Fraud is real, that's why we underwrite, verify, and investigate, and most clients want us to
A journalists' view of occupational rating

Breaking trust, one answer at a time

There is a way of thinking that means most humans when asked a question we don't know the answer to, will supply out of our store of related knowledge, a comment pertaining to the subject that we do know or understand. This heuristic, while generally useful, can cause trouble sometimes. Consider the following, deliberately simplified example:

Client: will this policy pay out for [weird syndrome]?

Adviser: this trauma contract covers the most extensive list of conditions available, and has the back-up of a good total and permanent disablement benefit.

Client: I'm just really concerned about this disease, it runs in my family you see

Adviser: you can check the policy document, and also the claims paying reputation of this company is excellent

Client: so this will cover me?

Adviser: certainly [weird syndrome] is not listed in the exclusions

A typical client may have felt that the answer to the question was yes. The adviser may have felt that they were as helpful as they could be without more detailed information to hand. But no real communication is happening here. What happens if there is a claim for [weird syndrome] a year later which is declined for some unanticipated reason? How will the client remember that conversation? They might look back and think, with judgment clouded by hindsight, 'that adviser knew they wouldn't pay out' which is a dark and scary place to be starting a complaint with the dispute resolution body. The unthinking approach to 'tell them what you know' looks more and more like deliberate evasion. Focusing on what the customer is actually saying is a skill, to do it we have to overcome some environmental programming. It takes work, but it is the work professionals do. All it requires is the honesty to add, during that process above "I don't know the answer to that question directly, I will write it down and ensure that I have clarified that point for you before we proceed, what I can tell you in the meantime is..." plus, of course, actually delivering on the promise. Because that is also what professionals do.


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