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.


FYI: How to quote Fidelity's Trauma Multi on Quotemonster

Fidelity's Trauma Multi Cover is intended to provide customers with ongoing cover for multiple unrelated conditions.

Trauma multi cover pays out a lump sum if the insured suffer from a condition named in the insurance policy, like a heart attack, cancer, stroke, angioplasty and more. Trauma multi cover offers the opportunity to claim for up to five unrelated medical conditions. Each individual claim will pay up to 20% of the total sum insured.

For further information on this product please click here

To quote Fidelity's Trauma Multi Cover on Quotemonster, click “Settings” and under the Trauma column, select Trauma Multi as shown in the screenshot below.

Once you’ve selected your product basket, click “Save” and “Close” and don’t forget to re-crunch your quote to ensure your premiums and ratings reflect your new Product Selection.

Mutli

This unique product is quoted differently on Quotemonster to reflect 5 potential claim payments. For example, if you are quoting $300,000 total cover on Fidelitys software, you will need to enter 1/5th of the amount on QM - so $60,000 to match your quote.

Example mult

This method allows us to compare a premium and rating for Trauma Multi on Quotemonster, however if you have any feedback please feel free to send this through to info@quotemonster.co.nz


Quality Product Research: Proposed rating for Coma (Trauma)

Introduction

Following on with our recent theme of revising ratings, we have reviewed Coma, re-assessing the item based on modern definitions.  A rarely claimed on benefit, yet significant coverage in the media when the insurer decides not to pay out.  

Below are the proposed items for Coma.

Coma

Notes

Momentum life is the only provider that requires the insured to be in a coma for 96-hours, while Westpac uniquely requires a permanent neurological deficit. Three insurers, Fidelity, Pinnacle and Westpac specifically exclude medically induced comas and a similar definition is observed in the use of life support systems and response to internal and external needs.

Few insurers continue to use the Glasgow Coma Scale in their definitions – here is a quick overview of what the scale demonstrates https://medictests.com/units/glasgow-coma-score

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


Quality Product Research: value-based research supports evidence-based advice

We have recently had an influx of new users register on Quotemonster and would like to take the time to re-introduce our Research and Rating Methodology.

We think that using real-world data to make our research value-based makes it a lot easier to see which features and benefits really count, and which are just bells and whistles.

Our Four-Factor Research includes:

  1. Definition – the quality of the policy wording

In our definition score, we are purely looking for differences between policy wordings but will use the same sub-items across products (e.g., Agreed value, Indemnity, Loss of Earnings). We start with a score of 100 and usually make deductions according to restrictions and limitations in cover. Our approach differs for “Exclusions” as these take away from the policy so you will see this as a negative total score. A variation of this approach is also used in our rating for “Offsets.  

  1. Incidence – How likely the benefit is to be claimed

We collect data from re-insurers, statistics, underwriters, and medical experts to identify how likely each benefit will be claimed on.

  1. Amount – How much would be paid

Here we identify how much each insurer will pay. In trauma insurance, some companies pay the full benefit for an item, others only make a payment of 10% or 20% of the sum insured because the condition was not severe enough to warrant a full payment. Our score is varied according to how much would actually be paid. For some benefits, we create a claims scenario to determine the amount paid as it is not as clear-cut.

  1. Frequency – How often the benefit would be paid

Here we determine if a claim can be made more than once. A client can only claim on life insurance once, therefore the frequency will be 100% however this is less clear-cut for Medical which is where we create a claims scenario that will reflect multiple claims over a lifetime of the policy.

We then multiply the four factors to obtain the Insurance Quality Score that you will see on Quotemonster.

Definition x Incidence x Amount x Frequency = Insurance Quality Score

Also, we don't so this alone. We take advice - from a variety of expert sources below, and also from regularly engaging with advisers and insurers. In fact, we are running two consultations right now, and receiving input from reinsurance research to update our trauma claims incidence rates. We support an evidence-based approach to advice. 

Methodology add on v1

If you would like a one-page explanation of why methodology matters please email or call the team and we can send you the methodology info-graphic. If your team has new staff members (or any that would like a refresh), we can invite them to our regular Quotemonster and Advicemonster training sessions (attendees include Insurer Product Managers and various other Industry members). Please feel free to email through contact details of those who are interested in attending (researcher@qpresearch.co.nz). 

 

 


Quality Product Research: (Inbuilt) Child Trauma – Part Two 

A reader has queried whether QPR takes the sum insured into account in our Research Ratings.  And the answer is yes, we do consider the amount paid by each insurer. In fact amount paid are a vital part of a value-based assessment approach - and something we capture much better than simple feature lists of benefits do. 

In trauma insurance, some companies pay the full benefit for an item, others only make a payment of 10% or 20% of the sum insured because the condition was not severe enough to warrant a full payment. Our score is varied according to how much would actually be paid. In the scenario for Child Trauma, we have a claims amount of $100,000 and calculate how much would be paid out by each insurer.  

Capture123

Furthermore, based on adviser feedback we have corrected our ratings to reflect the fact that Asteron does include the option to convert their child cover to adult trauma at age 21. Interestingly, if the parent is on Trauma Recovery (TR) and considering converting their child cover to TR with Early Trauma they are required to complete an application. 

