5 Minutes With Evgeney Schkola, 2018 ALUCA TurksLegal Scholarship Winner

How did you hear about the ALUCA TurksLegal Scholarship and what made you decide to enter?

I heard about the ALUCA TurksLegal Scholarship through my employer, CommInsure. CommInsure heavily promotes participation in the scholarship through internal communications and via the leadership team.

As I’d been developing my skills in writing over the last couple of years, this seemed like a good challenge. My mind was made up once I saw that one of the questions was about InsureTech as this aligned perfectly with my own interests.

What was your paper about?

My paper was about InsureTech and how it will shape the insurance industry over the next 10 years. By InsureTech I mean emerging technologies such as automation, Big Data, machine learning and block chain. I looked at how these technologies may solve current challenges facing the insurance industry, and highlighted how pioneering start-ups that have embraced these technologies are already taking customers away from the more traditional insurers. InsureTech will impact every level of insurance: actuaries, product managers, underwriters, administrators and claim managers. The challenge for our industry is to embrace InsureTech sooner rather than later. Click here to read Evgeney’s paper.

Tell us what you won.

The prize for winning the Scholarship was a trip to attend a life insurance conference of my choice in the U.S. The Scholarship prize included flights, accommodation, conference registration and $1,000 in spending money! I chose to attend the Eastern Claims Conference held in Boston in April this year. The conference was very interesting and I had the opportunity to speak with a number of delegates about InsureTech. I found U.S. insurers have a much stronger appetite for cracking down on fraud and they rigorously prosecute those who commit fraud. For example, one of the strengths of InsureTech they promoted was the ability to identify fraudulent activity through profiling customer actions and behaviours, resulting in substantial cost savings for the business. It was also interesting to see the number of InsureTech products already available in the U.S. marketplace to streamline processes for insurers. What I took away from the conference is that Australia is behind the U.S. in adopting InsureTech by about five years.

Have any opportunities come about since winning the Scholarship?

Since winning the Scholarship I have had the opportunity to participate in the TurksLegal ALUCA LIFT (Life Insurance Future Thinking) Roundtable event held in November last year. This was a fantastic opportunity to get together with Scholarship alumni and industry experts to connect and share ideas on a particular life insurance topic. The topic of debate was Mental Health in Insurance which I found very interesting. Also, as part of the prize for winning the Scholarship, I have been invited to sit on the judging panel alongside senior industry leaders for this year’s ALUCA TurksLegal
Scholarship.

What would be your advice to others considering entering the ALUCA TurksLegal Scholarship?

I highly recommend entering the scholarship. You need to give yourself as much time as possible to complete your submission, so I strongly recommend planning ahead and setting aside plenty of time in your calendar. Start working on your paper as soon as the questions are published. Pick a question that interests or resonates with you. Then start researching. Read as much as you can on the topic. The internet is a good starting point. Keep a list of the articles and any other sources. Then you need to plan your paper. Make sureyou have a clear, logical argument, and support your argument with plenty of examples, referencing and acknowledging the sources. Keep your writing simple and to the point, and try to avoid unnecessary jargon.

Evidence Alert : Heart attack claims and cardiac biomarkers above the 99th percentile

Caution should be used when claims assessors assess heart attack critical illness claims given the findings of a recent study (Mariathas et al., 2019). The study measured high sensitivity troponin I (hs-trop I) in 20,000 consecutive in-patients and out-patients seen at a UK hospital, regardless of why they presented to hospital (most presented without any clinical suspicion of myocardial infarction). Other studies have also found similar results, but this is the largest study population by far (Harvell et al., 2016).

The researchers (Mariathas et al) found that over 5% of the 20,000 patients seen had elevations above the manufacturers 99th percentile upper reference limit (99% URL). The manufacturers 99% URL was set at 40ng/L, and in the study group it was 296ng/L. 39% of patients in critical care had levels above the manufacturers 99% URL.

What is the 99th percentile upper reference limit? For many cardiac biomarkers, the level is can set by the manufacturer, and should be confirmed by the testing laboratory as relevant for the local population. The level is recommended to be set by taking at least 300 ‘healthy’ men and 300 ‘healthy’ women and measuring the level of the biomarker in these subjects, a range of results will be produced, and the highest 1% will be considered above the 99th percentile upper reference limit. The study by Mariathas et al was a study on 20,000 ‘unhealthy’ subjects and obviously produced significantly different results compared to the manufacturer.

Many conditions are associated with elevated cardiac biomarkers other than myocardial infarction, including advanced age, cardiac injury, renal impairment, and heart failure. It is important for the clinician to take the clinical context into account when assessing the result of any test, including cardiac biomarkers. If there is a low likelihood (pre-test probability) of a myocardial infarction and the result is above the reference range there may be other explanations for the abnormal result.

This study should get clinicians and claims assessors thinking about whether the reference range supplied is appropriate for their patient or claimant prior to making a diagnosis of myocardial infarction or heart attack.

Most Australian heart attack critical illness definitions reference the 3rd universal definition of myocardial infarction (updated to the 4th universal definition of myocardial infarction in 2018). The standard definition of heart attack contained within the Life Insurance Code of Practice defines a heart attack as “meaning the death of a portion of the heart muscle as a result of inadequate blood supply, where the diagnosis is supported but the detection of a rise and/or fall of cardiac biomarker values with at least one value above the 99th percentile upper reference limit (URL)”.

As a result of this study and the fact most definitions reference the 3rd universal definition of myocardial infarction, claims assessors need to pay close attention to the clinical context in which the cardiac biomarker test was taken, before assuming an abnormal result represents a myocardial infarction. I would suggest routine involvement of medical staff when assessing cardiac biomarkers in heart attack claims.

