Cancer treatment in New Zealand and the need for diagnostics cover

Several advisers have shared this article about a woman's journey to get a cancer diagnosis. On Tuesday night I sat through a harrowing personal account of a man who cancelled medical insurance shortly before his wife started experiencing symptoms similar to those described in the article. Like the woman in the article, he related a story about his wife having trouble being taken seriously by their GP. I know that this must he hard for GPs. I also suspect that we may not be doing enough tests. The video tells us we do not fund enough cancer drugs. Like the woman in this article, the man I spoke with wished he had acted earlier, and if they had retained their medical insurance, maybe diagnosis would have been quicker. Unlike this woman, who has private treatment and is still fighting her cancer battle, his wife died. He blames himself. It's rough, but watch the video. I prescribe it for anyone contemplating cancelling their medical cover. 


Quality Product Research: Proposed rating for Osteoporosis

Introduction

We have recently renamed the “Osteoporosis” item to “Early Onset Osteoporosis” to reflect the severity-based definition that insurers use and a common limit of payment to those aged under 50 years old. 

Sub-items rating review

Osteon new

Notes

A noticeable difference is the fact that several insurers do not offer this benefit once the insured is over 50. Though osteoporosis among those younger than 50 is considered rare, a study conducted at the University of Arkansas found that it's a greater risk than most women realize. From information on 164 college-aged women, 2 percent had bone densities low enough to be considered osteoporosis, and 15 percent were low enough to be in the osteoporosis risk range. To read more on this click here. Nevertheless our previous penalty for the limitation on age was far below the level of cases that this probably removes from the claims pool. So we have increase the penalty from -10 to -75. 

This is also a great example of how our methodology, specifically the  “Amount Score” (one of four) comes into play, to highlight the different payment amounts made by insurers. Please note, Asteron Life only offers cover for Osteoporosis with their “Early Trauma Benefit” similarly with AMP products you will need to select the Plus Options. These are all available in your “Product Settings” on Quotemonster.

Your feedback

We value getting your feedback on how these wordings are being applied to claims you may be aware of. Please email any claims information you have regarding this condition.   

Doreen Dutt, Research Analyst, Quality Product Research Limited, researcher@qpresearch.co.nz


nib launch Kids Cover Free, and more daily news

nib announced the launch of Kids Cover Free, a new nibAPPLY platform campaign. Kids Cover Free is intended to help New Zealanders prioritise health by offering a free base cover for a child under 21 for 12 months with every adult insured under a new Easy Health, Ultimate Health or Ultimate Health Max policy through nibAPPLY. The offer is available through nib’s adviser partner network. nib CEO, Rob Hennin, has said that the offer reflects nib’s mission of improving the health of New Zealand families. Hennin also highlighted that the campaign is intended to improve the peace of mind of parents. The campaign is valid from today until 31 October 2021.

“Leading health insurer, nib New Zealand (nib), has today launched a new campaign via its nibAPPLY platform, to help Kiwis better prioritise the health of their families. The Kids Cover Free offer is available through nib’s adviser partner network and provides free base cover for one child for 12 months with every adult insured under a new policy.

nib Chief Executive Officer, Rob Hennin, said the special offer reflects nib’s mission to support the better health of Kiwi families and aims to provide members with greater peace of mind, knowing their child’s health is cared for.

“As a parent, taking care of the health and wellbeing of your children is one of your greatest priorities, and biggest concerns. We know from our own 2020 State of the Nation Parenting Survey, that at least three-quarters of Kiwi parents are more mindful of their family’s physical health because of COVID-19,” Mr Hennin said.

“Investing in private health insurance for your children is one way parents can significantly reduce these sorts of stresses, giving them the peace of mind that their child’s regular check-ups or unexpected healthcare needs are likely to be covered and that they’ll have access to timely and efficient care. We hope our Kids Cover Free offer helps take this burden off Kiwi parents, especially after a really difficult year,” he added.

