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Claims hotline

Claims management

SUCCESSFUL SOLUTIONS FOR GETTING PEOPLE BACK TO WORK

We provide advice, support and useful tips. Because employees often need help in returning to work faster after an accident or illness. Generali’s claims management service has you benefit from our many years of experience and valuable network. We help you take the most effective measures right away.

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Generali claims management

 

Professional support in returning to work

We believe that accompanying your employees who have been ill or had an accident on their individual road to recovery is the best way to enable them to get back to work quickly. Generali’s claims management process is available in conjunction with accident and daily sickness allowance insurance and gives you access to professional support and a competent service.

How you benefit

  • Get your own personal point of contact
  • Reduce your illness- and accident-related costs
  • Benefit from early recognition of chronification risks
  • Avoid and reduce cases of disability
  • Optimise a poor claims history, thus reduce the negative impact on the policy
  • Your affected employees get accompanied on their journey back to work
  • Get medical second opinions
  • Assess the individual’s rehabilitation potential
  • Get access to the best reintegration specialists

What is insured?

Generali claims management gives you access to a valuable network of top reintegration specialists: medical professionals and case managers accompany your sick or injured employees on their way back to work. If you have accident or daily sickness allowance insurance, you can take advantage of the following on request:

  • Personal point of contact: you have your very own contact for all accident- and illness-related claims.
  • Assessment by medical specialists with a proven track record: you find out whether or not the treatment, condition or incapacity for work is justified.
  • Independent clarification: medical professionals will examine the insured person and propose alternative treatment options.
  • Support for insured persons: expert case managers will visit the insured persons, explain their rights and obligations, and ask about their needs.
  • Mediation: if necessary, we can mediate between you and the insured person, and arrange meetings. Our specialists will come up with effective, legally tenable measures for discussion, agreement and planning with you.
  • Support: in the integration phase, your personal point of contact will stay in close contact with all the people, institutions and insurers involved. That way, they’ll be able to spot any irregularities almost immediately and take the appropriate steps in good time.
  • External experts: if required, you can draw on the expertise of outside specialists, such as case managers, for specific support in relation to specific cases.

 

How Generali claims management works

 

Real-life example

43-year-old Marcel Häfliger, an IT team leader, suffers from a serious burnout. He is signed off sick and admitted to a clinic to start recovering from his illness. Thanks to the insurance held by his employer, Mr Häfliger can benefit from the Generali claims management service. During his hospital stay, he first meets his personal point of contact.. The latter builds up a picture of the patient’s medical, social and economic situation, obtains reports and talks to the attending doctors. Above all, she talks to the patient, answers his questions and shows him tried-and-tested options for solutions.

 

Together, they determine how his journey back to work will be approached. And so, after a short while, Marcel Häfliger joins a programme designed to assess his capacity for work. For the next three months, he works as an IT support specialist in a small workshop, investigating problems and providing advice. During this important trial period, he realises that he feels strong enough to be able to return to his former place of work. Things have continued to look up ever since and Marcel Häfliger is once again head of the IT team. He attributes his speedy and successful recovery in large part to his contact at Generali.

FAQS

As an experienced insurance company, we have access to the best specialists. We can draw on a large network of professional experts and case managers. Your employees benefit from competent support and neutral advice; this increases their chances of rehabilitation. In other words, everything we do for you is particularly efficient and effective.

  • Large network of experts in different areas
  • Effective and efficient support
  • Wide-ranging benefits for a small price
  • Free additional services that have no impact on your insurance contract

The process of getting your employees back to work involves five steps:

 

Step 1: Notification and processing

You notify us of your employee’s absence – whether it’s due to illness or accident or because the person in question will be off work for a long time. Once we have received your notification, we’ll get the insured person’s consent to ask for the necessary medical reports.

 

Step 2: Analysis, early recognition and triage

An expert will take charge of the case and assess the situation. They will remain in close contact with all the relevant people and bodies throughout. That way, potentially lengthy absences can be identified at an early stage and effective measures taken in good time.

 

Step 3: Clarification, advice, evaluation and expert opinions

We visit the insured person, clarify issues and offer advice, conduct an assessment and establish their needs. If anything is unclear, we obtain medical reports and second opinions.

 

Step 4: Coordination, outsourcing and support

Case managers can intervene in a number of different ways, depending on the case:

  • coordinating the actions of everyone involved (e.g. insured persons and their families, doctors, the employer, lawyers, social insurance schemes and private insurers)
  • providing advice and support in choosing the right therapy
  • organising the return to work. Considerations include the insured person’s capabilities, the courses of action open to the employer and ergonomically optimising the workspace, etc.
  • providing support in contemplating a career change if a return to the former workplace is no longer feasible.

 

Step 5 – Progress monitoring and conclusion

We continue to accompany the insured person on their return to work. For as long as is necessary.

Helpful documents