MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS ... - Invest in ME

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“It is important to understand why we believe the biopsychosocial model of disability is so important…the older
medical model provides a very incomplete view of what lies behind sickness and incapacity…There is more to disability
and incapacity than just illness or a disease. We know, for example (that) beliefs about causation….are more important
predictors of long‐term absence….
“Many people confuse illness with disease, when in fact they are distinct.
“By definition, some illnesses occur in the absence of disease. Irritable Bowel Syndrome is one such illness.
“What determines the subjective experience? Previous life experience will be important. Were they brought up by
over‐protective parents and developed negative and fearful expectations of life?
“(Our) application form…contains a series of behaviour‐based questions….We believe our move away from diagnosis‐
based underwriting to a decision‐making process linked far more closely to applicant behaviour and attitude is a
significant first step….An applicant’s GP consultation pattern, when added to a history of medically unexplained
symptoms, may well steer the underwriter to an adverse terms decision.
“The biopsychosocial model tells us that what keeps people off sick often has little or no relation to what they went off
with in the first place. Early intervention can prevent harmful ideas or beliefs becoming embedded.
“At UNUMProvident we believe that the only way to ensure that our claimants and customers receive the help they
really need is by understanding what lies behind illness and incapacity.
“ Just understanding is not enough, we have to ensure that this understanding is correctly applied to ensure that we all
reap the benefit”.
2007
The next publication in the series (“Enhancing our claims management service”) delivered the same sermon:
“In 2005 we introduced the concept of the biopsychosocial model….We explained that through our links with the
UNUM Centre for Psychosocial and Disability Research at Cardiff University, we had grown to wholeheartedly
embrace the BPS model.
“We are continuing to build on what has proven to be a very successful model.
“UNUM has been specialising in Income Protection since 1970. As our knowledge, experience and understanding of
this complex area has grown, so too has our hunger to drive and enhance the market in terms of delivering leading edge
theories (and) concepts”.
2007
In November 2007 Mansel Aylward wrote the Monthly Editorial for HCB Group News. HCB stands for
Health Claims Bureau Group and incorporates James Harris Investigations. Aylward is a non‐executive
Director of HCB. Another non‐executive Director is Peter Le Beau, who previously worked at the re‐insurer
Swiss Re (where Peter White is Chief Medical Officer) and when at Swiss Re was one of the first people to
use the services of HCB.
Aylward’s Editorial is entitled “Changing the culture about work, health, and inactivity: challenging the
path to economic activity” and he says:
“The social contexts of economic inactivity…must be fully recognised and soundly addressed if the desirable shift in
culture about work and health is to be attained.