Research from BNZ in 2018 estimates that the average cost of raising a child in New Zealand is just under $16,000 annually or around $285,000 up until the age of 18. Furthermore, IBISWorld uncovered that childcare, clothing and footwear costs had increased by up to 60% from 2013/2014 to 2018/2019.

nib’s own claim statistics also show that the number of healthcare claims for children has increased by 5% in the past 12 months* at a cost of more than $10 million.

The most common claims for children during the period* were:

  • Specialist services (consultations including seeing a dermatologist about skin issues such as eczema, dermatitis or an ENT specialist due to tonsils or ears issues) – 3,500 claims, totalling $915,000
  • Treatment by General Practitioner – 1,300 claims, totalling $45,000
  • General diagnostic –700 claims, totalling $205,000

And individual claims for children can be quite large. nib’s three largest claims for members under the age of 21 during the period* were:

  • Fusion to treat scoliosis - $90,000
  • Jaw surgery - $69,000
  • Electrophysiology and ablation to treat racing heart and restore normal heart rate - $58,000

“We know raising a child doesn’t come cheap, even more so if you’re faced with the need to pay for unexpected healthcare costs out of pocket. Common conditions such as grommets can often set parents back between $2,200-$3,500 and wisdom teeth extraction can cost on average $3,500 - $5,200.

“Making sure your children are insured early means that many of these conditions may be covered, as they have a policy in place before they become pre-existing conditions - which are excluded from most health insurance policies. That’s a huge benefit and one that enables parents to provide greater certainty around their child’s access to quality healthcare for the future,” Mr Hennin said.

The Kids Cover Free is valid for one designated child (under the age of 21) per every adult insured under a new nib policy between now and 31 October 2021. The offer which applies to base cover only is applicable for new members who apply for nib’s Easy Health, Ultimate Health or Ultimate Health Max policies through nibAPPLY (usual underwriting conditions and terms and conditions apply).

In addition to the special offer, nib also provides child only cover options for families looking to cover just their children.

For more information and to view the terms and conditions advisers can visit nib.co.nz/adviser/ or contact their nib Adviser Partner Manager.” Click here to read more

In other news

Lifetime: Once in a lifetime business - Take two

Medical Assurance Society: Do insurers fully understand the realities of customer vulnerability?

RBNZ: Reserve Bank's stress testing plans for insurers revealed


A failure of product design - TPD benefits

Several advisers have been writing to me over the last few months with issues with TPD benefits. I have also conducted a review of TPD benefits recently for a client. Several aspects of TPD design have come into focus through the process. Two that stand out are variations in loss of independent living features, which are usually based on activities of daily living (ADLs).

Almost all companies have five activities. At first glance these appear very similar. Closer inspection shows differences. The first is that the walking definition of some is not fulfilled if the insured person can get about in a wheelchair, whereas with others it is fulfilled if the insured has to use a wheelchair. The second difference is that independent existence requires the assistance of a person to help the insured, which is not fulfilled if technology can help. 

Although I have not done the research, I am willing to bet that consumers believe that if you are confined to a wheelchair that would indicate a claims payment would be made. In fact, to be fair, it probably does pay out most of the time: as in most cases the claim would qualify under other factors. But claims do exist where the decision will hinge on this one fact - and I think consumers would expect the cover to consider you sufficiently disabled if you needed a wheelchair to get about (assuming the other conditions were met, of course, such as this being permanent - not merely temporary). In fact I saw the details of one such claim yesterday. Likewise with technology: the rapidly improving situation with technology means that someone who could not walk at all may be able to buy a set of robotic legs that enable them to walk. Here are examples: on in the US, another using technology developed here in New Zealand

Individually these are interesting issues - and should be resolved - but collectively they indicate both a communication and product development challenge. The communication issue is how we get across to customers what we mean by loss of independent existence. We cannot simply allow a situation to exist where we allow our different perceptions of what is meant to exist. At best, that's simply too sloppy,  at worst, if it is done knowingly, then its a form of misrepresentation of what the product does. The product development challenge is to work out what consumers need and deliver a product that does that. Robot legs do not come cheap - I suspect that consumers want a policy that will pay for them, not fail to pay out because of them. In product design that means some hard work has to be done. That means literally testing scenarios and descriptions and working out what level of cover is needed, how to communicate about that cover, and building the wording and pricing up from there. Then launching that and successfully demonstrating how much better that product is compared to the rest. There is definitely room for improvement. 