Gfsfss

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


Quality Product Research: Diabetes Mellitus (Adult) – Part Two

Following on from our previous blog post regarding Diabetes Mellitus, we would like to clarify that in the case of Type 2 Diabetes, in general insurers do not pay out upon diagnosis of this condition, the insured is required to display severe complications such as irreversible retinopathy, diabetic gangrene and/or neuropathy to be eligible for a claim payment. Type 1 is less defined, but most insurers offer partial payments upon diagnosis once the insured person is over 30. We have therefore renamed this item to “Severe Diabetes” to reflect these related complications. 

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


Merely stating facts is not enough

In research covering more than 6,000 claims for trauma conditions across greater than 2.6 million policy years, recorded claims causes show that cancer accounted for more than 40% of male claims and more than 70% of female claims. That's a huge share. It astonishes me that claims cause was not recorded for over 1,500 claims - but this gap in the data is more likely to be due to poor /legacy management information systems, than actually paying claims without a cause, it is unlikely to affect the ratio of claims causes. 

Consider another pair of facts: in a 30 year period a male non-smoker may have about a 16% (or one in six) chance of claiming on their trauma policy. Trauma claims enjoy a high claim payment rate - it varies, but in the UK a figure of greater than 90% is common. Now consider how they interact: there is about a 1.6% chance that this person will be unable to make a claim. Trauma insurance is a good bet. 

Clients, living their lives, have little or no idea about the risks and odds. It is up to someone to tell them. What's more, if you are basing product selection decisions on long lists of things that have little or no bearing on whether a claim will be payable then the information is true, but of limited use. Weighting the features by claims likelihood is essential to helping the client make an informed decision. 


Life price comparison database update

We have updated the life price comparison database, version 113, to reflect the changes to Cigna's pricing, which were extensive. Corporate subscribers should examine the update notes that have been sent with the database and the change report function. Advisers should check out comparisons on Quotemonster to see the effect of the changes which involved some increases - but also some notable decreases - which tended to favour larger cover amounts and the 90 day wait period for IP / MP. 


Quality Product Research: Proposed rating for Benign Brain and Spine Tumour

Introduction

The World Health Organisation states that 130 different types of brain tumours exist. A benign brain tumour is a non-cancerous growth in a distinct area of the brain. The survival rates for patients with benign brain tumours are higher than others, however this depends on the size and location of the tumour within the brain.

Proposed sub-items

Capture

Notes

There are some noticeable differences between insurers such as whether partials exist, or if the spinal cord or tumour on the pituitary gland is covered. We have tried to make the sub-items clearly demonstrate the variation between insurers.

Why is this important?

Although QPRs weighting of this item is low, it would be of high interest to those that have a family history of brain cancers. With a lot of insurers now having specialised cancer products we would like to ensure that our rating is relevant. 

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


Cigna premiums to increase, and more daily news

Cigna has announced that from 15 April 2021 there will be changes to underlying premium rates on Life, Trauma and Disability covers across Assurance Extra, Business Assurance, Business Extra and Agribusiness Extra. Changes to Life, Trauma and Disability cover are a response to feedback and market developments. The price changes represent the changes. The price changes will be applied for new customers but current customers will have the new rates applied on their next premium review date after 15 April 2021. Applications that are submitted  before 15 April 2021 and issued before 15 May 2021 will not be immediately affected by the price changes. All changes are listed below:

 

·     Life cover rates on Assurance Extra, Business Assurance, Business Extra and Agribusiness Extra are increasing by 3% for yearly renewable, 5-year level and 10-year level premium structures.

·     Alongside this we’ve increased our large sum assured discounts for customers with over $500,000 of life cover.

·    Trauma cover on Assurance Extra, Business Assurance, Business Extra and Agribusiness Extra are increasing by 3% for yearly renewable premium structures.

·    Accelerated Complete Disablement Cover on Assurance Extra, Business Assurance and Agribusiness Extra are increasing by 3% for yearly renewable premium structures.

·    Disability covers including Income Cover, Mortgage Repayment Cover and Premium Cover are increasing dependent on factors including age, gender, wait period and benefit period. The increase will generally vary between 1-10%, however in some cases customers will experience a decrease.

 

“We wanted to give you a heads up about upcoming increases to the underlying premium rates on our current Life, Trauma and Disability Cover pricing across Assurance Extra, Business Assurance, Business Extra and Agribusiness Extra.

 

The new underlying rates will come into effect on 15 April 2021.

 

Over the past year in response to feedback, and in line with market developments, we’ve made a number of enhancements to our core Life, Trauma and Disability cover to make it easier for customers to access support when the unexpected happens.

 

These new competitive rates reflect the recent enhancements and will contribute to the long-term sustainability of our products while remaining good value for your customers.

 

For new customers: The refreshed rates come into effect on 15 April 2021 for all new policies.

 

For existing customers: The new rates will be applied to existing customers at their next premium review date from 15 April 2021. Customers will receive notification of their new premiums via the renewal letter which is sent prior to their premium review.

 

Any applications submitted before 15 April 2021 and issued before 15 May 2021 will be honoured at the old rates and will not be subject to the new rates until the first premium review.” Click here to read more 

In other news

FMA: the FMA has issued a public warning to Roger David Gannon of Gannon Insurance

Cigna: Simon Prentice to join Cigna as Business Partnership Manager based in lower South Island

Cigna: Sharon Duffell new Christchurch Senior Underwriter in the New Business & Underwriting Team

Cigna: Multi-Benefit Discount extended until 30 June 2021