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


Database V14.6 now Live!

Our updated database is now live on Quotemonster and reflects the following changes:

Changes to Research include:

  • New policy documents and minor rating changes for Accuro and Unimed
  • Asteron Life's new range of enhancements (for more details click here)
  • Cignas’ new range of enhancements (for more details click here)
  • Income and Mortgage Protection product weightings have been updated (for more details click here
  • Definition reviews for:
    • Aplastic Anaemia - Trauma
    • Critical Cancer & Booster (AMP only) – reflecting the difference between the base and plus range
    • Peripheral neuropathy- Trauma
    • Diagnostic tests – Medical
    • Imaging – Medical
    • Product flexibility – Medical
    • Support & Allowance – Medical
    • Inflation Adjustment (Partners Life Income and Expenses only)
    • Offsets – Income protection
    • Partial Disability – Income and Mortgage Protection

Changes to Quotemonster include:

  • The option to add a 50% benefit loading to health cover – initiated by your feedback
  • Family Protection Research now available for AIA, Cigna, Fidelity Life and Partners Life
  • Spring cleaning for our Research ratings:
  • Optional items that are not included in the score are shown as 0*

0

  •   If an insurer does not have an item (but others do) this will be shown as a dash (-) for their score

Dash

  • A legend has been added to our Heat Map report once generated

Leg

  • Rate changes for the following companies:
    • nib (effective 1 October 2021)
    • Unimed (effective 1 August 2021)
    • AIA Private Health (effective 1 November 2021)
    • Southern Cross (effective 1 November 2021)

Please email us on info@quotemonster.co.nz if you have any questions or feedback.

Happy Crunching!


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


Recent Product Updates

QPR subscribers have just received the latest database version (138) it is also live on Quotemonster, the changes in this version include:

* Cigna - new policy document 11/11/2020 -  rating changes applied

* Unimed - new policy document 01/08/2020 -  rating changes applied

* AA Health - new policy document nib366402 and nib366401 effective 01/05/2019 -  rating changes applied

* ANZ Life and Living - new policy document A0006 effective 31/01/2020 -  rating changes applied

* Momentum Life: - New policy document for Life 2633-MLPL2-PW 22/10/2020, New policy document for funeral 2667-MLF6-PW 21/09/2020 - Rating changes applied

* Revised view on: Medical - Treatment (overseas)


UniMed announces new CEO, and more daily news

UniMed has announced that a new CEO will be appointed in January 2021. Louise Zacest is set to take over from Dermot Martin, who is retiring after 30 years at UniMed. Zacest has held senior roles in different industries and is the current General Manager, Strategy and Partnerships at Healthcare New Zealand. 

“He will be succeeded by Louise Zacest.

 

Zacest joins UniMed from Healthcare New Zealand, the country’s largest home and community service provider, where she has held senior executive positions, including acting Chief Executive.

 

She is currently General Manager, Strategy and Partnerships. Her previous health and insurance experience includes senior roles with Southern Cross, Tower Financial Service Group and Counties Manukau District Health Board.” Click here to read more

 

In other news:

nib: nib’s 2020 virtual Annual General Meeting (AGM) will be held at 1pm (AEDT) on 5 November 2020 - note that we have five companies that have updated financial results in our tracking set for the life and health insurance sector, which will all be updated in the company information section of the Quarterly Life and Health Sector review due on 20 December

'Advisers take note' RIAA welcome sustainable finance roadmap

Long Covid a new problem for insurers to grapple with contrast this with our view: we think it is not too much of a problem provided we keep COVID-19 at bay.


Product Research Database Update

We have uploaded the latest product research database (version 12_7) onto Quotemonster and distributed it to subscribers. This version includes the following changes:

  • Asteron Life policy wording added and rating changes applied effective 30.09.2019
  • BNZ LifeCare 01.04.2019 policy wording added and applied rating changes
  • Unimed Hospital Select 01.09.2019 policy wording added and applied rating changes
  • Fidelity Trauma Multi 08.09.2019 wording added and applied rating changes
  • AA Life and Funeral cover 01.08.2019 wording added and applied rating changes
  • Kiwibank Home Loan and Life & Living 01.08.2019 wording added and applied rating changes

QPR Update - V107

On Friday the latest version of the Quality Product Research database was sent to subscribers. QPRv107 is now also live on Quotemonster. This version includes the following changes:

  • Update Business Expenses Cover
  • New Sovereign Medical Wording and Rating
  • New Unimed wording and Rating
  • Update Key Person Cover
  • Incidence changes income protection for "Plus" range

Difficulty Comparing Policies Highlighted by Interest.co.nz

Jenée Tibshraeny, at interest.co.nz, has a good piece about "navigating the road blocks preventing you from comparing 'apples with apples' when shopping for life insurance." As we spend a lot of time comparing policy documents we agree. The article is well worth a look. 

Tibshraeny highlights: 

"Of the 20 life insurance providers I’ve looked at, only half have published their policy documents on their websites.

These include AA Life, ANZ, ASB, BNZ, Cigna, Co-op Bank, Countdown, Kiwibank, Pinnacle and Westpac.

Those that haven’t include AIA, AMP, Asteron, Fidelity, MAS, OnePath, Partners Life, SBS, Sovereign and Volo."

Although I have to point out that AIA, AMP, Asteron, Fidelity, OnePath, Partners, and Sovereign do make their documents available publicly online: through sites like LifeDirect, KiwiCover, and others. If you google them, you can get several links to their policy documents. 

Tibshraeny then moves on to highlight the differences in wordings. This is trickier territory. There's a difference between "bad" differences which are merely confusing and make it hard to compare policies and "good" differences which make a policy demonstrably better than the others. There is a difference between documents that have a lot of superfluous words and details for cover that you did not buy, and those that have lots of long words because they cover more medical conditions. 

There have been some interesting developments in the UK to help raise consumer confidence in wordings.

But it all starts with a policy document.

Of course, most consumers do not read the document before they buy, but it is hard to argue that they should not have the opportunity to do so.