Harvell, B., Henrie, N., Ernst, A. A., Weiss, S. J., Oglesbee, S., Sarangarm, D., & Hernandez, L. (2016). The meaning of elevated troponin I levels: not always acute coronary syndromes. Am J Emerg Med, 34(2), 145-148. doi:10.1016/j.ajem.2015.09.037

Mariathas, M., Allan, R., Ramamoorthy, S., Olechowski, B., Hinton, J., Azor, M., . . . Curzen, N. (2019). True 99th centile of high sensitivity cardiac troponin for hospital patients: prospective, observational cohort study. BMJ, 364, l729. doi:10.1136/bmj.l729

The 2019 MLC-ALUCA-Monash Prize for Industry Collaboration for Health Students

ALUCA-MLC-Monash Award Scholarship Program

For the 3rd time (2016, 2107 and in 2019), MLC and ALUCA have once again teamed up to provide the University of Monash Allied Health Students an opportunity to research and present on key topics impacting the Australian Life insurance industry, particularly within Underwriting and Claims.

Final year Monash University medical, nursing or allied health are invited to apply their health knowledge in a commercial context. To be considered for this prize, students will need to prepare a (written and verbal) response to key questions facing underwriting and claims professionals today.

Students who are chosen to participate will have support and access to mentors from the insurance underwriting and claims business units provided by MLC.

Did you know that allied health professionals play a crucial role in the life insurance industry?

Life insurers use the skill and expertise of allied health, nursing and medical professionals in roles such as rehabilitation management, complex case management, insurance policy and product development and underwriting.

Allied health and medical professionals bring their speciality to a corporate environment to achieve the best health outcomes for the customer as well as meeting the business needs.

What’s the prize?

  • $500 for each of the eight students selected to participate in writing and presenting on one of the eight insurance and underwriting claims topics.
  • $1,000 for the second best submission, and
  • $2,000 for the best submission

In addition, each of the eight students selected will:

  • Have access to a MLC Life Insurance senior claims professional or a senior underwriter as a mentor for the duration.
  • Potentially have their paper published in industry newsletters.
  • Receive an exclusive invitation to a Welcome and Awards event, and

Opportunity to apply for a three month intern placement at MLC Life Insurance.

What’s required?

The eight students selected will need to prepare

  • A 2,000 word essay on one selected topic (word limit must be adhered to).
  • A five minute presentation to Monash employees, MLC Life Insurance senior leaders and ALUCA board members on the selected topic. This must include a PowerPoint presentation (a maximum of 10 slides) created to support key findings.

The students will be required to submit their PowerPoint document prior to their presentation.

Selection process

Monash University staff will select eight students who will each respond to one of the topics. Only eight papers (and presentations) will be prepared and considered in the running for first prize.

The selection of the eight students will be based on the discretion of Monash University employees and the topics selected by eligible candidates. Any questions about this process please speak to Professor Marilyn Baird.

Support provided

Each of the eight students selected will have access to a mentor from MLC Life Insurance to assist in developing their understanding of the life insurance industry.

Those selected to participate will be invited to attend an ‘Insurance 101’ welcome event at MLC Life Insurance’s office at Tower 2, Level 16, 727 Collins Street, Docklands to meet your mentors who will support you (as required) throughout the time allowed to develop your response to your assigned topic.

Topics

  1. How can we combat the negative impact of social media on the mental health of our future workforce?
  2. A sedentary lifestyle has been compared to smoking 20 cigarettes per day. How do we motivate Australians to become more active and healthier?
  3. How can we support Australians who live in more remote areas to access appropriate and holistic healthcare?
  4. How can allied health and non-allied health professionals working in the life insurance industry interface with treating doctors, surgeons and other allied health professionals to obtain the information they need in order to best support a customer on claim?
  5. How can we explain and apply complex medical terminology to customers and other non-allied health stakeholders within the life insurance industry?
  6. Alcohol consumption, harmful drinking and health. What are the implications for income insurance and TPD insurance?
  7. How can the life insurance industry leverage Behavioural Economics to improve return to work and health outcomes at claim time?
  8. People are working longer than ever before with the expected retirement date moving past 65 years of age.  How could we extend the working life of a manual worker in the context of physical deterioration over time?

For further details please see the ALUCA MLC Monash brochure here.

Important information

MLC Limited (MLC) ABN 90 000 000 402, AFSL 230694, operates the MLC Life Insurance business. MLC Limited uses the MLC brand under licence. MLC Limited is part of the Nippon Life Insurance Group and not a part of the NAB Group.

The internship will be conditional upon satisfaction of MLC Life Insurance employment requirements including necessary probity checks.

Participation is conditional upon agreement to publication of your entry by MLC Life Insurance.

ALUCA Life Insurance Excellence Awards Night 2019

ALUCA’s 2019 ALUCA Life Insurance Excellence Awards night held on May 22nd at the majestic Arts Centre in Melbourne was once again a wonderful testament for the best in the profession to be recognised by their peers and colleagues for the fantastic work that they do. Feedback from those who attended the night was very positive with many commenting how much it meant to them to celebrate the value great Life Insurance underwriting, claims, rehabilitation and other professionals/services contribute to this vibrant industry of ours. 

Judging Process

In total we received almost 60 nominations across all of the categories. The papers once again were judged via a 2-round process. A first round panel of cross industry judges marked and scored all of the papers independently. They marked these against the key criteria for each of the award categories using a marking sheet. The scores were sent back and collated at a central level. Judges then met to discuss the papers and the scores. The top 2 – 4 finalist entries were agreed on for each category.

