Aviva has criticised members of the critical illness (CI) industry who it says put out a “negative spin” about claims being paid.
The insurer noted this was particularly important as the sector has had a formidable record in paying claims over the last decade and it was approaching the “huge” milestone of paying £1bn per year.
Speaking at the CI Expert tenth anniversary awards, Aviva critical illness product manager Jonathan Cater publicly called for restraint from his colleagues across the whole market.
“As an industry we’ve been paying out over 91% of CI claims for more than 10 years and this is something we should be celebrating,” he said.
“In the next few years we are likely to go through £1bn of CI claims on individual products in one calendar year across the market and that is huge.
“But one thing that really irks me is every time one of us goes out and puts a negative spin about a claim being paid – it hurts absolutely everyone. I hope none of my colleagues do it and it really annoys me when I get it from feedback internally.
“The key thing at the root of it… these products are designed to pay claims and that’s what we should be concentrating on, they pay a lot of claims in volume across the market and we should be celebrating that,” he added.
Updating definitions to pay claims
Cater also told the audience that the insurer adapted definitions on its policies to enable more claims to be paid and that seeing this subsequently happen was his most pleasing moment.
“We monitor definitions to see if it performs as we expect and if we see a definition that isn’t paying claims we take action,” he said.
“We look at our claims history to look at declined claims to see if there’s any trends and anything that we can do.”
Using the example of Cardiomyopathy, when Aviva looked at those claims it had declined, it found a quarter of these were having a defibrillator inserted for the individual.
When former England cricketer James Taylor revealed he had to retire from professional sport and recounted his story of the mental and physical impact of having a defibrillator, the insurer made the choice to update its definition.
“The biggest gratification you can get as a product manager is seeing a claim paid where you’ve made a change to the definition, that wouldn’t be paid previously,” he continued.
“The second biggest is seeing a colleague from one of the other providers following suit because you know they are having the same problems with that definition.”
