ePR 150 Feb 2013 - Protection · The full report is available to members of The Syn-dicate only,...

EPR 150. Published by Protection Review Limited, Bank House, Great Rissington, Cheltenham, Gloucestershire, GL54 2LP.

e-Protection Review (incorporating HealthCare Insurance Report)

from Peter Le Beau MBE, Andy Couchman, Kevin Carr

Don’t know or can’t be bothered? Casino mentality prevails for many

Quotes of the month:

Consumers are increasingly confused about protection insurance and instead many adopt a casino mentality, according to The Syndicate’s second annual report, published to its members on 23 January. The innovative research initiative was launched last year as a part-nership between Protection Review (publisher of this newsletter) and reinsurer Han-nover Re UK Life Branch. Members, which include leading life and health insurers, pay an annual fee to become a member of The Syndicate and help devise its research pro-gramme and co-analyse its results and what they mean to the industry.

The report, Where are we on the consumer’s radar? Navigating a route for protection insurance, is based on an omnibus survey of over 3,000 adults, conducted over the tele-phone and online by ICM Research. The latest report is based on surveys carried out in September 2012.

In terms of products, half of those polled said life insurance was the most important type of protection, although 80% could not accurately identify how basic life cover worked. The economy had had a significant affect on people’s planning, with 58% saying they had abandoned plans to save in the current economic environment to focus on monthly out-goings. A third are continuing to save, despite the economic conditions, although a further third had resorted to borrowing to meet current outgoings.

Among other key findings in the 68 page report were:

• 62% of respondents said they were more likely to buy a protection policy if it was rated by Which? magazine.

• Up to three quarters (75%) said they were less likely to cancel an insurance policy if their loyalty was rewarded.

• The vast majority (80%) said it would be useful to receive an annual statement detailing their existing cover.

• 75% could not identify how a basic critical illness insurance policy worked.

• Younger people (42% of 18-24 year olds) were more willing to see insurance as a way to achieve security than older people (less than 20% of 55+’s). (Continued on Page 2).

‘I would never say to anyone cancel your policy but insurance companies look for any loop hole to get out of paying this is a fact (sic)’, Sharlene9’s comment on a This is Money article on non-disclosure (see 6), 16 January 2013.

‘Moderate Premiums are charged to Naval and Military Men, and Members pro-ceeding to the British Colonies, or to For-eign Countries.’ Ah, a different age—from a Reliance Mutual Life Assurance Society ad in the 1866 Post Office Directory of Sussex.

“As I hurtled through space, one thought kept crossing my mind—every part of this rocket was supplied by the lowest bidder.” John Glenn, astronaut. One good reason why cheapest is not always best…

No 100 February 2008 ISSN 1461-5746 Inside this issue:

News News Raising a child costs £222K; Independent healthcare £40bn pa; Average life payout £46K; AMII opens up to insurers; 43% now pay full LTC cost; new FSA guidance issued.

2-62

Reviews New products from Cigna Healthcare; Friends Life; InterGlobal; Nucleus; PruHealth and Simplyhealth.

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Medical and political Choice helps private providers; Obesity doctor call; NHS surgeon league tables within two years; Dilnot £75K cap?

10-12

Features ABI protection new busi-ness stats for Q3 of 2012; Blogs; Statistics (deaths, suicides and cancer are the cheery subjects this month); Top 10 in the news.

13-16

Statistics H

16

.

Key statistics:

• NHS RTT median wait England November 2012:

8.3 weeks (See Page 12)

• e-Protection Review Long Term Protection Sales Index: 126.1 (Quarter 3, 2012, compared to base 100 in Quarter 1, 2000).

• e-Protection Review Em-ployment Index: 109.15 (To end November 2012, compared to January 2000, see Page 12).

No 150 February 2013

ISSN 2045-5925

Inside this issue:

2-6

2


news

(Continued from Page 1) The research highlighted that peo-ple see their savings as performing a dual role—77% said they were saving for pleasurable activities, while 70% re-ported saving for security. As the average person only has savings of around £2,000, this suggests unrealistic demands being placed on savings, and an apparent acceptance that if misfortune hits, pleasurable activities would be at best de-ferred and more probably have to be cut out altogether.

There was some recognition of the value of protec-tion, with 50% of respondents seeing life insurance as a top three priority ‘essential’ (more than for any other optional type of insurance). A quarter of respondents (26%) saw critical illness insurance as essential, followed by private medical insurance (PMI, 23%) and income protection (19%). Looking wider, only 26% had travel insurance as a top three priority, with pet insurance lowest at 13%.

One interesting finding was how much people said they were prepared to pay for protection insurance. Most people said they were only willing to pay up to £20 a month for life insurance, with only PMI higher, at up to £30 a month. Care needs to be taken when looking at these numbers though—which are about half or below the indus-try’s actual averages—as it is likely that price is a quality symbol. That is, the low figure reflects the fact that many people simply do not see protection insurance as impor-tant enough to commit a larger sum to.

PMI was also an exception in that while only 1% of those polled said they would be willing to pay over £80 a month for life, CI or IP, the figure for PMI was 9%.

Low knowledge Another concern was how little people know about particu-lar types of policy. One of the simplest is term insurance—which pays a fixed cash lump sum if the life insured dies dur-ing the term of the policy. Yet, when given a choice of three definitions, only 20% chose correctly, while over 40% said they did not know, 30% expected the policy to pay out at the end of the term too and over 7% expected the policy to pay out on death or diagnosis of a critical illness. The finding suggests that insurers and intermediaries should not assume knowledge, even at a basic level, and may need to explain commonly used terms, even where their use seems obvious.

A third of those polled also assumed that a critical illness policy was one which paid a regular income on diag-nosis of a critical illness, with just 25% correctly choosing the right definition (again from a choice of three) and 30% saying they did not know.

The highest understanding was for income protec-

tion, with almost half choosing the correct definition, even though that was from a larger choice (five) of options.

When asked why they had not bought protection insurance, many people were defensive—the most com-mon reason given (37% of respondents) was that the prod-ucts were expensive and an unaffordable luxury. That is despite the cost of many types of cover (especially basic life cover) being lower than in the past.

The report identified three broad types of con-sumer. They are:

• Believers, or the convinced. Those who already have cover. The challenge is to avoid them becoming dis-connected from their policy and the benefits it provides. The survey also found consumers felt rewarding and valu-ing loyalty would lead to less policy cancellations.

• Rejectors. Those who used to hold polices but are now disenchanted. The industry’s challenge is how best to bring them back.

• The mass indifferent. The issue is how to educate them and influence them to alter their mentality, which is often focused on living for the moment.