The finalist papers for each category were then provided to a cross industry and external industry panel of judges who also all marked against the key criteria for each of the award categories via a marking sheet – these were all scored separately and independently. Once again, the scores were sent back and collated at a central level. Judges then met to discuss the papers and the winners for each category. Any judging bias was removed first via a strong cross industry panel and where papers were very close, to remove any judging bias – judges scores for their company were taken out of the process.

Our Thanks

A huge thanks and congratulations to everyone who was nominated for an Award. The judges were very impressed by the high quality of the submissions. Everyone should all be incredibly proud of their achievements. It was very close in a number of the categories with a joint winner for one of the team award categories.

A huge heartfelt thanks to all the 20 judges involved in this process. It takes a lot of time to read and rate each submission against the key criteria.

Many thanks to all of ALUCA’s sponsors who helped to make these Awards possible. A shout out to our platinum sponsors who each awarded one of the winners in a category.

A big thanks to our Awards committee who all worked tirelessly to ensure the night ran seamlessly.

Guest Speaker: Dr Harry Eeaman and Mc Dan Devine

Before the Awards presentations began we were privileged to hear from guest speaker Dr Harry Eeaman. Harry is a Rehabilitation Medicine Physician and a Specialist Pain Medicine Physician – who shared his inspiring and touching life story. He sustained a severe form of Guillain Barre Syndrome half-way through his training at University of Sydney as a medical student. He was hospitalised for 2 years, of which 5 months were in ICU.

The MC for the night was Dan Devine. Dan did an excellent job keeping the audience entertained and the award presentations moving along.

SAVE THE DATE ALUCA Life Insurance Excellence Awards Night 2020 – THURSDAY MAY 21st.
May 21st, 2020 – save the date in your diaries for ALUCA’s 2020 Life Insurance Excellence Awards night at Dockside, Darling Harbour. Nominations for all awards will open in November 2019.

ALUCA Life Insurance Excellence Awards Finalists & Winners, 2019

The award finalists and winners for each category are listed below.

Individual Awards

1 ALUCA Life Insurance Leadership Excellence Award
Andrew Correlje – MLC Life Insurance
Gary Oberg – MLC Life Insurance
Peter Tilocca – OnePathWINNER

2 ALUCA Life Insurance Claims Excellence Award
Michelle Byrne – CommInsure WINNER
Lisa Lowe – EMLife
Kristal Williams – MLC Life Insurance

3 ALUCA Life Insurance Underwriting Excellence Award
Scott Power – Zurich Australia Limited WINNER
Andrew Correlje – MLC Life Insurance
Gary Oberg – MLC Life Insurance

4 ALUCA Life Insurance Rehabilitation Excellence Award
Erin Beilby – AMP Limited
Melissa Colonna – MetLife WINNER
Curtis Guglielmana – Konekt Workcare
Vicki Ruskin – Thrive Re Consulting

5 ALUCA Excellence in Life Insurance Rising Star of the Year Award
Stephanie Doesburg – AMP Limited
Emily Plahuta – AMP Limited WINNER
Christopher Thompson – AMP Limited

6 ALUCA David Mico Excellence in Life Insurance Education Award
Tony Baker – Zurich Australia Limited WINNER
Paula Ramsay – MLC Life Insurance

7 ALUCA Life Insurance Excellence Volunteer Hero Award
Jennifer Jackson – CommInsure WINNER
Tony O’Leary – G&T Risk Management
Mary Sinclair-Porter – Zurich Australia Limited

TEAM AWARDS

8 ALUCA Life Insurance Excellence Underwriting Team of The Year Award
MetLife WINNER
MLC Life Insurance
Pacific Life Re
Zurich Australia Limited

9 ALUCA Life Insurance Excellence Claims Team of The Year Award
BT Financial Group JOINT WINNER
Zurich Australia Limited
MLC Life Insurance JOINT WINNER

10 ALUCA Life Insurance Excellence Team of The Year Award: Customer Service
EMLife Team
MLC Life Insurance Underwriting Team
AMP Limited Motivational Interactions TeamWINNER

11 ALUCA Life Insurance Excellence Team of The Year Award – Innovation
IPAR / AIA / SwissRe
MetLife
MLC Life Insurance –Mental Health Navigator – WINNER

This slideshow requires JavaScript.

Born At The Right Time

At ALUCA’s inaugural Life Insurance Excellence Awards night held at Darling Harbour in 2018 the guest speaker invited to open the night was Professor Ron McCallum. His armchair presentation was touching, inspiring and uplifting.

The feedback from his session was overwhelmingly positive and Ron shared with the audience that he was writing his memoir and would let us know the details of it and when it was being published. We are pleased to now share details of his book below.

How to win a copy of Ron’s Book: Born At The Right Time

Ron’s publisher has also very kindly provided us with 2 copies of his book to give away to 2 lucky members. The first 2 ALUCA members to email us with the answer to the below question @ secretariatofficer@aluca.com

  1. Q) In January 2011, Ron was appointed to an Emeritus Professorship at which Australian Law School?

BORN AT THE RIGHT TIME By Ron McCallum PUBLISHED: Monday, 1 JULY 2019

‘A brilliant man who often “saw” the needs of our world more clearly than the sighted people around him.’ ‐ The Hon Michael Kirby AC CMG Past Justice of the High Court of Australia

Ron McCallum has been blind from birth.  When he was a child, many blind people spent their lives making baskets in sheltered workshops, but Ron’s mother had  other ideas for her son. She insisted on treating him as normally as possible.

In this endearing memoir, Ron recounts his social awkwardness and physical mishaps, and shares his early fears that he might never manage to have a proper career, find love or become a parent. He has achieved all this and more, becoming a professor of law at a prestigious university in addition to chairing a committee at the United Nations.

