Critical Illness Plus

The Critical Illness Plus tool enables comparison of CI definitions in current policies based on our medical panels’ opinion of the policy wordings and the likelihood of clients’ suffering from the condition.

Overview:

Working with a specialist medical panel, we have reviewed critical illness definitions across insurers in order to help advisers better understand

  1. The critical illness definitions that are more likely to give rise to a claim during the term of the plan based on the client’s age and gender, and;
  2. How different insurers wordings compare.

Quality Analyser enables the comparison of critical illness policies based on the comprehensiveness of the features that are important to clients.

 

Key Features:

  • Enables comparison of current critical illness policies based on the medical panels opinion of definition wordings based on the likelihood of clients suffering from the condition.
  • Compares insurer propositions to show which is more likely to pay more to clients.
  • Independent Analysis of 16 critical illness propositions.
  • Provides the ability to compare insurer propositions on over 35 product and operational features.
  • Bespoke output report based on the features that are important to the client.

Quality Analyser – CI Definition Analysis

Background:

Recognising that neither financial advisers nor their clients are well placed to understand the detailed medical wording used in Critical Illness insurance policies FTRC initiated research in 2017 to conduct a detailed review of policy wordings, working with medical practitioners and researchers.

FTRC collated every insurer’s CI definitions to present them side-by-side in one document. We decided to focus on the conditions that had been assessed with the claims record of one insurer that had released details of which conditions they had paid claims for in the last three years. This comparison showed that the 56 conditions assessed to date accounted for 99.8% of that insurers claims record.

Our initial analysis was successfully published in November 2017 and has been very positively received by financial advisers and insurers. As a direct result many insurers are now considering how they can improve their policy wordings based on findings. We have committed to extending and updating this research on a regular basis and are now seeking to form a partnership with a suitable medical organisation who could provide the necessary incidence data on an ongoing basis.

Six-monthly review:

When we launched our medical analysis of critical illness conditions we set out to conduct six monthly reviews of the analysis in order to:

  • Review our scoring of each condition against the latest medical advancements
  • Review the incidence data to ensure the latest data is used

The first review was published in July 2018. Through this exercise there are a number of conditions where our scoring of definitions have changed across all products and providers including:

  • Main Cancer definition
  • Carcinoma in situ of the colon or rectum
  • Carcinoma in situ of the vagina
  • Addition of mental illness conditions

Insurers who subscribe to Quality Analyser can speak with us in advance of the publication of the new scoring in order to understand why the scoring for these conditions have changed and the impact this has on their products.

Our medical panel:

  • Dr Adam Hazell

Consultant GP

  • Dr Chris Ireland

Epidemiologist, Royal Cornwall NHS Trust

  • Paediatrician
  • Geriatrician

Quality Analyser – Children’s CI Comparisons

Problem

Insurers offer a wide range of critical illness definitions that the life assured’s children can claim on if diagnosed with and the definition criteria is met. Most of these definitions are based on the adult wordings, however some insurer also offer child specific definitions.

It is extremely difficult for advisers to understand which conditions children are more likely to suffer from and at what age or which insurers definitions are more comprehensive.

To further complicate matters the child specific conditions can be split in 2 types, congenital and childhood. Congenital conditions are diagnosed at birth or during pregnancy and childhood conditions can be diagnosed from 0 onwards.

Where clients are not expecting to have any more children in the future, the congenital CI conditions are not relevant as opposed to clients that do intend to have children in the future.

Solution

FTRC have split conditions into 2 sections, congenital CI and childhood CI, and obtained age banded incidence data for childhood conditions. As there is a high incidence between birth and 1 years of age we have applied a specific 0-1 age banding to highlight this.

We have obtained incidence data per birth for congenital conditions. This highlights the number of diagnosis per 100,000 births. We have not used gender incidence on this as many clients will not know the gender of their child.

Doctors have assessed insurer wordings for children specific conditions. We are using the existing assessments for the adult conditions as it is our understanding that insurers do not change their wordings.

This has been built into QA so advisers can now compare insurers wordings by selecting congenital and/or childhood critical illness definitions.

Quality Analyser – Age banding

In order to effectively compare insurer critical illness policies on a client by client basis, advisers need to understand:

  1. Which conditions a client is more likely to suffer from throughout the term of the policy.
  2. The comprehensiveness of each insurers definitions compared to each other.

The conditions a client is more likely to suffer from will depend on a number of factors:

  • Age
  • Gender
  • Term of the plan
  • Smoker Status

Advisers without medical training are not equipped to evaluate the likeliness of incidence or apply this to an objective comparison of insurers.

F&TRC have obtained age banded incidence data in 5 year bands from 15-19 up to 75-79 for the 15 highest incidence conditions in order to understand which are more prevalent for males or females at different age ranges.

We have built this into QA where we will now capture the clients gender, age, term of the plan and use this to apply an automatic weighting to each condition. This along with our doctors analysis of insurer wordings enables advisers to compare critical illness plans based on the conditions that clients are more likely to suffer from during the term of the plan.

Incidence data on smoking will also be built into the system to deliver a more accurate comparison taking the smoker status into account during the term of a plan (this will follow in a later update).

The above implementation is based on the feedback from previous forum where we discussed two approaches to comparing and being able to produce the data.