Philippe Rambaud


Published on

  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide
  • 21/07/2009
  • 21/07/2009
  • 21/07/2009
  • Philippe Rambaud

    1. 1. Services & Consulting Engineering : Bodily Injury Case Management Philippe RAMBAUD – AXA ASSISTANCE Directeur de la BU Domicile 3 ème Conférence internationale sur les services à la Personne Madrid 11-12 novembre 2010
    2. 2. index <ul><li>Current report & target </li></ul><ul><li>Economic context </li></ul><ul><ul><li>Drift average costs </li></ul></ul><ul><ul><li>Weight of futures costs </li></ul></ul><ul><ul><li>Deficient control of costs </li></ul></ul><ul><li>Managing serious bodily injury </li></ul><ul><li>Albatroos moovie </li></ul><ul><li>Our offer </li></ul><ul><li>The solution of AXA Assistance </li></ul><ul><li>Our service target </li></ul><ul><li>Practical implementation </li></ul><ul><li>Albatroos </li></ul>Madrid 11/11/10 CONFIDENTIEL
    3. 3. Current report & target Madrid 11/11/10 CONFIDENTIEL <ul><li>A plan of action – enrolled in a context: </li></ul><ul><ul><li>Inflationist </li></ul></ul><ul><ul><li>In evolution </li></ul></ul><ul><ul><li>Juridical favourable for victims </li></ul></ul><ul><ul><li>Professional changes </li></ul></ul><ul><li>The target : </li></ul><ul><ul><li>Global strategy answer : conduct the insurer (claim manager) in one hand and in the other the victim, respecting at the same time their rights and obligations. </li></ul></ul><ul><ul><li>Build a life project for bodily injured persons </li></ul></ul><ul><ul><li>Implement all the services needed </li></ul></ul>
    4. 4. <ul><ul><li>Drift average cost of bodily injury </li></ul></ul><ul><ul><ul><li>+ 7% /year </li></ul></ul></ul><ul><ul><ul><li>Since 2000, the number of bodily injuries has doubled </li></ul></ul></ul><ul><ul><ul><li>Absence of foreseeable nature of bodily injury’s costs with a temporal volatility </li></ul></ul></ul><ul><ul><li>Weight of the futures costs and the carers costs </li></ul></ul><ul><ul><ul><li>Funds increased for the future costs and human care items representing about 50% of file’s reserves </li></ul></ul></ul><ul><ul><li>Deficient control of costs </li></ul></ul><ul><ul><ul><li>Disparity of prices for the care. </li></ul></ul></ul><ul><ul><ul><li>Estimated cost in the lawyer’s complaints are exaggerated. </li></ul></ul></ul><ul><ul><ul><li>There is no real implementation of services. </li></ul></ul></ul><ul><ul><ul><li>The forensic approach is not detailed for the futures costs. </li></ul></ul></ul>Inflationist economic context Madrid 11/11/10 CONFIDENTIEL
    5. 5. Madrid 11/11/10 CONFIDENTIEL <ul><li>When a person is injured by an accident, or by a medical error, and consequently becomes disabled and dependent, his/her everyday life, and that of those around them, changes. </li></ul><ul><li>Until now, insurance companies only paid out financial compensation . Yet, the victim and their family are faced with a whole new set of needs created by the dependent state and the different types of handicap. </li></ul>Managing serious bodily injury
    6. 6. Madrid 11/11/10 CONFIDENTIEL <ul><li>How does one cope in the maze of regulations and laws? </li></ul><ul><li>How can we compensate for the inevitable change in the behaviour of the disabled and dependent victim? </li></ul><ul><li>Who will help him/her to accept his/her new condition, and in practical terms, who will organise and provide the specific help he/she now needs? </li></ul><ul><li>Despite the willingness of a few insurance companies, the appropriate solutions and services are rarely and disparately offered or followed up. </li></ul>Managing serious bodily injury
    7. 7. Châtillon – 21/07/2009 - classification : CONFIDENTIEL «  ALBATROS  » Moovie Madrid 11/11/10 CONFIDENTIEL
    8. 8. Madrid 11/11/10 CONFIDENTIEL <ul><li>The skills developed by AXA Assistance cover all the aspects of day-to-day life for a disable person : </li></ul><ul><ul><ul><ul><ul><li>legal environment </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>fiscal environment </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>social environment </li></ul></ul></ul></ul></ul>Our service offer
    9. 9. Madrid 11/11/10 CONFIDENTIEL <ul><li>We offer multidisciplinary skills : </li></ul><ul><ul><li>Analyse in details the bodily injury cases : casualty’s description, medical expert report, victim or lawyer complains, … </li></ul></ul><ul><ul><li>Look for the best global solution for the victim and propose it to the Insurer Claim Manager. </li></ul></ul><ul><ul><li>Guarantee the right and the long term implementation of the proposed services . </li></ul></ul>Our services’ offer
    10. 10. Madrid 11/11/10 CONFIDENTIEL <ul><li>On the Insurer request, we : </li></ul><ul><ul><li>Assists the Claim Manager during the negotiation with the victim or his/her layer </li></ul></ul><ul><ul><li>Defines a macro-economic analysis of expenses – Draw up a report for legal use </li></ul></ul><ul><ul><li>Makes the evaluation and practical implementation : </li></ul></ul><ul><ul><ul><li>Needs of domestic and paramedical care </li></ul></ul></ul><ul><ul><ul><li>Medical supplies </li></ul></ul></ul><ul><ul><ul><li>Home fitting up </li></ul></ul></ul><ul><ul><ul><li>Vehicle fitting </li></ul></ul></ul><ul><ul><ul><li>Employment support </li></ul></ul></ul><ul><ul><ul><li>Psychological support. </li></ul></ul></ul>Our services’ offer
