BrightRock’s needs-matched group risk product in action – certainty when members claim.

Posted on 19 Jul, 22 by BrightRock

The last two years have been challenging for most people across the world. We’ve seen unprecedented change, and we’ve all had to adapt to those changes and find new ways of doing things. The insurance industry has seen some of the biggest changes, with many insurers experiencing a sharp increase in claims. According to ASISA, over the 12-month period ending in April 2021, the South African life insurance industry paid a total of R29,1 billion in death claims alone. This represents an increase of 70% compared to the previous 12-month period. BrightRock too saw a substantial increase in death claims during the period. We saw a 137% increase in the value of death claims paid out for group risk and individual life policies combined in 2021 compared to 2020.

Clients see the value of having life insurance

This period has highlighted the importance of life insurance and has also given us the chance to live up to our promise to members when they need it most – when they claim. This experience has also highlighted the need for life insurance. According to ReMark’s 2021 Global Consumer Study (brought to us by SCOR), 56% of South Africans surveyed had a more positive view of life insurance as a result of the COVID-19 pandemic.

Certainty when members claim under temporary expense needs cover

Certainty is one of the pillars of the BrightRock product. This is why our product design, for all our cover options, features clear and transparent claims criteria. When we assess temporary expense needs cover claims, we first do so on a comprehensive list of clinical definitions.

If a member doesn’t meet the criteria for one of the clinical definitions, we can assess under sickness criteria where we can pay a claim based on the member being booked off by a medical practitioner. This has led to BrightRock being able to pay claims sooner than most of the other providers in the market. We pay claims on sickness criteria to avoid the onerous steps of having an employee, and employer, prove that an employee can’t work temporarily.

Where BrightRock assesses a member’s temporary expense needs claim using occupational criteria, we can look at the client’s inability to do their own occupation – if the scheme has selected this option – at their own employer. We also clearly disclose the criteria that we use to assess members’ claims through the Job Fitness Test. This allows you, as the adviser, to show how many points a member can get, depending on the nature of their work, to qualify for a temporary expense needs claim. A member needs to score 10 or more points to qualify for a claim under this criteria on temporary expenses cover, but the condition doesn’t need to be permanent.

The case study below demonstrates the value of the approach and the interplay between temporary and disability cover in BrightRock’s unique group risk offering.

Case study: Client qualifies for a temporary expense needs pay-out for dementia

In 2021, our client, a female aged 58, submitted a claim for temporary expenses. She started experiencing symptoms of dementia. The scheme has both temporary expense needs and permanent expense needs cover. We paid her temporary expense needs cover after the three-month waiting period for five months while she was booked off sick. At the end of those five months, she failed a Job Fitness Test permanently as a result of her cognitive impairment.

Understanding that the nature of her job was admin-related, this meant that she was never going to be able to work again. She’ll continue to receive her recurring pay-outs and won’t ever have to prove her disability to us again. This is because BrightRock never reassesses a permanent expense needs claim, leaving her, and her family in relative peace as they deal with a difficult situation.

For many of our members, their group risk cover is all that they have to make sure that they and their loved ones are financial taken care of if the member were to become ill or injured and not be able to work. That’s why all of BrightRock’s group risk products are built around claim certainty.

This article was originally published on EBnet on 15 July 2022. Click here to read the original online version.