AIG Medical

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AIG Medical Rehabilitation Ltd Protection of
Human Assets.
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Rehabilitation - the insurers view...

• The cost of bodily injury claims rose by 117
  between 1992 and 2000
• Payments by reinsurers on bodily injury claims
  above 250,000 increased by more than 20 p.a.
• Legal costs for auto claims are around 1 Billion
  p.a.
• The Court of Appeal increased general damages for
  claims over 10,000
• No Win No Fee
• The cost rises above the rate of inflation

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Rehabilitation - the insurers view...

• Rehabilitation returns people to work quicker,
  healthier and in a managed way
• It reduces loss of earnings claims
• It reduces the time a file is open by promoting
  early resolution
• It promotes a less adversarial attitude and
  reduces legal costs
• It is a benefit that an employer can deliver
• It is welcomed and appreciated by the vast
  majority of claimants
• Its good for them Its good for you
• It should not be an option

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Rehabilitation - the rehabilitation expert view...

• More than saving insurers money
• More than support to the litigation process
• More than support to EL motor
• Wider concept of support to PL, PHI and
  occupational health services
• Benefits to individuals, their families society
  as a whole
• Alleviates the benefits NHS system thus our
  tax burden
• Better for employers as well as their employees

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Rehabilitation - the concept...

• Early intervention
• Co-ordination of treatment and reintegration
• Individually tailored non-adversarial
• An advocate for the individual
• Managing the best most cost effective means to
  reintegration back to health and employment
• Early safe return to graduated or full-time
  employment

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Rehabilitation - the process
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Medical Case Management

• To assess a clients medical status through
  liaison with their treating practitioners
• To arrange private treatment on a cost effective
  basis, as appropriate
• To work with all key parties involved in the case
  management process, to ensure a timely and safe
  return to work
• To identify cases suitable for vocational
  intervention

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The Medical Case Manager

• Medically qualified with experience of working in
  a primary or acute healthcare setting
• Has the ability to interpret medical information
  and implement appropriate treatment plans
• Is able to liaise effectively with health
  professionals, injured clients and their employer
  or future employer, as well as their
  representatives
• Acts as the point of contact for employers
  employees

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Vocational Consultancy

• To provide an opportunity for clients to return
  to work without exacerbating their condition
• Aims to understand the needs of both injured
  party and employer
• Carries out Vocational Assessments, Job Analysis
  and organises Graduated Employment Programmes
• Monitors the client as they return to work
• Investigates re-training and redeployment options

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The Vocational Consultant

• Has experience of working with people with
  disabilities in employment settings
• Aware of issues concerning physical disabilities,
  learning difficulties, mental health issues and
  sensory disabilities
• Aware of available private services and public
  funded opportunities
• Find employment solutions through creative
  thinking
• Is able to effectively liaise with solicitors,
  employers and clients in a variety of work
  settings

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Case Management how it works

• Case detail 38 yrs male, Depot Supervisor
  (Parcel Carrier firm)
• Nature of injury/absence Knee injury following a
  fall from a tail lift of a lorry
• Salary 16,500
• Affects on ability to work Depot had closed
  down, lived in a rural area with few job
  prospects
• Intervention
• The Case Manager was notified 2 years following
  the injury so we had lost the edge in relation to
  giving significant improvement to his physical
  condition.
• With the IP solicitor, VC worked with the IP to
  develop his work skills and established jobs that
  were available locally. IP undertook IT training
  and began applying for jobs with the help of the
  VC.
• 2 work trials were organised by the VC as tasters
  to see if he would like the work be able to
  sustain it.
• VC persuaded the insurer to fund a car for the IP
  to travel to work (as the jobs were 16 miles from
  his home with no public transport).
• Outcome IP secured a factory job as a
  supervisor with minimal physical constraints,
  therefore returning to work on a full time basis
  after 2.5 yrs (only 10 of people do that).
• Costs were 2,600 excluding the cost of the car.
• Potential future loss of earnings c275k
• Claim was settled for 32k.

