Memorandum on Disability Insurance


The information published here is available in the public domain. Speculations in this information are the work of a single individual and should be considered as informed but unsubstantiated guesses. This individual is an independent researcher and has carried out this work for no remuneration or other emolument.


  1. This report considers the evidence for a relationship between Mansel Aylward, Health Claims Bureau, James Harris Investigations and others.

  2. US private healthcare and disability insurance companies are keen to expand into the UK market.

  3. The UK market is regarded as a prime area for growth as it is immature and protections for claimants are few and costly.

  4. The UK market is regarded as a test market in that if the state near monopoly for disability insurance can be undermined and private disability insurance can grow then this model can be applied elsewhere.

  5. In the US there are protections in place for claimants. Claimants in each US state receive protection from the state's Department of Health. The DoH can take action on behalf of claimants to set precedents and fine companies.

  6. UK governments have been very welcoming to the McKinsey & Company processes for handling insurance claims (deny, delay, and defend). These processes have been discredited in the US.

  7. The UK treats cases on a case by case basis through judicial processes that are not able to set precedents.

Areas for Further Research

  1. While Mansel Aylward could influence honours, how many were awarded to the insurance industry?

  2. Of those honoured in the insurance industry, how many have been or are clients of Health Claims Bureau Group companies?

  3. What are the names of all the Health Claims Bureau Group companies?

  4. Is the Health Claims Bureau website misleading when claiming there is a group of companies?

  5. Who funds directly or indirectly Health Claims Bureau especially with taking on additional staff in the last few years?

  6. Who provides the software (liMa clone) used by Health Claims Bureau?

  7. Does the approach used by Health Claims Bureau infringe the copyright owned by the DWP and as licensed for use by Atos?

  8. Is it legal for Health Claims Bureau Inspectors to inspect birth certificates and financial documents?

  9. Will Atos close down its heathcare assessment operations and hand the business over to Alphonse (Al) Hemond?

  10. Are Ministers and the Select Committee aware of Alphonse (Al) Hemond?

Summary of Findings

  1. There is no evidence for wrong doing.

  2. James Harris Investigations is no longer active.

  3. James (Jim) Harris from James Harris Investigations is the Chairman and Managing Director of Health Claims Bureau.

  4. Mansel Aylward is a director of Health Claims Bureau.

  5. Health Claims Bureau is a "TOTAL EXEMPTION SMALL" company.

    For financial years starting on or after 6 April 2008, to qualify for total audit exemption, a company must:

    • qualify as a small company

    • have a turnover of no more than £6.5 million

    • have a balance sheet total of no more than £3.26 million

  6. Unum is a major US disability insurer.

  7. Unum has global ambitions.

  8. Unum's growth has stalled in the US.

  9. Unum's growth in the UK has been hit by adverse publicity.

  10. Unum has been forced to withdraw from selling direct to UK individuals.

  11. Unum UK only sells to employers directly or via independent financial advisors (IFA) which protects Unum from employee litigation.

  12. Unum US has sent a trouble shooter Alphonse (Al) Hemond (worked directly for Unum for 23 years) to take charge in the UK.

  13. Alphonse (Al) Hemond was VP of Reengineering and Claims for Unum. He was the most senior Unum man who took the McKinsey & Co approach used at Alstate and reengineered Unum. He was responsible at Unum for the discredited process.

    In July 2008, the American Association for Justice ( published a document "The Ten Worst Insurance Companies In America: How They Raise Premiums, Deny Claims, and Refuse Insurance to Those Who Need It Most". Allstate was the worst and Unum was the second worst.

  14. Alphonse (Al) Hemond has assisted in putting together a new company Health Claims Bureau which can grow rapidly.

  15. Alphonse (Al) Hemond remains in the background.

  16. Alphonse (Al) Hemond has selected James (Jim) Harris because:

    • he was a Police Officer in the British South African Police (Rhodesia) so is able to take pressure and may feel little empathy for those unable to stand alone. There may be a religious element. He lost everything in 1980 and started again in the UK.

