RSA & Parabis - From the heart

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RSA's rehabilitation initiative, delivered in conjunction with Parabis, impressed the judges with its benefits for insurer and injured victims alike. Lynn Rouse reports

Sponsored by UKRC

Finalists 2008

- Corpore
- HSBC Life UK
- RSA & Parabis
- Travelers

The rolling out of insurer-funded rehabilitation schemes to injury victims in the UK has arguably been hindered by its need to pass several tests simultaneously. Not only must rehabilitation be cost-beneficial to the insurer, it must also prove itself an effective means of returning people promptly to their pre-accident state of health and mobility.

The winners of the British Insurance Awards 2008 Rehabilitation Award convinced the judges they had succeeded on all fronts; the panel was particularly impressed by the initiative's scale and its entrenchment in the business.

RSA Care is a victim-centric initiative with rehabilitation at its heart, which the insurer launched in December 2006 after creating a 'bodily injury proof of concept' claims team in conjunction with Parabis. As one of the largest UK insurers of personal injury liabilities, RSA believed existing BI compensation arrangements were unnecessarily adversarial, with legal processes delaying settlement and adding to cost - without delivering optimum outcomes for injured victims.

Therefore, it set about developing a new approach based on proactive contact and support of victims, needs-based rehabilitation and an altered claims culture.

Between 2006 and 2007, RSA Care processed more than 10,000 BI claims. And with independent monitoring of outcomes it was possible to extrapolate significant annual savings.

This cost benefit, combined with proven outcome improvements for injury victims, has compelled RSA to migrate all BI claims management to the methodologies developed for RSA Care - a process that will be complete by the third quarter of this year. So how did the insurer achieve this?

First, it had to test its belief in the shortcomings of the existing system. To do this, RSA worked with Parabis, undertaking a comprehensive review of closed motor and liability BI claims. Working under independent statistical supervision, files were reviewed by a team of industry experts to identify opportunities for improvement in process, claims management technique, victim outcome and cost reduction.

The BI proof of concept claims team then set about testing the effectiveness of these improvements with live claims over a period of 12 months. This team was multi-disciplinary, staffed by claims professionals, lawyers and rehabilitation clinicians. To support it, Parabis designed and built an automated legal and claims management system together with a fully integrated rehabilitation process.

Early and proactive contact with injured parties underpins the RSA Care concept and so the circumstances and severity of each motor accident are assessed to predict injury likelihood and stimulate this contact. The claims team is also empowered to make practical offers of help to the injured victim, appreciating that continued mobility or income security are often top of the worry list for those hurt in motor accidents.

By working with a university's epidemiology department, RSA also developed injury severity predictors so that the claims team could anticipate BI claims before they are notified without adversely affecting claim frequency. As soft tissue damage is not always immediately apparent, follow-up contact is also programmed into the case management software to ensure late emerging injuries can be identified.

Another central element is telephone-based triage. This is immediately undertaken by a rehabilitation clinician to determine the victim's needs and make sure that decision-making is both consistent and evidence-based.

In addition to these practical elements, the insurer recognised that a cultural shift was needed to expunge the adversarial environment. Thus, claimants are referred to as 'third-party customers' to better reflect the way injury victims are communicated with and supported by the service.

Obviously, a central plank of RSA's initiative is this 'capture' of third-party claimants or potential claimants - a practice that has been criticised by some personal injury lawyers. Their concern lies in the fact that injured victims may have their claims settled directly by the at-fault insurer, for a lower figure, without awareness of their right to legal representation.

However, under its scheme, RSA not only alerts injured people to their right to legal representation, it also issues them with a free 'sue me' voucher. This provides sufficient funding to cover legal costs without the inconvenience of having to arrange an after-the-event legal expenses policy.

Independent statisticians that have compared claims processed traditionally with those handled via the RSA Care initiative have found injury victims treated under the scheme are principally concerned with clinical recovery, not legal rights, and 50% of victims participate in rehabilitation where early intervention is possible. That said, where a victim engages a lawyer at the outset, settlement time has still been reduced by 35% - a figure that rises to 55% for those choosing not to engage lawyers.

As well as rapid access to support helping to minimise the impact on normal living and employment for the injury victim, speedy clinical recovery reduces anxiety and symptom chronicity. This hastens case closure with reduced dependence on financial compensation.

The insurer's belief in the service and protection that RSA Care affords to third-party customers has prompted it to invite the Financial Services Authority to review all the initiative's processes and solutions. In short, RSA is confident this will show the regulator, first hand, what 'treating a third-party customer fairly' means in practice.

WINNING WORDS

Steve Maddock and Tim Roberts show a joint approach can improve the injury claims process.

Steve Maddock, UK technical claims director for RSA, and Tim Roberts, senior partner at law firm Parabis, were in euphoric mood after winning the Rehabilitation Award for their joint efforts in devising and executing RSA Care - an initiative that has driven through real results in terms of ensuring fast access to the most appropriate form of treatment while simultaneously benefiting the insurer's bottom line.

Speaking shortly after stepping down from the stage with the firemark trophy in his hand, Mr Maddock stressed how RSA has seized the initiative ahead of its peers: "If you think about the whole issue of process reform in bodily injury claims, there's a part that's sitting and waiting for the government to announce its plans and there's a part already making changes for the benefit of claimants. That's what RSA Care is all about: taking hold of the process now and owning it, dealing with BI claimants while unashamedly locking lawyers out, removing redundant cost and ensuring injured parties receive effective rehabilitation."

Mr Roberts agreed wholeheartedly with this summation: "This is a great example of a big insurer being brave enough to drive through real change in how it handles injury claims at a time when everyone else is waiting for the legislators to do their job for them. RSA has gone a long way to solving the issue for itself."

Mr Maddock added that, since the initiative has been up and running, RSA has more than quadrupled its levels of rehabilitation by diving straight in and offering the most appropriate form of recovery.

"The power of RSA Care lies in the fact that it looks after the consumer: the party that really counts. It builds their trust and confidence by giving them the knowledge that they will be rehabilitated properly while also receiving fair compensation for their injury."

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