Effective management of accident and illness cases

The management of accident and illness cases in Switzerland is a complex process that presents companies with numerous challenges. But why is this the case?

On the one hand, it is because the available tools are unfortunately often incomplete. They require multiple data entries, manual management of employee files and manual monitoring of deadlines. In practice, the latter is managed using Excel spreadsheets, Post-it notes or Outlook tasks. In addition, the coordination of the various parties involved in case processing, such as Insurances, case managers, medical professionals, payroll accounting or pension funds, requires special attention. Missing deadlines can have serious consequences for the company and employees, including reduced services from insurance companies. Apart from the direct processing of the absence, it is often impossible to carry out a case analysis due to a lack of information. The insurer is often the only party involved that has a history of compensated cases - a history that a company could lose if it changes insurance.

The result: the HR department is forced to invest more time and resources in administrative management. This leaves little time for the essentials: looking after the person who is absent due to an accident or illness.

It is not only the employees who suffer from an inadequate accident and illness management process - the company itself is also affected. As well as committing too many valuable HR resources, poorly managed processes can also have a negative impact on absenteeism and therefore insurance costs. Finally, let's not forget the loss of productivity, including that of HR.

Are Software tools THE solution?

One way to make processes more efficient is to do away with the aforementioned manual processes and replace them with digital solutions. So far so good - at least in theory. However, HR is faced with a new challenge here: finding your way around the variety of tools available on the market, such as UKA from HRM Solutions and assepro.online from Assepro. There are also tools offered by insurance companies, insurance brokers or HR service providers.

Apart from the differences in the technologies used (attention to "end-of-lifecycle" solutions) or the choice between on-premise and cloud, there are also differences in the functions and the potential for "end-to-end" digitisation. Knowledge of current and, above all, future needs is therefore a crucial step in being able to compare the various solutions.

In addition to the choice of solution, the protocol for data transmission to insurers and integration into the company's payroll tool should also be analysed. In fact, the "Claim Report" protocol has been used for many years to transmit data and information to insurers, and almost all insurance companies accept this format.

For some months now, Swissdec's KLE (Customer Integrated Claim to Benefit Process) solution has offered a more integrated approach to the payroll process (goodbye multiple entries and interfaces). It uses an advanced encryption method based on symmetric and asymmetric encryption algorithms. Our assessment of KLE: In recent months, the KLE protocol has been tested intensively with the SwissSalary payroll accounting tool, with extremely positive results. However, it should currently be noted that only a few insurers accept this protocol and that it is also dependent on ELM 5.0 certification at the payroll accounting software level. Whether this will be the solution of the future remains to be seen. Nevertheless, the value proposition offers significant advantages in terms of time savings, data accuracy, process simplification and data security. The future will show whether this approach will continue to gain acceptance.

And why not outsource this process?

In addition to investing in a powerful tool, another option is to outsource these processes entirely. Outsourcing the management of accident and illness claims can offer various benefits, but also comes with different implications.

• Time saving: By outsourcing case management, HR can save time by not having to handle these processes internally. Instead, HR can focus on other tasks that offer greater added value.
• Expertise: Organisations involved in accident and sickness case management must have highly skilled and experienced staff to ensure quick and accurate case processing. However, in times of skills shortages, it can be difficult to find such specialists.
• Cost reduction: By outsourcing case management, companies can avoid the costs associated with the training and development of in-house staff.
• Flexibility: Outsourcing case management can offer companies more flexibility, as they can decide whether to transfer the management of all or only some of their cases to an external provider.

However, outsourcing can also have disadvantages, such as the loss of control over the process, the need for continuous close communication with the external service provider and possible additional costs that may be associated with outsourcing. If employees are ultimately in contact with an external person as part of the outsourcing process, this must be communicated clearly and transparently. In addition, it must be ensured that HR does not lose contact with the injured or ill person despite external support. It is therefore important to carefully weigh up the pros and cons before making a decision on outsourcing the management of accident and illness cases.

Conclusion: Keep an eye on corporate strategy and culture

There are many ways to optimise accident and illness management in your company. The available tools and possible approaches are diverse and there is no single solution. When searching, you should focus on your company's strategy. Above all, don't lose sight of the desired corporate culture in the jungle of possibilities, because your employees are your most valuable asset.