The amended Policyholder Protection Rules (PPR) will have a significant impact on long-term insurance especially from a Group Risk perspective. Annalie Terblanche, product manager at SilverBridge, discusses what insurers need to be mindful of when it comes to these reforms.
“With these changes taking effect from October last year, insurers must significantly change not only how they communicate with policy holders, but also in the way group risk cover is designed, marketed, and managed from a claims perspective,” she says.
Under the amendments, the definition of a policyholder in a group scheme has changed from just being the employer or retirement fund, to now include all the members themselves. Insurers must therefore provide more detail around what cover is provided, possible exclusions, how costs and premiums are structured, the claims processes, to name just a few elements.
“The cornerstone of this will revolve around how effectively insurers have captured data in their systems. If their databases are not comprehensive or have not been kept updated with all relevant fields (think contact details, identity numbers, names, and so on), there is an administrative nightmare waiting to happen.”
She believes for an insurer to manage this process effectively it must work with a trusted service provider that has the technology available that automates as much of this as possible.
“Record-keeping becomes vital and if communication with a member is not done in accordance to the amendments, the insurer risks significant financial and reputational damage. Leveraging technology to assist in the process will become even more critical. Some insurers may have underestimated the scope of the amendments but must now prioritise getting their systems in line with integrated data management processes,” she says.
Part of ensuring the insurer complies with PPR regulation is working with a trusted partner that has the solutions in place to streamline the process.
“For our part, SilverBridge has developed the FAISapp that addresses a number of PPR requirements. This includes recording, managing, and reporting on all complaints received from members. Furthermore, our policy administration solution Exergy has all the functionality required to make sure compliance is taken care of,” she says.
This is essential as the insurer now needs to communicate with the individual member from submission of the claim through to the final decision. Exergy already provides this functionality as members are administered as policy holders in addition to the employer.
“Existing Exergy users must make sure that they collect the correct data from employers. All system functionality is in place, so there is no need to upgrade or search for new solutions. We are providing customers with an environment that enables them to remain focused on their processes and core objectives,” she concludes.
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