Protection Review co-chairman Peter Le Beau out-lined at the report’s launch in London on 23 January a five point action agenda for the industry:

1. Value should be emphasised rather than price. Value should also be made more tangible.

2. Simpler concepts that chime with consumers—such as a product that covered ‘essential expenses’ could be adopted. 3. Advisers’ knowledge of protection insurance should be enhanced. 4. Consumers should be helped to face their vulner-abilities. That could include annual statements of what protection people already have (supplied by their in-surer, employer or adviser) and greater understanding of their entitlement to sick pay and State benefits. 5. Protection should not be a secret—we need to make more noise about it! Hannover Life Re UK Life Branch head of marketing

Ronnie Bowes said at the launch: “The challenge for our industry is how we can offer solutions to people who don’t see a problem and are willing to take a risk—the ‘Casino Mentality’. Behavioural economics explain some of the rea-soning behind why consumers discount something that is in the future, the ‘enjoy now, worry about it later’ approach. We need to look at new ways to communicate the greater reward protection products offer to encourage them to look longer term to receive the valuable benefits they pro-vide ‘not today, but tomorrow’.

The full report is available to members of The Syn-dicate only, but a synopsis is available from Jo Miller who can be emailed at [email protected].

What is the benefit of being a member of The Syndicate? The Syndicate is unusual among life and health insurance research in that it is a research community comprising members, some of whom are in direct competition with each other. Such cooperation is not unusual among successful businesses (a Ford Ka and a Fiat 500 have the same platform chassis for example) but it is still relatively rare in our sector.

So why join? The bottom line is that joining The Syndicate means every £1 spent on this research buys so much more than if it was spent on standalone research. The community also benefits because there is group input to themes, questions and, most importantly, results.

The Syndicate goes further, by involving outside experts (such as claims consultant Karin Lloyd, the Money Advice Service, Which?, and Quietroom) in the analysis too. Membership also includes mem-bers being able to ask one question, the results of which just go to them. In that way, results can be tailored to each business’s needs.

Above all, every member gets fast access to each survey’s results and is able, immediately, to build the results into its own planning. Being an ongoing rather than one off project, The Syndicate research also builds up intelligence of consumer attitudes over time, each report build-ing on and adding to its predecessors. To find out how to join, e-mail Jo Miller at [email protected].

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news

Raising a child costs £222,000 The cost of raising a child from birth to age 21 has risen by £4,000 over the past year to a record £222,458, ac-cording to new research from LV=.

The cost has risen 58.4% since 2003, with educa-tion having overtaken childcare and babysitting as the highest cost. A family will now spend a total of:

• £72,832 on their child’s education.

• £63,738 on childcare and babysitting.

• £19,270 on food.

• £16,195 on holidays.

• £10,770 on clothing.

• £9,316 on hobbies and toys.

• £7,353 on leisure and recreation.

• £4,458 on pocket money.

• £3,462 on furniture.

• £1,165 on personal spending.

• £13,909 on other spending. The economic situation had led many parents to

cut back in various ways, with 42% having cut their saving and 26% had reduced their insurance spending. Almost half (47%) of parents had no life cover, only 11% had criti-cal illness cover and just 6% had income protection.

Comment: The actual costs can be even higher. First, expenses often start even before the child is born and second, they can continue well after age 21. One factor is that it is now harder for children to buy their first home without parental help. And that, in turn, depends on the parent being able to continue to work to provide the funds to be able to afford to help their children.

Protection insurance isn’t often avoided because par-ents do not want to help their children. But parents often need help to look at their long term situation, not just where they find themselves today.

Independent healthcare £40bn The value of independently provided health and care ser-vices in the UK is almost £40bn a year, according to the latest Laing’s Healthcare Market Review, published by Laing & Buisson on 18 January. This is made up of:

Private acute medical care: £6.4bn. Care homes for the elderly and disabled: £13.4bn. Care homes: learning disabilities/mental health: £3.4bn. Homecare (all client types): £6.2bn. Mental health hospitals: £1.1bn. Children’s homes (England only): £0.6bn. Foster care (England only): £0.6bn. Special educational needs (England only): £1.1bn. Primary care dentistry £5.7bn. Primary medical care (England only): £0.7bn. Occupational health: £0.25bn. Community health services: £1.0bn. Total: £39.9bn. Author William Laing said: “Companies serving the

privately paid market have experienced a challenging mar-ket environment following the global credit crisis, with PMI and medical expenses cover dipping by 8% between 2009 and 2012, and growth in private dentistry falling off.”

Laing’s Healthcare Market Review 2012-13 costs £350 for hard copy and £710 (including VAT) for hard and electronic files. See www.laingbuisson.co.uk.

Average 2011 life payout £46K The average life insurance payout in 2011 was £46,000, two and a half times the average annual take-home pay, according to figures released by the ABI (Association of British Insurers) on 19 December. 32,540 term claims were received, of which 31,581 were paid, giving a figure of 97.1% of all life cover claims being paid.

The trade body also revealed that, on average, every day insurers paid out £6.7m to 170 claimants on protection insurance policies.

The average payout on critical illness (CI) policies was £59,000 and 92% of all CI claims were paid (excluding TPD claims, or 89.0% if they are included), up from 80% in 2005. Since the end of 2012, as well as standard CI defini-tions, ABI member insurers must also now adopt a stan-dard definition for total and permanent disability (TPD)—a condition that was previously often ill-defined on many CI policies, which helped result in the majority of TPD claims being rejected. 15,060 CI claims were received in 2011, of which 13,408 were paid.

The average payout on new income protection (IP) claims in 2011 was £14,000 a year, paying out on average for 260 weeks (five years). Some 27,848 IP claims were received in 2011, of which, 23,844 were paid, giving a fig-ure of 85.6% of IP claims paid in 2011. The ABI is cur-rently reviewing its IP Statement of Best Practice ‘to ensure the product is as simple as possible and is explained very clearly to ensure customers understand when they can make a claim’.

Director of savings and protection, Stephen Gay, said: “Insurance companies want to pay all valid claims. It is important that all insurance policies are clear so that customers are able to understand the circumstances in which they can make a claim.”

Comment: In December, Health Insurance’s Tessa Norman reported inconsistencies in the way in which insurers reported CI claims, with some ignoring TPD or children’s claims and others not, and the magazine called for consistency in the way providers report claims.

Then, on 23 January, the magazine reported that many IP insurers still (unlike their CI counterparts) do not publish IP claims stats. One concern often given is difficulties in compar-ing like-with-like.

ABI data also shows that while 85.6% of individual IP policy claims were paid, that figure was lower—81.1%— for group IP policies. The Income Protection Task Force is looking to agree a common basis for IP claims reporting and encourages IP insurers to publish claims data, but the issue is complex. One concern is that insurers should not be able to pick and choose the set of data that presents their claims re-cord in the best light.

IP premiums rise with age Group income protection premiums (IP) are rising as workforces get older, according to Canada Life.

The insurer says the average age of its group IP scheme membership rose 0.8% between Q1 of 2009 and Q1 of 2011 and that for every year average age rises, pre-miums go up by up to 10%. Data from Saga in December shows 124,000 more over 65s working between Q4 of 2011 and Q4 of 2012.

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news

Wrap life cover: comment On Page 8 we comment on what, to us, is a new develop-ment—that of wrap based life cover. The idea is not wholly new though.

