2012
ALUCA TurksLegal Scholarship
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Application Form
Completing a paper for the ALUCA TurksLegal Scholarship each year has always given me a strong sense of achievement and satisfaction. During the research and writing I have always developed new ideas and insights which have benefited my day to day work.
Andrew Prichard Team Manager, Life Insurance Claims BT Financial Group 2011 ALUCA TurksLegal Scholarship winner
My 2011 paper in particular led me on a completely new journey and raised my awareness around the way we do things in our industry. I have been quite humbled to receive comments and encouragement from some very experienced and well known people, who have taken the time to read my paper. Having received acknowledgment from people I look up to as mentors and leaders has been a strong motivating force. I have been supported at work to undertake further study and training and to expand ideas and concepts in claims management. The opportunity to travel to the Unites States and attend the Eastern Claims Conference (ECC) was incredible! I can only describe it as “the trip of a lifetime”. The ECC was fantastic and I especially loved sitting in the main conference room with the Australian Flag displayed up front letting the rest of the world know we were represented. It was a valuable opportunity to attend seminars in the US and observe how different our two industries appear. Conference aside, the rest of the opportunities the trip provided were priceless: including enjoying the sights of New York and getting engaged in Central Park. None of this would have been possible without the support of ALUCA and TurksLegal. I encourage you to participate in the 2012 ALUCA TurksLegal Scholarship.
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Applications close 5.00pm (Sunday) 9 September 2012
About the Scholarship The ALUCA TurksLegal Scholarship is designed to support the professional growth of ALUCA and its members by providing a significant career development opportunity for professionals working in the life insurance industry.
2012 Judging panel The judging panel for the ALUCA TurksLegal Scholarship comprises senior industry professionals who have a broad wealth of knowledge and industry experience. This year’s judges are: • Jim Minto - Managing Director, TAL Ltd • Paul Rayson - Managing Director, CommInsure • Simon Swanson - Managing Director, ClearView • Tracey Peters - President, ALUCA • Phil Hay - Head of Life Insurance, BT Financial Group • Chris Healey - Claims Manager, Swiss Reinsurance • John Myatt - Partner, TurksLegal • Alph Edwards - Partner, TurksLegal • Lisa Norris - Partner, TurksLegal
Entry criteria Your submission (word limit of 2,500 words) will be assessed on: • Understanding and insight of the chosen topic • Research foundation and conclusions supported by sound evidence • Clarity of thought • Commercial insight • Presentation
Who can enter The Scholarship is open to all members of ALUCA regardless of country of residence. Each entrant must be a current financial member of ALUCA and work in the life insurance industry. Lawyers, accountants or medico-legal consultants who meet the above criteria are eligible to enter provided they are direct employees of life insurance companies, life reinsurance companies, superannuation trustees or superannuation administrators.
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Prizes Winner
The winner of the Scholarship receives a package valued up to AU$8,000 including return travel, accommodation, $1,000 cash and registration to one of the following overseas conferences of their choice:
2013 Eastern Claims Conference
| Date TBA
| New York City, New York
2013 LOMA Life Insurance Conference | 15 - 17 April
| New Orleans, Louisiana
2013 DI & LTC Insurers’ Forum
| Location TBA
2nd Prize
Winner of 2nd prize will receive a AU$1,000 Red Balloon gift certificate valid for 12 months.
3rd Prize
Winner of 3rd prize will receive a AU$250 restaurant voucher.
| Date TBA
Announcement of winners The winners will be announced at the ALUCA Conference in Auckland, New Zealand 20 - 24 October 2012. Applications for the ALUCA TurksLegal Scholarship open on Thursday 26 July 2012 and close at 5:00pm on Sunday 9 September 2012.
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Questions Answer ONE of the following eight questions. The content of your submission must be no more than 2,500 words.
Q1 Early Intervention
What has been your experience with early intervention in disability and TPD claims? Has rehabilitation and return to work been as successful as many have suggested in the literature? Are some claims more open to early intervention than others? If so, when is it most effective, and what do companies need to do to get the maximum benefits from early intervention? Your answer should review the evidence for and against the effectiveness of early intervention and also discuss the particular problems that may arise in the group claims arena where the company has to work with a trustee or fund administrator to action an early intervention program. You answer should give practical examples of how these problems can be addressed and overcome.