    • he may have been awarded a medal by Rhodesia: "Meritorious Conduct Medal (MCM) Harris, JW (No. 18049S) Field Reservist on 07-Dec-1979". See BSAP ( Rhodesia Unilateral Declaration of Independence from the United Kingdom ended in 1979. BSAP had fought alone, to maintain control by the tiny white majority, against enormous odds since 1965. Rhodesia was renamed Zimbabwe.

    • he has extensive experience of investigating disability claims.

    • he has an excellent track record in disproving claims because he is still in business paid by the insurance companies.

    • he is likely to have strengths as an enforcer and is able to intimidate.

    • he has extensive knowledge of disability claims investigations.

    • he has built a database of useful information and contacts.

    • he is close to law enforcement in the UK.

    • he knows people who are close to criminal organisations and individual criminals.

    • he is probably a mason which used to be and still might be important in both law enforcement and in insurance.

    • he is likely to be a bully and likes to be seen as the boss.

    • he is likely to be easily intimidated.

    • he does not deal well with sensitive questions either clamming up, blustering or smiling like a Mandelsonian crocodile.

    • he would not like to be interviewed and will give the clipped considered evasive answers as trained police officers do.

    • he has little life outside work and is most comfortable in the company of like minded manly men who do manly activities like shooting (though it never can come up to his Rhodesian exploits).

  17. Alphonse (Al) Hemond has selected Mansel Aylward because:

    • he is a proven Unum champion

    • he has set up a research facility to improve the credibility of the Psychosocial pseudo science.

    • he has close contacts in Government and was appointed by Labour Ministers to influential positions.

    • he can influence honours awarded by the Queen. There is nothing a fat cat insurance director likes better than a gong.

  18. Alphonse (Al) Hemond has selected the others because:

    • they add UK experience, contacts and operational skills.

  19. Unum has off balance sheet control of HCB.

  20. Health Claims Bureau website states "Our assessment requires a different mindset from clinical medicine"

  21. Unum through Health Claims Bureau are using the discredited and illegal in the US approach to the unprotected UK market. Many disabled who think they have bought insurance will find that the insurance is worthless.

Findings - Mansel Aylward

  1. Mansel Aylward along with many influential people in government attended functions in the UK and elsewhere funded by the private healthcare industry.

  2. Mansel Aylward has had a major role in introducing to the UK a "non medical" model for assessing disability insurance (state or private) claims which was obtained from the USA and has been discredited in the USA.

  3. Mansel Aylward has had a major role in the decision to contract out assessing disability claims to private healthcare companies.

  4. Mansel Aylward has had a major role in undermining the reputation of the state in carrying out the state's duty to meet disability claims.

  5. Mansel Aylward has produced research papers, presented at conferences and used every opportunity to give credibility to the "non medical" model for assessing disability claims.

  6. Mansel Aylward works closely with industry bodies and the major companies to meet their needs to reduce payouts to claimants.

  7. Mansel Aylward has supported the Unum suggested name changes of benefits to confuse and misdirect e.g. IB to ESA, DLA to PIP, various to UTC etc.

  8. Mansell Aylward
    Director ID: 916446072
    Mr Mansell Aylward is a director of
    Aylward Maurice Limited
    Director Summary
    Mansell Aylward has 1 company director or secretary appointments.
    Short name - Mansell Aylward 
    Director ID : 916446072
    Year of Birth: 1942
    Regency House 61a Walton Street
    Walton On The Hill, Tadworth, Surrey KT20 7RZ, United Kingdom
    Company Summary
    Company Name Company Status  
    JIGSAW DIAGNOSTICS LIMITED Active (Director Resigned 10/11/2011) 
    Sir Mansel Aylward CB MD FRCP
    Director ID: 910666131
    Sir Mansel Aylward CB MD FRCP is a director of see below
    Director Summary
    Mansel Aylward CB MD FRCP has 11 company director or secretary appointments.
    Short name - Mansel Aylward 
    Director ID : 910666131
    Year of Birth: 1942
    Cefn Cottage, Cefn Coed Y Cymer, Merthyr Tydfil CF48 2PH
    Company Summary
    Company Name Company Status  
     - Dissolved  
     - In Liquidation  
     - Active  
     - Active (Director Resigned 04/01/2012) 
     - Active (Director Resigned 03/04/2007) 
    - Active (Director Resigned 31/12/2009) 
    - Active (Director Resigned 18/06/2007) 
    - Active (Director Resigned 01/04/2007) 
    - Active (Director Resigned 24/11/1992) 
    - In Administration (Director Resigned 27/05/2009) 
    - In Administration (Director Resigned 01/10/2008) 