Ron’s glass is always half full. He has taken advantage of every new assistive technology and is in awe of what is now available to him and other blind people to realise their potential. His is a life richly lived, by a man who remains open to all people from all walks of life.

 ‘Ron McCallum’s life story is both fascinating and inspiring.’ ‐ Julian Morrow, The Chaser

 Ron McCallum AO is Emeritus Professor of Law at the University of Sydney, the first ever totally blind person to be appointed to a full professorship at any university in Australia. He has been the chair of the United Nations Committee on the Rights of Persons with Disabilities in Geneva, has received a Centenary medal for his work and was the 2011 Senior Australian of the Year.

Book Published by Allen & Unwin CATEGORY: Non‐Fiction RRP: $29.99

 

 

Sub Group Updates – Winter 2019

WESTERN AUSTRALIA

This slideshow requires JavaScript.

ALUCA WA hosted our second event of the year in June and while everyone is busy in the lead up to EOFY it was nice to see so many members support our local seminars. Thank you to Katherine Matterson (Committee member) for providing the below update.

Jim Welsh, National Chair ALUCA was in attendance and provided updates from the National ALUCA committee. He encouraged all of us to seek accreditation so that we can all be seen as insurance professionals. ALUCA is committed to making significant investments to ensure ALUCA meets the educational and professional development needs of its members now and in the future.

Dr Paul Davis, CMO with RGA provided the audience with a very insightful presentation on Assessing Coronary Artery Disease Risk. Dr Davis took us on a historical tour of the rise of CVD as a cause of death and the tools used to predict risk of cardio vascular events. He challenged the audience to consider opportunities to classify the actual disease rather than risk of disease using the now readily available Cardiac CT for Calcium Scoring and presented some of his ideas on how this test might bring about improved outcomes for some customers and protect from those at risk clients that are not identified on traditional Exercise ECG testing. Thanks again Dr Davis and RGA for supporting us in the West and we look forward to seeing you again in the future.

Your committee now turns its attention towards our Mini-ALUCA planned for late August and the end of year event.  Please see our save the dates on the website for further details.

See you in August

Stephen Chapman
ALUCA Western Australia Chair


CMG ALUCA

This slideshow requires JavaScript.

Winter edition of RiskeBusiness already it seems like this year is flying along.  The ALUCA CMG held our first events across Sydney and Melbourne in early May 2019 with approximately 130 people attending these sessions. Our speakers this year were from Australian Financial Complaints Authority (AFCA) and HWL Ebsworth.

Andrew Weinmann from AFCA was interviewed by Dianna Comelli from the CMG committee and he gave the audience an insight into what has happened at AFCA since they replaced FOS/SCT/CIO in November 2018. Andrew spoke about the people that work at AFCA, what we can expect from AFCA and key findings since November.

Anyone interested in regular updates from AFCA can subscribe to AFCA News at afca.org.au under “News and outreach”

Our second session was entitled CMG news your trusted voice in the Laws of Life with Nicholas Matkovich and Diren Fernando from HWL Ebsworth Lawyers. They handed out a newspaper to the audience and presented the ‘Top stories’ impacting the industry.

We are currently planning our next session to be held in August which will see us looking at Financial assessments

Together with ALUCA NSW we are continuing to plan the NSW PD Day to be held in October 2019.

We look forward to seeing you at our future events in 2019.

Myles Kennedy
CMG ALUCA Chair


ALUCA NEW SOUTH WALES

This slideshow requires JavaScript.

For NSW’s first ALUCA event for the year we were joined by Dr Bill Monday from Pacific Life Re Australia with an insightful presentation on Underwriting Chronic Pain including mental health consequences of chronic pain and the present crisis of opiate abuse. There was a record breaking attendance of 100+ people for the event.  The session allowed us all to gain a greater understanding of chronic pain including areas to consider when assessing chronic pain, biopsychosocial aspects of chronic pain and the impacts of opioid use .

Thank you Dr Bill and Pacific Life Re. The presentation is available on the website in members only section. The session also saw our entire new committee working together to deliver this successful session.(photos below) Our next  ALUCA seminar will be in late August, watch the space for details. For those who like to plan ahead, ALUCA CMG and NSW committee are working together to deliver an excellent PD day on 16th October at Dockside, Darling Harbour.

See you all at our next event. In the meantime, enjoy our photos from the first event.

This slideshow requires JavaScript.

NSW Committee from L to R- Simon Andrew, Catherine McAdam, Tonja Nachman, Erin Touzell, Gabriela Siefert, Ami Barua, Jacqueline Little, Stephen Connolly, Lisa-Marie McKechnie

Regards

Ami Barua
ALUCA NSW Marketing & Comms Lead


ALUCA REHABILITATION GROUP

In May, the ALUCA Rehabilitation Subgroup held its first professional development seminars for the year across both Sydney and Melbourne. The Sydney event was hosted by Amlan Sharma (AMP) and the guest speaker was Dr Katie Di Marco, Consultant Psychiatrist. Dr Di Marco’s talk focused on optimising rehabilitation involvement in mental health claims – a psychiatrist’s perspective. Melbourne event was hosted by Joanna Else (MLC) and the guest speaker was Dr Richard Chambers, Clinical Psychologist. Dr Chambers presented on the science of mindfulness and its benefits in assisting with recovery from injury/illness. Dr Simon Rosenbaum, Exercise Physiologist & Honorary Fellow presented at both Sydney and Melbourne. Dr Rosenbaum’s talk focused on the latest research and benefits exercise physiology plays when an individual experiences different mental health conditions and how to establish motivation to continue with an exercise program leading to a recovery, wellness or return to work goal. Both events were a huge success thanks to our engaging and expert speakers. Feedback received from attendees was very positive.