    11. 11. Madrid 11/11/10 CONFIDENTIEL <ul><li>This solution permits to control the drifts and to contribute to better answers in care needs . </li></ul><ul><ul><li>To have immediate and secure visibility of the global cost . </li></ul></ul><ul><ul><li>To increase conciliation for a global benefit for the victim , her lawyer and the claim manager. </li></ul></ul><ul><ul><li>To have persistent services and avoid the feeling of relinquishment. </li></ul></ul><ul><ul><li>To supply to the victims a high quality service with the best providers control. </li></ul></ul>The aim of AXA Assistance solution
    12. 12. Madrid 11/11/10 CONFIDENTIEL <ul><li>The aim is to increase the number of settlements reached out of court by creating a trusting relationship that would benefit to the victim, his/her legal advisor and the insurer. </li></ul><ul><li>This is done by providing victims with the best possible global indemnification & long-term support so that they don’t feel abandoned, and by offering quality services with better cost control. </li></ul>The aim of AXA Assistance solution
    13. 13. Madrid 11/11/10 CONFIDENTIEL Practical implementation <ul><li>A dedicated team of disability consultants to advise the insurers and specialised on domestic care </li></ul><ul><li>A team of physician speciali s e d on bodily injuries </li></ul><ul><li>Specialised providers for disability equipment (medical supplies, architects, vehicle experts, carers, …), KPI,SLA’s </li></ul><ul><li>Capacity to move on the field for serious cases, to assist claim managers , and lawyers </li></ul><ul><li>Capacity to assist the expert physician to evaluate the technical needs of care. </li></ul>
    14. 14. Madrid 11/11/10 CONFIDENTIEL <ul><li>Build a Life Project including the solutions step by step in the victim’s life </li></ul><ul><li>Manage & Control the suppliers (Implementation, bills… ) </li></ul><ul><li>Offer a Regular Quality control </li></ul>Practical implementation
    15. 15. Châtillon – 21/07/2009 - classification : CONFIDENTIEL ALBATROS for AXA Moovie Madrid 11/11/10 CONFIDENTIEL
    16. 16. Madrid 11/11/10 CONFIDENTIEL Before the Albatros Scheme <ul><ul><li>Before the Albatross scheme , in case of serious bodily injury, AXA waited for the status of the person to be consolidated prior to discuss of a financial compensation (capital or annuity). It could take from a few months to 3 or 7 years. </li></ul></ul><ul><ul><li>Results for AXA : </li></ul></ul><ul><ul><li>High costs </li></ul></ul><ul><ul><li>Impact on the brand image and awareness </li></ul></ul><ul><ul><li>Paying blind without services </li></ul></ul><ul><ul><li>We have developed for AXA France , an innovative approach for disability persons after a serious bodily injury under the name : “The Albatros scheme” </li></ul></ul>
    17. 17. Madrid 11/11/10 CONFIDENTIEL Albatros Scheme <ul><li>In case of a new case of serious bodily injury, AXA checks that the case can be in the scope, then AXA transmits the case to AXA Assistance </li></ul><ul><ul><li>First step : AA contact the family and organize the urgent services for the victim’s family : psychological support, transport of the family to the hospital, baby-sitting…) </li></ul></ul><ul><ul><li>Second step : Our medical team study the situation of the victim (health and housing), elaborate a life plan and decides for several fittings </li></ul></ul>
    18. 18. Madrid 11/11/10 CONFIDENTIEL Albatros Scheme <ul><ul><li>Third step : After the agreement of the victim , his family and AXA on the life plan and development of housing, we proceed to these adaptations and we organise the home care services at the expense of AXA </li></ul></ul><ul><ul><li>Fourth step : When the victim leaves the hospital, all the services are initialized at home and we follow the situation day after day and proceed to the necessary changes </li></ul></ul>
    19. 19. Case Management suppliers Assistance / Care Medical Rehabilitation Gain Autonomy Social Rehabilitation Back to social life Vocational Rehabilitation Back to work Home assistance (pets, gardening..) Professional coaching Temporary Permanent Medical Assessment Medical experts Driving aids Home Architects House equipment and adaptation Social coaching Network of specialized homes Physiotherapists Medical equipment Babysitting Housekeeping Home nurse Transport Training centers Psychologists Recruiting centers Schools Rehabilitation clinics * Intern AXA Home architects Medical experts Sport’s coaching Madrid 11/11/10 CONFIDENTIEL
    20. 20. Madrid 11/11/10 CONFIDENTIEL Albatros Scheme : results for AXA <ul><li>Results for AXA : </li></ul><ul><li>From October 2006 to October 2010, over 500 cases have been managed by AXA Assistance under this innovative approach for various entities of AXA in France. </li></ul><ul><ul><li>The felt of the victims and of their families is very good concerning the Albatross scheme : > 95% of satisfaction </li></ul></ul><ul><ul><li>Significant reduction of costs under Albatros Scheme </li></ul></ul><ul><ul><li>AXA is the only insurer to have such an elaborated answer </li></ul></ul>