Protection Guru has launched Designed by Doctors – a series of recommended and updated example critical illness (CI) definitions covering ten conditions including the three most commonly claimed heart attack, stroke and cancer, and total permanent disability.
From next year advisers using the Protection Guru Pro service will be able to use a Designed by Doctors assessment when recommending insurers who meet the medical committee’s benchmarks for clarity and reflect latest medical practice.
The organisation explained its ambition is to ensure the best possible patient outcomes by improving the clarity of policy wordings and ensuring alignment with latest medical practice.
With the introduction of Consumer Duty this summer, Protection Guru brought together an independent medical committee of doctors and epidemiologists to create new example wordings for CI policies.
The committee revisited 10 key CI conditions to identify unnecessary complexity and obsolete medical terminology.
While CI policies are legal documents and by nature must include complex medical terms, Protection Guru argues this wording should be easy for qualified medical professionals to understand, which is not always the case – so this is the test the medical committee has applied in creating these new standards.
Protection Guru pointed out that this new work does not conflict with the existing work by the Association of British Insurers (ABI) on minimum standards which was passed over from the IFAA in 1999, and the firm is not seeking to encourage adoption of a single or standard CI wording.
But speaking to Health & Protection, Protection Guru founder Ian McKenna (pictured) revealed the firm asked its medical panel to come up with example conditions that focus on clarity and ease of understanding.
“If you’re talking about critical illness conditions they are somewhat technical in their nature, I don’t think it’s reasonable to expect the average person on the street to be able to understand every single critical illness policy wording,” McKenna said.
“But what we’ve aimed for as a benchmark is to make them clear to members of the medical profession.
“Because if someone has got a serious illness that is going to result in their claiming on a CI policy, they’re going to be talking to their doctors.
“So we think the right thing to do is to make them as clear as possible for everyone but our benchmark has been would your clinician understand this if they presented it to you?”
McKenna told Health & Protection the full list of conditions that has been looked at in this first stream include cancer, heart attack, stroke, total permanent disability, multiple sclerosis, benign brain tumour, Parkinson’s Disease, coma, deafness and high grade pre invasive lesions.
But McKenna committed to looking at more conditions in future.
“We will continue to look at more,” he continued. “It’s an ongoing process but these are the 10 we think are most important at day one…
“The average CI contract at the moment typically has about 60 conditions, many go to 100.
“We will look at the full list in the fulness of time.”
Medical profession has moved on
Dr Adam Hazel, chairman of the Protection Guru independent medical panel and founder of Harley Street-based Tyburn Medical Practice, said: “Medicine, diagnostics and treatment is moving at a pace never seen before and is continuing to accelerate.
“It cannot be in the interests of consumers for policy wordings to be based on measurements and diagnostic techniques that the medical profession has moved on from.”
Johnny Timpson OBE, the Financial Inclusion Commissioner said: “Consumer research has shown previously that one of the reasons consumers buy critical illness plans is the certainty of a payout they can rely on.
“This only works properly for them if we keep wordings as clear as possible and in line with medical practice. It is essential the definitions are both accurate and keep patient outcomes front of mind.”
Keith Richards, CEO of the Consumer Duty Alliance, said: “Any initiative that makes wordings clearer and more up-to-date, must be a huge step forward and aligns with the expectations of Consumer Duty.
“When it comes to critical illness plans, inevitably there will be some medical terms that most of us struggle with, which is why initiatives like this are so important.
“People with serious illnesses will be talking to their physicians regularly, so putting wordings into language doctors can easily understand is a natural and welcome development.”
Debbie Kennedy, CEO at LifeSearch, said: “Achieving the best outcomes for consumers is core to our DNA at LifeSearch.
“We are delighted to see this independent Designed by Doctors analysis, which brings new transparency about where and how policy wordings need to advance, to achieve the best results and much-needed clarity for families”.
Phil Jeynes, director of corporate strategy at Reassured, said: “It was clear last year that the ABI process needed a refresh.
“This is an outstanding piece of work produced by Protection Guru and the medical committee looking at how we can make wordings fit for purpose again. It is great to see organisations in our industry challenging the status quo with a view to affecting positive change.”
