The overarching programme objectives were:

• Organisation and management of occupational medicine throughout Poland using the e-referral tool.
• Preparing ranges of medical packages tailored to the needs of employees and their families, including the possibility of providing medical cover for parents /in-laws of employees.
• Enabling freedom of treatment outside the network of available medical facilities of the provider.
• Honouring referrals from outside (including from doctors from the National Health Fund).
• Number of available medical facilities in designated locations throughout Poland.
• Increasing awareness of the use of medical care by employees and their families.

Having identified the key needs and framework for the programme, we began a review of the healthcare market for our client. This activity included, in particular:

• a comprehensive analysis of the offers received from subscription and insurance companies
• implementation of a new healthcare programme
• monitoring the implementation of the programme by the provider
• monitoring and reporting on the progress of the programme throughout the contract period, i.e. surveying the quality and satisfaction of the medical services offered

The starting point of our cooperation was the unsatisfactory organisation of occupational medicine and the lack of consolidation and unification of the medical programme for both of our client’s companies. In doing so, there could be no lack of guidelines, including the needs of the employees and the employer co-financing the programme. The whole process from conception to implementation took about 4 months, resulting in a change of supplier and an improved and more computerised organisation of occupational medicine, thanks to which our client’s HR department increased control over the timeliness of examinations and implementation in the case of initial surveys. The ability to use e-referrals for employees spread across the client’s construction sites and the control of their validity through the use of a dedicated platform helped to eliminate situations in which an employee was not allowed to work due to a lack of up-to-date periodic examinations.

Our actions

1. Analysis of the situation

Company XYZ had a receivables insurance policy concluded directly with the insurer for several years. When a loss occurred, the insurer refused to pay the claim, arguing that certain requirements in the policy were not met. In addition to this, the insurer’s level of credit limit coverage had deteriorated (limit reductions and single total withdrawals).

2. Consultation with the client

We held a series of meetings with XYZ to better understand the client’s needs and the company’s procedures. We prepared an appeal against the insurer’s refusal. As a result, the client received compensation partially covering the loss. We worked with the client to develop assumptions for a new insurance programme.

3. Insurance bidding competition

Based on the mandate received from the client, we organised a tender competition (Allianz Trade, Atradius, Coface, Credendo, Ergo Hestia, KUKE) and conducted negotiations. By using the competition, we were able to obtain more favourable terms, including a premium reduction of almost 20%. At the same time, the insurance terms were better adapted to the client’s business practice (e.g. no need to report receivables from retail chains for collection, despite overdue amounts). We introduced a clause into the contract entitling the client to terminate the contract when the aggregate limit coverage falls below 75%.

A new insurer was selected as a result of a competition.

4. Adjustment of internal procedures

The client, with our assistance, made some minor changes to its claims management procedures to better fit the requirements of the new insurance contract. This minimises the risk of claims being denied in the future.

5. Supplementary agreement with a second company

As the insurer selected in the competition, could not offer satisfactory limits for several customers, we negotiated with a second insurer. As a result, the client concluded a ‘supplementary policy’. This significantly improved the overall credit limit coverage (more than 90%). In order to facilitate the handling of both policies, the complementary contract introduced the same procedures as in the main policy (same deadlines for applications, identical reporting periods, etc.).

Service after conclusion of insurance contracts

A Prospector-appointed account manager supports the client’s staff in the day-to-day handling of the policies. The need for support is most often related to ‘difficult credit limits’ and clarification of detailed policy provisions in the context of relations with counterparties (e.g. permissibility of payment deferrals, reporting for debt collection).

In addition, we keep the client informed of market developments, e.g. corporate insolvency statistics.

Results

Nasze działania przyniosły XYZ następujące korzyści:

1. a partial claim payment on the existing policy (PLN 130,000), despite an earlier absolute refusal,
2. reduction of insurance costs in the next period by slightly less than 20%,
3. better security of receivables obtained (higher credit limits from two insurers),
4. minimised risk of claim refusal (alignment of procedures in the policy with the client’s business practice),
5. reduced burden on insurance handlers on the client’s side (support from Prospector’s supervisor).