29 April 2020

Coronavirus: Employee Benefits Claims FAQs for Employers

By Jonathan Skeels CONSULTANT

In response to the COVID-19 outbreak, we have compiled a list of frequently asked questions and answers surrounding claims to support employers during this time.

Please note, this information is based on the latest updates from our insurers. We will keep monitoring the latest advice from the Government and update accordingly.

What kind of signatures are acceptable on new claim forms?

Although insurers have given slightly different responses, the bottom line is that all insurers have produced workable solutions to make it easy for a claimant to submit claims forms. Aston Lark Employee Benefits is always on hand to assist you in the claims process. Examples of solutions are as follows:

  • The need for original wet signatures has been removed, forms can be either scanned or photos taken, if the signature is legible. Forms will need to be sent using a work email address.
  • Where the above is not possible, then electronic signatures can be used. Please note, some GPs may not be happy with this type of medical consent so members may need to then contact their GP to authorise verbally.
  • An edited PDF with a typed name in the signature box.

Given the difficulty of obtaining evidence from GPs to verify new claims, what procedures are being adopted to avoid delays in claim decisions?

All insurers have acknowledged that whilst they need to adapt their procedures in order to remove the impact on the claimant/client, claims still need to be agreed as quickly as possible. This is because it is highly likely that GPs and consultants may be slower to respond than normal. Aston Lark Employee Benefits will continue to manage these claims closely to ensure that everything possible is done to bring these to their conclusion.

Possible workarounds include:

  • Insurers accepting medical evidence by email rather than through the post.
  • Phone calls direct to claimants to gather as much evidence as possible verbally.
  • Asking claimants to provide as much medical evidence as possible (i.e. by providing letters from their consultants, etc.). Some GP surgeries provide patients with electronic access to medical records, so information can be obtained in this way.
  • Use of Occupational Health reports from clients.
  • Utilising the expertise of their rehabilitation teams, nurses and chief medical officers to assess the claim forms, removing the need for additional medical evidence wherever possible.
  • In certain circumstances, insurers may agree claims on a discretionary basis for a short period, until the required evidence is obtained.

Can you confirm your stance on furloughed employees and how their benefits will be covered? 

Insurers have said that for all Group Risk contracts, Group Life, Income Protection and Critical Illness polices, furloughed employees should not be disadvantaged in any way.

Therefore, furloughed members or those on reduced hours or pay (even to zero) will continue to have their benefits insured based on their salaries/benefits prior to such a reduction. This is subject to the following:

  • Their furloughing status is only due to COVID-19.
  • Members must remain on any renewal data and premiums paid based on their full benefits.
  • Employees continue to remain employed.

Most insurers have stated this arrangement would be for a maximum period of 12 months.

Will existing Group Income Protection claims in payment still be reviewed, given the difficulty in now obtaining reports from GPs? Or will review dates now be extended?

Insurers have stated that they intend to review ongoing Group Income Protection claims as normal. Only in rare circumstances would they consider extending the review date. To remove the burden from GPs by asking for a report or additional information, the following could be utilised to assist instead:

  • Phone calls direct to claimants to ascertain how their condition is impacting them day to day.
  • Request to claimants directly, asking for any recent medical notes they have been sent.
  • Use of Occupational Health Reports from the client, where available.
  • Review the case internally with either their rehabilitation teams or chief medical officers.
  • Ask claimants to complete Activity Questionnaires.

If the pandemic reaches levels where it becomes difficult to register death claims quickly (i.e. no certificate or entry on the death register for a while) would you accept an email from the company/trustee to confirm a death?

From the current information available, insurers are not anticipating much in the way of delays in deaths being registered, although this will continue to be monitored.

As it currently stands, insurers would not be looking to change their procedures and either a death certificate or coroner’s certificate would still need to be issued. It is worth noting that for death certificates, most insurers do not need to have sight or receive this certificate as they have access to the online death registry.

If we do start to see long delays in deaths being registered then Aston Lark Employee Benefits will be looking at alternatives with the insurers, as we recognise that funds may be required urgently where the deceased is the main income provider.
In some circumstances, would you be prepared to pay Group Income Protection claims for a small period (for instance, two months) whilst evidence is being obtained?

Insurers have stated that they will look to assess the claim and obtain evidence in line with their adopted procedures (see second question).

However, for more serious conditions their requirements would be less stringent, and a fit note may be all that is required. Certain insurers may be prepared to pay claims for a short period on a discretionary basis until the required evidence is obtained. Aston Lark Employee Benefits will look to ensure that insurers are adopting sensible procedures and pushing for insurers to adopt this approach (i.e. paying claims for a short period where claims appear to be clear-cut).

Should you have any further questions, please contact your usual Aston Lark Employee Benefits representative. Alternatively, you can speak to the Aston Lark Employee Benefits team on 020 7543 2818 or email [email protected].

Related Articles