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Instructive Insurance Claims in the Netherlands

Posted Oct 03 2009 10:02pm

Better prevention can reduce claims for occupational diseases
An estimated 25,000 employees a year develop an occupational disease in the Netherlands. A growing number of these people submit a claim against their employer. Better prevention and better social and medical supervision of personnel could drastically reduce the number of claims for compensation in relation to occupational diseases.

This is the main conclusion of the study Leerzame Schadeclaims (Dutch) (Instructive Insurance Claims), for which the final report was published on 4 June. The study was carried out by a team of researchers from the University of Amsterdam (UvA), the University of Maastricht (UM) and the Netherlands Centre for Occupational Diseases (AMC-UvA).

The researchers analysed 37 occupational disease dossiers relating to RSI (repetitive strain injury) and CTE (chronic toxic encephalopathy), supplemented by 16 interviews with patients from the dossiers analysed. This was the first study in the Netherlands of the background to occupational disease claims and the possibilities of preventing such claims.

The development of occupational diseases
The researchers identified the factors which influence the occurrence of the occupational diseases studied. They observed that the occupational diseases in the dossiers studied could not be solely attributed to unhealthy work, but developed due to a combination of unsatisfactory working conditions, heavy workload and poor working relationships. In addition, the quality of health and safety management in the companies studied was well below standard.

No attention was paid to the occupational disease in the company’s risk inventory and evaluation (RI&E) report, and the work-related nature of the symptoms was not sufficiently recognised by the management, colleagues and the company doctor. The social and medical supervision in the cases involved also left much to be desired: company doctors were kept at a distance by the management, were not sufficiently pro-active or possessed inadequate knowledge.

Employees with work-related symptoms were mostly moved to other jobs with the same unsatisfactory working conditions, so that the symptoms became worse. In the area of treatment, too, there is often too little knowledge of occupational diseases: it is often several years before an occupational disease is diagnosed by a medical specialist. The treatment of work-related conditions in the Netherlands is still in its infancy.

The motives for submitting a claim for compensation
Contrary to the researchers’ expectations, financial reasons were not the main motive for submitting a claim. Employees’ motives were primarily of a social and emotional nature. They were prompted by factors such as the pain and suffering caused by the occupational disease and the refusal of the employer, company doctor and medical specialists to recognise the symptoms. Employees generally felt badly treated, were angry about this and therefore submitted a claim. Financial motives primarily play a role when patients become unemployed or have to rely on occupational disability benefit.

Recommendations
On the basis of the results, the researchers have made a number of recommendations:

  1. Early recognition of occupational diseases is extremely important. This makes it possible for steps to be taken at an early stage to prevent the symptoms from worsening and to guide the employee into suitable work. It prevents situations in which employees reach a complete deadlock at a late stage and feel badly treated. The working conditions can also be improved in time to prevent colleagues from developing the same occupational disease.
  2. Requirements for early identification of occupational diseases and timely action include low-threshold access to the company doctor, a company doctor with sufficient expertise on occupational diseases and a company doctor who ensures that work-related health conditions can be discussed with the employer.
  3. Complex labour-related problems require low-threshold access to external health and safety at work organisations: company doctors must be able to refer employees without financial obstacles for the latter.

The study was carried out by a team of eight researchers from three different research institutes: the Hugo Sinzheimer Institute for Labour and Law (UvA), the research institute Metro (UM) and the Netherlands Centre for Occupational Diseases (AMC-UvA), in collaboration with the Centre of Excellence of the NVAB (Netherlands Society for Occupational Medicine). The research was supported financially by the GAK foundation (Stichting Instituut Gak).

Posted in Compensation, Occupational diseases
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