IFA CLAIMS PROJECT PLAN

ISSUE ACTION STEP WHO WHEN

Claims Ambassador (“CA”)There is an urgent need for a dedicated person on the claims side who will serve as a ‘claims ambassador ‘. This person should be well versed with the claims process and at the same time should be a person with good interpersonal skills and be conversant in several African languages.

• Identification and appointment of a Claims Ambassador – done (Katehas been appointed on a 2-3 month trial period.

Job description and Key measurements of the CA will be reviewed Russell/Riaz 30 Sept

•Communication of the appointment of the new CA. (Russel to provide Kagisho 3-5 sep Kate’s details to Kagisho for him to communicate this to the L&As)

•Kate should also be introduced at Leaders meetings in particular high Areas such as KZN, WC, EC as a starting point Kagisho/ 30

Sept

•Kagisho to be the liaison for all A&L claims queries. This is for managing Kagisho Withthe query process both ways. Immediate

effect


Claims Communication

Confidentiality

Ongoing communication

PayoutsThere needs to be a clear plan to ensure that effective communication of our payout history is made to the network as we often do not communicate this effectively.

• A detailed communication plan needs to be developed which will Russell 30address communication to both staff and the network. This plan will Septcover the full spectrum of issues associated with communication ofClaims issues. Participants for this session are; Kagiso, Mthunzi, AyshaPeter, Kate and Kemble. To be communicated to Francois and Riaz

The Communication plan should also cover:• Payouts communication should cover monthly Rand amount paid out, the number of policies paid out for the month as well as the amount (in Rand terms) that has been paid out since inception. •Communication around repudiations and reasons why should also be addressed. •Commission Guarantee info, which is a major selling point. We needto get lots of marketing mileage on this benefit alone!•Please add appropriate stories (without individual names). Its is the stories not the figures alone that will demonstrate the benefits of claims. •The plan should cover the ST and MT, and various channels from the leaders meetings to Izindaba and posters.• Francois to be provided with monthly info to add to “Sizwe’s column” for the web.

Izindaba to have a corner set aside for claims on a monthly basis for at Russel l Fromleast the next six months. Thereafter a review should be done and a next issueColumn should be available every second month.

Due to confidentiality and legal issues we are often not able to dispel negative sentiment about claims in the network even though the claim has been addressed satisfactorily.

• A workshop involving Claims, Compliance, Kagiso , Mthunzi and Kemble needs to be conducted to explore alternatives to address the Kagisho 17negative sentiment arising from the legal and confidentiality constraints. Sept

Communication around claims is seen as sporadic and often in response to issues at hand. A long term plan needs to be developed to ensure that Claims communication is done on a regular basis.


Network Education

TrainingTraining that covers the claims processes and policies needs to be provided to both staff and presenters who in turn would need to provide this training to the network. This will ensure that there is a common understanding of the policies/rules and procedures around claims.


Network Education

Education that covers beneficiaries

BENEFICIARY EDUCATION

• A flyer should be developed specifically for beneficiaries- “Notice to Russell/ Midyour beneficiary” which is added to the policy pack and outlines what Aysha Octa beneficiary needs to do to lodge a claim.

•Educating the network that the claim is only paid to the beneficiary and Russell/ 30 SeptWhat the implication is if the beneficiary is a minor. AyshaTo form one of the issues to be addressed in the Claims Communication Plan.


Process MapsThe entire claims process needs to be mapped and these processes are to be reviewed and communicated to staff and the network. This will ensure that the network has a clear understanding of the processes and will reduce the level of uncertainty or confusion that exists within the network.

PROCESS MAPPING AND REVIEW

• Mapping of processes – Done• Review of process maps ( to be done by Peter, Riaz and Aysha) Peter 7-14 Sept

• Exercise to be done to assess what % of the funeral Comforter Benefit Peter 30 SeptBenefit paid on time. The aim is to determine whether we need a Donedifferent process without the need for an assessor for amounts under say R 10k. This will mean that a dedicated resource handles this- This has already been put in place

COMMUNICATION•Formulation of communication concept Peter/ Aysha 18 Sep

•Approval of concept (Francois, Keeran, Mthunzi, Kagiso, Russell and Riaz) Peter 21 Sep

• Communication roll out Peter/Aysha 23 Sep


Formulate a relationship approach for funeralsOf Commission Earners

Claims on LineThe development of a web based function which allows for claims to be lodged on-line and to monitor the status of the claim. As part of this exercise a mobile solution also needs to be considered.

