Claims_header_700_2
Claims_header_700_2

Our compassionate approach reduces stress and hassle for claimants

Empathy eases the claims process

We remove the stress for claiming consumers, setting expectations and avoiding escalating confrontations.

Independent honest approach

By discussing events and conditions directly with the claimant we avoid any bias from doctors or employers.

Cutting out the paper cuts costs

We eradicate cumbersome claims forms reducing turnaround times and costs.



About

News

Launch of e-signature process to speed up GPR reports - May 31, 2016

  Introduction of e-signature process for protection processing AMRA approval from client obtained electronically Compliant with ABI and BMA guidance 80% of consumers are happy to use, 20% prefer traditional paper method 95% of GP accept e-signatures Process reinforced by traditional manual wet signature process Turnaround times significantly improved MorganAsh introduced an e-Signature process for the consumer’s approval of the AMRA (Access to Medical Records Act) consent from, a process previously undertaken using paper and “wet signature” ...

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Our success

PG Mutual are a specialist Income Protection insurer. Their origins lie with the pharmacy industry.  Over the last few years they have re-focused their distribution to partnering with multiple professional organisations.

PG Mutual started working with MorganAsh in 2007 and have used the Tele-interview service ever since.  This has been highly successful reducing claims and speeding up the application process. 

Afeter adopting the MorganAsh Tele-claim serice, PG Mutual also took up the Claims Management service in 2011.  The service manages ongoing disability claims throughout the duration of the claim.  The service monitors each case and determines its viability.  Where approriate MorganAsh encourage return to work strategies, equally MorganAsh demonstrate empathy to each claimant, and where appropriate offer advice and help in managing their condition.

The service has already had great results:-

  • Claimants appreciate being able to talk to a medical professional.
  • Around 10% have opted to return to work, resulting in a considerable saving to PG Mutual.

 "The MorganAsh service is fantastic"

Elisa Ashford, Operations Manager 


"What I like about MorganAsh, is that they bring innovation and value to our business. They are far more than just a supplier. They are a true partner."

Mike Perry CEO PG Mutual

Irish Life is the largest insurance company in Ireland and part of the Irish Life & Permanent group of companies.  They market a number of protection, pension and investment products.  They are the largest and leading provider of Income Protection in Ireland, with a leading market share, for both individual (retail) clients and group (corporate) schemes.

Irish Life had a traditional claims process.  Claimants would complete a paper application form to be submitted to Irish Life.  Irish Life would then assess the submitted form and request a four page medical certification form to be completed by their doctor or surgeon.  In addition, Irish Life provided an in-house claim assessor team who visited every claimant.  In 2009 Irish Life undertook a review of their claims processes, notably problem areas were identified:

  • The quality of information provided on the application forms was poor, and in many cases answers were insufficient, vague or even left blank.
  • The process for submitting claims was taking several months.  Not only was this considered poor customer service but also the first few months are vital for the treatment and rehabilitation of conditions, and the delay in the claims process was excluding the opportunity for these services to be beneficial.

Irish Life has been using the MorganAsh Tele-Interview service for Insurance applications since 2006 and this has been a great success. Irish Life started using the MorganAsh Tele-claims service, initially on a pilot basis.

Initially Irish Life ran the MorganAsh Interview in addition to receiving the claims form.  This was so successful, that the service was extended, and the claims form is gradually being phased out.

The service has not only overcome the identified issues, but also provided some additional benefits not originally expected.

Tele-Interview guarantees a 100% completed claim form; but not only this, the MorganAsh Tele-Claim interview is an extensive interview, that goes far beyond just completing the application form, and examines circumstances, lifestyle and employment issues.  Rather than just a 1or 2 word answer the claims manager receives an in depth report of the condition, and all the relevant circumstances.

Irish Life underwriters are able to use this information to make decisions quickly, and to focus and minimise the medical confirmation required.

The MorganAsh interviewer is a professional and independent nurse, and collects far more information than the previous approach. It has now become apparent that as claimants provided their claim form to their employer, they may have been withholding some information.  This is overcome with the MorganAsh process.