  1. Mansel Aylward continues to have good connections with influential people in Government.

  2. Mansel Aylward is a KEY person in progressing the interests of the private healthcare companies.

  3. Mansel Aylward travels widely and makes payments to professional bodies.

  4. Mansel Aylward receives payments from different sources including those relating to being a director on the boards of various organisations.

  5. Mansel Aylward uses tax avoidance schemes to minimise tax paid.

Findings - Alphonse (Al) Hemond

  1. Alphonse (Al) Hemond attended South Portland High School, 637 Highland Avenue, South Portland, Maine, USA. He was sent a birthday card from the South Portland High Class of 1977 on his birthday 2008-06-08 (8th June).

  2. Prudential Financial Launches New Web-Based Capabilities for Employees of Group Disability Clients

    Insurance Networking News, April 19, 2004

    Prudential Financial Inc., Newark, N.J., has launched a new online disability claim submission application for employees of group disability clients. The new functionality also lets employees handle many aspects of their claims using a highly secure and confidential online process.

    "Continuing to provide our clients and their employees with the secure tools they need to effectively manage disability issues is of paramount importance to us," says Al Hemond, vice president of disability risk management for Prudential's group insurance business. "Online employee claim submission supports our strategy of providing claims management services that are responsive to the varying needs of claimants."

    Once a claim is submitted, employees receive automatic access to an online application that enables them to:

        Set up tax withholding information.
        Establish or make changes to electronic fund transfers.
        Change contact information.
        Provide date of birth information for themselves and their families.
        View and print claim statements via a Portable Document Format (PDF) file.

    The latest enhancements serve as a follow-up to January 2004 employee modifications that included online applications to report delivery dates related to pregnancy claims and dates when individuals have returned to work.

    Prudential's group disability clients already have access to a range of automated services, including online billing, access to claim and payment reports, access to an online document center and an integrated online/IVR enrollment application.

    Source: Prudential Financial Inc.

  3. Professional Disability Associates

    Al Hemond, President - International and Domestic Business

    Al directs the Planning, Operations and Financial activities of PDA and leads the company while focusing on strategic goals both domestically and abroad. Al has an extensive background in executive leadership, most recently with Prudential as Senior Vice President managing their disability claims organization. Al spent the first 23 years of his career working for UNUM in various capacities including two years in Los Angeles and two years in the UK.

    Al holds a B.A. degree in Mathematics from Boston College and an MBA from the Whittemore School at the University of New Hampshire.

  4. GettingHired, LLC Announces the Addition of Al Hemond, Former Prudential SVP of Disability Risk to its FastTrackRTW Team

    The FastTrackRTW program will be used by major Short & Long Term Disability and Workers Compensation carriers to better manage their return to work challenges, helping newly disabled individuals find employment and return to productive lives.

    Bedminster, NJ (PRWEB) January 20, 2010

    GettingHired, LLC announced today the retention of insurance industry executive Alphonse Hemond as a primary consultant for the companys new FastTrackRTW product line. In this capacity, Mr. Hemond will assist CEO Thomas Capato with product development strategy, sales and marketing activities as well as operational strategy and support.

    Mr. Hemond has twenty-five years of senior international management experience in the insurance industry, with specific expertise in short and long term disability product lines and claims operations. His prior positions include SVP of Disability Risk for Prudential, Managing Director for HRS Consulting, and VP of Reengineering and Claims for Unum. Mr. Hemond holds a B.A. degree in Mathematics from Boston College and an M.B.A. from the University of New Hampshire.

