[0001] This invention relates generally to a method of providing short to medium term support to a person who is afflicted by a stressor event, at a relatively affordable rate.

[0002] Stress-related psychological and physiological illnesses can cause financial and reputational loss to an employer, an employee, his family and community, which ultimately feeds through to a country and its economy. This loss results from manifestations of these illnesses such as increased work absenteeism, reduced employee productivity whilst at work, and reduced morale.

[0003] The stressors that can cause such illnesses are varied but they typically are significant life events that cause severe stress to the individual and result in poor performance, depression, emotional distress and mental illness.

[0004] In the past, scant regard has been paid to this increasing problem primarily because of the subjective nature of the cause and its severity, which is usually underestimated.

[0005] An object of the present invention is to provide a mechanism for addressing the aforementioned situations.

SUMMARY OF INVENTION

[0006] The invention provides a method of providing support to a person afflicted by at least one predefined stressor event wherein a support-providing party, subject to periodic receipt of an actuarially calculated payment over a predetermined term period, provides stressor-specific support to the person, once a claim is received within the term period, from the person evidencing the occurrence of the stressor event.

[0007] The periodic payments may be made by the person or by a third party who has an interest in the mental and physical wellbeing of the person, for example an employer of the person.

[0008] A stressor event may be the occurrence of a death of a related person, a divorce, an addiction, work-related stress or financial incapacity (indebtedness).

[0009] A death may be defined as a death of a related person, for example, the spouse, a child or a parent of the person.

[0010] A divorce may be defined as the termination of a civil marriage or any other similar union recognised by law as such and, in the case of a civil marriage, evidenced by a decree or an order of divorce.

[0011] An addiction may be defined as a state of being enslaved to a habit or practice or to something that is psychologically or physically habit-forming, for example narcotics, to such an extent that its cessation causes severe psychological or physical trauma. The addiction may be evidenced by production of a report, from an appropriately qualified person, confirming the addiction.

[0012] Indebtedness (financial incapacity) may be defined as a state of being indebted to the extent that a person is unable to pay his debts, as they fall due and payable. Indebtedness may be evidenced by production of a report from an appropriately qualified person, for example an accountant, confirming the indebtedness.

[0013] Work-related stress may be defined as a condition or event which adversely affects the wellbeing of an individual to the extent that his performance at work is significantly adversely influenced. This type of stress may be assessed, for example, by an employer, human relation consultant or any other appropriately qualified person.

[0014] Stressor-specific support, with respect to a related death, may be provided in one or more of the following ways: a psychological assessment by a medical professional, payment of costs of bereavement counselling, a payment to the person as compensation for loss of income whilst absent from work and a payment to an employer of the cost of employing temporary staff. The last-mentioned type of support is referred to herein as a "Business Benefit".

[0015] Stressor-specific support, with respect to divorce, may be provided in one or more of the following ways: a payment to the person as compensation for loss of income whilst absent from work, payment of costs of counselling, payment of a cash lump-sum, for example an additional month's salary to cover the costs associated with forced relocation, and payment of a Business Benefit.

[0016] Stressor-specific support, with respect to indebtedness, may be provided in one or more of the following ways: a payment to the person as compensation for loss of income if absent from work, payment and provision of a debt management course, payment of a cash lump-sum, for example three times monthly salary, to assist with reducing the debt, and payment of a Business Benefit.

[0017] Stressor-specific support, with respect to addiction, may be provided in one or more of the following ways: a medical or psychological assessment by a medical professional, payment of costs of treatment at an accredited rehabilitation clinic or for counselling, a payment to the person as compensation for loss of income whilst absent from work, and payment of a Business Benefit. This support may also extend to addiction related to a member's spouse or child. [0018] The provision of any of the stressor-specific supports may be for at least a limited time, for example for a period of up to 3 months depending on an assessed need.

BRIEF DESCRIPTION OF THE DRAWINGS

[0019] The invention is further described by way of example with reference to the accompanying drawings in which:

Figure 1 is a chart or matrix which depicts various principal features of the invention; and

Figure 2 is a graphical depiction of the impact of emotional insurance as envisaged in the present invention.