The TPD working group also presented across Sydney and Melbourne on “extending the scope to include information pertinent to all stakeholders involved in Employability Assessments.” Thank you to Lena Kesoglou (KMPG) and Alicia Gibbs (Onepath), Eleni Katsoulis (MLC) and Michael Deville (AIA) for your insights for stakeholders involved in TPD employability assessments.

The ALUCA Rehabilitation Subgroup wish to congratulate our industry rehabilitation colleagues recently announced as winners and finalists at the inaugural ALUCA Life Insurance Excellence Awards. Melissa Colonna from Metlife won the Excellence in Rehabilitation Award, with Vicki Ruskin (Thrive Re), Curtis Guglielmana (Konekt Workcare) and Erin Beilby (AMP) announced as a finalists. Christopher Thompson (AMP) was announced as a finalist in the Rising Star category. Well done to all.

The ALUCA Board engaged Tony O’Leary to do a review of the ALUCA Competency Framework that was developed in 2017 to ensure it is consistent with changes in the industry. The Board were keen for the ALUCA Rehabilitation Subgroup members to review the revisions and in particular the competencies and frameworks for rehabilitation professionals within the industry. Both constructive and positive feedback were provided.

The ALUCA Rehabilitation Subgroup is currently preparing for its annual professional development days which will be held in both Sydney and Melbourne in September. Further details of these events will be available shortly.

Amlan Sharma
ALUCA Rehabilitation Group
Communications Lead


ALUCA VICTORIA

This slideshow requires JavaScript.

ALUCA VIC were delighted to welcome Jessica Cucchiaro from assessability to the TurksLegal offices at the Rialto building to deliver her insights  on maximising the value of employability assessments at our Lunch & Learn on Thursday 6th June 2019.

It was a packed room with a variety of attendees from across the insurance industry including Rehab Specialists, claims and Legal professionals. Our National Chair Jim Welsh warmed up the crowd with a quick update before Jessica jumped right in to her very comprehensive presentation to assist insurance professionals with understanding the importance of an employability assessments (EA), the role it places within a claims decision, when an EA should be requested, what information should be provided to maximise the quality of the report, key factors to consider and alternative options to an EA.  Jessica touched on her experiences at Court defending EA’s which demonstrated how valuable an EA can be when used correctly but also how damaging they can be if poorly instructed or utilised incorrectly.

If you were unable to make this session, please refer to the ALUCA website to obtain a copy of Jessica’s very informative slides.

With event number two now under our belts we are focusing on miniALUCA.  This will take place on Thursday 17th October at RACV.  We will issue further details nearer the time although we can share that we have already locked in some amazing speakers.  We look forward to seeing you then but in the meantime stay warm!!

Regards,

Suzanne Whyte
ALUCA VICTORIA CHAIR


ALUCA QUEENSLAND

Greetings from the warm winter shores of ALUCA QLD.

We’re currently gearing up for our next seminar, to be held as a breakfast session, on July 24th.

We’re very fortunate to have SCOR’s Chief Medical Officer, Dr Zeshan Shaikh, presenting an update in relation to drug use. This session will specifically cover recreational and illicit drug use, medicinal marijuana and the challenge it brings to our industry.

Dr Shaikh has 12 years of clinical experience with a special interest in occupational medicine. He has worked in the insurance industry, across both General and Life insurance for the past seven years, and is equipped with an abundance of knowledge of both clinical and insurance medicine.  Zeshan joined SCOR in November 2016.

Please also mark your diaries for September 12th, when we will hold our Triple Treat seminar. More details to follow.

Jody O’Sullivan
ALUCA QUEENSLAND SECRETARY


ALUCA SOUTH AUSTRALIA

Our first seminar we had of the year Dr John Cummins from SCOR presented to a small group by comparison to other states but a good turnout for us on the Transformation of Medicine where it’s been and where is going. Our big event for the year and one not to be missed is our MinALUCA to be held on the 6th September with 3 fantastic speakers Paul Pers who will talk about Blame, Shame & complain, Nic Linke to discuss some of the legal challenges we face today and Quentin Malone to talk about all things Neurology.

Ashley Hicks
ALUCA South Australia – Chair

 

Evidence Alert: Risk of Psychiatric Co-Morbidity

Evidence Alert: Risk of Psychiatric Co-Morbidity

Diagnosed psychiatric conditions are common, with an estimated 20% of Australians aged 16-85 years old experiencing a mental health disorder in a given year. They are also associated with high levels of disability (the WHO now lists depression as the leading cause of disability in the world).

Assessing the risk associated with diagnosis of a past psychiatric condition in an individual is challenging but important. There are lots of factors to consider (personal, diagnosis related, and environmental factors). Some of the diagnosis related factors include: what the diagnosis was; its severity; treatment; risk of recurrence; and risk of psychiatric co-morbidity (or the development or later diagnosis of another psychiatric condition).

In January this year there was a fascinating and important study [1] published in JAMA Psychiatry, one that should be read by anyone in life underwriting or claims.

Importantly, the study found that if a patient was diagnosed with any prior mental health disorder, they were seemingly at risk for development of any other class of mental health disorder at a later stage. This risk was highest within the first year following the initial diagnosis (probably representing initial diagnostic uncertainty), but then remained elevated for the next 15 years.

The study also adds evidence to the shared factors model of mental health disorder development or pathogenesis. This model that proposes there are shared genetic and environmental risk factors underlying all mental health disorders.

The strengths of the study were its size (5.9 million Danish people) and the duration of follow up (up to 17 years of follow up for individuals, and 83 million years of follow up in aggregate). The researchers also grouped diagnoses by their ICD10 codes and looked at diagnostic clusters such as substance use disorders, eating disorders, mood disorders and personality disorders. To me, one of the major strengths of the study was that the researchers made their findings available to the public, and used an amazing data visualisation tool to let the public explore the methodology, the results, and conclusions.