The MorganAsh Tele-Claims interview is an interactive session, and although no decision is given to the claimant, in many occurrences the nature of the conversation and the topics covered give the claimant an indication of the claim's success.  As a result, a good proportion of initial claimants have withdrawn their claim, returned to work, or taken up redundancy programmes instead of pursuing the claim.  This has resulted in a reduction of those claims Irish Life would otherwise have had to “decline”.   This has been particularly welcome, as the recent period of financial austerity has led to an increase in these sorts of claims, the introduction of the MorganAsh Tele-Claims service proving to be particularly timely.


“We have been greatly impressed with the MorganAsh Tele-Claim service, the benefits have exceeded our expectations, and we are now rolling it out throughout our claims service.”

Kevin Nolan, Claims Manager, Irish Life.

Claimant case studies

Detected fraud

Seamus is a 59 year old JCB driver who was off work for 10 months with a shoulder problem.  He told the nurse he could not drive and could not even get to work, but when he had been called to make the appointment he was driving and was asked to pull over. This abnormality in evidence was reported to the insurance company. As all calls are recorded this provided sufficient evidence should this be disputed.

Claim quickly paid, no need for further evidence

Alison is a 40 year old supply manager in healthcare products who had been off work with breast cancer. We were able to gather full details of investigations, operation, associated treatment, nodes involved and follow up treatment. As sufficient information was gathered, no further medical information was needed to make a sound case assessment. So allowing speedy payment and saving money on further medical evidence.

The nurse also dealt with a confusion of the claimant who thought she was covered with someone else too. We were able to liaise with insurer and discovered that the group scheme had changed insurer, of which Alison was not aware. This enabled  the situation to be quickly resolved.

True nature of situation revealed

Rachel is a 40 year old bank specialist who was off work with depression. She had a poor relationship with her employers who had changed her role at work causing a major impact on her family life (she had small children aged 4 & 6). She felt it was generally a bullying environment and was not happy at work. Rachel was not attending a psychiatrist, but had taken herself off work due to the work environment.

Rachel was not very forthcoming at the start of the interview but then thanked the nurse and said she found the experience much less daunting than she had anticipated, and was glad that she had done this over the phone.  This allowed the truth of the situation be clarified to the insurer and employer.

Tele-Claims

Quick and easy claims processing

Our industry-leading Tele-claims service improves the claims process for both claimants and insurers. At the start of the claims process an experienced nurse undertakes a high quality interview to triage the claim. This ensures that genuine claims are paid quickly, claimants are handled sympathetically and evidence is targeted appropriately.

Created with SCOR

MorganAsh developd the service with SCOR Global life in 2007, who are so confident in the positive benefits of this service, they will reduce reinsurance rates by 10% for Income Protection.

The service:

  • Reduces or replaces cumbersome claims forms, and the arduous process of sending letters back and forth to applicants, thus reducing costs
  • Is independent of the GP and the employer
  • Removes the stress to the claimant of the whole process, thus improving customer satisfaction
  • Helps to set appropriate expectations

Historically, claimants have been baffled and stressed by having to complete claim forms, and unable to put over their version of events. This leads to a stressed and confrontational environment with claims assessors, and referrals to the Financial Ombudsman Services (FOS).

Most claimants would like to be able to return to work but perceived barriers may exist which can easily be solved with a personal call. Our nurses can identify these barriers and help the claimant to break them down.

For our Critical Illness claims the client is speaking to a professional who understands their journey and can help to reduce the trauma of the claims process.

There are situations where claims are made which are not genuine or may not fit with the insurers' criteria. The MorganAsh nurses use advanced conversation management skills to check and validate the claims. All interviews are recorded which further encourages the claimant to be accurate with responses. This provides our Insurers with a documented history from which to make future comparisons.

Cost savings are delivered from:-

  1. Reduction in claims pay-outs
  2. Reduction in claims administration
  3. Reduction in reserves for claims
  4. Clarity at the beginning of the claim reduces erroneous claims and errors
  5. Opportunity to obtain reduced reinsurance rates in line with improving morbidity experience
  6. Reduction in vague and incomplete claim forms improves efficiency

Claims Management

Our Claims Management service manages claimants through their condition until they are fit enough to return to work or a settlement is agreed. The service delivers:-

  • Better customer experience
  • Quicker claims processing
  • A process FOS and legislators applaud
  • Cost reductions
  • Less draining on claims resources
  • Improved public relations and enhanced brand value