Detailed schedule of Partners Life Product Changes and Benefit Improvements

Partners Life Product Changes and Benefit improvements 

Special Events Increase benefit limits increased from 75% to 100% for aggregated sum insured and new special event added

Counselling Benefit increased “use by” time to 12 months after claim

Financial and Legal Advice Benefit increased “use by” time to 12 months after claim and the maximum benefit increased to $3,000

Special Events Increase deal on offer to customers who missed policy anniversaries. Customers will have a have an additional 12 months added to their 60-day time limit that applies to their immediate past anniversary

Dependent Child Funeral Support Benefit updated to include unborn child age moving to 20 weeks or weighing more than 400 grams

Bed Confinement Benefit added under the daily care of a registered nurse as an alternative requirement

Alzheimer’s Disease, Dementia, Aplastic Anaemia, HIV (medical acquired), Multiple Sclerosis, Major Organ Transplant, Diabetes definitions changed in Trauma Cover

Non-surgical Benefit (Private Hospital and Serious Illness Benefits) annual limit increased from $300,000 to $500,000

New Public Treatment Top-Up Benefit means Partners Life will pay for some treatments after customer has covered treatment in public system.  

$5,000 maximum limit removed for Second Opinion Benefit (Private Medical Cover)

New cover for mental health consultations has a maximum of $2,500 under Surgical and Non-surgical Benefits (Private Hospital and Serious Illness Benefits)

Optional Specialists and Test now includes Podiatrist as a specialist for consultations

Cancer definition simplified in Excess Waiver Benefit.

 

Income and Expenses Cover

Income and Expenses Cover is designed to include sustainability features, remove over-insurance and moral hazard opportunity, and provide customer support

Benefit is the greater of pre-disability income less offset x 75% of life assured’s share of pre-disability monthly domestic expenses

The cover term for Income Cover and Expenses Cover is to age 65 with payments term options of 2 years, 5 years and to age 65

Pre-disability income is the same as Income Cover

Disabled for occupation classes 1-4 includes 10 hours or 75% of activities but it moves from own to reasonable occupation after 12 months

Customers will be considered to be in occupation class 5 if they have been unemployed, on unpaid leave, working less than 25 a week, incarcerated in a penal institution, or legally barred 12 months before disability

Income Cover offsets apply to Income Cover and Expenses Cover

Income and Expenses Cover has a payment term restriction that applies for medically unevidenced claims. These are not a fixed restriction for mental health claims

Unevidenced claims in the Income and Expenses Cover are paid for up to 12 months

Fixed payment terms reset for new disability for the Income and Expenses Cover, although customers must be back to full time work for more than 12 months to reset.

Disability within 12 months of claim for any reason is a recurrent disability

Income and Expenses Cover ancillary benefits include Bed Confinement Benefit, Return to Work Benefit, Increasing Income Benefit, Recovery Support Benefit (reduced to 6x SI), and Vocational Retraining and Rehabilitation Benefit (reduced to 3x SI or max $10,000)

Income and Expenses Cover ancillary benefits don’t include Lump sum TPD, Critical Illness Benefit, Specific Injury Benefit, Child Care Assistance Benefit, Death Benefit, and Return to Home Benefit

YRT option only applies.

Moderate Trauma Cover

Partners Life desires to get back to the principle of indemnification meaning that customers don’t need claims paid unless they have financial losses, and they don’t need to pay premiums that doesn’t indemnify against loss

Moderate Trauma Cover allows price efficiency, cutting out claims with immaterial financial consequences. This enables customers to afford higher sums insured.

Moderate Trauma Cover will mean future prices will be sustainable and will allow advisers to fine tune severity based on trauma solutions

Moderate Trauma Cover will have more defined conditions for Alzheimer’s Disease, Dementia, Aplastic Anaemia, Angioplasty, Blindness, Cardiomyopathy, Chromic Kidney Failure, Cancer, Diabetes, Heart Attack, Intensive Care, Loss of Cognitive Function, Motor Neurone Disease and Muscular Dystrophy, Multiple Sclerosis, Severe Rheumatoid Arthritis, Stroke.