    "Having Al's great wealth of knowledge and expertise will be a tremendous asset to the FastTrackRTW team and its customers as we finalize development and take the product to market" said CEO Tom Capato. He further stated, "FastTrackRTW will aid insurance carriers in the Short & Long Term Disability and Workers Compensation sector to better manage their return to work challenges. FastTrackRTW is uniquely positioned with a robust set of career tools for claimants/injured workers as well as a tracking module for caseworkers to monitor and encourage utilization. Long Term Disability and Workers Compensation insurance carriers will utilize FastTrackRTW to enhance their Return to Work programs by helping newly disabled individuals find employment and return to productive lives."

    About GettingHired, LLC - GettingHired, LLC is a software and services organization focused on creating employment opportunities for people with disabilities and helping employers find talented employees. In addition to FastTrackRTW, the company is well known for its national employment and social networking portal - Careers and Community for People with Disabilities. uniquely connects talented job seekers who happen to have disabilities, employers, advocacy organizations, veterans groups, colleges and service providers.

  5. Alphonse (Al) Hemond was appointed to Health Claims Bureau board of directors 2 July 2008 (company director form).

  6. There is only circumstantial evidence that links Alphonse (Al) Hemond with either the objectives of Unum or Unum itself.

Findings - Health Claims Bureau - Company

  1. Health Claims Bureau Limited is active.

    Company category: Private Limited Company
    Company number: 02820780
    Company status: Active
    Company homepage, website: n/a
      country of origin: United Kingdom
      incorporation date: 1993.05.24
      last member list: 2011.05.24
      has UK establishment: No
      has appointments: Yes
      in liquidation: No 
    Company sics:
      7487 - Other business activities
      account ref date: 31.12
      next due date: 2012.09.30
      overdue: NO
      last made up date: 2010.12.31
      account category: TOTAL EXEMPTION SMALL
      document available: 1
      next due date: 2012.06.21
      overdue: NO
      last made up date: 2011.05.24
      document available: 1 
  3. Board:
      James Harris MIPI - Chairman & Managing Director
        - has a wide experience of investigative matters
        - served as a British South African Section Officer
            - Police Criminal Investigations Department (Zimbabwe)
        - has parents born in the UK
        - moved to the UK in 1980.
        - worked briefly in general investigation
        - set up company in 1984
            - investigate disability insurance claims
        - invited to set up HCB by a leading re-insurer in 1993 (Chief Executive).
        - appointed Chairman and Chief Executive in April 2008.
      Professor Sir Mansel Aylward CB MD FRCP FFOM FFPM - Director
        - was from 1996 to April 2005
            - the DWP Chief Medical Adviser,
            - the DWP Medical Director,
            - the DWP Chief Scientist
            - the MoD SPVA Chief Medical Adviser
            - the MoD SPVA Head of Profession
        - was in 2001 appointed
            - as The Royal Society of Medicine's Academic Sub Dean for Wales.
        - is Director of the Centre for Psychosocial
          and Disability Research at Cardiff University
            - psychosocial, economic and cultural factors
              that influence health, illness, recovery,
              rehabilitation and reintegration.
        - is the first-ever Chair of Public Health Wales
            - a new unified NHS Trust responsible for the delivery
              of public health services at national, local and
              community level in Wales.
        - was Chair of the Wales Centre for Health (Assembly Government Sponsored Body)
            - established to be the 'hub of connected organisations'
              and to communicate better health messages to the people of Wales.
        - undertook in October 2007
            - a review of Health Commission Wales' functions
              including its decision-making processes and appeals mechanism.
            - produced a report on key findings, advice and recommendations
              submitted to the Minister in June 2008
        - advised the Minister  on the healthcare provision
          in Merthyr Tydfil and surrounding areas.
        - asked by the Minister in December 2008 to head the Bevan Commission
            - to change NHS structures in Wales
        - was elected in 2005 to the new Queen's Birthday Honours Committee,
          designed to make the system more transparent.
            - was in September 2008 re-appointed for a further 3 years.
        - is Patron of The Shaw Trust
            - provides training and work opportunities
              for people disadvantaged in the labour market due to
              disability, ill health, or other social circumstances.
        - was knighted in the Queen's New Years Honours 2010
          for services to healthcare.
      Eoin Byrne B.Comm (IRL) - Marketing Director
        - is a Commerce graduate from University College Dublin,
        - has over 30 years experience in the Financial Service Industry.
        - operated at Director level with Norwich Union
        - operated at Director level with Hibernian Groups (retired 2005)
        - was responsible for
            - all Operational Divisions
            - Business,
            - IT and Process Solutions and Implementation,
            - Legal and Compliance,
            - Underwriting and Claims.
        - served on many Industry panels and Boards
            - Irish Insurance Federation
            - Insurance Ombudsman Board.
        - joined HCB in 2007
        - was appointed to the Board in 2008.
      John Gillman LLB (Hons) ACII FRSA - Director
        - holds an Honours Degree in Law
        - is designated a fully qualified Chartered Insurance Practitioner
          by the Chartered Insurance Institute.
        - was elected a Fellow of the Royal Society of Arts in 2008.