DESCRIPTION OF PREFERRED EMBODIMENT

[0020] The method of the invention has application in the accredited financial market but particularly in the insurance industry in that it may give rise to a product that provides funding for medical treatment, for time off from work and for associated business costs, and loss of income cover to individual members that suffer from a stressor life event such as an addiction, indebtedness, death of a spouse, child or parent, work-related stress and divorce. Each of these events can give rise to considerable psychological stress. It is an aim of the method of the invention, and the concomitant product of the invention, to provide support to the member before the stress can cause psychological, physiological or behavioural illness.

[0021] Statistical evidence shows that mental illness claims have risen considerably in recent years. These claims are, inherently, subjective in nature and can be difficult for insurance companies and employers to manage. If these conditions can be addressed at an early stage and in an adequate manner then it might be possible to stop these conditions from progressing to the point that they result in individuals being absent from work for extended periods.

[0022] The support provided, in accordance with the invention, is stressor-specific, but includes one or more of the following core support categories:

(a) medical assessment and funding of treatment and psychological counselling;

(b) loss of income compensation, when time off work is needed or advised; and

(c) a cash lump-sum payment.

[0023] The support, provided by a support-providing party such as an insurer, ultimately is intended to manage and assist in overcoming the member's personal situation without fear of financial loss or loss of personal status.

[0024] The method of the invention can also aid an employer with a means of assisting and retaining valuable staff, and can help an employer and an insurer in reducing long term absence and concomitant costs and claims occasioned by chronic illnesses due to such stressor events.

[0025] Members, on application, will be provided with the "cover" or support they desire. This cover will relate to one or more of the stressor events described, i.e. death of a related person, divorce, indebtedness, work-related stress and addiction. By using actuarial-based methodology the insurer will determine an amount (premium) to be paid for the insurer to assume the risk of the event occurring and, on payment of the premium by the member, cover will be provided.

[0026] A claim by the member to the insurer will, on acceptance, lead to the provision of the stressor-specific support. [0027] The stressor life events which are covered by the method of the invention are described in greater detail hereinafter.

[0028] Addiction: This event covers each form of addiction that has a severely negative impact on the member's health and well-being, for example drug and alcohol abuse. The stressor-specific support includes a confidential assessment and admittance to a rehabilitation clinic. The duration of the admission is dependent on the severity of the condition. By way of example only:

(a) Severity 1 : one month spent in a rehabilitation centre with all costs covered plus one month's current salary. If limited further recovery at home is medically supported the claimant's full salary will be paid for an agreed period;

(b) Severity 2: two months spent in a rehabilitation centre with all costs covered plus current monthly salary for each of the two months. If limited further recovery at home is medically supported the claimant's full salary will be paid for the agreed period; and

(c) Severity 3: three months spent in a rehabilitation centre with all costs covered plus current monthly salary for each of the three months. If limited further recovery at home is medically supported the claimant's full salary will be paid for an agreed period.

[0029] Work-related Stress: Stress is a generic term and includes psychological stress and physiological stress. Stressor events are included in this category only if they have a direct impact on the member's performance at work. Exclusions could be any of the following (by way of example only): performance and work-related issues such as personality disagreements, work disagreements, poor performance with no obvious reason, early retirement and position appointment errors e.g. where a person is appointed in a position in which the person is not capable of performing satisfactorily.

[0030] By way of example only, accepted stressor events which could give rise to a benefit would include:

(a) a traumatic event, for example assault, severe robbery, hijacking or a car accident that results in a period of shock and reduced performance at work and at home;

(b) the diagnosis of a terminal illness related to the member's spouse or child;

(c) a car or other accident involving the member's spouse or child, resulting in disability which impacts the member's way of life and in poor performance at work;

(d) a long-standing employee with a good performance history starts performing poorly due to increased pressure at work or career restlessness and requires a sabbatical to rest and make career choices; and

(e) a severe traumatic event related to the member's dependants, for example the diagnosis of a terminal illness which impacts on the member's ability to perform at work.

[0031] The stressor-specific support includes a professional stress assessment and covers the costs of the treatment. The length of the treatment will be decided, during assessment, by a medical professional but may be limited by policy terms and conditions.

[0032] The types of treatment include admittance to a stress clinic or similar institution, counselling as an outpatient or career counselling. The average expected duration of cover is three months. This may however vary according to case specifics. The claimant's full salary will be paid by the insurer for the agreed period of treatment. This includes a recovery period at home if recommended by a treating medical professional and agreed to by the insurer.

[0033] Death of a spouse, child or parent: The stressor-specific support includes an assessment by a medical professional who will recommend if grievance counselling is required and what period of absence from work is needed for adequate recovery. The member's full salary will be paid for the agreed period.