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Case Management how it works

• Case detail 34 yrs male, Cargo Operative
• Nature of injury/absence Crush injury / trapped
  btw vehicles
• Salary 19,800
• Affects on ability to work Unable to undertake
  his current role due to highly physical
  nature of the job.
• Intervention
• The Case Manager was notified a month following
  the injury and organised extensive private
  treatment. IP returned to work on restricted
  duties (clerical) whilst physiotherapy continued,
  but went off sick again 6 weeks later referred
  to the vocational team.
• VC carried out a job analysis of both the
  temporary clerical position the original role
  (as employer would only accommodate the original
  role on an ongoing basis).
• Medical validation was sought with regard to his
  abilities to return to the original role this
  was confirmed as perhaps achievable on a
  graduated return programme. This was then agreed
  with the employer.
• Regular meetings were held both during and after
  the graduated programme was introduced, to ensure
  that the IP was managing safely.
• Outcome Returned to work on a full time basis.
• Costs were 12,700 including treatment (60)
• Potential future loss of earnings c400k.
• No claim was submitted.

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Case Management how it works

• Case detail Human Resources Manager
• Nature of injury/absence Suffering stress
  depression relating to his job
• Salary 30,000
• Affects on ability to work Taking frequent
  periods of sickness due to not being able to
  cope with the job
• Intervention
• A Case Manager ascertained that the employee was
  already receiving adequate medication and
  counselling under care of their GP, on NHS
• A Vocational Consultant provided the employer
  with advice regarding mental health issues.
• A graduated return to work programme was
  formulated to welcome the employee back to work
• Outcome No claim was submitted by the employee,
  as he returned to work on a full time basis
  after the graduated programme was complete.
• Costs were 3,520.

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Case Management how it works

• Case detail Chef
• Nature of injury/absence Suffered a considerable
  back and shoulder injury after an unstable
  load fell on her
• Salary 23,000 overtime
• Affects on ability to work Unable to return to
  work due to the extent of her injuries
• Intervention
• The Case Manager arranged private treatment but
  employee has suffered a permanent disability.
• A Vocational Consultant worked with the IP and
  her employer to adjust the original job but this
  proved impractical.
• Assistance was provided to the employer to
  identify an alternative role.
• The Case Manager sought medical validation that
  an identified alternative job was physically
  suitable for the IP.
• Outcome IP secured a supervisory role within
  the same company at a different site to
  accommodate her physical abilities /
  restrictions, so she returning to work on a
  full time basis.
• Costs were 15,800.
• Potential future loss of earnings c750k.
• Claim was settled for 33k.

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The rehabilitation gap
Association of British Insurers 2003, in its
support for a national policy on rehabilitation
states that Rehabilitation can avoid the loss
of the economic contribution by otherwise
productive employees and members of society, and
the associated erosion in the national skills
base. Early and appropriate intervention would
benefit the nation by reducing dependency.
Dept of Work Pensions (DWP) is committed to the
concept of increasing access to rehabilitation,
to improve outcomes for employees and thus reduce
absence from work. Nicholas Brown, Minister of
State for Work,DWP. 2003
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The cost of sickness absence

• Costs to employers of 450 - 550 per employee
  head
• 200m days per annum are lost due to sickness
  absence
• 30m due to stress
• 33m due to work-related accidents
• Work Foundation absence rates increased by
  2.9 4.12 in 01 02 respectively
• Average of 9 days absence per employee head
• Best performing companies 3.5 days per annum
• Worst performing companies 14 days per annum
• Uninsured hidden and direct costs 81 - 361 in
  lost production, cover inefficiency equating to
  11billion per annum (CBI)

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The Financial Benefits

• Early effective medical intervention impacts on
  average claim costs by over 20
• Client comparison
• rehabilitation v non-rehabilitation client
• Claim costs 2631 v 5067
• Claim file comparison of 30,000 PI claims
• rehabilitation v non-rehabilitation settled
  claims
• 5400 v 6850

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Rehabilitation the benefits

• To the ill or injured Employee.
• Rapid access to a quality range of care not
  always available through the NHS
• Reduced waiting time for appointments treatment
• Support and advice during their illness
  recovery period
• Opportunity for an early graduated safe return
  to work
• Minimises concern with regard to personal
  finances job prospects

• To the Employer.
• Reduces both the hidden and direct costs of
  absence inefficiency
• Improves employee relations reduces the absence
  culture
• Facilitates health at work minimises health
  risks in the workplace
• Allows for an employee to be monitored following
  their return to work
• Improves union employee relations support

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Prevention is better than cure.

• Pre-employment screening
• Routine screening services (eg Alcohol and Drugs
  of Abuse)
• Health Surveillance
• Absence Management
• Mental well being programmes
• Stress management awareness training (managers,
  staff)
• EEC Compliance working time directive
• Manual handling training

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AIG Medical Rehabilitation Ltd Protection of
Human Assets.