The aims of the service are:

  • To understand the medical condition the claimant is suffering
  • To demonstrate empathy to claimants
  • To encourage claimants to recover from their condition in a timely manner
  • To reduce fraud
  • To reduce costs and claim payments
  • To signpost claimants to receive assistance from all available sources

Benefits of Using the MorganAsh tele-claims management service for the Company:

  • Reliable regular contact with claimants at intervals agreed with company.
  • Ability for the nurses to build relationships with the claimants
  • Arrange interviews for just after appointments allowing the most up to date and valuable information to be passed to insurers
  • Collation of facts and details of how the recovery is progressing or regressing allowing the claims assessor to objectively review claims impartially
  • Enables medical reports to be tailored to the most recent information received via the tele-interviews or negates the need for a report from the GP.
  • Clear audit trail
  • Support for the claimant
  • Reassurance, that as a trained professional, the nurse undertaking the interview will understand the member’s incapacity and be sympathetic
  • Script questions can be altered/reviewed if required
  • Communication directly with the nurses if urgent information is required

Claimant case studies

Delivering empathy and support 

Sarah is a 64 year old pharmacist who was claiming income protection following unsuccessful knee replacement surgery for osteoarthritis. She spoke to the nurse several times and found the conversations helpful and supportive. The company were kept up to date and informed of her plans. Ultimately she opted for early retirement.

At her last follow up interview she was still struggling and tearful. She felt the operations had gone wrong and had decided she would not ever be able to return to work. The nurse listened to her grievances and then gave advice about who she should contact at the hospital and GP surgery; how to go about raising the concerns through PALS, write statements etc. This last chat left Sarah feeling sufficiently empowered to plan her future.

Early intervention reduces claim

Cheryl is a 43 year old full time lawyer with Labyrinthititis and numbness. From the first talk with the nurse in March it was very apparent how anxious Cheryl was about length of time taken to get a neurology appointment. This was passed on to the insurers and the nurse liaised with the company who were able to facilitate a faster appointment for her. Following a further three chats for updates and support  Cheryl returned to work on a part time basis after seeing the neurologist and a clear scan. The earlier neurology appointment and subsequent reassurance meant she was able to get back to work earlier, thus allowing speedy resolution to the claim.

Support and care for long term claimant, delivers philosophy of caring mutual company

John was diagnosed with Alzheimer’s disease and has been unable to work for some time. He is supported regularly by the MorganAsh nurse. The nurse was able to gain a good understanding of his family and social circumstances.  Realising that he needed more support, the nurse put John in touch with local support groups. He has been given advice about obtaining more practical help and support in his life.

The nurse alerted the company to the fact he was still driving, which enabled further contact with the John’s GP to close any loops in the patient’s care.

Permanent claimant working part time, enables reduction in claim

George is a 60 year old teacher claiming since 2003 due to deafness.

This is a permanent claim. The interview has to be conducted through 3rd party using talk / type. The first interview established the difficulties he had but the second interview found out that he was currently working part time. He was able to do about four hours a week as a cleaner/maintenance/DIY as paid seasonal work. George had previously submitted a declaration but then stopped working and forgot to do this when he took up the work again.

The contact with the nurse, although very difficult through talk/type, highlighted the work and meant that the company could objectively assess the discrepancies between day to day function and medical information. They were unaware he was currently working again in any capacity.  This enabled the claim payment to be amended in-line with the part time work, and the claimant to be far happier this is in the open and all agreed.

Non-disclosure discovered

John is a 47 year old fitness instructor and had been off work and claiming for around a year before referral to MorganAsh. He had a prolapsed disc causing nerve compression with sciatica and also had symptoms of depression. During his 2 discussions with the nurse it was discovered that the condition had started prior to taking out the policy.  On further examination it was established that this information had not been divulged at the time of application. Based on this information the company were able to obtain further evidence from the GP that indeed confirmed the non-disclosure at the application stage.  As a result of the non-disclosure at application stage, the company ceased to pay the claim. 

Claims Management - The service in detail

The following gives more detail on the Claims Management services

Understanding the condition

It is important to fully understand the condition from which the claimant is suffering. We validate the symptoms, tests, diagnosis and treatment to confirm that there is clear understanding. In many cases this is straight forward but also in some cases this is not so obvious, stress and back issues being the most common claims where it is difficult to get clear diagnosis and prognosis.

