Prevention and early intervention in South African disability claims management: The private insurer perspective

Article type: Research Article

Authors: Howell, Kerri-Lee^a | Naidoo, Deshini^b | Govender, Pragashnie^{b; *}

Affiliations: [a] Private Practice, Gauteng,South Africa | [b] School of Health Sciences, University of KwaZulu-Natal, Durban,South Africa

Correspondence: [*] Address for correspondence: Pragashnie Govender, Associate Professor, Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa. E-mail: [email protected].

Abstract: BACKGROUND:Current available literature lacks a focus on the prevention and early intervention stages of the disability claims management process within the South African context. OBJECTIVE:This study aimed to identify fundamental principles to be applied during the prevention and early intervention stages of the disability claims management process within South Africa. METHODS:A qualitative explorative design with a purposive sampling technique to identify stakeholders. Data were collected fromn = 26 stakeholders using virtual semi-structured interviews. Inductive analysis was used to establish fundamental principles for promoting success in applying a prevention and early intervention approach. RESULTS:Four fundamental principles were identified: stakeholder communication and education, stakeholder collaboration, support, and buy-in, early identification and early intervention. The literature, data and themes were used to inform development of a prevention and early intervention disability model as well as an employee health and productivity continuum. Analysis of the results showed that achieving and maintaining employee health and productivity is a complex goal. However, a prevention and early intervention approach is beneficial in decreasing the likelihood of ill-health progressing to short or long-term disability absence. CONCLUSION:This study has proposed a prevention and early intervention model for a disability that may be applied to the employee health and productivity continuum in an attempt to mitigate the risk of ill-health and disability occurring and if they do occur, to decrease the length of time that the symptoms impact an employee’s productivity at work.

Keywords: Health continuum, insurance claim, ill-health and incapacity, presenteeism, wellness, prevention

DOI: 10.3233/WOR-211384

Journal: Work, vol. 75, no. 2, pp. 577-590, 2023