Back in the 1980s, back in my corporate days, the cheapest way to buy critical illness cover was to add it to an endowment policy (back in the days before such policies became toxic and yes, it was one of the products in my portfolio as a product manager...).

That was because the risk premium was effectively based on the policy sum insured less the policy surrender value. As the value of your plan (hopefully…) rose over time, so the sum insured to be funded by insurance fell, which was useful, as the life insured was getting older. It meant you could protect your mortgage by adding CI cover to your mortgage endowment much more cheaply than by having standalone CI cover, although the net effect was reducing cover as your endowment built up (not a problem, as the purpose of the CI cover was essentially to repay your mortgage anyway).

It was one of the reasons why, in my company, we sold significantly more CI as part of an endowment policy than any other way. That got us thinking about whether the concept could be extended to look at other invest-ments too. At the time we had a forerunner of the modern wrap, although it was fairly clunky and limited in its scope. The idea never progressed beyond the drawing board and in effect we have had to wait for technology to catch up before the idea could be marketed on any scale.

But how good is the new idea in practice? Setting aside the obvious benefit—this should be the cheapest way to ensure you can leave an estate of £x million, regardless of how well your investments do—let’s look at some of the issues around the idea.

First, to work best, the wrap platform should in-clude all the customers’ assets—house(s), cash; works of art; antiques; chattels; business values and so on. If not, the idea will only work partially, unless the customer can allow for the value of such assets in other ways.

Second, the target value on death may be £Xm, but what the beneficiaries actually receive will be the policy sum insured (crystallised at the date of death) plus what-ever the assets are now worth (not their value at death).

Third, if you buy and sell a lot or need to increase your life cover beyond the limits set out in your policy, you may have to be re-underwritten. Each time.

Finally, Nucleus’ solution, good as it is, ceases at age 75—below the age at which most customers are likely to die. As the need for life cover may be permanent, we would expect whole life solutions to follow (although, ar-guably, if you haven’t built your estate by age 75 to what you want to leave to your heirs you probably never will).

None of this takes away from the soundness of the basic idea. It even illustrates how no protection solution can be a perfect fit—the art is simply to minimise the unac-ceptable or unwelcome compromises and to get the best rather than a perfect fit.

What is certain is that Nucleus will not be the last to go down this route. Once the genie has been released from the bottle…

Andy Couchman, Editor

Denplan launches discount dentists Denplan is launching a Denplan Discount Network, which will offer discounts of 5%-25% on treatment costs for em-ployees who have Denplan as an employee benefit.

The network includes 1,500 dental practices. One reason behind the move is a greater focus on cost and encouraging treatment closer to places of work, in order to minimise employees’ downtime due to having dental treatment. Denplan has not ruled out extending the con-cept into the self-pay arena though.

On 13 December, the Department of Health reported that in the last two years, 94% of people who tried, had been able to see an NHS dentist. In total 60% of half a million people polled had tried to get an appoint-ment, with most of the others seeing a private dentist or, for 20%, saying they had no need to see a dentist, while 8% no longer had any natural teeth.

AMII opens up its membership AMII, the Association of Medical Insurance Interme-diaries, is to open up its membership to providers follow-ing a supporting vote of 40 of 45 members (around 40% of its membership) who attended an emergency general meeting on 10 January.

The move, which is designed to boost the member body’s finances and to create a unified health insurance voice, will avoid AMII running out of money within three years, Cover magazine reported chairman Wayne Pontin as saying. In recent times AMII has raised its role in education, including working with the CII (Chartered Insurance Institute) to improve its IF7 exam and issuing guidance to insurers to improve service to customers.

The first provider member is expected to be Bupa, which has already agreed in principle to become a member.

1 in 5 odds highlight IP gap One in five (20%) employees have experienced being made redundant and one in five (21%) have been off work for more than four weeks, with 51% having been affected by one or both, according to research from MetLife. But less than one in five (15%) has any form of insurance against losing their income, and only 7% as an employee benefit.

Protection Review news Tables are selling out fast for this year’s Protection Re-view dinner on 11 July. Again being held at London’s pres-tigious The Landmark in Marylebone, we celebrate ten years of Protection Review, ten years of change and ten years of opportunity and challenge.

The daytime conference is now being finalised and current planning is that the day will revolve around three themes—protection ten years on, customers, and why is there such a perceived gap between medical and longer term protection. Details are being finalised but the day promises to be the protection event to be at in 2013.

Our generic training programme continues (more important than ever in this pivotal year) and, to find out more about what’s happening and how to be part of it see www.protectionreview.co.uk.

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news

43% now pay full LTC costs Almost half (43%) of independent sector care home resi-dents paid the full costs of their long term care fees in 2012, according to Laing & Buisson’s Care of Elderly Peo-ple UK Market Survey 2012/13, published on 15 January.

The full cost was paid by 175,000 older residents (43.4%), with 56,000 (14%) getting council support backed-up by top-ups from family or friends.

The remaining 43% of residents had their fees paid in full by councils (143,000) or by the NHS under the con-tinuing healthcare programme (29,000). State owned and run homes had just 38,800 care beds, down 11% on the year before.

Author William Laing said: “The private payers’ share is projected to continue growing in the future as the rate of owner occupation continues to expand among the very old population at risk of entering care homes. Mean-while, the quasi-private, top-up market will be reinforced by the minimal or zero local authority fee uplifts which look likely to continue in the medium term.”

55% of residents paid their own fees in the South East, compared to just 22% in the North East, Northern Ireland and Isle of Man.

On average, English councils were paying £480 a week in 2012/13, around £50-140 less than the ‘fair market price’ range of £528-£623 calculated by Laing & Buisson (with nursing care fees being around £150 a week higher).

L&B has now calculated constituent care costs as:

Resident CC AC AS OP Total Residential, frail £197 £151 £205 £44 £596 Res, dementia £221 £151 £205 £47 £623 Nursing, frail £347 £153 £205 £59 £764 Nurs, dementia £356 £153 £205 £160 £774 Key. CC: care costs; AC: accommodation costs; AS: ancil-lary support; OP: operator’s profit; Total: total weekly costs including profit. The report points out that under the Dilnot proposals, families would still have to pay £399-£418 a week, even after the State had picked up the full cost of ‘care’. Raising the asset threshold from £23,250 to £100,000 would mean large numbers of care home residents would then be drawn into the ambit of local authority payment, resulting in fees gravitating towards the low fee regime of councils (at present, privately funding residents in effect subsidise local authority funded residents).

At September 2012 there were 487,800 places in residential settings for long term care, up 36,000 over April 2011. Of this, 432,000 places were occupied, giving an average occupancy rate of 89.9% in 2012 (up from 88.5% in 2011). Average care home fees in 2012/13 are £731 a week for nursing care and £531 for residential care.

The residential care market was worth £15.2bn in 2012, compared to £14.6bn in 2011, splitting down into the for-profit sector (£11.1bn); voluntary sector (£2.2bn) and public sector (£1.9bn).