        - started his career as a pensions consultant with Legal & General
        - spent 10 years with the US based Cigna Corporation
            - became National Accounts Director
              responsible for relationships with major UK employers.
            - helped employers reassess their workforce healthcare strategy
              with the use of pioneering risk management tools
              such as Managed Care.
        - joined Noble Lowndes & Partners (now part of the Mercer Group) in 1993
            - set up a new Healthcare Consulting Practice
        - recruited by Watson Wyatt
            - set up a new Healthcare Consulting Practice
            - managed their health and risk consulting team for 6 years
            - managed the cost of
                - ill-health early retirement under pension funds,
                - sickness absence management,
            - designed health related insurances
            - resourced appropriately qualified occupational health advice.
        - provides consulting services in his own right.
        - has produced strategic reviews of the UK disability insurance market,
        - advised on
            - benefit design
            - Equality Law compliance
            - long term absence management.
        - appointed as an expert witness in a High Court case
          involving a dispute about Group Income Protection Insurance
          and its role in contracts of employment.
        - is a Director of RADAR Promotions Limited
          (the commercial arm of the Royal Association for Disability Rights)
          which campaigns for the rights of disabled people.
        - is a member of the Income Protection Task Force Executive Committee,
          an industry body representing insurers, consultants and lawyers
          who specialise in health related benefits.
      Mark Handford - Operations & Technical Director (appointed September 2011)
        - spent 10 years as a Medical Underwriter at Confederation Life
          before setting up, developing and managing a specialist Claims Department
          to handle the assessment of IP, GIP & contentious Death claims.
        - was responsible for a Pensions Department
            - for both Individual & Group pensions.
        - joined Sun Life of Canada as Client Service Director in 1995.
            - responsible for 350 staff
            - located in 44 sales offices
            - providing administrative support and compliance checking
              for the direct sales force.
        - joined HCB to handle Claim visits
            - became lead contract assessor for
              IP, GIP, TPD, CI, Death & Waiver claims.
      Al Hemond BSc MBA (USA) - Director (appointed February 2008, birthday 8 June)
        - is a recognised expert and world leader in disability claims management.
        - has a degree in mathematics from Boston College.
        - has an MBA from the University of New Hampshire.
        - worked for Unum for 23 years
            - in a variety of capacities,
            - including two years in the UK,
            - followed by two years managing a private consulting firm
              specialising in disability insurance.
        - has been Senior Vice President for disability risk for
          Prudential Financial in New Jersey for the past five years.
        - Al brings a wealth of international expertise to the Board.
      Peter Le Beau MBA FCII - Director
        - is one of the best-known consultants in the life and health insurance sector
        - began his career at Commercial Union (now Norwich Union),
        - went to Swiss Re (left 2001)
            - was initially head of underwriting
            - became head of UK marketing.
        - set up an independent consultancy, Le Beau Visage,
           - focus "on differentiation in the protection sector".
        - has regularly co-authored the Protection Review.
        - and regularly co-authored the Redmayne Report on Reassurance.
        - runs a strategic discussion group called The-Net-Work
        - set up in 2005 the Income Protection (IP) Task Force
            - with Clive Waller to promote greater awareness of 
              the value of Income Protection
            - produced a White Paper on IP in 2006.
        - is a non-executive director of several companies.
        - is a passionate believer in the value of protection.
      David Pitcher FCII FAMS DMU (AMS)
        - was Chief Underwriter for the Medical Sickness Group,
            - was responsible for both Underwriting and Claims from 1981 to 1997.
        - became Claims Manager for Permanent Insurance Company in 1997.
        - was Permanent's representative on the Association of British Insurers (ABI)
          Income Protection and Critical Illness Forum
        - was a member of the Industry Working Party liaising
          with the Government's New Deal project (Labour Blair/Brown).
        - retired from Permanent at the end of 1999.
        - is a Fellow of the Chartered Insurance Institute
        - is a Fellow of the Assurance Medical Society.
        - is a member of the Health Claims Forum.
        - is a member of the Association of Medical Underwriters
        - is a member of other (not specified) Industry Associations.
      Jonathan Webster
        - bio and image not available
    Medical staff:
      Dr Geoffrey Robb FRCP - Chief Medical Officer
        - is a practising consultant physician.
        - is also a Chief Medical Officer of 
            - Friends Provident
            - UNUM
            - Pension Annuity Friendly Society.
        - is immediate past President of the Assurance Medical Society.
        - is associate editor of the 4th edition of the Medical Selection of
          Life Risks, the standard industry textbook.
      Dr John Delfosse MB.BS DRCOG MRCGP DDAM FAMS - Medical Officer
        - GP with a particular interest in disability assessment.
        - joined HCB as a Medical Officer
        - is Chief Medical Officer for Gen Re and Legal & General.
    Key Head Office Staff:
      Louise Montgomery - Operations Assistant
      Lindzi Smith - Accounts & Administration
      Keith Thornton - IT & Systems Administrator  

