The keys to effective management of disability claims

With disability claims rising, many plan sponsors are questioning whether they’ll be able to offer their employees a complete group benefits plan in the coming years.

“From a cost perspective, we’re seeing organizations asking about this more and more,” Travis Kelly, director of group disability claims and operational support at Desjardins Insurance, told Benefits Canada’s Calgary Benefits Summit on May 5.

In recent years, Canadian insurers have seen an increase in the number of disability claims. Several factors are behind the trend, including an aging worker population and a variety of chronic health issues, such as obesity and mental-health and stress management issues.

“It all adds up to chronic illness touching approximately 40 per cent of Canadians,” said Kelly, noting that the long-term cost of pharmaceutical support to treat chronic illness is unsustainable.

What are the options to get the numbers down? Effective disability management involves lowering the incidence rate of disability and decreasing the duration. The road to better health management, according to Kelly, covers four milestones: prevention, intervention, time management and communication.

The first milestone involves taking better approaches to prevention. “Forty per cent of cancers, strokes and heart attacks are preventable,” said Kelly, noting employers can inform, encourage and empower employees to make lifestyle changes and proactively take charge of their health. “Our favourite claims are the ones we never even see because we’re able to stop them from happening.”

The second milestone involves designing an optimal intervention strategy by “doing the right thing at the right time at the right price,” said Kelly.

The third milestone is optimal time management because “the longer an employee is away on disability, the more likely it is they’re not coming back,” said Kelly. “We have a really small window at the beginning of a claim to try to bring people back to work. It’s got to be done right the first time.”

The fourth milestone involves optimal lines of communication woven throughout the entire system. Affordable health management, said Kelly, must involve everyone: employees, plan sponsors, health-care professionals, unions and other stakeholders.

“For plan sponsors, when all four milestones are in place, productivity levels come back up and, most importantly, employees get their health back,” said Kelly.

“The idea of partnership is really the way of the future for group insurance. By taking a comprehensive approach to health and proactively working together toward the same goal, we can deliver optimal health management.”

Read more from Benefits Canada‘s 2016 Calgary Benefits Summit