Earlier this year Health & Protection reported on AIG, Guardian and Scottish Widows as examples of insurers singled out for praise by advisers who have taken a flexible approach to underwriting protection cover so they can act in the best interests of customers.
It is clear positive progress is being made in some regards, but other groups who traditionally struggle to secure cover – such as those who have tried to take their own lives or the immunocompromised – are fareing less well.
And insurers have also been criticised for their approaches to non-binary people and gender re-assignment, with advisers calling some processes “bonkers”.
But there are some improvements in policy being made and advances in technology could offer a solution to easing the underwriting journey.
Back in August, Health & Protection spoke to a number of advisers who had positive stories to tell about insurers who have taken a flexible approach to underwriting protection to secure cover for customers.
These cases involved a client who was suffering from clusters of blood vessels that had matted together and had not been surgically removed, a patient with an abnormal heartbeat and a customer who had been diagnosed with Myotonic Dystrophy Type 1.
But advisers also point out that some groups continue to struggle to secure cover. Andrew Wilkinson, director at Moneysworth, gives the example of the immunocompromised.
“The immunocompromised were treated in a different way before the pandemic anyway and then again during the pandemic,” Wilkinson tells Health & Protection.
“If you talked about a list of health conditions or areas of health conditions that got affected by the pandemic, I would say it’s quite a long list.
“For example, it would include the majority of heart conditions and what we found was a total turning off of any appetite from insurers generally for that type of business.
“Very typically, if you called their pre-sales underwriting line or sent them an email, it would typically be six months postponed due to the pandemic and what they meant was until things improved and there was a positive change in sentiment among insurers, they wouldn’t be able to look at the application.
“That definitely did apply for people who are immunocompromised.”
Suicide and non-binary
One of the advisers Health & Protection spoke to in August was Alan Knowles, co-managing director of Cura Financial Services (pictured).
He acknowledges that while the situation has clearly improved for certain specific cases, some sections of society continue to encounter difficulties in securing cover, such as those who have tried to take their own lives.
“There’s a definite improvement with some insurers on historic attempts,” Knowles tells Health & Protection.
“One of my real bugbears is most insurers will ask, have you ever tried to take your own life, and someone says, ‘Well, yes, 40 years ago when I was a teenager.
“Why do we make people go through that? Why do we make them relive that? Is it really relevant that someone has tried to take their life 40 years ago? They’re obviously in a very different position now.”
However, some insurers are making accommodations and being more open-minded.
“So, there’s two insurers now who have timeframes on it,” Knowles continued.
“One asks about attempts over the last five years and the other in the last 10 years. To me, that is much more relevant, and I think that is something we should be moving towards with these groups.
“Why drag somebody through it? If it was 15 or 20 years ago, is it really relevant to a policy they are buying today if they haven’t had any issues now for say 10 years?”
Another group Cura is working to help is non-binary people.
“Clients who are non-binary or people who don’t want to identify as male or female [can be difficult to place] because ultimately, if you’re buying an insurance policy, you have to be male or female,” Knowles explained.
“There are clients who are transgender as well so the waiting list now for someone to have gender reassignment is anywhere between five and 10 years. So, if someone is on the gender reassignment list, technically pending surgery should be a postponement – we can’t offer you cover until your surgery is done.
“So are you going to postpone somebody for five to 10 years until they get this gender reassignment surgery done? We’ve got a couple of insurers who have taken clients on like that for us.
“But there are equally the insurers who will say we postpone people until they have the surgery even though that surgery might not be for 10 years, which is just bonkers when you think about it.”
Helping human underwriters
However, technological platforms are increasingly offering new digital solutions which in turn is freeing up human underwriters to turn their attention to more complex disclosures, according to Craig Paterson, chief underwriter at Royal London.
“More GP reports are being returned digitally than ever before and some evidence now has an element of digital assessment to allow human underwriters to focus their attention on more complex disclosures,” Paterson explained.
“Increases in post-issue sampling and product developments such as Underwrite Later are also helping customers get cover immediately with the underwriting then taking place when the policy is in force at a more convenient time for the customer.”
And Alan Lakey, director at Highclere Financial Services, added there are a number of areas in which technological advances are moving underwriting forward.
“UnderwriteMe is adding insurers and is a valuable resource for advisers,” Lakey revealed.
“Royal London, Legal & General and Zurich to name a few, enable pre-application access to underwriters thereby allowing advisers to give a better indication of the likely premium for those clients with health conditions or raised BMI.
“Additionally, insurers are placing greater underwriting information on their websites.”
Role of intermediaries
Although no matter the technological advancement, it appears the relationship between intermediary and insurer will always prove pivotal to securing smoother outcomes for clients, as Isaac Feiner, owner of Lifepoint Healthcare, points out.
“We find that the better the relationship and experience of intermediary to insurer, the easier it is to transact business on behalf of a client, allowing for a much smoother outcome,” Feiner told Health & Protection.
“Knowing how each insurer works and their internal underwriting parameters and indeed wordings well and with clarity is vital.
“This reduces delays on decisions and allows you to recommend the right products even on the first call after your fact find when appropriate.
“The best thing you can do is to educate yourself and your teams. This is why I say you can’t dabble in various insurance classes. You need to know your stuff really well. There is zero room for mediocrity in this area.”