We ascertain how the claimants manage their daily life. Our approach considers many aspects such as family, home and work environments. This creates a thorough picture of the claimant's position and helps identify how the claims manager should best respond to the claim.

Contact and support

It is our experience that in having a full discussion with the claimant in a professional but caring manner the claimant is more open about their situation and also will welcome support offered.

In cases where it is clear the person cannot return to work in the short term, a regular interview is a way of keeping in contact and updating the situation. Then a fully informed decision can be made regarding ongoing payments. It is evident too that such a “service” is highly valued.

Demonstrating empathy

MorganAsh believes that there is significant business benefit to insurers in demonstrating empathy to claimants, this good relationship results in:

  • The claimant being honest in their dealings with insurers
  • Reducing animosity and the view that the claimant should maximise their claim
  • Willing to assist with case studies
  • Talking positively to colleagues about the insurer

Monitoring the life cycle of the condition

We monitor the claimant as they progress through their treatment and recovery. In most cases conditions and treatment follow a predictable path of symptoms, tests, diagnosis, treatment and rehabilitation. We monitor the claimant against this path, and question deviations from this. Should these deviations be of concern then this will be flagged to insurers. If the claimant is undertaking self diagnosis and treatment, then MorganAsh will monitor this closely, and will discuss with insurers if there is cause for concern.

Signposting for assistance

Support from the nurse may help the claimant to access appropriate resources to inform them how best to manage their conditions. These resources may include:

  • Informing them of their rights within the NHS
  • What they may be entitled to from their private medical provider
  • Charities that may assist them
  • Voluntary or self help groups that may assist them.

Where appropriate to suggest where alternative resources can be located.

Reducing fraud

All our claims staff have been trained in advanced conversation management techniques and paralanguage assessment to detect fraud. In addition, questions for specific conditions will be included to double check the claimant is being honest.

Reducing costs

Our Claims Management service has been shown to reduce the costs of claims. This is achieved by several means

  • Reducing fraud
  • Encouraging early return to work
  • Reducing the cost of collecting medical evidence
  • Reducing administration
  • Reducing contentious claims
  • Claimants withdrawing their claim before it is registered
  • Targeted medical evidence gathering to corroborate the information from the MorganAsh interview

Due to the reduction in claims some reinsurance companies have reduced their premium rates by up to 10% for Income Protection.

Reducing pay outs

When appropriate in the treatment cycle MorganAsh will encourage people to go back to work, and try to set a timetable for this. In many instances, this encourages people to return to work, or seek part time work if this is appropriate. Getting people back into the work environment is important and has proved to be valuable for the well-being of claimants.

Knowing the options

The nurse is able to liaise with the Company to inform claimants of their options. If it is clear that they do have a valid claim, then there may be alternatives. The options could include partial payment if they were able to return to work in some restricted way, proportionate payment for re-training or rehabilitation. The Tele-Claim interview provides an excellent opportunity to explain to claimants that returning to work on a reduced basis is a viable option.

Changing the mindset

Many claimants are put off from returning to work, as they believe that their condition is likely to last for many months. Perhaps someone has told them that it could last that long and they therefore fall into that way of thinking. This negative mindset may be reversed by contacting them early in the process and by giving them a positive and inspirational way of looking at their situation.

For many common health problems, (including prevalent stress and musculoskeletal problems) recovery is improved with proper management and support. Long-term disability is not inevitable. There is a powerful role to play in making it clear that the claimant should be able to make a recovery and return to work (in some form) in the short term.

MorganAsh nurses have many years firsthand experience in dealing with patients and know the value of being positive. They encourage patients to adopt a positive approach to their condition and outline their possible options.

Managed in MARTIN

The MorganAsh MARTIN (MorganAsh Real Time Information Network) is used to maintain a real time management of the case. Each case is logged and a record of the contacts and conversations kept. Insurers' Claims Managers can access this at any time and review the case.

Claims Underwriting

Our experienced claims team assess and manage all aspects of individual claims for Life, Critical Illness, Permanent & Total Disability, Income Protection and Waiver of Premium policies.

