Insurer’s roles and responsibilities

  1. Determine whether the employee meets the criteria of his/her disability contract and whether he/she is eligible for benefits (Corbière et al., 2020)
  2. Determine the services/interventions to which the worker is entitled by taking into account his/her file and the cost associated with these services/interventions (Corbière et al., 2020)
  3. Assess whether these services/interventions are relevant and whether they are intended to promote the worker’s RTW and preserve his/her employment relationship (Corbière et al., 2020)
  4. Ensure that treatment costs, as well as sickness benefits and the interventions required are covered (depending on what is permitted by the insurance contract) (Corbière et al., 2020)
  5. Be in regular contact (e.g., every 3-4 weeks) with the worker, especially if there is a risk of long-term sick leave (Corbière et al., 2020)
  6. Update your file according to the medical, social and professional information collected (Corbière et al., 2020)
  7. Provide clear and factual explanations to the worker about his/her insurance contract and what lies behind it (Corbière et al., 2020)
  8. Adopt an integrated approach to managing the worker’s health issues, while taking into account the worker’s particularities, and working with the employer while respecting confidentiality (Corbière et al., 2020)
  9. Draft a RTW agreement with the workers on sick leave in collaboration with other key stakeholders (employer, union) (Corbière et al., 2020)
  10. Be aware of the factors predicting RTW of workers on sick leave (Corbière et al., 2020)