Claims teams are so important. I'm delighted you've asked this because it gives me a chance to really plug the role of a good, experienced claims person, because they can feed into the proposition they should feed into the proposition, the design of products. You can leverage the whole claims experience to build a brand and to market. You can use the claims experience to actually help sell business, to talk to advisors, to be transparent, to build trust. All of those things are so, so important and I've experienced that. I've done that. I'll anecdotally tell you of one story where a claims person was involved in speaking to an underperforming advisor firm on a BDM's panel and actually after that session where they did a bit of a Q&A and talked about the claims process and that advisor firm went to that BDM's top performing firm in the space of about two months because they built the trust. They had access to a technical expert that they don't normally get access to and it was fantastic to see.

Speaker 1:

Well, I think that's all the time we have, unfortunately, guys, I think we could continue chatting for maybe a couple more hours on this subject. But I think it's clear that the Seven Claims storage project is vital right now to shine a light on these issues, to shine a light on the fact that perhaps maybe we do need to invest more in our claims teams and help support people trying to get back to work, among many other things, but that's why this project is so vital. But I want to say thank you very much for everyone for joining us today. It's been an absolute pleasure to chat with you all. Um, finally, before you go, where can listeners find out more about the, the topics today? You know it's their websites, any resources or any contact info that you can give them. Phil, I'll go.

Speaker 2:

Come to you first yeah, well, the first place to point people towards is the iptf website. Um, so we'll be sharing all of the stories, the case studies. There's a video for the first story. Um, obviously, this podcast, um, they will be. They will be going out on various social media, but the IPTF website is probably the home where they all sit. So that would be the first place that I would point people to.

Speaker 1:

Oh, yes indeed. That's very true indeed, phil Monica, anything from your side.

Speaker 3:

Yes, I would signpost people to three places. So the first one is the Guide to Income Protection by the Chartered Institute of Insurers. So really good in terms of what rehabilitation is, what vocational rehabilitation is in the context of IP. Then the Vocational Rehabilitation Association website so I'm one of the trustees of the vra uk um. Really useful resources about. You know examples of how is how is conducted um different areas um and my website. You can find a lot of information there in terms of blogs and uh. You know examples and and references. So that's monicagarciaconsultingcom great.

Speaker 1:

Great plug there, monica. Well done, and Charlotte.

Speaker 5:

I would just tap into all of your BDM support. Ask them what rehabilitation services are typically considered in an average claim. They may not know, and that'll be a great education piece for them to then go back to their counterparts at the providers to find out exactly what the products are doing. I think we get stuck on the headline figures. Income protection is there to replace your income and it's so much more than that.

Speaker 4:

I was going to say. As Phil said, what would be the great scenario would be get the BDM to get the claims assessor to come and speak to the team, because clearly it had an impact on the performance of that firm. So why not? Great tips.

Speaker 1:

Thank you everyone so much, and for all the listeners, all the links provided and will be in the episode description. Thanks again, everyone. Thank you, okay. So that's it for this episode of let's Talk Income Protection. This was story two of the seven claims story series. Do look out for the next story in the series, which looks in detail at misrepresentation, incorrect, incomplete or misleading information, whether intentional or unintentional, which can lead to claims denials, policy cancellations or reduced payouts. You can find all the resources, videos, podcasts and articles over on the iptf website, iptfcouk in the education area. So don't miss it. And don't forget to rate and review us, if you can, on apple podcast it really helps the show out and do share the podcast with your colleagues and spread the word if you're enjoying it. And finally, do remember to claim your unstructured CPD points for the episode. And if you're not subscribed, why not do so now on your podcast platform of choice? So that's it for this episode. Join us again next time. See you soon. See you soon.