Stuff argues against insurer’s use of genetic tests in underwriting, and other news

An article in Stuff by Sophie Harris and Daniel Smith says kiwis should be ‘very concerned’ about genomic discrimination. NZ insurance companies are allowed to see the results of genetic tests, which has led to some people having difficulties getting cover for treatments related to results of their genetic tests. It could also be leading to reduced donations to fertility clinics as potential donors decide against donating because results of the required genetic tests can be used by insurers in underwriting decisions. International research also shows some people decline medial genetic testing and participation in genetic research because of fear of the impact on being able to obtain insurance cover.

A United States survey found 28% of participants declined genomic testing because of concerns about insurance discrimination, the New Zealand Medical Journal reported recently. But Australia and Canada are legislating to protect individuals from genetic discrimination by insurance companies. Canada, in 2017, introduced a complete ban on the use of genetic test results to discriminate, including for insurance and employment. The Australian life insurance industry, in 2019, introduced a five-year ban on the use of genetic tests in underwriting. New Zealand insurance companies have not followed suit.

Southern Cross chief sales and marketing officer Kerry Boielle said it did not add a pre-existing condition exclusion as a result of a genetic abnormality, and typically would not increase premiums or refuse to issue a policy based on that information. However, it may exclude any consultations, further tests, or treatment required in its policy as a result of an abnormality. Southern Cross said that in the past five years, 51 members had disclosed a genetic abnormality or mutation, and 51 people had exclusions applied to their policy as a result of genetic abnormalities.

The patient advocacy group AGenDA (Against Genetic Discrimination Aotearoa) is calling for a complete ban on the basis that genetic discrimination is a consumer protection issue and a human rights issue.

These articles all tend to overlook the impact on insurance and by implication the other consumers in the insured pool. Underwriting protects the other insured people from paying claims where the risk of claim is too high to be insured normally.

Insurers use medical information to price risk, of course, and it is not clear how this would be affected by a ban on the use of genetic test data. The use of health information by insurers in New Zealand is a protected form of discrimination provided it is based on sufficient statistical evidence. Information which an applicant knows, but which an insurer is not permitted to know, heightens an information asymmetry between applicant and insurer which exacerbates anti-selection. An applicant who knows they are more at-risk will seek out insurance, while applicants who know they are not at-risk may not seek insurance – skewing the insured pool and increasing costs for everyone insured. At extreme levels this can make insurance no longer affordable for the market at large or even threaten the viability of insurance markets. For this reason, the limits on the use of genetic testing have tended to be quite modest. For more information refer to this article by Australian Genomics on the Australian Financial Services Council moratorium on the use of genetic tests in life insurance.

More daily news:

FMA's figures show only ~900 firms out of 1800 operating under transitional regime have applied for full FAP licence

Paula Harris believes insurers are under considerable pressure to ensure pricing supports the global market while remaining sustainable locally

Disputes Tribunal orders Allianz Partners to pay $28,353 for wrongly turning down travel insurance claim

ANZ is introducing six weeks of paid gender affirmation leave, and up to 12 months’ unpaid leave


New Zealand’s protection gap according to Sharron Botica, and other daily news

A recent report suggests New Zealanders are under-insured by hundreds of billions of dollars. Spinoff asks Sharron Botica from AIA New Zealand to explain why it’s so important to make up the shortfall.

“Customer insight work carried out by AIA has told us that people often feel protected against death, illness and other physical circumstances because they feel they can lean on whānau and community to help out. But this isn’t always realistic, and it can be a dangerous mistake that could leave that support network severely and unexpectedly cost-laden.

According to a Financial Services Council NZ report from 2020, 71% of New Zealanders are under-insured when it comes to life insurance.

….. we drastically underestimate how much financial pressure is created when a household loses half of its income.

In 2018, the retirement commissioner Diane Maxwell said the New Zealand “she’ll be right” attitude could be playing a part. That attitude has major consequences and leaves your loved ones to carry a heavy burden.

While relying on savings is a common plan in case of a significant event causing a loss of income – the proverbial “rainy day fund” – you need to have savings to use. Data from Stats NZ showed New Zealanders typically don’t have great savings, with just 0.4% of income being saved over the quarter ending March last year."

More daily news:

FSC says NZ Income Insurance Scheme needs "more time"

Southern Cross wins Organisational Change & Development award at the NZ HR Awards 2022

Jackie Waddams appointed as General Counsel for AIA New Zealand

FANZ’s 1 June webinar covers key insights, updates and best practice for insurance advisers, register here.