Findings - Health Claims Bureau - website

  1. Who Are HCB

    HCB was established in 1984 and consolidated into the existing Group of Companies in 1993. The Group provides claim visiting and claim assessment services to insurers, ill health retirement assessment services and absence management services.

    HCB's offices are situated within a gated perimeter fence which is locked when the building is unoccupied. The office building is protected by an alarm system linked to the Police. All paper records are stored in fire resistant cabinets which are locked when the building is not occupied. Keys are stored in a password protected key safe.

  2. Why Use HCB

    Background and Pedigree

    • The most experienced visiting service in the UK.

    • We have a distinguished panel of industry experts on our Board of Directors.

    • The majority of the Directors have been involved in Income Protection and Disability Insurance for many years.

    Operating Standards

    • Visits are undertaken by our professional staff who are fully experienced in Income Protection, Waiver, Critical Illness and Creditor Disability Insurance.

    • Appointments are made by our staff by telephone on receipt of instructions.

    • 10 day turn round from receipt of instructions. Your policyholder is provided with a clear explanation of any policy conditions that are not understood.

    • The claims procedure, including envisaged timescale, will be explained to your policyholder so that there are no surprises, thus reducing complaints.

    • You will be provided with a full report tailored to your requirements.

    • We can identify cases where providing funds for investigations or treatment might expedite recovery and arrange the investigations and treatment if required.

    • We will only provide an opinion on the validity of a claim and the prognosis if specifically requested.

    Inspector Visits

    • Our inspector can help your policyholder complete the claim form.

    • Birth Certificates and financial documents can be inspected or collected at a claim form visit.

    • Inspectors will identify potential for rehabilitation at an early stage.

    • We can demonstrate how a claim form visiting programme can benefit your policyholder, the assessor and the insurance company.

    Health Claim Consultant Visits

    • Health Claim Consultants with a nursing or occupational therapy background and experienced in disability assessment undertake visits.

    • All our consultants have full product knowledge.

    • For Group business our Health Claim Consultants will meet with the employer to discuss opportunities for rehabilitation.

    • Following a visit our Health Claim Consultant will contact your claimant by telephone to follow up plans for rehabilitation or other relevant issues if required.