Designed to be 20% cheaper than Trauma Cover (TC), price differential expected to grow

Designed to be a mid-range trauma cover (between TC and Serious Trauma Cover)

No built-in TPD, customers that need TDP will need to take TPD Cover.

Moderate Trauma Cover can be combined with TC and STC to create a severity-based trauma option.


Grieving: stage theory challenged

Research challenges the popular stage theory of grieving: 

"Grieving is not a stage-like, sequential, orderly, predictable process across time. Bereaved people do not (and should not expect to) go through a set pattern of specific reactions. Grief can involve complex, fluctuating, emotional reactions (sometimes experienced as a ‘‘roller coaster’’). There are different patterns of ‘‘normal’’ (as well as complicated) ways of grieving. Patterns vary greatly in terms of specific reactions, time-related changes, and duration of acute grieving period. There are large individual/cultural differences in reactions to loss. There is no sound scientific basis for Kübler-Ross’s stages."

The research recommends that those teaching on grieving or offering support for those grieving should explore some of the other research and models. More information at this link: https://journals.sagepub.com/doi/pdf/10.1177/0030222817691870 


AIA Vitality campaign launches and more daily news

AIA has announced the launch of an AIA Vitality campaign to encourage advisers to share their AIA Vitality experiences. AIA has noted that the campaign is designed to support adviser businesses and amplify health and wellbeing. Chief Partnership Insurance Officer Sam Tremethick has said that AIA is aware of countless AIA Vitality stories and would like to hear more personal stories from advisers and clients. Advisers have the opportunity to share their stories and go into the draw to win a day with one of the AIA Vitality ambassadors. Ambassadors will offer their services throughout the day. Advisers are able to enter the draw until 9 July 2021.

“AIA New Zealand has launched a campaign encouraging its advisers to share their experiences with AIA Vitality, the insurer’s flagship programme.

The campaign’s winners can spend a day with one of the programme’s three ambassadors: Dame Valerie Adams, former All Black Ian Jones, and wellness advocate Jess Quinn. The ambassadors will support the winning advisers in their business for a day, taking part in various activities, such as speaking at a business event, participating in a team activity, or supporting a community project. 

According to AIA NZ, the competition is its way to further support advisers’ businesses with a creative concept, as well as broadcasting its message of health and wellbeing for all New Zealanders. Entries are open until July 09, and can be submitted through the AIA NZ website.

“There are so many amazing stories out there that bring the AIA Vitality journey to life,” said AIA NZ chief partnership insurance officer Sam Tremethick. “We know of advisers who have seen significant mental and physical benefits since joining the program, and clients who’ve shared their own positive personal experiences. We’d love to hear more of these, and how together we’re making a difference in people’s lives.” Click here to read more

AIA_NZ_Bring_Us_With_You_banner

In other news

nib: clients that have stopped vaping and/or smoking tobacco for more than 12 months, can apply for non-smokers rates

Russell’s piece in Good Returns: The tale of two claims - The media's perception of insurance

 


AIA to join Relief Run, and more daily news

AIA NZ has announced that employees will be joining the Relief Run, a global initiative for those in India affected by COVID-19. AIA NZ alongside AIA Australia will contribute $30,000 to World Vision’s COVID-19 India crisis appeal. Employees will also complete 5km near the AIA House on 9 June 2021. AIA NZ CEO Nick Stanhope has said that it is important AIA joins this movement.

“AIA NZ are joining their Australian colleagues in the global initiative Relief Run, as the trans-Tasman business contributes $30,000 for the people of India devastated by COVID-19.

On Wednesday 9 June, the AIA NZ team will be running or walking 5km around the Smales Farm precinct in Takapuna, Auckland, and encourage participation from anywhere in the world.

“This is a global virtual event so anyone can take part from wherever they are,” says Nick Stanhope, AIA NZ CEO. “The scale of the tragedy in India is devastating, and we have family members, friends and colleagues directly impacted by the COVID-19 crisis. I feel it’s important we join this movement, and take this small step to make a difference.”

