2010 ALUCA TurksLegal Scholarship
“The ALUCA TurksLegal Scholarship is a great platform to look at life insurance from a strategic perspective and engage in creative thinking. The Scholarship gave me the opportunity to highlight the issues that I am are confronted with, and are called upon to solve, on a regular basis. It provided me with an audience for my solutions. I was fortunate to win the 2009 ALUCA TurksLegal Scholarship and attended the LOMA Conference in Washington. It was great to meet with professionals from around the world with similar backgrounds to mine and learn about the challenges faced by my counterparts and the solutions that are being used to deal with these challenges on the world stage. I encourage you to submit an entry for this year’s Scholarship - you will learn from the experience and may even win a trip overseas ! Good luck !” Gavin Lai Tower Australia 2009 ALUCA TurksLegal Scholarship Winner
2010 ALUCA TurksLegal Scholarship
ABOUT THE 2010 SCHOLARSHIP The ALUCA TurksLegal Scholarship is designed to support the professional growth of ALUCA and its members by providing a signiﬁcant career development opportunity for claims professionals working in Australia’s life insurance industry. The ALUCA TurksLegal Scholarship winner will be awarded with a package valued up to $8,000 including return travel, accommodation, $1,000 cash and registration to one of the following overseas conferences: • 2011 Eastern Claims Conference, 27 February - 1 March 2011, New York City, New York • 2011 LOMA Life Insurance Conference, 11-13 April, 2011, Las Vegas, Nevada • 2011 DI & LTC Insurers Forum, Date and Venue to be conﬁrmed The ﬁrst runner-up will be awarded a $1,000 Red Balloon Day gift certiﬁcate valid for 12 months. The second runner-up will be awarded a $250 restaurant voucher.
2010 JUDGING PANEL • • • • • • • • •
Alph Edwards Phil Hay Kristen Malanot Jim Minto John Myatt Lisa Norris Tracey Peters Simon Swanson Linda Winterbottom
Partner, TurksLegal Head of Life Insurance, BT Financial Group Committee Member, ALUCA Managing Director, TOWER Australia Partner, TurksLegal Partner, TurksLegal President, ALUCA Managing Director, ClearView Committee Member, ALUCA
WHO CAN ENTER? This Scholarship is open to all Australian resident members of ALUCA. Each entrant must be a current ﬁnancial member of ALUCA and work directly in a capacity connected with claims or underwriting in the life insurance industry. Lawyers, accountants or medico-legal consultants who meet the above criteria are eligible to enter provided they are direct employees of life insurance companies, life reinsurance companies, superannuation trustees or superannuation administrators.
2010 ENTRY CRITERIA Entrants will be assessed on: • • • • •
Understanding and insight of the chosen topic Research foundation and conclusions supported by sound evidence Clarity of thought Commercial insight Presentation
ANNOUNCEMENT OF WINNERS The winner, ﬁrst and second runner-up ﬁnalists will be announced at the ALUCA Christmas Party in December 2010, in Sydney.
2010 QUESTIONS - choose one of the following six questions:
1 Time to show us your PECs
Companies have sought to make insurance cheaper and more accessible by relying upon more complex and detailed pre-existing conditions (‘PEC’) exclusion clauses to screen out unacceptable risks at claim time, sometimes as an alternative to underwriting. Are PECs the answer to limiting the underwriting information and offering cover cheaply and quickly? Is it reasonable for companies to use PECs as well as underwriting individual risks? Does this create problems for companies offering products through competing advice and non-advice channels for instance? Your answer should address these issues and the beneﬁts and pitfalls of using pre-existing conditions exclusion clauses from product disclosure, customer expectation as well as any legal issues affecting the interpretation and validity of exclusion clauses including the impact of relevant statute law.
The amendments to the Insurance Contracts Act currently before the Federal Parliament have enjoyed widespread support because they strike a fairer balance between the interests of consumers and insurers.
The ‘new’ Insurance Contracts Act - An Opportunity for Better Claims Solutions
What problems do the amendments seek to address and how effectively and fairly do they do it? Your answer should compare and contrast the existing provisions with the new remedies offered under the proposed amendments with particular reference to the remedies for non-disclosure and misrepresentation and with respect to the issue of ‘unbundling’.
3 Show me the Money
Please also evaluate the beneﬁts for consumers and for life insurers in the current proposal and provide practical examples of the different approaches that claims people will be able to take under the new legislation.
The ﬁnancial affairs of self employed business people are becoming more and more complex making calculation of their income from personal exertion less and less easy, particularly from the point of view of add backs and tax shelters such as family trusts that enable income splitting. It is desirable that the formula used at underwriting is consistent with the methodology used at claims time and for the company’s approach to be clearly stated in its product disclosure statement and in the policy documentation. Is there an optimal way to approach describing and determining a self employed person’s income? Discuss this concept of income, outlining the pros and cons and suggest a best practice way forward. This question can be addressed from an underwriting or a claims perspective, or both.
