Iain Laws: Is open-referral private PMI right for employers?

Clear evidence is emerging in our portfolio of employer clients that cost and employee satisfaction gains are being achieved by employers that have chosen to implement this claims process.

The adoption of open referral by most insurers demonstrates growing employer demand and employee comfort with this approach. We recognise there will always be employers that place more importance on having a choice of consultants and treatment, so we support open referral as a design option rather than compulsion for employers.

When communicated clearly, we have seen little, if any, negative reaction from employees to the removal of consultant choice, because the NHS already operates this system at the highest level.

It is not yet clear whether quality of care or cost is the overriding factor in deciding which consultants an insurer will offer a claimant. While there remains a lack of information on this point, there will be concerns that cost is dominant.

However, a positive aspect is the increasingly detailed information gathered at the point of claim by some insurers, which enables claimants to be directed to a suitably specialised consultant. This can shorten diagnosis and speed up treatment, with the employer gains of reduced absence and enhanced quality of care.

Employers provide private medical insurance (PMI) for various reasons: to protect their employees and their business, and as a benefit from which staff engagement arises. Open referral is a welcome development which is seen to strengthen all of these factors. 

Iain Laws is corporate sales director at Jelf Employee Benefits