We are proud to announce the launch of 7 Claims Stories, a pioneering project led by industry expert Phil Deacon, who brings a wealth of experience from his previous roles. This initiative aims to shine a light on the income protection claims process to Drive Change for Better Outcomes. We hope you find these stories useful. We will add each story as it’s published.
“7 Claims Stories is a collaborative effort designed to share insights, educate, and create actionable strategies that could improve claims payout rates, enhance customer perceptions, and reduce both misrepresentation and processing times. By drawing on real-world examples and the expertise of claims experts within IPTF members, the project will try to understand what a seamless and supportive claims journey for consumers and advisers should look like.”
Phil Deacon
Story 4 - Demystifying Income Protection Calculations
Ask any Income Protection Claims Assessor what their least favourite part of the job is, and most will say the same thing – financially assessing! It seems to be the one thing that causes most difficulty. Judging from my years spent in Claims, this appears to be the case for advisers too, with many being unsure about what income to base cover on, how pay-outs will be calculated at claims stage, and what financial information is needed to evidence income. Indeed, we’ve had several advisers ask that we specifically cover this topic as part of our 7 Claims Stories project – and we do like to oblige.
We’ve split this Story 4 – Demystifying Income Protection Calculations into 3 parts to properly explore and understand each aspect: Calculating accurately how much cover an IP applicant needs, Understanding the Calculation used at Claim and Returning to Work – Proportionate Benefit. To bring these subjects to life, Vicky Churcher, Executive Director at the IPTF asked Tom Salmon, Senior claims Assessor at Pacific Life Re to share his thoughts.
Story 3 - Misrepresentation Matters
Story 3 in our 7 Claims Stories series, Misrepresentation Matters, takes a deep dive into one of the most common – and costly – reasons income protection claims are declined: misrepresentation. Whether it’s an innocent mistake, a careless oversight, or something more serious, over 52% of all declined IP claims in 2024 were due to misrepresentation. That’s a staggering figure – and it affects everyone in the industry.
What is misrepresentation?
Misrepresentation is when incorrect, incomplete, or misleading information is provided during an application process. It can have serious consequences for whether a future claim is paid. Most income protection claims are paid in full. However, those that are not, often fail due to misrepresentation, errors or omissions made during the application process. So, why does misrepresentation matter and what is the true cost to the industry? Read our blog to find out more.
Misrepresentation Matters
Read MoreCase studies offer a practical way to understand how real-life scenarios are assessed, from the application stage through to a claim decision. These case studies highlight the differences between innocent, careless and deliberate misrepresentation, and how each one can impact the outcome of a claim.
Innocent Misrepresentation
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Deliberate Misrepresentation
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Careless Misrepresentation
Read MoreA Different Perspective: Exploring Emerging Technologies in Misrepresentation Management
As part of the broader conversation around misrepresentation in income protection, it’s important to consider a range of approaches being developed across the industry. One such example comes from empath-AI.co.uk, who explain how biomarker technology could be applied to address some of the challenges faced, particularly around mental health, cognitive assessment, and claim integrity.
While this is not an IPTF-endorsed view, it offers an interesting view into how AI-driven tools might supplement traditional methods and highlights the growing focus on innovation in claims and underwriting practices.
Story 2 - Vocational Rehabilitation: Getting Back on Track
Our second story explores the important role of vocational rehabilitation support. These services are tailored to each person’s needs and complement the broader health and wellbeing services included in many policies. The aim is to support recovery and facilitate a return to employment where possible. Included is a real case study and an informative podcast.
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About Vocational Rehabilitation
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Mike’s Story
Read MoreStory 1 - Guiding a client through a storm
Our first story examines the role of the Adviser when there’s a claim, defining Advisers’ responsibilities before and after claims initiation and highlighting how they can help gather evidence to expedite claims and deliver better outcomes.
In story 1, Phil Deacon talks to Rob Higgins (Head of Claims, Cirencester Friendly) and Zuzanna Ritter (Director, Smart Choice) who share their story of how Zuzanna supported her client through a claim on his Cirencester Friendly Income Protection policy.
Read our blog post for more on the role of an Adviser during the claims process, the 5 key responsibilities of an Adviser during a claim and long-term strategies for successful claims. And, if you are an Adviser or Provider, read the lessons you can learn from Story 1.
”Great initiative - looking forward to the second story!
Katharine MoxhamGroup Risk Development (GRiD)