A research collaboration between TAL, the Digital Health Cooperative Research Centre (DHCRC), the University of Sydney, and Workcom is assessing a co-designed digital platform for how life insurers in Australia support income protection customers with mental health conditions.
The Pathways project focuses on customers’ experiences of mental health claims and recovery, amid increasing mental-health-related claims in life, disability, workers’ compensation, and CTP portfolios.
Researchers from the University of Sydney’s Central Clinical School are leading the initiative, which will develop and trial a digital platform for TAL income protection claimants who are recovering from a mental health condition. The platform is being designed with input from claimants, clinicians, and frontline claims teams. It is intended to outline key stages of the claim and recovery process and offer tools to support goal setting, decision-making, and engagement with treatment and support services. According to the project partners, the concept arose from feedback that customers want clearer information, better visibility of their options, and a stronger role in decisions made during their claim.
DHCRC chief executive Annette Schmeide said the research is responding to the volume and complexity of mental health-related claims being seen in the life insurance sector. “The rising prevalence of mental illness in the community is reflected in income protection claims, with life insurers seeing more – and more complex – claims than ever before. The Pathways project is designed to find a better way to support people with these claims. Applying behavioural science, evidence-based goal setting, and decision-aid models, we hope to find new ways to put people at the centre of their own recovery – and avoid the ‘solution overload’ and trial-and-error referrals that can occur,” Schmeide said.
The research team is using a co-design approach, involving customers with lived experience of claim-related recovery, as well as clinicians and claims staff. The aim is to identify which stages of the claim and recovery process are most challenging and where digital support may assist. Dr. Elizabeth Stratton, research fellow at the University of Sydney’s Central Clinical School, said the project is examining the gap between how recovery plays out for customers and how claims and recovery systems are structured. “By working directly with customers, clinicians, and claims teams to understand what is missing and what genuinely helps people navigate recovery, Pathways aims to help people exercise choice and maintain a sense of control during the claims process,” Stratton said.
Stratton added: “This project is not about testing a single solution. It is about co-designing tools with customers and learning from their experiences to ensure future processes are designed to support autonomy, informed decision-making, and active participation in recovery. There is a clear gap in the industry for recovery tools shaped by lived experience and real-world claim journeys, and Pathways seeks to help address that.” TAL and Workcom will lead the design, build, and implementation of the platform for TAL’s customers, while DHCRC will support evaluation and evidence generation under the Australian government’s Cooperative Research Centres Program.
The project forms part of TAL’s initiatives in mental health-related claims management. Georgina Croft (pictured), chief claims officer at TAL, said the initiative reflects the insurer’s intent to involve customers more closely in how their recovery unfolds during a claim. “We support customers during some of life’s most difficult challenges. We want to help them feel more connected and supported throughout their claim and recovery. Pathways will give our customers more clarity and control of the recovery journey, and provide their claim support team more information about how best to support them and when,” Croft said.
Workcom managing director John Mellors said the collaboration will examine the role of digital tools alongside existing recovery support. “Pathways is about giving people practical tools shaped by human-centred design, so they can more actively and optimally participate in their recovery from the very outset. We’re excited to explore whether involving people experiencing mental ill-health in a more structured and intentional way in their goal-setting and recovery journey leads to stronger and more sustainable outcomes,” Mellors said.
The Pathways project is being launched in the context of increasing mental health-related claims across life, disability, workers’ compensation, and CTP insurance in Australia. Research commissioned by the Council of Australian Life Insurers (CALI) for its “State of Australia’s Safety Net 2025” report found that mental ill-health is now the leading cause of total and permanent disability (TPD) claims. Drawing on SuperFriend’s Indicators of a Thriving Workplace survey, the report notes psychological distress and burnout across generations, with younger workers entering the labour market with higher levels of vulnerability and mid-career cohorts reporting heavy workloads and long hours.
The Insurance Council of Australia (ICA), in its submission to the Productivity Commission’s Interim Report on Delivering Quality Care More Efficiently, has also identified mental illness as one of the fastest growing chronic conditions and a major contributor to non-fatal disease burden. Data from the Australian Bureau of Statistics’ (ABS) National Study of Mental Health and Wellbeing (2020-2022) shows that 43% of Australians aged 16 to 85 have experienced a mental disorder at some point in their lives, with 22% experiencing a disorder in the previous year. Among those aged 16 to 24, 39% had a mental disorder in the prior 12 months, up from 26% in 2007.
These prevalence trends have translated into higher costs and more complexity in insurance claims. In life insurance, mental-health-related payments represented about 44% of all life insurance benefits in 2024, up from 25% in 2019, with claim payments for mental illness increasing from $1.2 billion to $2.2 billion over the same period. Permanent disability claims for mental illness among people in their 30s increased more than sevenfold between 2013 and 2022 and now make up more than a third of claims in that age group.
Workers’ compensation schemes report related pressures. In Victoria, mental injury claims have risen to about 16% of all claims, from around 2% in the mid-1980s. New South Wales has seen the number of psychological injury claims double since 2018, with average costs also doubling since 2020. Return-to-work outcomes are lower for psychological claims than for physical injuries, contributing to longer durations and higher system costs. In CTP insurance, actuaries have noted a growing share of claims with primary or secondary psychological injury components across multiple jurisdictions. Insurers report challenges in distinguishing accident-related psychological impacts from pre-existing conditions, adding complexity to causation assessments and reserving practices.
These dynamics have implications for pricing, underwriting criteria, product structures, and claims operations. They also place greater emphasis on early support and recovery-focused approaches, as insurers look for ways to manage long-duration mental health claims while maintaining affordability and sustainability of cover. Within this environment, the outcomes of the Pathways project are likely to be of interest to life insurers, rehabilitation providers, and advisers seeking evidence on how co-designed digital tools may influence claim duration, recovery outcomes, and portfolio performance in mental health.
