Our goal is to shorten claim durations and improve claim outcomes. For Clients, this means getting their plan members back to work sooner.
Claims criteria – how it works
The Claim Lab questionnaire assesses psychosocial factors that may influence a plan member’s disability recovery. It provides insight into a plan member’s desire or motivation for recovery using several key factors.
We’re testing the questionnaire with specific short-term disability (STD) and select long-duration claims.
This means that during the study period, some plan members will receive the questionnaire, and others won’t.
- Mental health-related STD claims. Once we approve a claim, the questionnaire will help validate claim complexity. It will also help us determine whether we need to take additional action. If warranted, the disability case manager will refer a claim to the Director, Mental Health Solutions. This can provide us with a better understanding of optimal recovery opportunities.
- Select long-duration disability claims. Questionnaires will be sent only on small sample of long duration claims that meet very specific criteria. The questionnaire will help us better identify opportunities for:
- non-litigated settlements,
- risk management, and
- continued entitlement – if the plan member can continue to receive disability payments.
For now, we’re excluding all salary continuance/ASO claims.
When will we have results to share?
We look forward to sharing some initial results midway through the study in 2022. We’ll share final results a few months after the study ends.
We’ll be sending a Focus Update to plan sponsors on February 3.
Questions?
Please contact your Sun Life group benefits representative.