The services we offer range from basic assessment of medical evidence to a fully outsourced solution providing support from claim notification to decision with all aspects of administration being undertaken.

We charge per transaction, thus relieving companies of the fixed overhead costs of maintaining staff internally, and the flexibility to increase and decrease resources in line with volumes.

PG Mutual are a specialist Income Protection insurer. Their origins lie with the pharmacy industry.  Over the last few years they have re-focused their distribution to partnering with multiple professional organisations.

PG Mutual started working with MorganAsh in 2007 and have used the Tele-interview service ever since.  This has been highly successful reducing claims and speeding up the application process. 

Afeter adopting the MorganAsh Tele-claim serice, PG Mutual also took up the Claims Management service in 2011.  The service manages ongoing disability claims throughout the duration of the claim.  The service monitors each case and determines its viability.  Where approriate MorganAsh encourage return to work strategies, equally MorganAsh demonstrate empathy to each claimant, and where appropriate offer advice and help in managing their condition.

The service has already had great results:-

  • Claimants appreciate being able to talk to a medical professional.
  • Around 10% have opted to return to work, resulting in a considerable saving to PG Mutual.

 "The MorganAsh service is fantastic"

Elisa Ashford, Operations Manager 


"What I like about MorganAsh, is that they bring innovation and value to our business. They are far more than just a supplier. They are a true partner."

Mike Perry CEO PG Mutual

Irish Life is the largest insurance company in Ireland and part of the Irish Life & Permanent group of companies.  They market a number of protection, pension and investment products.  They are the largest and leading provider of Income Protection in Ireland, with a leading market share, for both individual (retail) clients and group (corporate) schemes.

Irish Life had a traditional claims process.  Claimants would complete a paper application form to be submitted to Irish Life.  Irish Life would then assess the submitted form and request a four page medical certification form to be completed by their doctor or surgeon.  In addition, Irish Life provided an in-house claim assessor team who visited every claimant.  In 2009 Irish Life undertook a review of their claims processes, notably problem areas were identified:

  • The quality of information provided on the application forms was poor, and in many cases answers were insufficient, vague or even left blank.
  • The process for submitting claims was taking several months.  Not only was this considered poor customer service but also the first few months are vital for the treatment and rehabilitation of conditions, and the delay in the claims process was excluding the opportunity for these services to be beneficial.

Irish Life has been using the MorganAsh Tele-Interview service for Insurance applications since 2006 and this has been a great success. Irish Life started using the MorganAsh Tele-claims service, initially on a pilot basis.

Initially Irish Life ran the MorganAsh Interview in addition to receiving the claims form.  This was so successful, that the service was extended, and the claims form is gradually being phased out.

The service has not only overcome the identified issues, but also provided some additional benefits not originally expected.

Tele-Interview guarantees a 100% completed claim form; but not only this, the MorganAsh Tele-Claim interview is an extensive interview, that goes far beyond just completing the application form, and examines circumstances, lifestyle and employment issues.  Rather than just a 1or 2 word answer the claims manager receives an in depth report of the condition, and all the relevant circumstances.

Irish Life underwriters are able to use this information to make decisions quickly, and to focus and minimise the medical confirmation required.

The MorganAsh interviewer is a professional and independent nurse, and collects far more information than the previous approach. It has now become apparent that as claimants provided their claim form to their employer, they may have been withholding some information.  This is overcome with the MorganAsh process.

The MorganAsh Tele-Claims interview is an interactive session, and although no decision is given to the claimant, in many occurrences the nature of the conversation and the topics covered give the claimant an indication of the claim's success.  As a result, a good proportion of initial claimants have withdrawn their claim, returned to work, or taken up redundancy programmes instead of pursuing the claim.  This has resulted in a reduction of those claims Irish Life would otherwise have had to “decline”.   This has been particularly welcome, as the recent period of financial austerity has led to an increase in these sorts of claims, the introduction of the MorganAsh Tele-Claims service proving to be particularly timely.


“We have been greatly impressed with the MorganAsh Tele-Claim service, the benefits have exceeded our expectations, and we are now rolling it out throughout our claims service.”

Kevin Nolan, Claims Manager, Irish Life.