Australian AIA Vitality Ambassador and endurance athlete Samantha Gash is the co-creator of Relief Run, which last year raised more than AU$1 million in support of Australian bushfire relief efforts. Locally the Relief Run will be supported by AIA NZ Vitality Ambassadors Dame Valerie Adams and Ian Jones.

“It’s great to be able to get involved in supporting my fellow AIA Vitality Ambassador Sam Gash, and the Relief Run,” says Ian Jones. “I know the funds raised will have a big impact on the relief effort in India, and will undoubtedly save lives.”

All funds raised by Relief Run will go towards the World Vision’s COVID-19 India crisis appeal, which is sourcing equipment and supplies including beds, oxygen concentrators, food vouchers and tents for temporary COVID-19 care centres.” Click here to read more

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In other news

AIA: $597m in claims was paid in 2020. This includes COVID – redundancy, income protection and death claims

MAS: MAS is sponsoring the ILANZ: In-house Lawyers Young In-House Lawyer of the Year award

Asteron Life: Jacques Van Heerden joins Asteron Life as BDM

From Good returns: Keeping up - but not with the Kardashians

 


nib announce grant programme, and more daily news  

nib foundation has launched Health Smart Grants, its first New Zealand grant programme. The grant is designed to support registered charities that work to improve the health and wellbeing of New Zealanders. nib has noted that there are three $40,000 grants available. nib New Zealand CEO, Rob Hennin has said that he is looking forward to seeing the impact the Health Smart Grants programme will have. nib foundation Executive Officer, Amy Tribe has said that Health Smart Grants will help in creating a healthier landscape. Expression of Interest applications are open until 30 June 2021. Shortlisted applicants will be invited to submit a full proposal in mid-August.

“nib foundation, the charitable entity of leading health insurer, nib New Zealand (nib), has today launched its first Kiwi grant programme, called the Health Smart Grants. Designed to support registered charities dedicated to improving the health and wellbeing of Kiwis and our rangatahi (youth and young adults), there are three Health Smart Grants of $40,000 up for grabs. 

 

nib foundation Executive Officer, Amy Tribe, said being able to offer the Health Smart Grants to Kiwi charities, is an important step towards creating a healthier landscape across both sides of the Tasman.

 

“Chronic conditions account for more than 80% of all deaths in New Zealand, but over a third of this health burden is avoidable. And with an ageing population and contributing lifestyle risk factors on the rise, it’s expected to continue to increase unless there’s adequate intervention,” Mrs Tribe said

 

“The good news is, in so many cases, these conditions can be prevented by addressing modifiable factors such as poor diet, lack of exercise, alcohol use and smoking. We know there are many amazing organisations in New Zealand doing great things in the community, so we hope word spreads about this opportunity,” Ms Tribe said. 

 

The Health Smart Grants are designed to provide a healthy funding boost to charities specialising in prevention and that are using innovative ways to empower and educate Kiwis to be health smart in their everyday lives. Initiatives that are inclusive and relevant in supporting our rangatahi to achieve improved health and wellbeing outcomes will be given preference. 

 

nib New Zealand Chief Executive Officer, Rob Hennin, said he is looking forward to seeing the impact the Health Smart Grants programme can make for Kiwis and their health.

 

“There’s a huge opportunity to prevent and better manage the chronic conditions that exist among our community today. It’s time more investment is placed in this space and I hope that those working in the charitable sector driving these kinds of behaviour changes apply, as the work they do is truly life changing,” said Mr Hennin. 

 

Expression of Interest (EOI) applications are open from 1 - 30 June 2021. Following this, shortlisted applicants will be invited to submit a full proposal in mid-August for the opportunity to receive a $40,000 grant.

 

To submit an EOI, visit: www.nib.com.au/foundation/apply 

 

In other news

Fidelity Life: Part 3 accreditation questions on Learning HQ

FSC: FSC Research Launch: Technology and Micro-Investing 

nib: April top five claims

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nib: nib Webinar Series – Tend