The website to explore the study and findings is here:

https://holtzyan.shinyapps.io/the-nb-como-project/

It is worth time to work through the site, as it explains several core features of the study and their results really well. You can easily select a prior mental health disorder and see how the risk for other groups of mental health disorder changes over time.

A few considerations to note when interpreting the study: the subjects in the study were recruited from hospitals (either in-patients, out-patients, or from the emergency room). Many studies on mental health disorders recruit patients from hospitals, and it this probably means the subjects studied have a more severe mental health disorder than most. The researcher indicate they intend to consider people assessed and treated by their GPs in further work, the information from this study will be very interesting.

  1. Plana-Ripoll, O., et al., Exploring Comorbidity Within Mental Disorders Among a Danish National Population. JAMA Psychiatry, 2019.

 Dr Matthew Paul is an occupational physician with 20 years of clinical experience, and an interest in occupational disability and risk assessment. Working as CMO for Munich Re.

5 minutes with Samantha Norton, Executive General Manager, MLCOA

In this ReB edition we spend 5 minutes with Samantha Norton, Executive General Manager at mlcoa. 

mlcoa is part of the MedHealth Group.  MedHealth has grown to be Australia’s largest provider of independent medical advisory services. MedHealth’s expertise spans all major medical specialties and allied health disciplines, plus rich experience in all Australia personal injury, disability, health and employment schemes. It works with insurers, Government, lawyers, employers and other stakeholders.

Samantha Norton, Executive General Manager, mlcoa. She has over 20 years’ experience in the health industry in Australia and the UK. Sam is a qualified Pharmacist specialising in oncology before progressing into an Executive role for the Care Quality Commission UK responsible for the regulation of the quality and safety of care offered by healthcare within the UK. Sam then moved to Australia where she worked as a Senior Executive for the Health Quality and Complaints Commission (former HQCC) now Health Ombudsmen in QLD.



A day in the life of Samantha Norton is…….  
I am an early riser at 5:00am, I feed and rug my horses, buy a coffee and commute to the office by train to start my day. I was once told that in this job no two days are ever the same and I can say that this is very true! Most of my day consists of communication including meetings, seminars, emails, lots of phone calls, always making time in my day to chat to staff and clients. I also spend a lot of time talking to our doctors which is always interesting. I leave the office around 6-7pm most days and travel home to feed my horses.

How and why did you get into a career at MedHealth/mlcoa…. I have been working for MedHealth/mlcoa for just over 6 years, previously I worked for the Queensland Government as a senior executive. Initially I commenced at mlcoa as the General Manager for Queensland – the role interested me as I was looking for a challenge, I also wanted to diversify my skill set and broaden my exposure to other industries.

The biggest challenge for you at mlcoa is…. WOW! This a hard one as each day brings different challenges. If I had to pick one I would say trying to continuously reprioritise my tasks for the day, in the medico-legal business there are always new products or services being developed and operationalised which keeps me busy! I also try and remember to fit lunch into my schedule.

What most excites you about being a services provider in Australian Life insurance… I believe that now is the time for change and this gives mlcoa a great opportunity to partner with our Life insurance clients; listen to their challenges and work closely to reengineer the way mlcoa’s diverse capabilities are made available to support a better future for the life sector. We understand the need for customer centricity with the requirement of fast and fair decision making and transparency.

What excites you the most about mlcoa… the uniqueness and pace of the business, the endearing culture, the passion and commitment of the staff to ensure each of our clients receives the best customer experience.

Four words to describe the culture at mlcoa…. Passionate, innovative, loyal and hardworking (plus one for luck ….caring).

Four words to describe you… Passionate, thoughtful, ambitious, humorous.

Most passionate about….  Doing anything I do well. And being the greatest supporter of my daughter in her quest to be in the QLD dressage squad and ultimately represent Australia. I am also passionate about providing guidance and support to my son in completing his Chiropractic degree.

What most annoys you…..  Delays on my commute to work and not finding a car park at Woolworths!

A little-known fact about you that not many people know… I worked for 15 years as a medical trainer for an international airline.

What makes your job interesting… the diversity of work, the range of clients we provide services to, the amazing staff and of course our expert panel of specialists.

Who has been the biggest influence on your career and why… I am inspired by Richard Branson who in the face of adversity became a business magnate and entrepreneur. One of his quotes is my mantra: “Clients do not come first. Employees come first. If you take care of your employees they will take care of the clients.”

Your proudest career achievement to date is….. I have always followed my passion; each career move I have made has resulted in achievements big and small and I am proud of every single one of them.

5 years from now mlcoa will be… utilising the breadth and depth of all the MedHealth brands and our partners to be an industry disrupter, delivering innovative solutions to the life insurance industry.

Your best advice for young life insurance professionals looking to work in a medical advisory business…… Do what you do well. Be true to yourself, your ideas and focusing on the essentials.

If you were Chair of ALUCA, name one thing that you would love to do … Ensure that we don’t lose sight of the purpose of the life insurance industry which is to look after people in their time of need.

 

Business Expenses Insurance – What is Actually Covered?

Business Expenses Insurance – What is Actually Covered?

Business Expenses Insurance is an important offering provided by several insurers in the Australia market.  The purpose of Business Expenses Insurance is to assist our client’s that are Business Owner’s with meeting the daily running costs of their business, if they’re unable to work due to sickness or injury.

Using the employment measure of small business, there were 2,065,523 small businesses in Australia employing less than 19 people, accounting for 97 per cent of all Australian businesses by employee size (1). Businesses are stressful enough to run as is – but the financial ramifications on a business if an owner is rendered unable to work due to sickness or injury could be significant.