Detected fraud

Seamus is a 59 year old JCB driver who was off work for 10 months with a shoulder problem.  He told the nurse he could not drive and could not even get to work, but when he had been called to make the appointment he was driving and was asked to pull over. This abnormality in evidence was reported to the insurance company. As all calls are recorded this provided sufficient evidence should this be disputed.

Claim quickly paid, no need for further evidence

Alison is a 40 year old supply manager in healthcare products who had been off work with breast cancer. We were able to gather full details of investigations, operation, associated treatment, nodes involved and follow up treatment. As sufficient information was gathered, no further medical information was needed to make a sound case assessment. So allowing speedy payment and saving money on further medical evidence.

The nurse also dealt with a confusion of the claimant who thought she was covered with someone else too. We were able to liaise with insurer and discovered that the group scheme had changed insurer, of which Alison was not aware. This enabled  the situation to be quickly resolved.

True nature of situation revealed

Rachel is a 40 year old bank specialist who was off work with depression. She had a poor relationship with her employers who had changed her role at work causing a major impact on her family life (she had small children aged 4 & 6). She felt it was generally a bullying environment and was not happy at work. Rachel was not attending a psychiatrist, but had taken herself off work due to the work environment.

Rachel was not very forthcoming at the start of the interview but then thanked the nurse and said she found the experience much less daunting than she had anticipated, and was glad that she had done this over the phone.  This allowed the truth of the situation be clarified to the insurer and employer.


Quick and easy claims processing

Our industry-leading Tele-claims service improves the claims process for both claimants and insurers. At the start of the claims process an experienced nurse undertakes a high quality interview to triage the claim. This ensures that genuine claims are paid quickly, claimants are handled sympathetically and evidence is targeted appropriately.

Created with SCOR

MorganAsh developd the service with SCOR Global life in 2007, who are so confident in the positive benefits of this service, they will reduce reinsurance rates by 10% for Income Protection.

The service:

  • Reduces or replaces cumbersome claims forms, and the arduous process of sending letters back and forth to applicants, thus reducing costs
  • Is independent of the GP and the employer
  • Removes the stress to the claimant of the whole process, thus improving customer satisfaction
  • Helps to set appropriate expectations

Historically, claimants have been baffled and stressed by having to complete claim forms, and unable to put over their version of events. This leads to a stressed and confrontational environment with claims assessors, and referrals to the Financial Ombudsman Services (FOS).

Most claimants would like to be able to return to work but perceived barriers may exist which can easily be solved with a personal call. Our nurses can identify these barriers and help the claimant to break them down.

For our Critical Illness claims the client is speaking to a professional who understands their journey and can help to reduce the trauma of the claims process.

There are situations where claims are made which are not genuine or may not fit with the insurers' criteria. The MorganAsh nurses use advanced conversation management skills to check and validate the claims. All interviews are recorded which further encourages the claimant to be accurate with responses. This provides our Insurers with a documented history from which to make future comparisons.

Cost savings are delivered from:-

  1. Reduction in claims pay-outs
  2. Reduction in claims administration
  3. Reduction in reserves for claims
  4. Clarity at the beginning of the claim reduces erroneous claims and errors
  5. Opportunity to obtain reduced reinsurance rates in line with improving morbidity experience
  6. Reduction in vague and incomplete claim forms improves efficiency

Our Claims Management service manages claimants through their condition until they are fit enough to return to work or a settlement is agreed. The service delivers:-

  • Better customer experience
  • Quicker claims processing
  • A process FOS and legislators applaud
  • Cost reductions
  • Less draining on claims resources
  • Improved public relations and enhanced brand value

The aims of the service are:

  • To understand the medical condition the claimant is suffering
  • To demonstrate empathy to claimants
  • To encourage claimants to recover from their condition in a timely manner
  • To reduce fraud
  • To reduce costs and claim payments
  • To signpost claimants to receive assistance from all available sources

Benefits of Using the MorganAsh tele-claims management service for the Company:

