Published by Dan Johnson on July 15th, 2020

One of the lessons we have all learned in 2020 is how quickly the world can change. On top of that, as an insurance company, we’re learning how important it is to stay on top of those changes. The insurance industry isn’t known for being the fastest to react to new trends, but more and more we’re learning that we need to be.

Trustmark’s work with our Trustmark Critical HealthEvents® product has been the “proof in the pudding” for us. This innovative product was introduced in 2015 and featured many new concepts designed to enhance customer satisfaction.  Now here in 2020, after several years of gathering results, we are seeing solid evidence of the positive changes the product has made.

For example, prior to 2015, the critical illness marketplace saw many claims that were being denied. A prominent study found that as many as 1 in 3 critical illness claims in the industry were being denied.1

So, what did we do? We adapted our product. In doing so, we have seen our denial rate steadily drop year over year, with 2019 ending up at 6%. This means we’re paying 94% of claims that we receive which ultimately means better protection and greater satisfaction for our customers.

What did we do to change? We listened.



Listening to trends in the industry

  • In the early stages of developing our product we looked at the trends in the industry. We looked at our own claims experience and reworked our product to focus more heavily on the most-experienced conditions: cancer, heart attack and stroke. This focus on recognizable and more common conditions means less confusion about what is covered and what is not.
Listening to the voice of the customer
  • The most important step for us was conducting research with actual customers. The voice of the customer is at the heart of everything we do at Trustmark and, from our customers, we learned that separation periods were confusing and that early-stage or less severe diagnoses were often misunderstood in regard to benefit payments. We would hear clients say things like, “My doctor said I had a stroke, so why is there no benefit payable until I’ve been impaired for 30 days?” With that in mind, we developed our product with a replenishing annual benefit to eliminate separation periods and we added benefits for early-stage diagnoses.
Listening to trends the medical field
  • Insurance isn’t medicine; that’s not a particularly profound or revealing statement, but it’s worth noting because we found that the way insurance treats a critical illness didn’t necessarily match the ever-changing views and treatment protocols in the field of medicine. Many claim denials were a result of the treatment from a medical doctor and the language in the contract being out of sync. So, we simplified our language, and we relied on input from medical experts with today’s treatments and procedures in mind. Many critical illness contracts in the marketplace were written in the early 90s and have not been kept current with the rapid advancements in medical science. How we treat heart attacks and strokes is completely different than it was 25 years ago. We now focus our benefits on current diagnoses and modern treatment practices to make sure policyholders are protected.
More than the methods we used, the most important piece in all of this is that we feel we’re delivering better protection to our customers. Where the industry average is denial of 1 in 3 claims, we’re only denying roughly 1 in 16.

For those of us in the industry, it’s a reminder of the importance to listen, to observe the trends in the industry and to adapt. Doing so can make a difference for policyholders and ultimately for their families and their employers as well.  It also means less noise for Insurance brokers and consultants and employers offering these plans. Claims denials can create noise that the HR team and the broker don’t want to deal with on top of all the other things they have come across their desks daily. As I mentioned at the top, keeping up with trends and adapting is more important today than ever. Let’s keep pushing the envelope to provide the protection that employees and families need.
 
1 Gen Re. U.S. Critical Illness Insurance Market Survey. 2013/2014.