[0034] Debt: This benefit covers the cost of a debt management course and pays three times the claimant's current salary as a cash lump sum (this is exemplary only and non-limiting). Absence from work is not considered necessary under this benefit unless there is evidence of behavioural addiction directly associated with the debt. Qualifying criteria will for example, be based on the quantum of the debt as a percentage of the claimant's actual monthly income. Other criteria can however be defined by individual insurers based on their costing formula, business objectives and competitive advantage. If debt is due to a gambling or a compulsive behavioural addiction, then appropriate treatment for the addiction can be covered. This may result in absence from work in which case the individual's salary should also be paid for the period of absence. This would be assessed on a case-by-case basis.

[0035] Divorce: This benefit covers one month's absence from work with the claimant's full salary paid as well as an additional month's salary.

[0036] Individuals and companies can select any of the events for which cover is required. The choice will have an effect on the pricing (premium payments) of the policy. By way of example only the following options are available: [0037] The preceding aspects of the invention are illustrated in tabular form in Figure 1. Five identified stressor events are listed and the cover which is available for each of the events is given in general form.

[0038] The stressor events are numbered 1 to 5 and for each event particular benefits are set out. These are exemplary, and non-limiting.

[0039] Purchase options: Individuals and companies can select if they want all the events to be covered or only certain events which will have a direct effect on the pricing of the policy. The following options might be offered:

(a) comprehensive basket - includes all five events;

(b) addiction and stress events only;

(c) death of spouse/child and debt events only; and

(d) divorce and debt events only.

[0040] The "policy" or cover duration options include:

(a) cover of one claim/event and then cessation of cover;

(b) cover of one claim/event every five years; and

(c) cover of one claim/event every seven years.

[0041] Other purchase and product options can include:

(a) a minimum service requirement of 3,6,9 or 12 months. For example the member would not be covered under a group policy unless the member has been in service with his employer for a defined minimum period of time;

(b) a period of no claim - the support provider, for example the insurer, will not allow claims during an initial period, for example within the first year of policy commencement; and (c) a Business Benefit option - this is available to employers and self- employed individuals where specific business costs associated with the member's absence are covered, for example the cost of hiring temporary staff.

[0042] By way of example only, to prove the occurrence of each of the mentioned stressor events, during the claiming process, an insurer would require the following:

(a) Death - a death certificate, marriage certificate, a birth certificate for a child and a medical assessment report re grievance counselling.

(b) Work stress - evidence of stress, for example poor performance reports from an employer or medical evidence such as a stress assessment report from a medical professional;

(c) Addiction - medical evidence to establish substance abuse or a report from the member's employer or a suitably qualified social worker;

(d) Divorce - a divorce order or any other appropriate document proving the dissolution of union recognised by law as a customary marriage.

(e) Indebtedness - evidence of an inability to pay a debt as it falls due and payable.

[0043] Currently the only solution to address absence from work due to addiction and stress is a limited period of sickness leave provided by the employer/state and long term absence benefits provided by insurers in the form of income protection, capital disability or severe illness/dread disease benefits. As mental illness is a subjective condition it is difficult for employers and insurers to assess and manage long term absence claims and successfully rehabilitate employees back to work. Long term absence claims due to subjective mental illnesses are increasing substantially. A number of long term mental illness claims can be avoided by making use of the method of the invention as it provides individuals with support during life events that are not critical but which, if left unresolved, are likely to take on a more serious form. Debt, divorce and the death of a spouse, child or parent are life events that can lead to depression and stress if an affected individual is unable to deal with these events effectively. The prevailing employment and insurance markets do not currently have a product or method that provides support and consideration to individuals on a manageable level. In addition, the costs associated with adequate (internationally regulated standards) substance and behavioural addiction treatment at an in-house or out-based rehabilitation centre are high and limit the number of average to low income individuals who can benefit from such treatment.

