Hi ho, hi ho, it's off to work I go...

There is strong research evidence which suggests that work is generally good for physical and mental health and well-being. However, in the insurance industry we experience, on a daily basis, that policyholders become claimants because of their firm belief that it is no longer safe for them to work, or that they do not enjoy sufficient health to continue working.

There seems to be two main areas of concern. The perception that one has to be 100% disease and symptom free to be considered fit for work, and the lack of engagement and understanding from clinical medical practitioners who are in a position to address this misperception.

 

A 1948 definition of health by the World Health Organization (WHO) still rings true today. "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Could it be that the industry’s search to identify and objectify a strictly medical cause as a reason for absence from work, or performing occupational duties, is causing unintended consequences for claim drivers? Actually, the opposite seems to be true. Self-belief and how people perceive their health aggravate and perpetuate illness and disability.

The challenge, therefore, is to convince policyholders that work is good for them, and to achieve this, a move to a bio-psychosocial model, rather than the industry’s traditional biomedical model, is necessary.

In 2008, Dame Carol Black presented a review titled Working for a healthier tomorrow, which considered the economic cost of ill-health to Britain. Her paper proposed a number of recommendations, including changing the view that it is inappropriate to be at work unless one is 100% fit. Acknowledging that the general practitioner is often the first to shape the claimant’s perceptions about his or her illness, whether absence from work or duties is warranted and for how long, she recommended that the sick note should be replaced by a fit note, thus focusing on what the person is able to do. Black also recommended the development of a strategy for early intervention that incorporated a holistic care approach.

In South Africa, the absence of a comprehensive national health service and significant state benefits mean that private life insurers can expect to fill this gap that cost Britain £100 billion annually in lost productivity due to worker illness, with taxpayers covering more than £60 billion in benefit costs, additional health costs and lost taxes.

In Australia it is estimated that group insurers are paying out more than $160 million annually for income protection and permanent disability claims, and that is only for mental illness claim causes.

It is no easy task to challenge long-held assumptions and beliefs, but we can start the conversation through:

• acknowledging the fact that psychosocial factors are claim drivers and incorporate them in assessment and case management principles;

• educating the insurance sales force, policyholders and various other stakeholders on the benefits of returning to work and earning an income; and

• promoting early intervention by engaging with policyholders to help shape their personal beliefs and attitudes surrounding health and their ability to work.

By accepting the responsibility and owning the process, we can convince policyholders that work is good for you.