Q2 Successful Underwriting of Mental Illness
According to the Australian Institute of Health and Welfare, the impact of mental illness within the Australian population has become increasingly apparent. A survey conducted by the Australian Bureau of Statistics in 2007 found that an estimated 3.2 million Australians (20% of the population aged between 16 and 85) had a mental disorder in the twelve months prior to the survey. This represents a significant proportion of the Australian population and more relevantly a significant proportion of customers of the life insurance industry. Since 2001 the life insurance industry has been working with support groups and other mental illness stakeholders to change the industry’s underwriting approach to mental illness. Please discuss the progress of the Memorandum of Understanding over time and the changes that have occurred to industry practices as a result of it. The first MoU between the Life Insurance Industry and Mental Health Stakeholders was signed in March 2003, and re-signed again in 2004, 2006 and 2008. Your answer should include an evaluation of the industry’s progress to date and an analysis of the options for further understanding and improvement in the future.
Q3 Insurance Implications of Auto Consolidation of Super
Industry experts have modelled a potential reduction in member accounts of around one third as a result of the Federal Government’s decision to automatically consolidate inactive superannuation accounts. This will clearly have an impact on the number of insured superannuation accounts and hence the overall level of cover that members have. What (if any) will be the impact on the current under-insurance gap and the impact on premium rates? How should the industry approach auto consolidation in order to maintain current cover levels? Your answer should describe the potential problems that may occur with auto consolidation and include your recommendations about the sort of protocols the industry should put into place to maintain overall cover levels and address the other issues you have identified.
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Questions (continued)
Q4 Claims in the Global Village
One of the features of the high Australian dollar and cheap air travel is an increasing number of death and disability claims arising while the insured is outside Australia. These claims are usually more difficult for companies to investigate. Some high profile death claims, both here and overseas, have been established to be hoaxes perpetrated by criminals who have devised complex schemes to fraudulently obtain the policy proceeds by staging the death of the life insured. What are the problems with administering these claims and how should companies develop systems and procedures to address them? How do companies go about identifying fraudulent claims involving death or injury outside Australia? What are the “red flags� that claims assessors ought to be looking for? What investigation techniques do you need to use to combat fraud in cases such as these? If possible, your answer should be illustrated with actual claims situations and investigation strategies (with any identifying information suppressed of course) of death and disability claims that you have managed or investigated outside Australia.
Q5 Structured Product Offerings
Many companies have underwriting protocols that guarantee some form of cover is always ultimately offered in response to a retail application. This may occur through the company ultimately offering heavily modified terms and conditions (such as an offering accidental death cover only) and/or subject to very significant exclusions. What are the commercial and legal risks associated with this decision? If you decide that this is where your company does want to position itself, how can these risks be minimised or perhaps even be eliminated? Your answer needs to specifically identify and address the legal risks associated with the decision to always offer some kind of cover in response to an application and analyse whether this may or may not be a good decision for your customers as well. You should then look at practical means of minimising the legal risk and the impact this may have on customers.
Q6 Solving the Value Equation
In the current economic climate many companies are experiencing higher than usual lapse rates across a range of risk products. How can life companies combat this apparent willingness on the part of established customers to jettison their risk cover? Does this depend on demonstrating the true value to their customers of the products and services that life companies offer? In the mature market we have for financial services in Australia, how will companies stay front of mind with customers with risk products? What will consumers be looking for in terms of products that have value to them and in terms of their overall experience with the company, including the claims experience? Your answer should address these questions and put forward practical suggestions about what companies can do to arrest lapse rates.
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Questions (continued)
Q7 End to End Claims Management – where does the buck stop?
For claims professionals, the buck stops with you when it comes to reaching claims decisions. However, the nature of the information which you get from doctors has a major impact on how effectively you manage the claim. Do standard approaches to getting personal medical attendant’s reports ensure you are getting the right medical information about a claimant’s condition? If not, how do they need to be improved? What is the optimal way to go about asking for medical information? Which questions should you be asking your customer’s doctors and your company appointed independent medical examiners (“IME”)? How do you go about reconciling the treating doctor’s views with an IME’s opinion where they differ? Assuming it is not always possible to get doctors to agree with each other, explain how you choose which opinion to base your decision on? Most importantly, how should companies ensure that they make decisions that take the successful resolution of the claim forward?
