Quality Product Research: Health Insurance - major review process commenced for exclusions item rating

Introduction

Medical insurance is one of the most hotly contested areas of product comparison. Adjustments are made frequently to many features. Exclusions, however, are complex and difficult to compare. Although we update our exclusions ratings with every new product change released it is time to review the method and balance of the scoring of these items. We have therefore started the process of a major review.

Theme of review

The themes of this review are:

  1. A thorough review of all terms
  2. A focus on the relative weighting of the terms
  3. Calling for claims examples of how the terms are applied

Review process

We have alerted advisers and insurers to our plan to do a review and asked for data on the themes above. Changes will be based on our view of all the information sent to us.

We will then publish a model for changes to the guide scores for exclusions sub-items and ask for input on the proposed new model. Further changes may be made at this stage.

We are seeking claims examples for the review. Further changes may be made at this stage.

Timeline for review

March - advise review started

April - review claims information

May - consult on new model for rating

June - implement revised ratings

Your feedback

We value getting your feedback on how these wordings are being applied to claims you may be aware of. Please email us with details of any recent claims to help us update our understanding.

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


Fidelity Life announce customer research, and more daily news

Fidelity Life has announced that it will be conducting customer research on new products and potential service improvements through Qualtrics. The research is intended to understand what is working and what isn’t. Fidelity Life has revealed that new advisers have already been involved in the research. More advisers will be utilised in future research.

“We’ll shortly be kicking off some research with customers about new product ideas and service improvements with the aim of finding out what they like, so we can do more of it, and what they don’t like, so we can make improvements. Don’t worry, we won’t be bombarding them!

As valued distribution partners, we’re keen to involve you along the way. The insights will not only support how we shape our products to better meet the needs of the market but will also provide us with valuable data on their preferences when it comes to customer experience.

From time to time we’ll share a summary of the findings with you, and hope you’ll find them valuable in supporting your interactions with customers and improve their overall experience with Fidelity Life.

We’ve already experimented in engaging a few advisers in this research so we can enhance your experience and improve the way in which we work with you. We intend to do more of this in the future too, more on that to come.

We’re working with a trusted and established partner in this space and using their survey platform – Qualtrics. If you have any questions, please feel free to get in touch”

In other news

From Stuff: Waiting in Pain: People without money and insurance the ones who suffer - a particularly valuable piece updating us on the situation with waiting lists and the process before that, even to get properly diagnosed. A powerful argument for having a plan and having insurance. 

FMA: March 2021 – A new financial advice regime begins for New Zealand


Legal and regulatory update for the life and health insurance sector

27 Jan 2021 – Privacy Commissioner announced that he will virtually chair an international Computer Privacy and Data Protection conference over 27-29 Jan, commencing NZ time 5 p.m. on Thursday, 28 Jan, with a live stream available. https://www.privacy.org.nz/resources-2/forums-and-seminars/computer-privacy-and-data-protection-conference-cdcp/

28 Jan 2021 - FMA released its review of NZX technology issues finding the stock exchange failed to meet its licensed market operator obligations due to insufficient technology resources. NZX also released a response to the FMA review. Relevant FMA and NZX web links are https://www.fma.govt.nz/news-and-resources/media-releases/fma-releases-review-of-nzx-technology-issues/ and https://www.nzx.com/announcements/366811

28 Jan 2021 – RBNZ released the results of a research report showing the Māori economy is increasingly diverse and opportunities remain for it to continue growing and reach its full potential. https://www.rbnz.govt.nz/news/2021/01/e-hauora-ana-e-matahuhua-ana-te-ohanga-maori-e-ai-ki-nga-rangahau


Do media hate insurance or love it?

Although it might appear that journalists love to bash insurers, it is easy to forget that there is some surprisingly useful coverage:

Last year the high-profile owner, Gabrielle Mullins of the Auckland performance venue The Powerstation, died of cancer. She was fundraising to pay for Keytruda, a chemotherapy drug not yet funded by Pharmac. https://www.stuff.co.nz/entertainment/music/122701023/gabrielle-mullins-the-owner-of-aucklands-powerstation-venue-dies-of-cancer. Earlier this year Michael Kooge, a radio show host, also hit the headlines with his cancer story, saying "It's all pretty unlucky, if I had medical insurance when I was in my early 20s, before I got sick, I would be able to get this treatment covered, but because I didn't I'm being left to die.” At the same time Stuff linked to coverage by Tim Fairbrother of Rival Wealth discussing which type of medical insurance would be best. https://www.stuff.co.nz/business/81385630/what-type-of-medical-insurance-works-for-you-will-depend-on-your-circumstances

Each story is a tragedy. Also, the insurance industry could hardly hope for better promotional coverage. I draw your attention to what is implicit the first article and explicit in the second: that an unfunded drug would have helped, and that insurance would have funded this. In stories like these, it seems, the media believe in insurance. At other times, it appears that they ignore the vast volume of claims paid and believe that insurers are solely focused on denying the payment of claims. Is the glass actually half full?


nib views on financial advice, and more daily news

nib has said that members that receive financial advice are better off. In addition, nib CEO Rob Hennin noted that half of nib’s members join via financial advisers. Hennin credited nib’s view by highlighting the findings from an internal study which found that members with advisers have more financial certainty and more health benefits. Hennin used the findings of nib’s internal study and studies commissioned by the FSC to conclude that people who receive financial advice are better off, saying that people with financial advice experience an improvement to their overall health.

“Health insurer nib says it is “absolutely clear” that customers with insurance advisers end up better off, and says advisers have done an “extraordinary” job adapting to the challenges that have come with COVID-19, and multiple lockdowns.