Goodreturns: JP Hale thinks he knows why your clients are unhappy


Quality Product Research: Medical – proposed rating for Product Flexibility

Introduction

Recently, we read an article on Risk Info NZ about Accuro removing their time restriction for members, and former members, who want to make a claim on their policy. This led to us to review if medical providers impose a time limit to their claims. Many insurers have reported that although this clause is present in their wording, they do not enforce it at claims time, however our stance is that we have to rate based on the policy document.     

If you would like to have a read of the article, please click here

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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


Assisted dying service data reporting and more daily news

The first data report from the assisted dying service has been issued. Although future reports will cover a three month period, the first one covers slightly longer because the start date for the service was not aligned with a quarter end - so it covers 7 November 2021 to 31 March 2022. In summary, this is what has happened: 

Between 7 November 2021 and 31 March 2022, 206 people applied for assisted dying. As at 31 March:

  • 59 people were still in the process of assessment or preparation for assisted dying
  • 81 people did not continue the process (due to being ineligible, withdrawing or dying of their condition)
  • 66 people had an assisted death.

In September of 2020 we estimated that the End of Life Choice Act could see around 240 people use the service each year. It is probably too early to say with any accuracy based on only one quarter's numbers whether that estimate is a good one. However some of the wilder ideas about usage are not yet supported by the numbers.

For more information check out the Ministry of Health's data page on the subject.

More daily news

  • Waikato-Tainui has partnered with Southern Cross Health Insurance (Southern Cross) to offer health insurance to its 14,000 kaumaatua and help facilitate better health outcomes for its tribal members
  • Fidelity Life has appointed three senior business development managers to co-ordinate the work of the others: congratulations to Gary Binnie, Michelle O'Connell, and David Telfer on their appointment
  • AIA reports that Bill Lisle, AIA Regional Chief Executive, and past Director and Regional Chief Executive for AIA Australia and NZ from 2017 to March 2022 has died.

 


Pinnacle Life explains why it sometimes deletes Facebook comments and more daily news

Pinnacle Life has a good post explaining why it sometimes deletes Facebook comments. We have probably all seen comments which fall into this category: a real problem, often with an insurer, but sometimes not even with a life insurer, let alone the insurer who runs this particular page. There is genuine hurt and heart behind the complaint, but sometimes this strays into abuse. They explain:

We don’t believe other people should be able to use our page or posts to promote themselves or their beliefs, including spreading misinformation or disinformation. If our feed is used in this way, we will hide or delete those comments.

For example, we get genuine complaints from people who have been let down or treated badly by their insurer from time to time. Our first step in these instances is to check if they are a Pinnacle customer. Of all the complainants on our Facebook page, none have turned out to be a Pinnacle customer. These folk often have valid reasons to be angry or upset. These stories upset us too.

We usually reply to these comments offering support but also pointing out that every company and policy is different. If, however, the commentator turns it into a platform for a tirade against the insurance industry, we will hide or delete those comments.

In the last 12-18 months, the type of comment we have hidden the most has been to do with covid and covid vaccines. We will hide any comment that purports the covid vaccine to be a cause of death or injury or that insurance companies won’t cover you if you have had the vaccine or any other type of misinformation. We have written several blogs about covid and the vaccine, outlining the fact that covid makes no difference to whether you are covered or not, and neither does the vaccine.

Any comments with swearing or bad language will also be deleted!

The whole post offers a good insight into what it means to manage a social media page.

 

More daily news:

Southern Cross has won the Reader's Digest most trusted health insurer survey

AIA is hiring three underwritiers

The FMA published an article on NFTs. https://www.fma.govt.nz/news-and-resources/fma-stories/spotlight-on-nfts/


Southern Cross update and more daily news

Southern Cross Healthcare appoints Chris White into permanent CEO role. In the same week Southern Cross Health Insurance is promoting the value of vaccination against inflenza – offering a free ‘flu vaccine to members, announced Nick Astwick.

Southern Cross Healthcare has announced that interim CEO Chris White will take up the role permanently, effective immediately. 

Since taking on the role of Interim CEO, Chris has led the Healthcare team through one of its most challenging and unprecedented periods in the organisation’s history.

On his appointment, Mr White said, “Despite the challenges Covid-19 has presented within health, it’s an incredibly exciting sector with huge opportunities to deliver quality outcomes to New Zealanders. Southern Cross Healthcare is a dynamic business filled with fantastic people who are passionate about delivering high quality healthcare experiences and it is a privilege to be in a position to lead our journey from a hospital-centric organisation to a healthcare organisation.”