    Health Claims Bureau has proved itself to be a professional and cost effective alternative to the use of Disability Counsellors. You benefit from a report from an independent and impartial organisation to help with the assessment of your claims. Your customers have the benefit of a visit at home so that questions can be asked and dealt with. We believe that visiting adds value to your claims service. Health Claims Bureau is managed by industry recognised experts and has developed a reputation for providing cutting edge, innovative services in a timely and professional manner.

  3. Our Services

    The Health Claims Bureau Group has been providing services to insurers and employers for many years. We have an extensive range of services to meet the needs and fit the budgets of most risk management professionals. Across the group, our core function is to gather information to help the industry make fast and informed claims decisions to contain their risk, improve customer experience and to accentuate their profitability.

    Our services are categorised below:

    • Disability claims assessment - Home visiting services

    • Managing in-house health related risks

    • Ill-health early retirement assessments

    • Pensioner tracing

    • Annuity validation for insurers

    • Provision of professional expertise for secondment and audit work


    We provide independant and impartial claims inspection services for disability insurers.

    Our health claims consultants, who have a nursing or occupational therapy background, visit claimants with a particular objective of helping with rehabilitation services as well as assisting in the claims process

    For example:

    Our immediate needs assessment will be of assistance to the claimant, their insurer and the employer. As well as giving help in the basic claims process (for example, how to complete a claim form) the process will also help to establish:

    • The validity and probable duration of incapacity

    • Whether recovery and return to work will benefit from immediate help or if the claimant is likely to need assistance with rehabilitation following treatment

    • An understanding of the claimant's full personal circumstances

    Our consultants are trained to look for the biopsychosocial pointers to non-medical factors that might be barriers to a return to work. As part of this discipline, they will undertake:

    • An Engagement/Motivation to Return to Work analysis - a diagnostic process which generates an immediate initial assessment of the claimants declared engagement with their employment, presented garphically and compared with normative data; and

    • A Field Force Framework #8220; a comprehensive graphical analysis of the key driving and hindering factors of the situation perceived to be the most influential in terms of outcome

    We also conduct Claim Review Visits since we know that a claimant's circumstances can and often will change during the duration of an absence.

    One of the Health Claims Consultants' main objectives is to try and establish the true physical functioning levels and psychological status. It is particularly important that these enquiries are carried out in an unobtrusive and non-invasive way. This can accomplished by observation and discreetly encouraging the claimant to carry out various simple tasks which will involve mobilising, bending, lifting, sitting, manual dexterity, the use of relevant questionnaires if appropriate, assessing cognitive functioning and the use of non-direct and direct questioning.

    Consultant visits can be particularly effective for self-reported disabilities such as anxiety state, depression, chronic fatigue and where the disability is said to be stress related.

    Clients are provided with a comprehensive report on the findings of the visit along with a set of recommendations if required.

  5. Ill-health early retirement assessments

    HCB are experts in disability assessment, which enables us to take an objective view to the assessment of applications for Ill Health Early Retirement. Our service is designed to determine if the applicant meets the scheme definition for ill health early retirement using a systematic and evidence based process. Our service has been praised by employers and trustees for its objectivity and evidence based reporting, which is refreshing different to other occupational health led services. This is particularly important in what is often an area where disputes may arise.

    The fundamental distinction with our service is that we use a Claims Management approach, which has been developed from undertaking Permanent & Total Disability case reviews for UK leading insurers. Assessments are undertaken by expert Disability Claims Assessors supported by our Medical Officers, a Consultant Physician, and a GP with the Diploma in Disability Assessment.

    Our assessment requires a different mindset from clinical medicine which uses evaluation of a patient, a diagnosis and a treatment plan.

    Our approach:

    • Collect all information available

    • Evaluate if there is an impairment

    • Define the impairment

    • Determine any restrictions/limitations arise from the impairment

    • Issue a conclusion as to the functional capacity of the individual in relation to the scheme definition.

    Whilst diagnosis does not equal disability, it is also true that the lack of a diagnosis does not mean lack of disability. Restrictions are things that a person should not do because it will put them or others at risk. That is, delay healing, cause a recurrence of an injury or illness or endanger others. A limitation is something a person cannot physically perform due to actual loss of function. Limitations should be measurable, whereas restrictions are not measurable. The applicant's Functional Capacity is then used to determine what level of work they can do (if any) to assess whether the applicant meets the scheme definition.