According to nib New Zealand CEO Rob Hennin, approximately half of the insurer’s business currently comes through its adviser channel. He says its internal studies have been clear – customers with advisers have more financial certainty, and also see increased health benefits as a result.

“It’s absolutely clear from our research and the work the Financial Services Council has done that Kiwis who receive financial advice are better off,” Hennin told Insurance Business.

Hennin acknowledged the work advisers have done saying that their response to COVID-19 was extraordinary. Hennin mentioned the increased use of digital tools and other methods to reach and assist clients.

“Advisers have just pivoted and done an extraordinary job throughout COVID-19,” Hennin added.

“They’ve really embraced digital tools and they’ve gone out, consulted with their clients and done whatever they can to ensure they all have access to the care and protection that they need.”” Click here to read more

In other news

Southern Cross: Insurer promises to “build momentum” and enhance products at AGM

AIA: Belief in oneself key to empowering women


Your insurer would not be happy about this...

Finder.com.au, an Australian money site, has done some research on Kiwi attitudes towards insurance. This was about general insurance, but I did think it amazing: 

A nationally representative survey of 2,001 New Zealanders aged 18 and above found that 88% of Kiwis lock their door, leaving 12% who do not.  That’s equivalent to 218,880 households not taking necessary safety precautions and leaving themselves vulnerable to break-ins. 

The second most commonly used home protection is house and contents insurance with 64% of Kiwi households having an insurance policy. Rounding out the top three is having locks on windows (52%). 

Do you see what I see? I think it amazing that insurance is referred to a home protection method in the midst of a list about locking your house and having locks on windows. We, the industry, may be partly to blame for referring to insurance often as wealth protection, equally frequently abbreviated to 'protection'. But the problem I have is that it may be seen as an alternative to physically securing your home. That is an exemplar of 'moral hazard' - that people may take less care when the financial consequences of their actions are reduced. Do we see this in the way people treat their health? Put another way, is there any evidence that we would not?

Of course I don't think that there are lots of people rationally, consciously, deciding to eat too much, not put on sunscreen, and undertake hazardous activities because they have insurance. It is a more subtle kind of pressure that is relieved. It is more like the way everyone drives a little faster when the road is wide and even than when it is narrow and has many corners. 


AIA enhance AIA Vitality, and more daily news

AIA has announced the addition of a new benefit to AIA Vitality. Customers will have the chance to earn an Apple Watch when weekly physical targets are reached. This change is intended to motivate customers to increase physical activity. To have the chance to earn the Apple watch customers will need to enter into an interest-free loan agreement to ensure upfront costs are covered. Once customers enter to agreement, AIA contributes to monthly repayments, if physical targets are met, customers will not be required to pay anything. Len Elikhis, chief product and vitality officer, has said that this new addition to AIA Vitality will offers significant value to customers.

“AIA recently launched a new benefit for its AIA Vitality customers, and is giving them the chance to earn an Apple Watch for reaching weekly physical targets – an initiative it says will be a strong motivator for customers to increase their physical activity.

 

To earn their Apple Watch, customers must enter into an interest-free loan agreement to cover the upfront cost. AIA then contributes to the monthly repayments, and if all physical targets are reached, the customer ends up paying $0.

 

Len Elikhis, chief product and vitality officer says the initiative offers “significant value” to the AIA Vitality membership base, which has been growing steadily since its launch.”

 

Elikhis noted that the new initiative is intended to make the Apple Watch Series 6 more accessible as well as encouraging members to achieve goals. 

“The Apple Watch Benefit is another example of the significant value AIA Vitality is providing for our members,” he concluded.

 

“The aim of the benefit is to make it easier for members to access Apple Watch Series 6 to further encourage our members to achieve their physical activity goals.” Click here to read more 

In other news

AMP: AMP Capital insider flies into top job

NZFSG: NZFSG Makes New Appointment


Industry associations merge

The Health Funds Association of NZ will merge with the Financial Services Council from 1 December. Congratulations to the FSC and HFANZ on concluding the merger. In an increasingly complex environment, driven by regulatory change, technology, and consumer choice, it makes sense to have a single, stronger, industry advocate capable to looking across the wide range of issues in common facing the sector. 

From the media release: 

Health Funds Association of New Zealand (HFANZ) and the Financial Services Council (FSC)
today announced a merger into one single organisation under the Financial Services Council
banner from 1 December 2020, creating a membership association of close to 90
organisations.

In a major milestone for the sector, the merger brings together Health Insurance with the
Life Insurance, KiwiSaver, and Investment industries and will place a focus on achieving
good customer outcomes, ensuring sustainability of the sector, and lifting standards and
professionalism from a single, stronger voice.

Rob Flannagan, Chair of the Financial Services Council said, “The merger is a great
opportunity to bring the health and life insurance industry together under one roof and
focus the efforts of our joint members on the important issues of the day, and most
importantly of all, driving better consumer outcomes.”

Len Elikhis, Chair of HFANZ, said “The Health Funds Association of NZ members represent
80% of the health insurance sector and has a rich heritage of over 30 years.

“The private health insurance sector supports 1.4m New Zealanders to meet their health
care costs. We believe that a well-balanced and integrated health system is key to achieving
great patient outcomes.

“I would like to take this opportunity to thank our members for their significant contribution
and we look forward to playing an active part within the Financial Services Council,”
concluded Elikhis.

Richard Klipin, CEO of the Financial Services Council said, “Coming together to build a
stronger association is exciting and important for protecting the health of Kiwis.

“With a bigger, stronger and larger organisation of around 90 members, this merger will
focus our work in the sector and create a stronger voice that will help shape the future
financial wellbeing of Kiwis,” concluded Klipin.