Attitudes to Rehabilitation Revealed - Survey
Rehabilitation is a term with which all claims assessors are familiar in theory. But in practice when a disability claim occurs and rehabilitation is possible, there’s often a reluctance to implement a plan.
Because we're interested in gaining a better understanding of what kinds of interventions prove most effective for disabled claimants, we developed a questionnaire to understand what insurers are currently doing in the rehabilitation space.
Before discussing the results, it is useful to explain what we mean by rehabilitation in the context of insurance - return to work is not a discreet "all or nothing" event but rather a process. First the individual prepares to return, grows closer to being able to work and then engages in work. People with persistent or recurrent health problems are liable to further sickness absence. When we measure success, we are therefore not talking simply about return to work. Successful rehabilitation means productive and sustained periods back at work.
In the UK two-thirds of disability claimants have common health problems that are mild or moderate muscular skeletal, mental health or cardiorespiratory conditions. Often these illnesses are characterized by personal responses to symptoms rather than objective, measurable impairments. Although it is important not to deny the effect of these symptoms on individuals, the majority of claimants' health problems should be manageable.
Vocational rehabilitation for common health problems should revolve around de-intensifying and addressing health-related personal problems. This is in contrast to vocational rehabilitation for severe permanent impairments where individuals overcome, compensate or adapt to permanent catastrophic injury or illness.
We gained some insightful results when we asked a sample of insurance companies in the UK about their current rehabilitation practices.
- 75% of respondents do not have a documented rehabilitation philosophy.
- 60% reported that the return to work process is coordinated by their claims assessors.
- 50% also make use of external service providers to help manage the rehabilitation process.
- Only 43% sign a formal agreement with claimants at the start of the rehabilitation process.
- 43% of insurers put a cap on the amount that can be spent per rehabilitation case.
- The cap is dependent on the reserve value of the claim (as opposed to a multiple of the monthly benefit or a cap imposed on the benefit in the policy terms and conditions).
Types of Rehabilitation:
- All would consider paying for acute rehabilitation services, such as occupational therapy, physiotherapy or psychological services.
- All would consider funding a short period of reskilling or retraining of one to three years, though longer-term training, such as tertiary education or university, was less popular.
- Around two-thirds are willing to fund other popular forms of rehabilitation such as workplace adaptations and transport to work.
- 40% do not keep statistics of any sort on rehabilitation cases.
- Of those that do, only 42% record whether rehabilitation was successful.
The survey shows that the majority of insurers surveyed are actively engaged in rehabilitation, albeit often in the absence of a particular rehabilitation philosophy or formal contract with the claimant.
However, more active measurement of both successes and failures would lead to a greater understanding of the efficacy of the many and varied interventions available to insurers.