Chris began with the Southern Cross family as a CEO on the Insurance side of the business in 2017. From there, he moved across to Southern Cross Healthcare as Chief Operating Officer, and then to his current role as Interim CEO in October 2021.

 

More daily news:

Southern Cross has also announced a new online procedure checking tool

The FMA is hiring: https://careers.fma.govt.nz/jobdetails?ajid=ADlq7

Donate to long-covid research: https://www.auckland.ac.nz/en/giving/donate/a-z-list-of-funds/long-covid-research-project.html


New Southern Cross CEO appointment, and more daily news

Southern Cross Healthcare has announced that Chris White will take on the role of CEO permanently. He has been operating as the interim CEO since October 2021. White has said that Southern Cross operates in an exciting sector and that the insurer is filled with great people.

“Southern Cross Healthcare has announced that interim CEO Chris White will take up the role permanently, effective immediately.

Since taking on the role of Interim CEO, Chris has led the Healthcare team through one of its most challenging and unprecedented periods in the organisation’s history.

Greg Gent, Chair of the Southern Cross Healthcare Board, said: “Despite the additional challenges of Covid, Chris’ strengths in leadership and his commercial but personal approach to building a strong and sustainable business are very evident and the business remains in a strong position.

“Together with our very capable Executive Leadership Team, the Board is extremely confident that we have a CEO who will lead the business through this exciting and progressive phase in our organisation.”

On his appointment, Mr White said, “Despite the challenges Covid-19 has presented within health, it’s an incredibly exciting sector with huge opportunities to deliver quality outcomes to New Zealanders. Southern Cross Healthcare is a dynamic business filled with fantastic people who are passionate about delivering high quality healthcare experiences and it is a privilege to be in a position to lead our journey from a hospital-centric organisation to a healthcare organisation.”

Chris began with the Southern Cross family as a CEO on the Insurance side of the business in 2017. From there, he moved across to Southern Cross Healthcare as Chief Operating Officer, and then to his current role as Interim CEO in October 2021.

A part of the Southern Cross group, Southern Cross Healthcare comprises a nationwide family of joint venture and wholly owned hospitals; specialist centres; physiotherapy; rehabilitation; and employer health and wellness providers.

Southern Cross Healthcare directly employs more than 2,500 staff across a network of services spanning Whangarei to Invercargill.”

Chris_White-4504

In other news

From Good returns: Missing members: concerns raised over legality of code committee

AIA: AIA boss back


Southern Cross publish survey results, and more daily news

Southern Cross recently conducted a survey to understand ways New Zealand businesses can minimise the number of employees resigning. Participants were from different sectors and shared their views on job satisfaction, the best things about their jobs and the effect COVID-19 had had on their feelings. Southern Cross CEO Nick Astwick has said that the survey provides valuable insights.

“While the Great Resignation is sweeping the world as the global workforce enters a third year of pandemic-related disruptions, new research conducted by Southern Cross Health Insurance (Southern Cross) has uncovered what New Zealand businesses can do to help avoid the same fate.

Survey participants across a wide range of sectors were asked to share the best things about their job, as well as indicate their job satisfaction, including how those feelings might have changed since Covid-19 reached New Zealand’s shores.

Nearly half of those surveyed (46 per cent) said they feel grateful to have their job, with this figure slightly higher for female respondents (49 per cent) compared to men (41 per cent). Workers in the education and training (63 per cent) and healthcare and social assistance (49 per cent) sectors topped the list.

However, just over a third of those surveyed said they enjoy going to work most days (35 per cent). This increased significantly for those working in education and training (55 percent) while people employed in manufacturing ranked lowest out of all industries (24 per cent). Interestingly twice as many men (15 per cent) than women (seven per cent) said they already have their dream job.

When it comes to what New Zealanders say is the best thing about their job, factors that create a more supportive work culture rank above aspects like pay and flexibility. Just over a third of respondents (34 per cent) said a supportive employer or team was the best part of their job, while 30 per cent also noted their work colleagues feel like friends or family. Again, these sentiments skewed higher for female workers, with 38 per cent of women valuing a supportive environment compared to 26 per cent of men.

Some sectors scored particularly highly when it came to offering a supportive workplace. Just over half of those who work in education and training (53 per cent), for example, said having a supportive employer or team was the best thing about their job, while 41 per cent of those employed in healthcare and social assistance also shared that sentiment.

