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Should we be advocating self-serve?

This question is a bit of a dichotomy: Self-serve helps us manage our workload and focus on the stuff of being an adviser, but at the same time, self-serve directly reduces some of the value we provide.

Monday, September 2nd 2024, 9:02AM

by Jon-Paul Hale

I've had a strange week this week, full moon week in August. It finished with a weekly tip from nib about encouraging the use of their client app to help reduce adviser workload.

A message I appreciate and agree with, it can and does reduce workload. But at what cost?

I'm not having a go, just to be clear. More, are we thinking this through?

These speak volumes about the value advisers add to people's lives when we get involved and actively provide solutions.

This is part of why I question the use of automated portals. Yes, they have their place, but when it comes to claims, they become questionable.

I raise this as I have seen just over four new claims a week land on my desk this year. While many of them are straightforward and have little value added with me being across them versus direct to the insurer, enough have needed my help. Enough claims that the lack of my involvement the outcome for clients would not have been what it was.

For those who have read my musings, I've had a hot button on cancer and unfunded meds, which has resulted in an active approach to solving this with my clients using extension medical cover with Partners Life, which I have done for 12 years so far. I call it the unfunded medical wrap.

  • If you don't know what I'm talking about, talk to your Partners Life BDM to understand the specific mechanics used here.

In simple terms, I'm using their product to extend the client's underlying medical coverage with another provider to cover unfunded medicines.

  • This is a great solution and cost-effective. Unlike the extension covers now offered to the nib and Southern Cross policyholders, it is a full medical policy.

Coming back to my point on adviser involvement in claims, I've had quite a few this week cross my desk where my involvement has been critical and portal claims would have left the clients short.

  • One client has come to me with moles being removed, benign for the most part, except for the three small melanoma in-situ's they have had. The medical provider wouldn't have spotted or highlighted this client also has a possible trauma claim.
  • Another client, who has 80% coverage with Southern Cross pre-approved for a colonoscopy, has the remainder of their costs picked up by Partners Life. The major diagnostics benefit allows access despite the high main benefit excess.
  • Another is working through shoulder surgery with AIA, and we also have a disability claim; they had started as a medical claim without considering the off-work component.
  • Yet another has bariatric surgery. Their medical policy has exclusions for bariatric surgery, but the unfunded wrap I put in place ten years ago doesn't. This means their surgery costs will be picked up with a reasonable excess, but they will still not be fully exposed to the costs.

This is just this one week! I have many, many claims where the client going through the portal would have been to their detriment, and we would have failed to provide on the promises I have made to look after people with the products we have arranged.

Are some of these product solutions complex? Yes, they are. That's the problem. You cannot arrange complex product solutions for clients and set them adrift to figure it out at claim time.

  1. When they claim, it's usually years later, and they have forgotten what they have and how it works. Even with regular reviews, clients are focused on living life rather than analysing insurance contracts.
  2. Clients are focused on their medical situation with all the fear and anxiety of "what's going on?" that this experience brings.

Your value as your client's trusted adviser bears fruit when your clients have claims that you can make easier and more effective than they can with an insurer portal.

As too with reviews, those legacy products Steven talked about, yes, this is where things are important too.

I've had a number of significant issues for clients pop up this year. I don't know if it's just poor service, a lack of provider staff knowledge, or just plain dumb luck.

One review revealed that the client's insurer had added two exclusions to the policy for the very things the client had held on to the cover for. It was human error, and it's been resolved, but this happened 16 years ago! Well, before I took over the client on a 22-year-old policy.

In another review, I had been looking after the client for ten years and finally received clear information on the policy from the insurer. Further demonstrating the issues with poor information provided by providers even when asked for specific details.

I discovered that the client had been moved from employee rates on their IP cover to self-employed rates when they became self-employed some years after putting the cover in place. This shouldn't have happened; reviewing this, I had this corrected, and the client refunded the overpayment of premiums. This, too, was a 16-year-old problem that should have been caught and sorted well before I picked it up.

Another review the client's premiums jumped 84% with a premium structure issue, once we worked though it the insurer concerned walked it back and sorted it out. The reason they did this, I had the product material on hand from when the policy was taken and how it was put in place. The insurer didn't have this historic policy material. Documentation is critical.

The FMA has applied documentation requirements to our FAP licences as an additional condition. I've talked about the challenges with providers with both their communication of changes and management of version controls.

The above examples all required clear and recorded documentation for me to provide the added value my clients expected. Your notes and filing are critical to your advice!

This week, I reviewed Southern Cross' update to their product range. In contrast to my critical comments last year, Southern Cross has done an outstanding job communicating its changes and improving the quality and delivery of its product documentation and material.

Kudos to the Southern Cross team on this one; they have gotten it right in ways the rest of us and providers need to aspire to.

If you are serious about your career as an insurance adviser, you must improve your attention to detail and the quality of your documentation.

Tags: Jon-Paul Hale

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