While the type of Business Expenses cover available in the market varies slightly, the fundamental nature of the product is to assist business owner’s with meeting the operating expenses of their business if they’re unable to work due to sickness or injury – up to the sum insured.

So what expenses are covered under a Business Expenses Insurance policy?

“Eligible expenses” that are covered are the Regular operating expenses of the business. Common examples are below:

  • Accounting and audit fees.
  • Electricity, gas, heating, water, telephone and cleaning costs.
  • Security costs.
  • Rent, property rates and taxes.
  • Membership fees, publications and subscriptions to professional
  • Leasing costs of plant and equipment.
  • Bank charges, interest on business loans.
  • Salaries and other related costs for non-income generating employees of the Life Insured’s business.

As you can see, the expenses listed above are all ongoing business costs.

On the flipside, examples of costs that are not covered are as follows:

  • Salaries and other related costs for the Life Insured and income generating employees of the Life Insured’s business.
  • Commissions or bonuses payable to the Life Insured.
  • Repayments of principal of any loan or other finance agreement
  • Any costs of a capital nature including the cost of any equipment, fittings, fixtures, furniture goods, implements, merchandise or stock
  • Depreciation
  • Losses on investments
  • Non-Cash Expenses i.e. Amortisation, Bad Debts etc

The common themes in the above examples are the exclusion of liability repayments, asset purchases, private expenditure & “one-off” type expenses.

Income generating Vs Non-Income Generating Employees

You will note that employee costs are classed as income generating and non-income generating within the policy documents of insurance firms.

Income generating staff are qualified & specially skilled staff who’s personal exertion contributes DIRECTLY towards income of the business e.g. lawyers, accountants, builders. Their costs are NOT eligible expenses. Whereas Non-income generating staff are non-qualified staff who’s personal exertion cannot DIRECTLY contribute towards income of the income of the business e.g. admin staff, receptionist, bookkeeper etc. Their costs are eligible expenses.

The rationale behind this is “Income producing staff” are able to generate income to cover their associated costs. Whereas non-income producing staff do not have the skills or qualification to contribute to the generation of business income to cover their associated costs.

In the above example of Ho’s Lawyer’s, the Legal staff are deemed to have the skills and knowledge to sign off and at least contribute to the earning of legal services income. Their salary and superannuation costs are deemed ineligible as per a Business Expenses Policy. Whereas the Practise manager, Bookkeeper & Cleaner are not qualified lawyers, nor have the legal skills and knowledge to contribute to the earning of legal services income. Their salary and superannuation costs are deemed eligible.

Calculating the Benefit Payable

Now that you are of the Eligible vs ineligible expenses of a business policy, let’s take a look at the assessment for Ho Lawyer’s for February 2019:

Ho Lawyer’s Pty Ltd
Business Expenses Claim
Profit/Loss statement for period 1/2/19 to 28/2/19
Account Eligible Not Eligible Notes
Accounting fees  $            1,000.00 business accounts
bank fees  $               200.00 business bank
loan repayments  $         6,000.00 repayment of liability
Private Expenditure  $         1,500.00 private – not business
Depreciation  $         2,100.00 non-cash expense
Rent  $            1,100.00 business premises
Purchase of Vehicle  $       18,000.00 capital (one-off) acquisition
Motor vehicle expenses  $               450.00 all business driving
Loss on sale of assets  $         8,000.00 non-cash expense
Wages  $            4,500.00  $       24,000.00 refer to payroll report
Superannuation  $               427.50  $         2,280.00 refer to payroll report
Bad debts  $            250.00 non-cash expense
GST paid  $         3,000.00 payment of liability to ATO
Sub Total  $            7,677.50
Sum Insured  $          15,000.00
Amount Payable  $            7,677.50

Ho’s Lawyer’s incurred $7,677.50 worth of eligible expenses for the period 1/2/19 to 28/2/19. Noting a Sum Insured of $15,000 per month, the amount payable to Mr Ho would be $7,677.50. Please note: some companies may apply offset’s where applicable.

Business expenses Insurance, at its core, is the promise of financial support at a time of disablement for a life insured that owns a business.  To determine the appropriate levels of cover or potential benefit payable, our clients really need to have a good understanding of the level of operating expenses they incur and how a period of disablement would affect their ability to meet these ongoing expenses.

Business owners are the heartbeat of our economy, and life insurers recognise the level of financial stress involved with running a business. The Business Expenses Insurance product exists to support business owner’s with covering their ongoing operating costs which will enable the business to stay afloat whilst a claimant is disabled so they can focus on getting themselves fit, healthy and ready to get back into running a successful business.

References:


Jason Noyahr is a degree qualified, chartered accountant with over 7 years’ experience. He started his career in a public sector accounting firm, moving on from his role of 5 years as a Senior Taxation Accountant, into the Life Insurance industry with AIA.

Since commencing with AIA in March 2017, Jason has been working as the Financial Specialist within the Retail Claims team, assisting the Claims department and other departments within AIA with the analysis & interpretation of financials, Forensic Accounting investigations and also being involved in the assessment of claims.

Ph: (03) 9009 4592 – Email: jason.noyahr@aia.com

 

 

ICLAM Mumbai 2019

Visit us @  www.iclammumbai2019.org

ICLAM is back to Asia!

The ICLAM (International Committee for Insurance Medicine) Congresses have become the international benchmark for congress aimed at scientific training, interactive discussion and networking on topics related to risk underwriting, claims assessment & medical trends and its significant to Life/Health/Disability insurance.

ICLAM has a very rich history over 100 years.

ICLAM 2019 will be only the second time that ICLAM will be coming to Asia (after a long gap of 32 years).

