Abstract

HOWELL, Kerri-Lee; GOVENDER, Pragashnie  and  NAIDOO, Deshini. Factors influencing prevention and early intervention within the disability claims management process: South African insurer's perspective. S. Afr. j. occup. ther. [online]. 2022, vol.52, n.2, pp.16-25. ISSN 2310-3833.  http://dx.doi.org/10.17159/2310-3833/2022/vol52n2a3.

INTRODUCTION: The disability claims management process may be divided into four stages: prevention, early intervention, rehabilitation, and return to work. There are various stakeholders involved in the process and various factors that influence the process. Currently, there is a lack of literature that creates insight into the prevention and early intervention stages. METHOD: An explorative qualitative study was conducted with 26 purpo-sively sampled stakeholders from the disability insurance sector. Qualitative data from virtual individual semi-structured interviews were inductively thematically analysed, using NVIVO Pro 12, to establish emergent themes. RESULTS: Four inhibiting and four facilitating factors emerged from the data analysis. Inhibitors included: psycho-social-economic hardship, group insurer inhibitors, disability stigma and deconditioning and poor health, and disability understanding. Facilitators included: group insurer facilitators, a remain-at-work (RAW) approach, medical and vocational management, and social and occupational support. The overarching theme emphasised disability as a complex phenomenon influenced by various medical and non-medical factors CONCLUSIONS: The complexity of a disability contributes to the disability claims management process, which lacks focus on prevention and early intervention. Despite this complexity, retaining an employee at work while receiving early intervention emerged as a meaningful approach to decreasing the likelihood of the employee's ill health progressing to long-term disability.

Keywords : remain-at-work; vocational management; disability income replacement insurance.

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