In May 2011 the Law Commissions proposed creating a duty for local authorities to ensure people can access advice on LTC funding and LTC provider Partner-ship is pushing for changes in the draft Care and Support Bill to ensure all such advisers are CF8 exam qualified.

FSA issues more guidance The FSA (Financial Services Authority) has published guidelines to help insurers prevent another PPI (payment protection insurance ) scandal.

With the Office of Fair Trading (OFT), the FSA published final guidance on 24 January. Next year the two bodies’ work will be combined under the auspices of the Financial Conduct Authority (FCA).

The guidance ‘stresses that firms should ensure that product features reflect the needs of the consumers they are targeting’ and sets out the importance of:

• Identifying the target market for protection plans.

• Ensuring cover meets the needs of that market.

• Avoiding the creation of barriers to competing, exiting or switching cover.

‘Firms should take note of the lessons learned from PPI where a significant proportion of the premium paid by the consumer was used to pay commission,’ the guidance says. Providers should also state whether potential cus-tomers should seek financial advice before buying. The guidance applies to short term plans rather than long term protection policies.

On 18 January the FSA reported that it had been approached by the British Bankers Association (BBA) ‘to discuss the potential for introducing a time limit for PPI complaints—if the industry funded a sufficiently widespread advertising campaign to ensure consumers are aware of the PPI issue and how to complain’. The FSA said it was prepared to consider the merits ‘of this and other options’ but added that a key consideration would be the potential to get compensation to more consumers more quickly, and that a full public consultation would take place before any FCA rules would be changed.

On 16 January the FSA published guidance to help firms ‘avoid creating and operating incentive schemes that drive misselling’. The updated guidance adds clarification and includes more examples of good and bad practice.

On 21 January, Wiltshire Friendly announced that certain friendly societies would be granted exemption from FSA RDR (Retail Distribution Rules) on selling, quali-fications and commission regarding Holloway type income protection plans. Such policies must not have a projected maturity value at outset of more than 20% of the premi-ums payable (although up to 5% of plans can project a fig-ure of up to 25%). The aim is to allow brokers to continue to sell Holloway policies where the main aim is to provide protection rather than an investment opportunity.

For more see www.fsa.gov.uk.

Presenteeism now more present The average time workers took off for colds and ‘flu was just 1.4 days in 2012, down from two days in 2011 and four days in 2008, according to Fisherman’s Friend’s annual Cold and Flu Survey, published on 25 January.

The poll of 2,000 adults estimated a further £1.35bn was taken off the cost of winter ailments through lost working hours, still leaving employers with a bill of £3.26bn a year. The reduction is largely due to workers being wor-ried about losing their job if they are absent.

One concern is that such short term action can impose greater long term costs as more become infected.

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news briefs

• Happy birthday to us! This is the 150th edition of e-Protection Review, while Protection Review is ten years old later this year.

• In his Autumn Statement on 5 December, Chan-cellor George Osborne announced that from 6 April 2015, the Inheritance Tax (IHT) nil rate band will rise in line with the Consumer Prices Index (CPI) rather than the Retail Prices Index (RPI). However, Parliament can still override the automatic increases if it chooses to do so, as it is now.

• Solvency II rules could be redrawn following ‘intensive lobbying’ at the World Economic Forum in Davos in January, The Times reported on 26 January.

• LifeSearch has teamed up with Which? to offer free, whole of market, independent protection advice to the consumer watchdog’s customers.

• As many as 80% of businesses have so far failed to adapt their approach to employee ill health following the introduction of the Welfare Reform Act, according to an online poll of PMI Health Group’s 12,000 corporate customers. This has created a potential protection gap that has left businesses underinsured. Only 3% of respondents said they had expanded their group income protection schemes and only 13% were considering altering their benefits, while 19% had introduced more stringent arrange-ments to evaluate incapacity and fitness for work.

• Legal & General has launched Healthy Living to allow all its group risk employee customers to assess, monitor and improve their health online through a Health Risk Assessment and Q score. Employers will get ano-nymised data to enable them to better understand trends and issues too.

• More firms should offer group income protection schemes for their employees, according to Duty of Care, a new report from thinktank Demos, based on GRiD (Group Risk Development) data published on 13 De-cember. It says only 9.4% of UK employees have GIP, com-pared to 30% of US employees and if the UK followed suit, it would save up to £2.24bn a year in State means-tested benefits. A Harvard Business Review study found that insur-ance against sickness and disability can improve return-to-work rates by up to 43%.

• Keeping international private medical insurance (iPMI) both affordable and comprehensive is the biggest challenge facing insurers in the market, Jelf Employee Benefits predicted on 28 November. On 9 January, it added that 48% of UK companies will be considering new initiatives to engage, retain and reward staff in the next 12 months. But 54% expressed concern there was not enough competition choice from insurers and hospitals.

• William Russell has withdrawn its Platinum Global Health iPMI plan, raised prices by 7-9% across other products in the range and introduced or improved benefits for the Bronze, Silver, Gold and Essential Care plans.

• US healthcare spending reached $2.7 trillion in 2011, or $8,680 per person, the Center for Medicare and Medicaid Services announced in January. 2011’s rise of 3.9% was lower than growth in some previous years (e.g. it was 7.6% in 2007) and spending remained at 17.9% of GDP (gross domestic product).

• Under the US’s Affordable Care Act, American young adults can continue to be insured under their par-ent’s health insurance scheme up to age 26. That contrasts

with a much lower figure for UK PMI. Should the UK change and allow parents to continue to cover (and pay for) their adult children’s health to a much older age?

• The Competition Commission (CC) is investi-gating the proposed merger between the Royal Bourne-mouth and Christchurch Hospitals NHS Founda-tion Trust and Poole Hospital NHS Foundation Trust it announced on 8 January. This is the first merger between two NHS trusts since the enactment of the Health and Social Care Act 2012, which confirmed the OFT’s and CC’s roles in assessing the competition aspects of mergers involving foundation trusts.

• Group risk insurer Ellipse is looking at expanding into the business protection market, with a product that would allow firms to re-evaluate their cover each year.

• Zurich announced on 18 January that it paid out 90% of its critical illness insurance claims in 2012, rejecting 8% due to the definition not being met and 1.8% due to non-disclosure. 62% of claims were for cancer, 13% for heart attacks, 7% for strokes and 4% for multiple sclerosis. The largest single claim was for £1.1m and 744 claims were paid in total in 2012.

• Income protection specialist DG Mutual an-nounced on 9 January that in 2012 it paid out over 99% of its IP claims, for the fifth year running. 67% of claims were paid within a week and 95% settled within two weeks. Av-erage length of claim was 15 days, average claimant age was 46 and 7% of members made a claim during the year.

• Ageas Protect has added the Best Doctors service on its term as well as CI/IP plans from 7 January. It has also revised its CI plan, which now covers 46 condi-tions (17 of which are now ABI+) and pays out on children up to age 21.

• Assureweb has reported whole of life compari-son requests up 72% in November and users up 41% in the run up to G-Day. Term and CI comparisons were up 17% (and users by 7%), with new business applications on 20 December the highest achieved on any day since As-sureweb launched in 1995.

