The Importance of Continuing Education for Claims Assessors
Best-in-class Claims organizations require knowledgeable, responsive, critical thinking claims professionals who understand the products they adjudicate to ensure the promise made at the time of sale is fully realized. If the COVID‑19 pandemic taught us anything, it’s that we cannot rest on our laurels when it comes to acquiring knowledge of new conditions, treatment options, the importance of work, and the way work is performed.
Throughout the pandemic, resilience and new ways of working were demonstrated daily. Many office workers experienced fully remote work, something 66% of employers worldwide will continue to accommodate minimally in a hybrid fashion moving forward.1
Pandemic impacts will continue across many sectors. If we think about a Disability diagnosis and its role in a claim, it’s not as easy as it may seem for the claims assessor to make a decision simply on its reliance. We know diagnosis in and of itself does not equate to a functional impairment necessitating a work cessation, satisfaction of critical illness triggers or the cause of death. It may be a component, but it is not the ultimate factor. The claims assessor must have up-to-date skills and knowledge as they work through the claims process.
Likewise, a job title does not equate to the material and substantial duties an individual performs within an occupation. The claims assessor must understand more than mere terms – they must be up to date on latest developments and current practices.
Let’s look at an example to further demonstrate what is meant. A Claims Assessor’s role involves, in part:
- Evaluating medical information (not just understanding a diagnosis) as it relates to the condition claimed or cause of death
- Understanding the material and substantial duties involved in the occupation performed just prior to a claimed date of loss (not just job title)
- Understanding the role, if any, of financial loss as compared to one’s pre-disability earnings
These responsibilities require the claims assessor to stay up to date on medical advances and treatment options, and to understand the way work is performed given its evolution. This means understanding such things as remote work capabilities, both in offering treatment and allowing the performance of prior work remotely or in alternative ways. The implications are broad and far-reaching. Our world continues to evolve: Things like the introduction of robotics are transforming the way work is done, from surgical procedures to factory work and farming. Self-driving or autonomous vehicles are being developed and tested. Even the way we look for work has changed significantly since the pandemic began.
In order for claims assessors to remain informed of all these developments, they need to take advantage of and be afforded different opportunities to continue to learn. Readily available professional development opportunities include online courses and live training events. The Gen Re Claims Academy and Gen Re Claims training events help our clients stay abreast of and respond to changing global situations.
For example, last year we held a Mental Health Think Tank that brought together Gen Re contacts to assess the pandemic’s impact on mental health and mental health claims, and to identify ways Gen Re can best support our clients and staff worldwide. Gen Re Claims Academy courses are offered online to our clients. Engaging and relevant content is structured around key topics, with quizzes and exercises to reinforce learning.
Employers can keep employees engaged by offering opportunities for professional growth. As the Harvard Business Review recently wrote, if “managers can’t find a way to steepen their [employees’] learning curves, they will eventually move to new organizations and new managers who can.”2
Providing opportunities to enhance skills, learn new things and stay on top of developments in medical advances, technology and the world of work are just a few ways to ensure your claims professionals have the knowledge they need to grow, therefore helping your company deliver the best-in-class service your customers expect!
Gen Re is always available to support our clients with their learning journeys. Let us know if we can help you.
- Microsoft 2021 report, The Work Trend Index, https://www.microsoft.com/en-us/worklab/work-trend-index/hybrid-work.
- Whitney Johnson, Harvard Business Review, “Manage Your Organization as a Portfolio of Learning Curves,” January-February 2022.