KEY SESSION FORMATS: https://www.iclammumbai2019.org/scientific-programme

ICLAM 2019 will bring many diverse formats of sharing knowledge via the Scientific Program

A. Preconference Workshops: 2 Masterclass workshops will be held with limited number of registrations to enable focused discussions and case studies.

Option 1: “Genetics and Genomics”: We will cover the advances & potential impact of Genetics and Genomics on the Life and Health insurance industry. Key technological breakthroughs (Liquid Biopsies, SNPs, Whole Genome Sequencing, CRISPR), Types of genetic testing (where, why and when are they used?), and general view of regulation and restrictions by various jurisdictions will be discussed with help of case studies.

Option 2: “Histopathology interpretation made easy- Every detail matters”:  Underwriting an applicant with cancer or assessment of CI claim of cancer requires up-to-date insight about the microscopic features of the underlying condition. In our day to day work, we seldom get a chance to brush upon our knowledge regarding the interpretation of Histopathology Reports. This interactive workshop is aimed at offering a bird’s-eye view on histopathology, starting with basics to a comprehensive updated review of few cancers followed by relevant case studies.

B. Concurrent Sessions: As part of the scientific program, Concurrent sessions with specialized themes like Cancer, Diabetes, Cardiovascular Diseases will be conducted to provide practical solutions to technical topics.

C. Technology Session: ICLAM Mumbai 2019 and The Digital Insurer are collaborating to deliver concurrent sessions on how InsurTech is changing the medical, underwriting and claims disciplines in the insurance industry. Each session will follow a fast-paced panel format where panellists deliver short mini-presentations allowing time to leverage the collective experience of both the panellists and audience in the room in an open floor Q&A

D. Satellite Sessions: The satellite programme will be provided by the where expert speakers from our main sponsors will address the “translation” of theory into practice. Topics like Mental Health, Disability and Health insurance will be covered.

E. Plenary Sessions: ICLAM Mumbai 2019 has invited speakers from all over the world to address on key topics relevant to Life & Health insurance industry. Some key speakers and their topics include

  1. Al Klein, Principal and Consulting Actuary, Milliman USA- Long Term Drivers of Mortality and Morbidity
  2. Eric Raymond and Maneul Plisson, SCOR- Cure for cancer: how far are we and how would it change insurance?
  3. Ronald Klein, Director, Global Ageing, Geneva Association, Genetic Regulations vs Direct to Consumer Genetics Test – What does the future hold?“
  4. Dr Kumar Prabash, Senior Medical Oncologist, Tata Memorial Hospital, Clinical Medicine- An Insiders’ view on Liquid Biopsy and Immunotherapy: Hype or Hope for the next decade
  5. Derek Yach, former World Health Organization (WHO) cabinet director and currently President of Foundation for a Smoke Free World- Smoking Harm Reduction: The myths vs facts and how it matters to insurers
  6. Prof Matthieu Allez, Hospital Saint-Louis, Paris, Dpt. Gastroenterology & Hepatology- Looking into Future of IBD (Inflammatory Bowel Disease)
  7. Dr Andreas Armuss, Chief Medical Officer (Asia Pacific, Middle East and Africa), Munich Re- Advances in Cancer Diagnosis and Treatment: What does all mean for Underwriting and Claims (CI/DI)?
  8. Takesumi Yoshimura, Director, Emergency Life-Saving Technique Academy of Kyushu- Radiation and its impact on Cancer- What we can learn from Japan about the long-term impact of cosmic ray and radiation exposure on cancer?
  9. Dr Yash Lokhandwala, Cardiologist and Electrophysiologist- Risk Stratifying Asymptomatic Arrythmias
  10. Dr Paul Davis, Chief Medical Officer,RGA Australia- 4th Universal Definition of Myocardial Infarction and its impact on insurers
  11. Lawerence Tsui, Director of Life & Health Products, Swiss Re- Cancer Only Product experience around the globe!
  12. Dr John O’brien, Life/Health Chief Medical Officer, London- Sweetening the deal- Products for Diabetics and its experience

WHATS IN IT FOR ME?

The Audiences: The ICLAM Congresses traditionally bring together over 300-400 insurance doctors, underwriters, claim evaluators and actuaries in scientific debate and social activities. ICLAM Mumbai 2019 will bring in a large audience from India and various countries in the East (South East and Far East), Australasia, Europe and Americas.

The academic event:  By being part of this one event, the audience will be able to engage with the experts across the region on the most relevant topics in an interactive manner.

The social events:  While we all love intellectually stimulating discussions, there is no harm in having some fun along with it. The social events we plan will bring everyone together to highlight the culture and food of different regions and make this event a memorable one for all participants and their partners.

Is ICLAM accepting any Abstracts/Essays?

Thinking creatively and out of the box are attributes that are essential for the creation of world-class companies. A culture encouraging Original research will inspire, solutions been identified for day-to-day challenges as well as broader issues faced by the insurance industry

With an aim to encourage original and scientific thinking, ICLAM 2019 invites Abstracts/Essay papers from Insurance and related institutions/ organizations. Submission deadline is August 15 2019. Abstracts may only be submitted online: www.iclammumbai2019.org

There will be two prize winning Abstracts and one Essay paper winner.  The winners will be declared in September 2019 and will be allocated a slot for presentation

The First prize Abstract winner will be eligible for free registration for the ICLAM 2022 which will be held at an International location (to be announced at ICLAM Mumbai 2019)

We look forward to your participation in this premier industry event, and to welcoming you in Mumbai in 2019.

Dr. Himanshu Bhatia                                                               Dr. Detloff Rump

President, ICLAM Mumbai 2019                                             President, ICLAM

www.iclammumbai2019.org                                                  www.iclam.org