CEO of Southern Cross Health Insurance, Nick Astwick, said the survey provides valuable insights into what New Zealand businesses are doing right when it comes to employee satisfaction, but it also shows the challenges that lie ahead.

“There’s been many reports of a significant wave of people overseas reassessing their jobs in the face of the ongoing effects of the pandemic, and New Zealand businesses have an opportunity to prioritise how to prevent the same from happening here.

“Businesses already have difficulty filling roles in a tight labour market, and this will only get worse if they have large numbers of unhappy employees silently looking to move on. There is also a huge risk that New Zealand will lose a large swathe of young people, and the upwardly mobile, who want to move overseas after two years of closed borders.

“As CEO of the country’s largest health insurer, I’m navigating these very challenges, and many of Southern Cross’ business customers have shared they’re also facing the same reality. We have a job as business leaders to step up and fight to keep our employees, because at the end of the day, a business’ biggest resource is its people,” said Astwick.

The research has been valuable in showing organisations what key areas they need to work on in order to retain its people. Despite the upheavals felt across the workforce, a proportion of New Zealanders do still enjoy going to work, and this is largely because they feel supported while they’re there and recognised for the contribution they make – but there is more work to do, added Astwick.

“Businesses need to look at the reasons why people are happy in their job - which is having a supportive workplace, a good work/life balance, and flexibility – and use that information to increase the number of people who enjoy their job, and reduce the number of people feeling burned out and reassessing their career.

“Getting those conditions right can mean greater retention of staff. There’s no denying the impact that employee turnover has on an organisation’s productivity and bottom line, so investment in building a purpose-driven culture that also encourages a feeling of belonging can help to retain a motivated and engaged workforce,” said Astwick.

Southern Cross works with more than 3,500 businesses to help them support their people, with just over half of Southern Cross’ almost 895,000 members part of an employer work scheme.

“As a health and wellbeing partner to a significant portion of Aotearoa New Zealand’s workforce, we see how employers are willing to support their people beyond the time they spend at work, and recognise how their workforce gives their everything, every day,” added Astwick.  

“Feedback from those businesses also shows the workplace wellness benefits provided to employees can make them feel valued – and people who feel recognised and supported at work are more inclined to support and show loyalty to their employers in turn, and as they continue to drive the New Zealand economy forward during these uncertain times,” said Astwick.

Key insights from the Southern Cross research

(Omnibus research commissioned with Perceptive – January 2022):

How do you feel about your current job?

I feel grateful to have my job

46%

I enjoy going to work most days

35%

My employer is supportive

31%

I receive recognition for a job well done from my employer

24%

I love my job

24%

I have a better work/life balance following the outbreak of Covid-19

19%

I want to do something completely different to what I am doing now

17%

I feel burned out at work

17%

The pandemic made me reassess my career

15%

I wish I could take a career break

14%

What are the best things about your job?

Good work-life balance

42%

Satisfaction in getting to help others

36%

Supportive employer / team

34%

Flexible hours

32%

Work colleagues are like my friends/family

30%

Positive work culture

30%

Remote / flexible working

29%

Variety

28%

I receive fair / competitive pay

28%

Challenging work

27%

In other news

Cigna: Product Manager role is being advertised

ACC: Wellington based Senior Actuarial role being advertised

 


Quality Product Research: Medical - Major review process commenced for UCR Limit

Introduction

Medical insurance is one of the most hotly contested areas of product comparison. Adjustments are made frequently to our Research to keep up with changes, however it’s still a complex and difficult product to compare. Following a challenge by a rated company to our methodology for assessing UCR/EMP/network limits, it’s time we reviewed the method of how insurers apply UCR Limits and have therefore started the process of a major review of this item.

Theme of review

We would like to begin by renaming the item from “UCR Limits” to "Network or market price limits/UCR"

Our review seeks to categorise and evaluate the impact of the following:

1) No requirement to use specified providers/network and no UCR/EMP

2) Requirement to use specified providers/network

3) UCR/EMP applied to all costs (including specified providers /network)

4) UCR/EMP applied to only non-network costs

5) UCR/EMP applied only specific sets of costs (e.g., overseas)

Review process

We will begin by alerting insurers of our plan to review, including the five points above anticipating they will respond with which applies to their product with appropriate references to their policy document.

Once all required information has been collected, we will make the appropriate changes to our database and share our new rating on our social platforms for further feedback.

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