• A steering group chaired by the ABI and Treas-ury is currently drafting a report on under-protection, Cover reported on 26 November.

• On 3 December Bupa announced it was splitting its Health and Wellbeing division into two.

• Nearly 80% of consumers do not understand the difference between income protection and payment pro-tection insurance, according to a poll by Cirencester Friendly. 63% of advisers said they worried that their cli-ents did not know what IP was, and more than half sup-ported a campaign to raise awareness.

• A third (32%) of consumers are likely to adopt DIY financial planning to avoid paying advisers fees, 27% would go direct to a provider to buy having made their choice of product, but only 31% say they are confident enough to choose the right financial products, according to a poll of 2,000 adults by YouGov for Deloitte.

• Do you still use fax? No, nor do we(!), so we have now dropped our separate fax line. You can still fax editor Andy Couchman but now on the combined 01451 821982.

• Product ratings. A reminder that we now rate products as Platinum (9+ out of 10); Gold (7-8); Silver (5-6) or Rust (below 5). See Pages 7-9 for latest reviews.

7


reviews

Pick of the month We review six new products this issue. The most revolu-tionary is Nucleus’ new way of buying life cover, and we comment more on this type of design on Page 4 too. There are also new or updated plans from Cigna, Friends Life, InterGlobal and Simplyhealth. Our top scorer is Pru-Health for its PMI updates, which reward customers’ ac-tions as well as delivering good value whether they become claimants or not. But there are some good new ideas emerging across the board this month, so read on!

Cigna HealthCare Choices Cigna has been very busy with product launches recently and has now relaunched its corporate PMI plan as Com-pany Health. This is now one third of its new HealthCare Choices proposition, which includes two new plans:

• YourHealth. This offers three choices: 1) Diagnos-tics, 2) Diagnostics and out-patient, and 3) Diagnostics and out-patient/day case. This plan is designed as a valuable reward for employees who do not already have PMI, focus-ing on only those treatments they are most likely to need.

• Essential Health. This provides cover for muscu-loskeletal and mental health conditions only, as these are key drivers of absence and productivity issues in the work-place for employees who do not have full PMI cover al-ready. It also offers three options: 1) MSD and Psych diag-nostics and out-patient, 2) MSD and Psych diagnostics and out-patient/day case, and 3) MSD and Psych diagnostics and all treatment.

In addition, CompanyHealth, which is the most comprehensive plan, gives a choice of three new cancer options: core (basic cover, paying for treatments not avail-able on the NHS due to lack of funding plus diagnostics only [otherwise, members will be switched after diagnosis to the NHS for treatment]), active cancer cover (includes second line treatments for secondary cancers, known as metastatic spread), or premier cancer cover (pays for all active and evidence based treatments at all stages of the disease plus clinical trials and also pays a donation towards hospice care, home nursing or family carer in the event that treatment becomes palliative. Psychiatric treatment can be in or out, as can cardiac treatment.

Overall, the plan is available to firms with 100+ em-ployees and can be included as an option within a flex (flexible benefits) scheme too. All plans include Cigna’s case management managed care system.

Comment: Cigna says its aim is to grow the market and we applaud that. Certainly, the new options (and giving CompanyHealth its own name for the first time), should help open up the market to those employers who do not currently have PMI for their people.

The options look to be well thought through and Cigna in effect says that as 88% of patients don’t need in-patient cover, employers can choose to insure for the majority while paying much less than full cover would cost. Our only concerns are around the complexity of choice to the uninitiated and whether this plan does enough to actually grow the market.

Product design points: Making the right decisions on PMI is becoming ever more complex as costs rise and insur-

ers and customers alike look to best balance coverage against cost. How best to help? Information is key, so marketing sup-port, ideas and help will become increasingly important.

Plus points: More choices; aim to grow the market; affordable cover.

Not so plus points: Choosing which options is not easy for those who (for example) are not medical experts. Website: www.cigna.co.uk. Rating (max 10): Innovation: 8. Overall: 8. Gold.

Friends Life Group Critical Illness Friends Life has made a number of significant enhance-ments to its existing Group Critical Illness Plan including:

• Ten more definitions have been enhanced over and above the ABI (Association of British Insurers) standard definition. These are for cancer, major organ transplant, multiple sclerosis, Parkinson’s disease and stroke on the Standard Cover plan. On the Comprehen-sive Cover plan there are new enhanced definitions for aorta graft surgery, blindness, coma, HIV infection and third degree burns. The plan now has 16 ABI+ definitions.

• Cardiac arrest has been added as a new definition.

• The maximum age for children’s cover has been increased from 18 to 21 if in full time education.

• The maximum benefit is now the lower of five times salary or £500,000.

• On flexible benefits schemes, members are now allowed unlimited benefit increases during the selection window and at standard lifestyle events.

In addition, the Best Doctors service is now ac-cessible to members and their dependants at any time, rather than only once a claim has been made. A new em-ployer microsite toolkit sets out information on the ser-vice in one place. Two new Best Doctor additions are i) ‘Ask The Expert’, which offers streamlined access to a world-leading specialist for a specified condition within a few days, without a full collection of medical records, and ii) ‘Ask Best Doctors’ giving access to an online multimedia library of medical conditions, treatments and testing.

Comment: Benefit improvements should mean more people being able to claim, while the extended Best Doctors options means that CI benefits are now not just financial but also include what may be ‘priceless’ help too. Both should widen the appeal of group CI—a product that is still some way behind its individual namesake.

Product design points: Not a criticism of Friends (all insurers struggle with this issue in our view) but services such as Best Doctors can be invaluable to real people in the real world, yet how do you get customers to put a value on that upfront? Case studies help (an area where too many insurers are woeful in our view), so does painting a picture in the mar-keting materials. It’s all about selling the sizzle rather than the sausage but that, for an industry that understands the price of everything rather than, necessarily, its value, is a tough call.

Plus points: Range of benefit enhancements means more people will be able to claim; new Best Doctors’ benefits.

Not so plus points: How many extra people will benefit?; more complexity on an already complex proposition. Website: www.friendslife.co.uk. Rating (max 10): Innovation: 7.5. Overall: 8. Gold.

8


reviews

InterGlobal Channel Islands UltraCare InterGlobal has introduced a variant of its UltraCare international private medical insurance (iPMI) plan designed specifically for Channel Islands’ residents and businesses. Benefits can include:

• Medical treatment throughout Europe, with an unlimited selection of hospitals and clinics.

• All costs of emergency evacuation to another Channel Island, the UK or France if adequate treatment cannot be provided locally.

• Up to £1,500 for non-emergency treatment on another of the Channel Islands.

• Full refund of all in-patient and daycare treatment costs, out-patient consultations, treatment and tests, up to plan limits.

• What is described as ‘generous’ cover for cancer care and maintenance of chronic medical conditions (there is a lifetime limit of £50,000 for chronic conditions).

• Insured dependants can accompany a member on an emergency medical evacuation.

• Inclusive travel and accommodation for a parent accompanying a child.