2010 QUESTIONS (cont’d)
4 Rehabilitation and the Management of Subjective Pain
5 That was my most Challenging Case !
6 Risk Insurance in a Globalised World
Customers who experience subjective pain present special claims management issues. Has rehabilitation worked for these customers and ultimately for your company? Please explain the problems in implementing rehabilitation solutions in these situations. What techniques has your company used? When have they been effective and why? Please include speciﬁc recommendations about how to effectively implement rehabilitation when the customer’s condition is not well understood from a medical point of view or the customer may be uncooperative. Please include some practical suggestions about how claims managers can set up, monitor and evaluate the results of rehabilitation strategies for claims of this kind.
Share the experience of your most challenging case in the last 12 months. What made it so difﬁcult? What were the individual problems you had to overcome and how did you address each of them? What was the outcome for you, your organisation and for the customer? How did the way the case was handled beneﬁt your company’s brand and reputation? What did you learn and what would you do differently next time? This question can be answered from either a claims or underwriting perspective though, in either case, you must ensure that individuals are not identiﬁed and that privacy is maintained.
With cover becoming more widespread in the community, particularly for employees through their superannuation funds and with more and more people continuously on the move, there is more chance than ever before that Australian claims people will have to deal with off shore claims issues. Twenty four hour global cover is one of the standard policy beneﬁts, but managing claims that occur off-shore can be a nightmare. What are the unique problems that can arise in the management of death and disability claims, that occur outside Australia and how can they be solved? As well as featuring practical examples which illustrate the issues, and providing your insights about how these problems can be addressed, your response should discuss how policy wordings can be used (or possibly need to be modiﬁed) to assist companies in the management of these sorts of claims.
TERMS & CONDITIONS Deﬁnitions A. TurksLegal: means the legal practice partnership operating under that registered business name. B. ALUCA: means Australian Life Underwriters and Claims Association. C. Major Prize: means an overseas package valued up to $8 000AU (inclusive of GST). It includes registration to one of the following overseas conferences: 2011 Eastern Claims Conference, 27 February - 1 March 2011, New York City, New York; 2011 Life Insurance Conference, 11-13 April, 2011, Las Vegas, Nevada; DI & LTC Insurers Forum, Date and Venue to be conﬁrmed; return economy airfares for one person to one of the above locations valued up to $3 000; four nights accommodation valued up to $2 000 for one person at a hotel to be conﬁrmed by the organisers; and $1 000 spending money. The package does not include: transfers to and from the airport, any insurances, taxes, additional spending money, charges, levies, hotel incidentals, tours and activities or meals not included in conference registration (except where speciﬁed). D. 1st Runner-up Prize: means the Scholarship 1st runner-up will be awarded a Red Balloon Day gift certiﬁcate valid for 12 months to the value of $1 000AU (inclusive of GST). E. 2nd Runner-up Prize: means the Scholarship 2nd runner-up will be awarded a $250AU (inclusive of GST) restaurant voucher. F. Term: means the entire period of the Scholarship commencing on 26 August 2010 and concluding on 29 October 2010 at 5pm. G. Judging Panel: means the Judging Panel constituted to judge the 2010 ALUCA TurksLegal Scholarship. H. Scholarship: means the ALUCA TurksLegal Scholarship. Rules 1. This Scholarship is open to all Australian resident members of ALUCA. Each entrant must be a current ﬁnancial member of ALUCA. Entrants must directly work in a capacity connected with claims or underwriting in the life insurance industry. Lawyers, accountants or medico-legal consultants who meet the above criteria are eligible to enter provided they are direct employees of life insurance companies, life reinsurance companies, superannuation trustees or superannuation administrators. Entry is not open to members of the ALUCA National Committee. 2. As a condition of entry, an entrant accepts these terms and conditions and any rules, policies or procedures that may be adopted by TurksLegal or ALUCA from time to time. TurksLegal or ALUCA may change, amend or vary these terms and conditions and may extend the period of, or cancel, the Scholarship without notice. 3. Entry forms for the Scholarship can be found on the TurksLegal website. Australian resident members of ALUCA who wish to participate in the Scholarship must complete the ofﬁcial entry form and send it with a copy of their paper by post to Jacqueline Lyson, Marketing & Business Development Manager, TurksLegal, GPO Box 2554, SYDNEY NSW 2001 or by email to: email@example.com by 29 October 2010 at 5pm. Only entries accompanied by an ofﬁcial application form will be accepted. Only one entry per Australian resident ALUCA member will be accepted. 4. Entrants in the Scholarship must submit a written paper (not exceeding 3000 words in length) on one of six questions selected by the Judging Panel and notiﬁed to entrants. 5. The entrant must certify that they meet the conditions and that their employer has no objection to their paper being entered. 6. At the conclusion of the Term all entries will have personal information removed so that entrants’ papers are considered anonymously by the Judging Panel; the winner and the 1st and 2nd runners-up will be ofﬁcially announced at the ALUCA Christmas Party in Sydney in December. 7. The entrant whose paper is determined by the Judging Panel to be the best response (“the winner”) will be awarded the Major Prize. The entrant whose paper is determined by the Judging Panel to be the next best (“the 1st runner-up”) will receive the 1st runner-up Prize. The entrant whose paper is determined by the Judging Panel to be the next best (“the 2nd runner-up”) will receive the 2nd runner-up Prize.
