Mentally impaired
Patients are locked in a room at a mental hospital in Banda Aceh December 12, 2012. According to the hospital's staff, who take care of more than 700 patients, the number of people suffering from mental illness rose because of the province's long conflict, devastating 2004 tsunami, and also because of the use of narcotics. In deeply traditional society, people suffering from mental illnesses are often kept chained at home and treated with traditional medicines. Indonesia is the world's most populous Muslim nation, but nowhere is the faith more strictly interpreted than in Aceh, sometimes referred to as the "verandah of Mecca" because it was one of the first parts of the archipelago to turn to Islam. Aceh is Indonesia's only province to have implemented sharia, or Islamic laws. Picture taken December 12, 2012. Reuters

SuperFriend, a not-for-profit mental health foundation formed by Industry Super Funds and their insurers, has taken a proactive approach to better manage psychological insurance claims by launching Australia’s first, evidence-based best practice framework.

The framework, called Taking Action: A Best Practice Framework for the Management of Psychological Claims, was developed after an extensive research and consultation process led by SuperFriend in partnership with more than 60 representatives of the Group Life insurance and superannuation industry. The Superannuation Complaints Tribunal, the National Mental Health Commission and respected researchers in this field also helped with the project.

In 2014, the foundation released a groundbreaking study called the Super Mental Illness National Data (SuperMIND) Project, which showed that claims attributed to mental illness and suicide represent approximately 10 percent of all insurance claims within superannuation. As the most frequently diagnosed cause of disability in Australia, insurers estimate that mental illness accounts for about $160 million a year in income protection and disability claims. In addition, psychological claim durations are observed to be longer, more debilitating and more costly.

The study cited the need for better claims management which will benefit members, funds and insurers. Apart from the prevention or reduction of secondary claims for psychological illness, the study also identified that access to affordable insurance and improved claims experience are important for improved psychological claims management.

The Taking Action framework, SuperFriend Chief Executive Officer Margo Lydon said, is designed to give clear guidance in providing better support to people who are either experiencing or are at risk of developing psychological problems while on claim. “Psychological claims are generally one of the most complicated and costly types of claims for the insurance sector. With the release of this framework, we are arming the industry with integrated, practical, actionable steps that will support them to deliver a better claims experience for members,” Lydon said.

Guiding the industry to improve their claims management, the framework incorporated eight interlinked action areas. The first area, called Developing the Management Practices for Psychological Claims, was unveiled with the framework, while successive action area guides will be released over time. These seek to address a range of areas including technology, product design and engaging employers in stay at work/return to work.

“The eight key Action Areas are designed as the ‘how to implement’ guides for the industry. However, it’s important to say that the Taking Action framework is not about a complete transformation process to be implemented exactly as suggested. These are evidence based recommendations for organisations to adopt according to their needs, their capabilities and their readiness for change,” Lydon said.

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