• Second, third and fourth children under the age of 18 are covered free.

• 24/7 security advice provided by crisis manage-ment specialists red24.

• 24/7 medical assistance helpline. The plan has an overall annual limit of £1m. Out-patient psychiatric cover is limited to £1,000 (after 12 months only). Complementary benefits are limited to ten sessions a year. The lifetime limit for terminal illness treatment is £50,000. Hospital cash benefit is £150 a night, up to £3,000 a year. Up to four optional benefits can be added:

• Dental and optical benefits. Initial waiting periods can apply.

• Maternity plan. This provides up to £1m cover.

• Worldwide travel plan. Up to £2m cover.

• Personal accident plan. Max payout £250,000. Individual plans can be underwritten on a 24 month rolling moratorium, full medical underwriting or switch basis. There is no excess payable on claims.

Comment: This plan aims at a small but easily recog-nisable market—the Channel Islands. It looks to include the benefits that islanders need, although we don’t like to see over-all annual limits applied—even if it is £1m (as an aside the optional travel cover has a £2m annual limit).

Product design points: Designing plans for a spe-cific geographic area is expensive but increasingly necessary in the iPMI space. Few insurers will go to this length, but such an approach limits competition and means that an insurer who does do this can make a name for itself as being the expert for a particular market and good relationships with specialist bro-kers and even trade and other organisations can be built up too.

Plus points: Channel Islands specific benefits and a choice of add-on options; no excesses.

Not so plus points: Some limits, including a £1m annual limit; limited market (although InterGlobal has a range of other products for other geographies).

Website: www.interglobalpmi.com. Rating (max 10): Innovation: 7. Overall: 7.5. Gold.

Nucleus Wealth Protect Nucleus, the IFA owned and controlled wrap platform, has teamed up with Integrated Protection Solutions (IPS) to offer the latter’s Wealth Protect proposition, initially to 11 member firms only, before it is rolled out to all Nucleus wrap users later this year.

Wealth Protect is a daily renewable term policy underwritten by Elips Life, a wholly owned subsidiary of Swiss Re. Customers select a target portfolio value and the difference between that and the value of their platform assets is then the sum insured. Only that sum is insured and so the policy payout can vary daily, as the value of the customer’s platform investments fluctuates.

In effect, customers can leave a specific sum to their beneficiaries on death, rather than see that subject to the market fluctuations of their investments. In other words, they have much more control over how much their death estate is worth. As an example, if a customer’s investments are now worth £10K more than they were yesterday, they now need £10K less life cover and, as only that day’s risk is insured, the actual premium should be as low as it can be. Over time, the value of their assets should rise, so reduc-ing the sum insured necessary (which is useful, as the un-derlying premium rate will rise with age).

The plan is available to UK residents aged 18-70 at outset and cover can last any period up to age 75. Al-though the sum insured fluctuates daily, the actual premi-ums are payable monthly. Cover can be increased by up to 10% a year without fresh underwriting, in certain circum-stances. In effect, premium rates are guaranteed at outset, although they rise with age. Maximum sum insured is £5m.

Comment: This idea has been a long time coming but, for people with easily marketable assets, it potentially offers a much better, cheaper and more accurate way to buy life cover. However, it is complex (particularly if you increase or decrease your investments), and only platform assets are taken into account and customers are effectively locked into this par-ticular provider. Most significantly, cover ceases at age 75, leav-ing customers to then have to consider how best to pass their estate tax efficiently onto their beneficiaries. If the plan is writ-ten in trust, IHT benefits can vary daily too.

Product design points: Wrap based life cover is a new and potentially exciting development, but its appeal is probably less than might be imagined. What it should do though is appeal not just to protection specialist advisers but also to wealth managers who, in recent years, have tended to shy away from protection.

Plus points: Should be the cheapest way to buy life cover for those with significant assets; helps avoid over or under insurance; the way forward?

Not so plus points: Cost will increase if the value of investments falls, even if only temporarily; possible timing/value issues between death and beneficiaries being paid; only wrap assets are included; some restrictions on changing cover; 15 days non-forfeiture only; cover ceases at age 75; cover ceases if the customer moves away from the Nucleus platform. Website: www.nucleusfinancial.com. Rating (max 10): Innovation: 9. Overall: 7. Gold.

9


reviews

PruHealth PMI PruHealth has introduced a raft of changes to its existing PMI propositions, centred around benefits that encourage a positive lifestyle. The main changes are:

• Non-smokers now get up to 15% cashback on individual policies (up to £150 a year on SME or corporate policies), following an annual £15 Vitality Healthcheck, which, among other things, proves that they have not smoked in the previous three months.

• An integrated end-to-end healthcare and wellness solution for obesity includes weight management and part-paid surgical intervention (minimum 20 member schemes).

• Lifestyle corrective surgeries. This is for corpo-rates and SMEs, with members co-paying 25%.

• Assistive at home cover. Post-hospitalisation care.

• Enhancements have also been made to the Vitality programme, including up to 50% off online bicycle costs and other health/fitness-related discounts.

• New lifestyle benefits including free movie tickets and mobile phone benefits.

PruHealth offers various PMI covers for both indi-viduals and businesses and has also just launched a new members’ magazine. In November it launched a tiered commission bonus scheme with a choice of how commis-sion could be paid.

Policies start with core cover, to which customers can add a choice of cover options. So, Business Healthcare can have dental cover (with a choice of two cover levels); worldwide travel cover; emergency overseas cover; psychi-atric cover (choice of two cover levels); core cancer cover (a premium saving, which reduces cancer cover from full to core); personal health fund (a pool to cover other health-care bills not usually covered by PMI); employee assistance programme; private GP helpline; out-patient cover (full cover or up to five optional annual limits), and therapies cover (full cover or limited to £350 per plan year).

Comment: PruHealth says three key trends need addressing. First, cost containment (but by cutting back and limiting cover insurers are eroding the PMI proposition it says), Second, coordinating bolt-ons and motivating behaviour change. And third, engaging the ‘silent majority’—those who don’t get value from their PMI now but whose unhealthy lifestyles could lead to the risk pool becoming unsustainable in future.

These latest changes all help engage in that. Perhaps most importantly, PruHealth’s proposition means that every customer can get direct benefit from their plan not just when they are ill but anytime, every year and regardless of whether they need to claim.

Product design points: Should insurers engage with their customers to the extent that they influence how they live? Why not? Insurers already influence choice in areas such as motor insurance and what security measures householders should adopt. Vitality aims to reward good lifestyle choices but it goes further than that and, the further it goes, the harder it is for competitors to copy. It should also help customers help see their insurer as ‘us’ rather than ‘them’ - something that is in-creasingly important in the age of social media.

Plus points: More changes and improvements that potentially benefit every customer—claimant or not; practical benefits; positive encouragement of lifestyle change should

benefit future claims costs as well as customers’ own health. Not so plus points: Some may resent insurers trying

to influence how their customers live; quite a complex proposi-tion for advisers to present to clients. Website: www.pruhealth.co.uk. Rating (max 10): Innovation: 9. Overall: 8.5. Gold.

