Quality Product Research: Medical: proposed rating for UCR


Most insurers have a clause referred to as Usual, Customary and Reasonable (UCR) charges, Efficient Market Place (EMP) price or Reasonable Charges. Although referred to differently, insurers use this to ensure that the amount they are paying their associated medical providers are reasonable and fair based on geographical location. Following on from our recent proposed re-rate for UCR, we have since received feedback from our readers and updated accordingly.

As previously indicated: we began by renaming the item from “UCR Limits” to "Network or market price limits/UCR" then categorised and evaluated how insurers apply UCR/EMP/reasonable changes.  We appreciate that UCR limitations in whatever form are rarely applied. We think that's reflected in the share of the total score that this affects. For context, typical product scores range between 94 and 107 points whereas the score for this item varies from 0.05 points to 0.7 points.

Item re-weighting

UCR two

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 Manager, Quality Product Research Limited, researcher@qpresearch.co.nz

Quotemonster supports insurance advisers – we do not compete with them

Quotemonster is not and never will be an insurance aggregator. We have no interest in providing financial advice or aggregator services to advisers: our chosen business model is to support financial advice providers and their chosen groups, aggregators, and service providers. We wanted to state this once again because of a mistake in an article recently published by Insurance Business.

New Zealand Dental Insurance Society Limited (NZDIS) - Income Protection

We were recently asked if we've rated the New Zealand Dental Insurance Society Limited (NZDIS) Income Protection policy (attached below). Although we don't currently have a QPR rating, here are some key points that we hope will help an adviser if they come across this product: 

  • The great feature of this product is that it’s a combination of income protection and business overheads – the two are commonly sold as separate products.
  • The sum insured of up to $10,000 per week is substantially higher than the average income protection product’s benefit amount – this is possibly a reflection of earnings for practitioners in this field.
  • It is comprehensive because it offers essential benefits that cover lost income from disability arising from illness/accident (total disability, partial disability, recurrent disability, loss of limbs, loss of sight, deafness) and payment can also be made if the insured dies. However, the policy does not have the ‘bells and whistles’ that other products offer (e.g. childcare assistance, home care etc.).
  • The benefit payment term is a significant limitation though – this policy has maximum payment term of 52 weeks. Other income protection products have greater payment terms (e.g. 5 years, to age 65, to age 70).
  • The death benefit provides payment of 100% of the specified sum insured. Other insurers only provide support benefits for death such as grief support, funeral assistance, or 3x the monthly sum insured.
  • The exclusions are like those cited in other products, but with ‘war, rebellion, act of foreign enemy’ and sexually transmitted disease being the exception.

Overall, the NZDIS product is both comprehensive and generous in terms of the benefit scope. It’s unique in that it pays for personal income and business overheads in the event of disability (total, partial, permanent). It does have some limitations (such as the maximum payment term of just one year and the exclusions listed above).

Download NZDIS-_Income_Protection_Policy_Wordings

We really are a monster

In the last 18 months Quotemonster has evolved significantly and we don’t plan on slowing down anytime soon. Like all businesses we have had our share of challenges, but have also had many highs and hit numerous records, and spent the times in between crunching along.  

Our users are currently creating over 600,000 quotes per quarter and we are now quoting and researching over 95% of current on sale life and health insurance products in the NZ market. Based on adviser feedback we have released a number of new report formats – the Heatmap report, Benefit Overview and Detailed Head to Head which have all been extremely well received by our users.

During this period, we have increased subscribers to both our Research and Advicemonster services by over 20% making us NZ’s most popular quote and research tool. Therefore, requiring more resources than ever to keep up with demand. We now have eight employees and five contractors working away to support our advisers and their admin staff to ensure consistent service levels from our Auckland based team.

Advicemonster has had some serious enhancements making customised SOA’s easier and faster than ever - saving you tonnes of time and ensuring your SOA is automated with your client details, product information and premiums.

Keep an eye out for our soon to be released Company Reports, Adviser Customer Experience forms, and API connections to name a few. These will be covered in more detail in our upcoming nationwide roadshow (soon to be announced). Alternatively, you are more than welcome to visit us in our new bigger and brighter Birkenhead office we moved into in March at 29 Enterprise Street.

As always, we love your feedback so, please don’t hesitate to get in touch.

Database version 14.8 is now live!

It has definitely been a big year for the Quotemonster team! 

We have recently released an updated version of the QPR database to Quotemonster which contains the following updates: 

  • New policy document versions for Accuro, AIA Private Health, ANZ Bank, and AA Health 
  • Research ratings for ASB Private Health are now available 
  • Minor reviews in Income and Mortgage Protection for Offsets, Dependent Leave without Pay, and Partial Disability amount score  
  • Minor reviews in Trauma for Survival Definition, Trauma Buyback, Cardiac Arrest, and Coma 
  • Full re-rates in Trauma for HIV, Benefit Payment, and Loss of Independence 
  • Minor reviews in TPD for Special Events and Benefit Definition over 65 
  • Minor reviews in Medical for Exclusions
  • Full re-rates in Medical for Mental Health, Second Opinion, Grief and Funeral Support, Network or Market Price Limits/UCR, Product Flexibility, and Loyalty Benefits 

QPR welcomes Omar!

Exciting news over at QPR! 

We have recently welcomed Omar Dayao who has filled the position of our new Research and Customer Service superstar. 

Omar has worked in various roles in the finance industry over the years and is a great addition to our diverse team. He will be working to help maintain our product comparison database as well as assisting with all your day-to-day queries.  

We are thrilled to have Omar join us and look forward to his growth and contribution to Quotemonster :)  

Quality Product Research: addition of specific injury insurance rating

Specific Injury Cover is of great benefit in circumstances where ACC or other insurance policies do not provide sufficient financial protection. Although it presents as a succinct product (or optional benefit), it offers a comprehensive injury cover at an affordable price. It may be the case that this product appeals only to a particular market niche, but we believe that its benefits and features are of considerable value and should therefore be included within our rated products’ suite.

We have a draft comparison of those insurers who offer this product but are yet to release this publicly, pending data to support our ratings.

We invite you to join us on this rating process as we greatly value your input and feedback on changes we make to our platform. We are looking at gaining further insight into this product and would really appreciate any data that you are able to share with us from experience. We are especially keen to gain a better understanding of:

  • The most claimed benefits within Specific Injury.
  • The most claimed fractures.
  • The features that are claimed more than once.

It would be of considerable assistance if you are able to provide us with relevant data and claims information.

Once we have received and reviewed all the feedback, relevant information and data from the Insurers we have communicated this to, we will publish a preliminary rating report for you to review.

Please note that at this stage, the rating framework we have formulated for Specific Injury Cover can change depending on the information we receive from those insurers who wish to participate in this exercise. The finalised ratings will subsequently be published and be available to view on Quotemonster.

If you're interested in being involved in this rating, have had a client with a claim, or are an expert in this field please email us on researcher@qpresearch.co.nz 

We look forward to your assistance and input with this rating exercise and thank you in advance for your participation and time.