Q8 Mental Illness Claims
DSM5 is about to be released and will no doubt redefine or create a raft of new set of diagnostic criteria around mental illnesses. What are the special characteristics of claims arising from mental illness and how do you most effectively manage mental illness claims? Your answer should address the practical issues of day to day claims management including proof of the claim, the role of rehabilitation and the use of third party providers. You may also wish to comment on what (if any) you expect to be the impact of DSM 5 on insurance for disability arising from mental illness.
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Terms & conditions Definitions A. TurksLegal: means the legal practice partnership operating under that registered business name. B. ALUCA: means Australian Life Underwriters and Claims Association. C. Major Prize: means an overseas package valued up to $8,000 (inclusive of GST). It includes registration to one of the following overseas conferences: 2013 Eastern Claims Conference, date to be confirmed, New York City, New York; 2013 LOMA Life Insurance Conference, 15-17 April 2013, New Orleans, Louisiana; DI & LTC Insurers’ Forum, date and location to be confirmed; return economy airfares for one person to one of the above locations valued up to $3,000; four nights accommodation valued up to $2,000 for one person at a hotel to be confirmed by the organisers; and $1,000 spending money. The package does not include: transfers to and from the airport, any insurances, taxes, additional spending money, charges, levies, hotel incidentals, tours and activities or meals not included in conference registration (except where specified). Dollars ($) means Australian dollars. D. 1st Runner-up Prize: means the Scholarship 1st runner-up will be awarded a Red Balloon gift certificate valid for 12 months to the value of $1,000AU (inclusive of GST). E. 2nd Runner-up Prize: means the Scholarship 2nd runner-up will be awarded a $250AU (inclusive of GST) restaurant voucher. F. Term: means the entire period of the Scholarship commencing on 26 July 2012 and concluding on 9 September, 2012 at 5pm. G. Judging Panel: means the Judging Panel constituted to judge the 2012 ALUCA TurksLegal Scholarship. H. Scholarship: means the ALUCA TurksLegal Scholarship. Rules 1. This Scholarship is open to all members of ALUCA regardless of country of residence. Each entrant must be a current financial member of ALUCA. Entrants must work in the life insurance industry. Lawyers, accountants or medico-legal consultants who meet the above criteria are eligible to enter provided they are direct employees of life insurance companies, life reinsurance companies, superannuation trustees or superannuation administrators. Entry is not open to members of the ALUCA National Committee. 2. As a condition of entry, an entrant accepts these terms and conditions and any rules, policies or procedures that may be adopted by TurksLegal or ALUCA from time to time. TurksLegal or ALUCA may change, amend or vary these terms and conditions and may extend the period of, or cancel, the Scholarship without notice. 3. Entry forms for the Scholarship can be found on the TurksLegal website. Members of ALUCA who wish to participate in the Scholarship must complete the official entry form and send it with a copy of their paper by email to Meredith Casbier, Marketing & Business Development Manager, meredith.casbier@ turkslegal.com.au by 9 September 2012 at 5pm. Only entries accompanied by an official application form will be accepted. Only one entry per ALUCA member will be accepted. 4. Entrants in the Scholarship must submit a written paper (not exceeding 2,500 words in length) on one of eight questions selected by the Judging Panel and notified to entrants. 5. The entrant must certify that they meet the conditions and that their employer has no objection to their paper being entered. 6. At the conclusion of the Term all entries will have personal information removed so that entrants’ papers are considered anonymously by the Judging Panel; the winner and the 1st and 2nd runners-up will be officially announced at the ALUCA Conference in Auckland, New Zealand 20-24 October 2012. 7. The entrant whose paper is determined by the Judging Panel to be the best response (“the winner”) will be awarded the Major Prize. The entrant whose paper is determined by the Judging Panel to be the next best (“the 1st runner-up”) will receive the 1st runner-up Prize. The entrant whose paper is determined by the Judging Panel to be the next best (“the 2nd runner-up”) will receive the 2nd runner-up Prize. 8. The Judging Panel will determine the winner, 1st and 2nd runner-up by simple majority. Where there is no clear majority in favour of any one entrant, the person