Simplyhealth Simply Cash Plan Simplyhealth has updated its company paid health cash plan, which now comprises a core plan with a choice of three cover/premium levels. All provide 100% reimburse-ment (subject to a maximum annual benefit) for dental cover (up to £180 a year on a Level 3 Plan), including for accidents (max £500); full body health screening (£300); optical (£180); physiotherapy/osteopathy/chiropody/podiatry/chiropractic; acupuncture and homeopathy (£450); diagnostic consultation, tests and scans (£500), and a 24/7 health and counselling helpline. The core plan costs £5, £10.75 or £17.50 a month per employee and partners under age 70 can be added at extra cost. Children are cov-ered free, pre-existing conditions are covered and there are no initial waiting periods.

The core plan also offers discounted gym fees, online health information, a 24/7 helpline, full European cover and up to six optional covers. These are:

• Employee assistance programme, up to six ses-sions per issue (cost, 65p per month per employee).

• Hospital (£20 per day/night up to 20 days a year) and accident (up to £10,000 for permanent total disability) cover (£1.30).

• New child payment of £200 per child (87p).

• Absence management programme (£1.08).

• PMI excess, up to £300 a year (from £1.08).

• Primary care (£1.50). This provides up to £75 for GP fees and vaccinations, £25 for prescription charges and a 24/7 GP helpline.

Comment: One of the features of HCPs is that they are WYSIWYG—(what you see is what you get) or, simple. That’s a word that resonates (the Government’s simple products initiative etc) these days and is one way to bring our industry’s offerings into line with what our publics want and understand. Simplyhealth looks to be aiming to take company paid HCPs more upmarket—but that’s no bad thing.

Product design points: In the first 30 days, em-ployees can upgrade their employer paid benefits, paying for any upgrade themselves. The industry is not great at upselling, so such features can help all parties achieve the results they should be aiming at, rather than our typical over-focus on cost. Focusing on the monthly rather than weekly cost also helps move the market away from the £1 a week plans that are often simply too ‘cheap’ in our view, while offering add-ons allows cover to be built up simply (that word again) and easily.

Plus points: Simple, inexpensive and a good range of options to encourage employers and employees to not just have a HCP but a good level of cover too.

Not so plus points: Employers may be reluctant to take on extra expenditure; the loss of ‘£1 a week’ will be la-mented by some; more choices = a more complex sale. Website: www.simplyhealth.co.uk. Rating (max 10): Innovation: 7. Overall: 8. Gold.

10


medical and political

Medical briefs: • There were 541 reports of needlestick injury in

2011, twice as many as in 2002 (271 exposures reported) according to the Health Protection Agency’s latest Eye of the Needle report. Between 2008 and 2011 there were five transmissions of hepatitis C virus from patients to healthcare workers in the UK. Reported injuries are be-lieved however to be just a fraction of all those that actu-ally occurred. See: BMJ 2012; 345: e8417.

• Figures published by the Office for National Statistics on 29 November show there were 19,500 ex-cess winter deaths in people aged 75 and over in England and Wales in 2011/12 compared with 4,500 in the under 75 group, an overall 8% reduction compared to the previ-ous winter. Influenza-like illness in winter 2011/12 was the lowest on record.

• The number of prescription drugs that react with grapefruit increased from 17 to 43 between 2008 and 2012 researchers have warned in the Canadian Medical Associa-tion Journal. See: http://www.tinyurl.com/d7dbeg.

• Cases of liver disease in England rose by around 20% in people aged under 65 between 2000 and 2009, but fell by the same amount in most EU countries. The same report highlighted a failure to tackle obesity, undiagnosed infection and harmful drinking as the major causes. See: BMJ 2012; 345: e7931.

• 33.9% of children were overweight and obese in 2011-12 (33.4% in 2010-11). Childhood obesity varied from 13.7% in least deprived areas to 24.3% in the most deprived. The prevalence of obesity doubled from 9.5% in 4 and 5 year olds to 19.2% in 10 and 11 year olds in 2011-12. See: BMJ 2012; 345: e8488.

• A US government task force has recommended everyone in the US aged between 15 and 65 be tested for HIV to help curb transmission and get treatment to those already infected. It is estimated that around 1.2m people in the US are infected with HIV and as many as 200,000 of them may be unaware of it. See: BMJ 2012; 345: e7944.

• The joint United Nations programme on HIV and AIDS claims that it ‘has enabled the foundation to be laid for the eventual end of AIDS’. Deaths from HIV and AIDS stood at 1.7m in 2011. Two regions have experi-enced major increases in the number of deaths, though: 21% in Eastern Europe and Central Asia and 17% in the Middle East and North Africa. See: BMJ 2012; 345: e7899.

• A league table compiled by charity Diabetes UK from data from the International Diabetes Federation shows the UK ranks fifth of 88 countries in the incidence of type 1 diabetes in children with, each year, 24.5 in every 100,000 children aged up to 14 given a diagnosis, double the rate in France. However the rate is in line with other developed countries we would typically compare ourselves with (US, Australia and Canada). See: BMJ 2013; 346: f22.

• The ITV show I’m a Celebrity Get Me Out of Here! has been criticised by consultants who point out that de-priving people of comforts and giving them meagre food rations but not limiting the supply of cigarettes conveys the wrong message to the 10.25 million people who watch (956,000 of whom were aged 4-15 years). They describe the show as a free nightly advert for the tobacco industry. See: BMJ 2012; 345: e8552.

Political briefs: • There were 308 breaches of the Government’s

mixed sex accommodation guidelines in December 2012, up from 177 in November and 242 in October the De-partment of Health revealed on 17 January.

• New plans from the NHS Commissioning Board will require NHS doctors to work across seven days a week. In 2013-14 this will focus on access to diag-nostics and urgent and emergency care but could extend to surgery later. GPs will be expected to extend opening hours to the weekend as it was ‘essential to offer a much more patient-focused service’. See: BMJ 2012; 345: e8601.

• The National Audit Office says the NHS has delivered £5.8bn of efficiency savings in 2011-12 (target £5.9bn), by concentrating on the ‘easiest savings’ but would struggle to repeat these savings to meet the rest of the government’s total target of £20bn by 2014-15, BMJ 2012; 345: e8480 reported on 13 December. Reducing demand for acute hospital services by greater integration and ex-pansion of community based care was the key to future savings but not enough progress had taken place so far.

• A group of MPs has called for private health com-panies to be subject to Freedom of Information (FoI) laws. The early day motion that says the model ‘favours’ the private sector over the NHS was sponsored by Labour MP, Grahame Morris.

• Public service healthcare productivity remained broadly constant from 1995 to 2010, according to Esti-mates of Public Service Healthcare Productivity published by the Office for National Statistics on 7 December. Av-erage cost increases were 2.4% a year. The fastest growing area of activity was in NHS funded/private, voluntary, local Government sector provided services (up 13.5% per year). The volume of GP prescribed drugs has also grown strongly by an average 8.4% per year since 1995.