  • Reliable regular contact with claimants at intervals agreed with company.
  • Ability for the nurses to build relationships with the claimants
  • Arrange interviews for just after appointments allowing the most up to date and valuable information to be passed to insurers
  • Collation of facts and details of how the recovery is progressing or regressing allowing the claims assessor to objectively review claims impartially
  • Enables medical reports to be tailored to the most recent information received via the tele-interviews or negates the need for a report from the GP.
  • Clear audit trail
  • Support for the claimant
  • Reassurance, that as a trained professional, the nurse undertaking the interview will understand the member’s incapacity and be sympathetic
  • Script questions can be altered/reviewed if required
  • Communication directly with the nurses if urgent information is required

Delivering empathy and support 

Sarah is a 64 year old pharmacist who was claiming income protection following unsuccessful knee replacement surgery for osteoarthritis. She spoke to the nurse several times and found the conversations helpful and supportive. The company were kept up to date and informed of her plans. Ultimately she opted for early retirement.

At her last follow up interview she was still struggling and tearful. She felt the operations had gone wrong and had decided she would not ever be able to return to work. The nurse listened to her grievances and then gave advice about who she should contact at the hospital and GP surgery; how to go about raising the concerns through PALS, write statements etc. This last chat left Sarah feeling sufficiently empowered to plan her future.

Early intervention reduces claim

Cheryl is a 43 year old full time lawyer with Labyrinthititis and numbness. From the first talk with the nurse in March it was very apparent how anxious Cheryl was about length of time taken to get a neurology appointment. This was passed on to the insurers and the nurse liaised with the company who were able to facilitate a faster appointment for her. Following a further three chats for updates and support  Cheryl returned to work on a part time basis after seeing the neurologist and a clear scan. The earlier neurology appointment and subsequent reassurance meant she was able to get back to work earlier, thus allowing speedy resolution to the claim.

Support and care for long term claimant, delivers philosophy of caring mutual company

John was diagnosed with Alzheimer’s disease and has been unable to work for some time. He is supported regularly by the MorganAsh nurse. The nurse was able to gain a good understanding of his family and social circumstances.  Realising that he needed more support, the nurse put John in touch with local support groups. He has been given advice about obtaining more practical help and support in his life.

The nurse alerted the company to the fact he was still driving, which enabled further contact with the John’s GP to close any loops in the patient’s care.

Permanent claimant working part time, enables reduction in claim

George is a 60 year old teacher claiming since 2003 due to deafness.

This is a permanent claim. The interview has to be conducted through 3rd party using talk / type. The first interview established the difficulties he had but the second interview found out that he was currently working part time. He was able to do about four hours a week as a cleaner/maintenance/DIY as paid seasonal work. George had previously submitted a declaration but then stopped working and forgot to do this when he took up the work again.

The contact with the nurse, although very difficult through talk/type, highlighted the work and meant that the company could objectively assess the discrepancies between day to day function and medical information. They were unaware he was currently working again in any capacity.  This enabled the claim payment to be amended in-line with the part time work, and the claimant to be far happier this is in the open and all agreed.

Non-disclosure discovered

John is a 47 year old fitness instructor and had been off work and claiming for around a year before referral to MorganAsh. He had a prolapsed disc causing nerve compression with sciatica and also had symptoms of depression. During his 2 discussions with the nurse it was discovered that the condition had started prior to taking out the policy.  On further examination it was established that this information had not been divulged at the time of application. Based on this information the company were able to obtain further evidence from the GP that indeed confirmed the non-disclosure at the application stage.  As a result of the non-disclosure at application stage, the company ceased to pay the claim. 

The following gives more detail on the Claims Management services

Understanding the condition

It is important to fully understand the condition from which the claimant is suffering. We validate the symptoms, tests, diagnosis and treatment to confirm that there is clear understanding. In many cases this is straight forward but also in some cases this is not so obvious, stress and back issues being the most common claims where it is difficult to get clear diagnosis and prognosis.

We ascertain how the claimants manage their daily life. Our approach considers many aspects such as family, home and work environments. This creates a thorough picture of the claimant's position and helps identify how the claims manager should best respond to the claim.

Contact and support

It is our experience that in having a full discussion with the claimant in a professional but caring manner the claimant is more open about their situation and also will welcome support offered.

In cases where it is clear the person cannot return to work in the short term, a regular interview is a way of keeping in contact and updating the situation. Then a fully informed decision can be made regarding ongoing payments. It is evident too that such a “service” is highly valued.