• To conduct initial research and to formulate the concept which will also Russell /Tim mid OctInclude a mobile solutionThere could be 2 approaches, 1st set up the training and communication documentation on the web, then investigate a claims on line processes. Tim has been briefed on this and we would want to launch this before the end of the year. Please include Tim in these discussions.

Attendance of IFA management at the funerals of L&A and presenters as well as of IFA at the funerals of downlines and of commission earners offers the business an opportunity to reaffirm our culture of being a family to the network.

• On a claim to be lodged, Claims to check if the person is a Commission earner on view IFA. If commission earner advise IFA Executive team Russell 18 Sep

•Rules of process and who to do what and sign off: Commission Earners receive a call from the Regional Exec and Kagiso Club earners, must receive a call from, regional exec, 1 snr. Exec, and CEO.Legends and Achievers must

receive a call from CEO and Chairman. Call assigned to a member of Executive team to call family Kagiso 18 Sep Establish IFA position and activity in the network with BDS and or RBM Based on position and activity levels of the IFA, an Executive attendance will be decided upon Where possible a hands on assistance by the RBM .The assistance involves making sure all the necessary paperwork for the FCB, where applicable, is dealt with and any other form of an

administrativeInitiatve and regular feedback bothways.

•IFA Division to invest in a funeral kit i.e Mthunzi 30 sep•IFA Tables•IFA marquee•IFA chairs

The funeral kit still needs to be investigated and costed and also the Logistics of who will have access to the kit and test if the kit can not be a benefit offered in the future.


A&L issuesCurrent query process

Expiry date of forms

A&L to assist in resolving and expediting claims

There is a misunderstanding within A&L forum that claim forms have an expiry.

A&L Committee• the A&L Committee and IFA managers are to be provided with a summary of the Peter 18 sepQueries on a monthly basis. This summary will cover issues raised and how they were addressed at a higher addressed at a higher level as given the regulatory and confidentiality issues it is not always possible to provide the detail. The communication will be via email.

•Email list of members of the committee to be provided to Peter Kagiso 3 Sept

There is NO expiry date on the claims form. The only time there is an expiry date is when it comes to ENCASHMENTS where there is an expiry date of 7 days. This is due to the fact that we have to compute surrender values for encashments and these values do not remain static but do change as the unit values which we use to compute the encashment values change.

Thie above to be communicated to the network so that they have a clear understanding. Helen/Russell From Oct This will be incorporated into the claims training process and feedback to be given to A&L Committee Riaz 3 Sept

Given the nature of our market , many of whom are not familiar with technology or are unable to read English the A&L believe that they are able to assist the network in expediting their claims.

There is a legal constraint regarding A&L acting as intermediaries. To explore what are the alternatives approaches that can be followed without circumventing the law a workshop is to be held comprising the A&L Committee, Claims, Kagisho, Kemble and the Russell/ 18 Sepcompliance unit. Kagiso

To consider fax receiving capabilities at platinum venues Keeran 30 Sept


A&L issues (cont.)Reduced documentation for Unnatural death claims

RESPONSE FROM CLAIMS UNIT ON UNNATURAL DEATH CLAIMS:The claims department is aware of the challenges that many face in obtaining police ADDRESSEDdocumentation for some claims received. This resulted in a review of the processes. However any amendments to processes have to consider or build in adherence to laid down laws, and regulations and at the same time must ensure that the process is always fair and does not penalize a client unnecessarily. This review also considered whether other forms of validations existed in the absence of police documentation. Last but not least we also had to ensure that we are mindful of fraud which continues to affect the industry as this has a direct bearing on our re-insurers who also have certain expectations or process requirements. By amending our process in SOME INSTANCES, we have been able to have a faster turn around times when the police are unhelpful. But it must be borne in mind that claims from certain areas, or having a certain cause/type of death are still assessed in the normal regard as it has not been possible to amend our processes in such cases given the requirements listed above. Having said this though it must be stated clearly that if a document is waived, it does not mean that all the police documentation is waived. We will continue to exercise caution and follow processes as laid down by law, regulators and our reinsurance companies.

The above needs to be communicated to the network by adding to the Claims training Russell/Helen From Oct document and the web document.

Above to be communicated to A&L Committee Riaz 3 Sept

IFA CLAIMS PROJECT PLAN

Documents

Transcript of IFA CLAIMS PROJECT PLAN