elected by the Judging Panel as its Chairman must exercise a casting vote which will determine the winner and runner-up. In determining the winner and 1st and 2nd runner-up the Judging Panel will utilise the marking criteria that it has agreed to apply to all entries. 9. Notification will be given to the winner, 1st and 2nd runner-up as soon as practicable after the conclusion of the judging. Notice may be given by ordinary post, electronic mail, courier or personally. 10. The winning entry and 1st and 2nd runner-up papers will be published on the TurksLegal and ALUCA websites, in the ALUCA e-newsletter, RiskeBusiness and other potential media sources. By signing the application form the entrant accepts these conditions and gives permission for publishing of the name and/or photos. Under the conditions of entry the copyright in all entries will vest in TurksLegal and ALUCA. 11. Entrants are responsible to ensure that their contact details with TurksLegal and ALUCA are up to date. 12. Prizes are not transferable or exchangeable and no prize can be taken solely in cash. 13. If for any reason the winner, 1st and 2nd runner-up are unable to utilise their prize once booked (including flights, accommodation, conference, restaurant and Red Balloon Day voucher bookings) and the date cannot be changed without penalty (of any kind, including financial charges) the winner, 1st or 2nd runner-up will not receive an alternative prize. 14. All entries are expected to be original work of the entrant, based on their own research. Reference to supplementary material must be clearly acknowledged in the paper. TurksLegal and ALUCA reserve the right to make whatever enquiries each consider necessary to ensure the work attributed to an entrant is that person’s own work. All claims for prizes are subject to TurksLegal’s and ALUCA’s verification procedures as determined by TurksLegal and ALUCA in their absolute discretion. 15. TurksLegal’s and ALUCA’s decision in relation to all aspects of the Scholarship, including but not limited to any dispute as to the identity of an entrant, eligibility to participate in the Scholarship and determination of an entrant’s eligibility to receive a prize, is final and binding and no correspondence will be entered into. These terms and conditions may be changed, amended or varied at any time by TurksLegal or ALUCA in their absolute discretion without notice and without assigning any reason therefore. TurksLegal and ALUCA reserve the right to cancel or vary the Scholarship in whole or in part in their absolute discretion at any time without prior notice. Any such cancellation shall not effect any entrant’s entitlement to any prize that has accrued at the time of the cancellation. 16. Entrants accept these terms and conditions as amended from time to time and agree to be bound by them. Entry in the Scholarship is subject to these terms and conditions. In the case of any inconsistency between these terms and conditions and any promotional material, these terms and conditions prevail. TurksLegal and ALUCA reserve the right to cancel an entrant’s participation in the Scholarship without assigning any reason therefore where TurksLegal and/or ALUCA, in their absolute discretion, consider that the entrant has not acted honestly, fairly, in good faith or in the spirit of the Scholarship. 17. Liability for any tax on any benefits provided to entrants pursuant to the Scholarship is the sole responsibility of the entrant. It is recommended that entrants contact their own accountant or taxation advisor in this regard. 18. TurksLegal and ALUCA accept no liability for late, lost or misdirected entries. 19. To the extent permitted by law, TurksLegal and ALUCA are not liable for and shall be kept harmless from any loss or damage to property or person including but not limited to direct or consequential loss and including loss from personal injury as a result of any person participating in the Scholarship or making use of a prize. 20. TurksLegal and ALUCA collect entrants’ personal information in order to conduct the Scholarship. If the information requested is not provided, the entrant may not be permitted to participate in the Scholarship. By entering the Scholarship, unless otherwise advised, each participant agrees that TurksLegal and/or ALUCA may use this information in any media for future promotional, marketing and publicity purposes without any further reference, payment or other compensation to the entrant, including sending the entrant electronic messages. A request to access, update or correct any promotion should be directed to TurksLegal and/or ALUCA.
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2012 ALUCA TurksLegal Scholarship
Application Form Entrants must submit this application form together with a paper (word limit of 2,500 words), answering one of the eight questions listed. Please also read the terms and conditions in this application form before submitting an entry. Entrants must submit by email their paper and a completed application form by 5.00pm on Sunday 9 September 2012 to: Meredith Casbier Marketing & Business Development Manager Email: meredith.casbier@turkslegal.com.au Further information about the scholarship is available at www.turkslegal.com.au and www.aluca.com
Full Name Position Organisation Email Address Direct Phone Mobile Question Answered Word Count (max 2,500 words)
By signing this application form and submitting your entry you confirm that you have read and understood the terms and conditions of the Scholarship, you agree to be bound by these terms and conditions, and the organisation you work for has no objection to your entry being submitted: Signed:
Current member of ALUCA (please tick):
Yes
No
Applications must be received no later than 5.00pm (Sunday) 9 September 2012