Demonstrating empathy

MorganAsh believes that there is significant business benefit to insurers in demonstrating empathy to claimants, this good relationship results in:

  • The claimant being honest in their dealings with insurers
  • Reducing animosity and the view that the claimant should maximise their claim
  • Willing to assist with case studies
  • Talking positively to colleagues about the insurer

Monitoring the life cycle of the condition

We monitor the claimant as they progress through their treatment and recovery. In most cases conditions and treatment follow a predictable path of symptoms, tests, diagnosis, treatment and rehabilitation. We monitor the claimant against this path, and question deviations from this. Should these deviations be of concern then this will be flagged to insurers. If the claimant is undertaking self diagnosis and treatment, then MorganAsh will monitor this closely, and will discuss with insurers if there is cause for concern.

Signposting for assistance

Support from the nurse may help the claimant to access appropriate resources to inform them how best to manage their conditions. These resources may include:

  • Informing them of their rights within the NHS
  • What they may be entitled to from their private medical provider
  • Charities that may assist them
  • Voluntary or self help groups that may assist them.

Where appropriate to suggest where alternative resources can be located.

Reducing fraud

All our claims staff have been trained in advanced conversation management techniques and paralanguage assessment to detect fraud. In addition, questions for specific conditions will be included to double check the claimant is being honest.

Reducing costs

Our Claims Management service has been shown to reduce the costs of claims. This is achieved by several means

  • Reducing fraud
  • Encouraging early return to work
  • Reducing the cost of collecting medical evidence
  • Reducing administration
  • Reducing contentious claims
  • Claimants withdrawing their claim before it is registered
  • Targeted medical evidence gathering to corroborate the information from the MorganAsh interview

Due to the reduction in claims some reinsurance companies have reduced their premium rates by up to 10% for Income Protection.

Reducing pay outs

When appropriate in the treatment cycle MorganAsh will encourage people to go back to work, and try to set a timetable for this. In many instances, this encourages people to return to work, or seek part time work if this is appropriate. Getting people back into the work environment is important and has proved to be valuable for the well-being of claimants.

Knowing the options

The nurse is able to liaise with the Company to inform claimants of their options. If it is clear that they do have a valid claim, then there may be alternatives. The options could include partial payment if they were able to return to work in some restricted way, proportionate payment for re-training or rehabilitation. The Tele-Claim interview provides an excellent opportunity to explain to claimants that returning to work on a reduced basis is a viable option.

Changing the mindset

Many claimants are put off from returning to work, as they believe that their condition is likely to last for many months. Perhaps someone has told them that it could last that long and they therefore fall into that way of thinking. This negative mindset may be reversed by contacting them early in the process and by giving them a positive and inspirational way of looking at their situation.

For many common health problems, (including prevalent stress and musculoskeletal problems) recovery is improved with proper management and support. Long-term disability is not inevitable. There is a powerful role to play in making it clear that the claimant should be able to make a recovery and return to work (in some form) in the short term.

MorganAsh nurses have many years firsthand experience in dealing with patients and know the value of being positive. They encourage patients to adopt a positive approach to their condition and outline their possible options.

Managed in MARTIN

The MorganAsh MARTIN (MorganAsh Real Time Information Network) is used to maintain a real time management of the case. Each case is logged and a record of the contacts and conversations kept. Insurers' Claims Managers can access this at any time and review the case.


Our experienced claims team assess and manage all aspects of individual claims for Life, Critical Illness, Permanent & Total Disability, Income Protection and Waiver of Premium policies.

The services we offer range from basic assessment of medical evidence to a fully outsourced solution providing support from claim notification to decision with all aspects of administration being undertaken.

We charge per transaction, thus relieving companies of the fixed overhead costs of maintaining staff internally, and the flexibility to increase and decrease resources in line with volumes.


Launch of e-signature process to speed up GPR reports - May 31, 2016

  Introduction of e-signature process for protection processing AMRA approval from client obtained electronically Compliant with ABI and BMA guidance 80% of consumers are happy to use, 20% prefer traditional paper method 95% of GP accept e-signatures Process reinforced by traditional manual wet signature process Turnaround times significantly improved MorganAsh introduced an e-Signature process for the consumer’s approval of the AMRA (Access to Medical Records Act) consent from, a process previously undertaken using paper and “wet signature” ...

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