[0044] The method of the invention:

1. provides a unique short to medium term product that can reduce long term liability for insurers;

2. assists employers to support and retain valuable trained staff, reduces extended term absence claims and known business complications associated with long term employee absence and helps to maintain and improve employee morale and loyalty;

3. assists self-employed individuals to reduce debt, and to take time away from their business while still meeting business requirements;

4. provides individuals, either employed or self-employed, with

(a) confidential treatment according to event, and recovery time away from work,

(b) finance to meet financial obligations without a loss of personal status, employment or way of life, 5. provides a means for regulating and improving current rehabilitation centre treatment standards and makes this type of treatment more accessible to individuals;

6. provides a mechanism which currently is unavailable to an average worker, to address and resolve individual personal issues which may result in increased mental illness; and

7. fits in effectively with currently established insurance products and the administrative infrastructure that supports such products.

[0045] The method of the invention has the potential to grow the individual and group insurance/financial services markets and can therefore contribute positively to the global economy.

[0046] The method of the invention additionally provides a framework for an indemnity-type insurance structure covering risks that have not previously been covered but which have steadily been increasing. The invention facilitates the provision of cover for such risks by reducing a subjective analysis part of an assessment process, and by linking a claim to the occurrence of an objectively- determinable event which can produce severe emotional stress.

[0047] Another advantage of the invention is that it provides for the provision of stressor-specific support in a proactive manner i.e. at a time when an event has occurred but before the resulting stress can cause a chronic condition or illness.

[0048] The invention can be used by an employer to shift or spread at least some of the financial burden, arising from an employer's employment obligations, because of an employee's reduced productivity or absenteeism caused by a stressor. The method can also dovetail with an employer's existing sabbatical leave policy by merely redefining what motivations or factors can give rise to leave for a typical "sabbatical" leave period of 3 months.

[0049] The present invention extends at least, to the following variations which could be adapted by individual insurers in any form or version together with existing costing/financial methods, sales ethics and business processes to provide a market advantage, namely any variation of or to the following:

1 . the duration of a claim benefit payment e.g. from 1 to 12 months or longer for any of the benefits;

2. medical and non-medical treatment suitable to a particular condition or event;

3. the duration of treatment;

4. the definition of severity levels under the benefits;

5. the amount of proceeds/cash paid out on acceptance of a claim;

6. product pricing and costing;

7. the period of absence from work allowed on acceptance of a claim under any of the benefits;

8. the duration of the policy term/duration;

9. the number of events which can be claimed during the term of a policy;

10. the number of simultaneous claims, claiming for the same condition more than once, multiple claims and linked claims;

1 1. when a policy ceases or terminates;

12. how defined benefit combinations are sold e.g. either individually, as a basket or grouped;

13. claim processing requirements;

14. claim acceptance criteria, proceeds paid or time of absence;

15. product benefits or special services to clients, either individuals or employers;

16. qualifying criteria under the debt benefit or any other of the listed benefits; 17. the "no claim" period i.e. a selected period from policy inception during which claims are not permitted;

18. rules on pre-existing conditions;

19. conditions covered under drug and behavioural addictions. The intention - an object is that the invention should be usable to provide cover for all drug and behavioural addictions and should allow independent insurers the choice of selecting the conditions for which they would provide cover;

20. the procedures, operations and processes for distribution, sales, service, claims, complaints and additional service channels, related to the product of the invention, as set out by an individual insurer or accredited financial institution;

21. financial governing bodies, complaints procedures and medical acts as stipulated by law in individual countries;

22. the name of any insurance products that cover the listed benefits; and

23. the number of the benefits which are offered by an individual insurer under a specific policy.

[0050] The method of the invention is designed to benefit an individual, an employer, an insurer, an insurance industry and, in general terms, an economy.

[0051] In respect of the individual the method of the invention provides a technique which enables the individual to manage and then gain control over a stressor event. An employer is assisted in supporting an employee during a stressful event. This enables a mutually beneficial relationship to be established between an employer and an employee. [0052] The method of the invention helps an insurer to reduce its claim liability and rehabilitation costs for it can lead to reduced mental illness claims and lower the difficulties associated with managing claims of this kind.

[0053] Figure 2 graphically depicts an overview of the impact of emotional insurance which has a positive effect on an individual 10, a self-employed individual 12 and an employer 14. The figure shows an anticipated possible growth in the insurance field if the product of the invention can be successfully marketed. Possible subjective mental illness claims are depicted in block 18. If these possible subjective mental illness claims are identified at an early stage and are correctly processed through the techniques which have been referred to herein then a reduction of mental illness claims 20 and, ultimately, claim liability, can be achieved. This would have a substantial positive effect on the income protection benefit, both for individuals and groups (22) with the additional benefit of reduced rehabilitation costs (24).