Insurers need to investigate every possible avenue to find out the root causes of why employees have fallen out of work before they can identify them as ‘gaming the system’, according to Matthew Smith, rehabilitation team manager at Aviva.
Smith also highlighted that a range of factors could be responsible for long-term sickness and that employees should not be labelled as good or bad.
Speaking at the Association of British Insurers (ABI) Keeping Britain Working conference, Smith was asked how insurers can share intelligence to ensure good customers who deserve cover are not impeded by those trying to game the system.
Smith said: “You’ve got to ask the question, why are you defining them as a bad person and how did I get there?
“Look at the person as a whole. Is it because they’ve fallen out with their boss at work and they don’t want to go back to that job?
“Is it because they’ve not got the treatment? Is it because they have ingrained pain behaviours that they need to learn more about and manage that pain?”
Not good egg versus bad egg
Smith maintained that assessing an employee’s fitness to work is broader than “bad egg” and “good egg”.
“We need to dig down on an individual basis on every case as to why that’s happening,” Smith continued.
“How I look at it is, is there something I can do to help that? Is there something I can do to turn this person around?”
While not blind to the fact some will try to game the system, Smith said insurers needed to go through every possible avenue to help workers as they run the risk of “missing the boat” in intervening early where someone has not been in work for years due to a bad back for example.
“So can we help them early? Can we stop these behaviours becoming ingrained?” he concluded.