8. The Judging Panel will determine the winner, 1st and 2nd runner-up by simple majority. Where there is no clear majority in favour of any one entrant, the person elected by the Judging Panel as its Chairman must exercise a casting vote which will determine the winner and runner-up. In determining the winner and 1st and 2nd runner-up the Judging Panel will utilise the marking criteria that it has agreed to apply to all entries. 9. Notiﬁcation will be given to the winner, 1st and 2nd runner-up as soon as practicable after the conclusion of the judging. Notice may be given by ordinary post, electronic mail, courier or personally. 10. The winning entry and 1st and 2nd runner-up papers will be published on the TurksLegal and ALUCA websites, in the ALUCA e-newsletter, RiskeBusiness and other potential media sources. By signing the application form the entrant accepts these conditions and gives permission for publishing of the name and/or photos. Under the conditions of entry the copyright in all entries will vest in TurksLegal and ALUCA. 11. Entrants are responsible to ensure that their contact details with TurksLegal and ALUCA are up to date. 12. Prizes are not transferable or exchangeable and no prize can be taken solely in cash. 13. If for any reason the winner, 1st and 2nd runner-up are unable to utilise their prize once booked (including ﬂights, accommodation, conference, restaurant and Red Balloon Day voucher bookings) and the date cannot be changed without penalty (of any kind, including ﬁnancial charges) the winner, 1st or 2nd runner-up will not receive an alternative prize. 14. All entries are expected to be original work of the entrant, based on their own research. Reference to supplementary material must be clearly acknowledged in the paper. TurksLegal and ALUCA reserve the right to make whatever enquiries each consider necessary to ensure the work attributed to an entrant is that person’s own work. All claims for prizes are subject to TurksLegal’s and ALUCA’s veriﬁcation procedures as determined by TurksLegal and ALUCA in their absolute discretion. 15. TurksLegal’s and ALUCA’s decision in relation to all aspects of the Scholarship, including but not limited to any dispute as to the identity of an entrant, eligibility to participate in the Scholarship and determination of an entrant’s eligibility to receive a prize, is ﬁnal and binding and no correspondence will be entered into. These terms and conditions may be changed, amended or varied at any time by TurksLegal or ALUCA in their absolute discretion without notice and without assigning any reason therefore. TurksLegal and ALUCA reserve the right to cancel or vary the Scholarship in whole or in part in their absolute discretion at any time without prior notice. Any such cancellation shall not effect any entrant’s entitlement to any prize that has accrued at the time of the cancellation. 16. Entrants accept these terms and conditions as amended from time to time and agree to be bound by them. Entry in the Scholarship is subject to these terms and conditions. In the case of any inconsistency between these terms and conditions and any promotional material, these terms and conditions prevail. TurksLegal and ALUCA reserve the right to cancel an entrant’s participation in the Scholarship without assigning any reason therefore where TurksLegal and/or ALUCA, in their absolute discretion, consider that the entrant has not acted honestly, fairly, in good faith or in the spirit of the Scholarship. 17. Liability for any tax on any beneﬁts provided to entrants pursuant to the Scholarship is the sole responsibility of the entrant. It is recommended that entrants contact their own accountant or taxation advisor in this regard. 18. TurksLegal and ALUCA accept no liability for late, lost or misdirected entries. 19. To the extent permitted by law, TurksLegal and ALUCA are not liable for and shall be kept harmless from any loss or damage to property or person including but not limited to direct or consequential loss and including loss from personal injury as a result of any person participating in the Scholarship or making use of a prize. 20. TurksLegal and ALUCA collect entrants’ personal information in order to conduct the Scholarship. If the information requested is not provided, the entrant may not be permitted to participate in the Scholarship. By entering the Scholarship, unless otherwise advised, each participant agrees that TurksLegal and/or ALUCA may use this information in any media for future promotional, marketing and publicity purposes without any further reference, payment or other compensation to the entrant, including sending the entrant electronic messages. A request to access, update or correct any promotion should be directed to TurksLegal and/or ALUCA.
HOW TO ENTER Entrants must submit this application form together with a paper (maximum 3000 words), answering one of the six questions listed. Please also read the terms and conditions in this application form before submitting an entry. Entrants must submit a copy of their paper and a completed Application Form by 5.00pm on 29 October 2010 by:
OR POST Jacqueline Lyson Marketing & Business Development Manager TurksLegal GPO Box 2554 SYDNEY NSW 2001
Full Name: Position: Organisation: Email : Address: Direct Phone: Mobile: Question Answered: Word Count (max 3000 words):
By signing this application form and submitting your entry you conďŹ rm that you have read and understood the terms and conditions of the Scholarship, you agree to be bound by these terms and conditions, and the organisation you work for has no objection to your entry being submitted: Signed:
Further information about the scholarship is available at: www.turkslegal.com.au
Applications close at 5.00pm on 29 October 2010
2010 ALUCA TurksLegal Scholarship Applic