    On completion of the assessment (Diagnosis, Impairment, Restrictions/Limitations, Functional Capacity), Health Claims Bureau will provide the Employer and/or the Trustees with a recommendation and a 'plain English' explanation of how the recommendation has been reached.

    Health Claims Bureau has provided services to the financial services industry since 1984 offering a wide range of products including data verification, tracing and investigating disability claims for major insurance companies. More recently this has evolved into an Ill Health Early Retirement Assessment Service for Employers and Trustees.

Findings - James Harris Investigations

  1. James Harris Investigations is not active.

  2. Welcome to James Harris Investigations

    James Harris Investigations (JHI) has specialised in providing confidential, ethical and professional Claim Enquiry and Investigation Services since 1984.

    JHI's services are used by a significant number of leading insurers making JHI a leading provider of investigation services to the insurance industry.

    Company category: Private Limited Company
    Company number: 03291520
    Company status: Active
    Company homepage, website: n/a 
      country of origin: United Kingdom
      incorporation date: 1996.12.12
      last member list: 2010.12.12
      has UK establishment: No
      has appointments: Yes
      in liquidation: No 
    Company sics:
      7460 - Investigation & security
      account ref date: 31.12
      next due date: 2012.09.30
      overdue: NO
      last made up date: 2010.12.31
      account category: TOTAL EXEMPTION SMALL
      document available: 1
      next due date: 2012.01.09
      overdue: OVERDUE
      last made up date: 2010.12.12
      document available: 1

  4. Board:
      James Harris MIPI - Chairman & Managing Director
      Eoin Byrne B.Comm (IRL) - Marketing Director
      John Gillman LLB (Hons) ACII FRSA - Director
      Mark Handford - Operations & Technical Director
      Al Hemond BSc MBA (USA) - Director
      Peter Le Beau MBA FCII - Director
    Key Head Office Staff:
      Kay Ryan - Operations Manager [DID NOT MOVE TO HCB]
      Louise Montgomery - Operations Assistant
      Lindzi Smith - Accounts & Administration
      Keith Thornton - IT & Systems Administrator  

Findings - Private Investigators

Private investigators are widely used in assessing the validity of disability insurance claims.

  1. Salary:

    Insurance investigators are likely to start on around £20,000 which can be expected to increase to about £50,000 with significant experience.

  2. Experience:

    While it is possible to enter the industry without prior experience, many successful investigators have a background in the military, police, security and intelligence services.

    A background in journalism also develops many of the key investigative techniques.


  1. The experience of Atos and Unum has been watched closely by the insurance industry (ABI).

  2. The insurance industry is pleased that the confidence in the welfare state has been lessened because this gives them more opportunities for profit.

  3. The insurance industry is concerned at the mauling that Unum and Atos have received. This has adversely impacted the whole industry. Potential customers are asking more questions.

  4. Health Claims Bureau is offering the insurance industry (and perhaps the government after the Atos contract expires) a very desirable proposition which is to handle all or particular types of claims. The insurance company can deny knowledge and responsibility.

  5. Health Claims Bureau will not offer insurance so is not subject to Financial Services Authority (FSA) regulation.

  6. Health Claims Bureau uses a "non medical" model for assessing medical conditions and so is outside all medical regulatory bodies.

  7. It is easier for Health Claims Bureau to "deny, delay, and defend" than it is for an insurance company.

  8. The only customer for Health Claims Bureau are insurance companies. It will be in the tiny small print that a clause stating that the insurance company may use third parties to investigate claims will be published.

  9. As James Harris Investigations has been rebranded to become Health Claims Bureau so Health Claims Bureau can be rebranded, cloned or closed down. These are low capital private companies.

  10. Health Claims Bureau could be a franchise model. Each new Health Claims Bureau clone ...

Created March 2012 and published September 2012.

Appendix A - ABI Member List

The current member list of the Association of British Insurers is available if required.