• Pilot screening for bowel cancer costing £2m, using flexible sigmoidoscopy, will be launched in five areas of England in March 2013 with over 55s invited to attend. Pilot testing for human papillomavirus (HPV), the major cause of cervical cancer, will also take place in six cities at a cost of £1.2m. See: BMJ 2012; 345: e8455.

• Patients could benefit from changes to the GP contract according to a Department of Health press release dated 7 December. Out will go rewards for routine office functions like record keeping as £164m is switched to services which support and benefit patients including better control of blood pressure and cholesterol and as-sessing of patients at risk from dementia.

• A Patient Association report in November claims poor care failings in communication, help in using the toilet, nutrition and access to pain relief remain much as they were in 2009, particularly in older people settings.

• Witnesses appearing before a parliamentary health select committee on 27 November said implementation of NICE (National Institute for Health and Clinical Excellence) guidance on adopting treatments was often ignored or delayed by commissioners as a way to save money. See: BMJ 2012; 345: e8138.

• The Support for Mortgage Interest scheme, due to expire this month has been extended until March 2015 the Chancellor’s December Autumn Statement confirmed.

11


medical

National response to obesity call A working party from the Royal College of Physicians has called for every hospital trust to have a lead doctor on obesity to work with commissioning groups, give informa-tion to patients and act as a link between the hospital and the community. There should also be a national lead on obesity to drive coordination across Government depart-ments it says and warns there are few coordinated services for overweight people who may have other health prob-lems. 25% of UK adults are obese, one of the highest rates in the world, costing an estimated £5bn a year at present.

Heat and the risk of MI In the light of global climate change and its effect on human health, a UK study in 11 large conurbations in England and Wales has found the short term risk of myocardial infarc-tion (MI) seems to increase at higher temperatures, above a threshold of 20°C. The increase was observed one to six hours after exposure, but was offset by a reduction in risk in the following days, consistent with exposure heat trig-gering MIs in highly vulnerable people who would have otherwise have had an MI some time later. Clustering may occur during hot spells leading to higher demands on the relevant health services. See: BMJ 2012; 345: e8050.

Half don’t understand health info Researchers have found nearly half (43%) of people in Eng-land do not understand standard health information such as instructions on calculating paracetamol dosage for a child. 49% lacked the reading and maths skills to under-stand and follow instructions provided in a bowel cancer screening kit for collecting a faecal sample. Interviews were conducted with more than 6,000 people 16-65 to assess understanding of 64 items of information on health and safety, BMJ 2012; 345: e 8364 reported on 7 December.

Physical activity helps survival Olympians have a slight survival advantage compared to the general population. However, research also suggests 150 minutes a week of moderate to vigorous intensity physical activity gives a survival advantage of just under a year to several years when compared with the physically inactive. Above 300 minutes of exercise a week, the additional benefit is negligible and recent reviews suggest excessive endurance training may be associated with harms. Research also shows that survival advantage was protected only if physical activity was maintained long term. Globally, inac-tivity contributes to more than five million deaths a year, more than obesity. See: BMJ 2012; 345: e8338.

Hypnosis before surgery? Recent Belgian studies have found that patients who, pre-surgery, were hypnotized and treated with a local anaes-thetic needed less opiate drugs, had a faster recovery time and spent less time in hospital compared with patients un-der general anaesthetic. A series of pre-surgery hypnosis audio recordings are available at: http://www.toddstofka.com/solutions/categories/surgery.

Choice helps private providers A report by the Institute for Fiscal Studies commis-sioned with the Nuffield Trust released on 19 November looked at the impact of choice and competition measures introduced under the Blair Government in 2006-08. The report found GPs increasingly referred patients to a wider range of providers, mirrored by a growth in Independent Sector Treatment Centres (ISTCs), and a significant fall in the proportion of patients seen at their local NHS Trust since 2006/07, although in 2010 most patients still received out-patient care from their nearest NHS Trust. The fastest change was in elective unilateral inguinal hernia repair with 17% of all patients being treated in an ISTC by 2010/11. Choosing a place of care is free to download from http://www.nuffieldtrust.org.uk/publications/choosing-a-place-of-care. The Times, 19 November, reported that one in five hip replacements is now carried out by private companies.

Screening overdiagnoses cancer A new study has concluded that screening mammography has resulted in overdiagnosis of breast cancer in 1.3m women in the US in the past 30 years. The rate of deaths from breast cancer fell considerably over the same period, but the authors said this was largely due to better treat-ment, not screening. An expert panel has concluded that in the UK every year, 4,000 women underwent treatment for breast cancer that would not have harmed them. See: BMJ 2012; 345: e7910.

Are regular health checks good? A recent systematic review and meta-analysis into the ef-fectiveness of health checks in adults in reducing morbidity and mortality found no evidence that general health checks made any difference to any of the studied outcomes. The authors also concluded that such health checks might in-crease overdiagnosis. The current study concluded that regular health checks are ineffective but targeted health checks may offer some benefit. The study looked at health checks in well people only and the authors said they may be effective in population groups with identifiable risk fac-tors and conditions, but evidence of this is needed. See: BMJ 2012; 345: e7775.

Disability and life opportunities A part report (Wave Two part one) of the Life Opportuni-ties Survey (LOS) published by the Office for National Statistics on 15 November, found of people with impair-ments a year ago, 34% no longer reported any impairment a year later. However, one in twelve who did not have an impairment at Wave One in 2009/11 reported an impair-ment twelve months on.

Generally, people with impairments at both waves were more likely to report having more impairments. Those age 65 or over were more likely to report three or more impairments than those of working age (16-64). Wave Three began in October 2012 and looks to help remove the barriers people face in their participation in society and give a greater understanding of the transient nature of disability.

12


political

Employment continues to rise Unemployment fell from 2.51m in July-September 2012 to 2.49m in September–November, having also been 2.51m in August-October, according to the latest Labour market statistics bulletins, released by the ONS on 12 December 2012 and 23 January 2013.

During the same periods, employment rose from 29.58m to 29.60m then to 29.68m in September to No-vember. This means that the e-Protection Review Employment Index, which is a proxy for the growth in size of the main health and protection insurance markets since 2000, rose from 107.78 to 108.86 then to 109.15. This index com-pares the latest employment figure with the 27.192m figure recorded for the first quarter of 2000.

The number of Jobseeker’s Allowance (JSA) claim-ants stayed at 1.58m in October and November before falling to 1.56m in December. Earnings in the three month period to end November (including bonuses) fell to 1.5% compared to a year having been 1.8% in both July-September and August-October.

On 15 January the ONS announced that in Decem-ber 2012 the Retail Prices Index (RPI) rose to 3.1% com-pared to a year before, up from 3.0% in November but still below October’s figure of 3.2%. The Government’s pre-ferred Consumer Prices Index (CPI) remained at 2.7% in all three months of 2012. This compares to an annual inflation target of 2.0%.

Hospital RTT waiting times fall The median Referral to Treatment (RTT) wait for NHS hospital admission in England fell from 8.8 weeks in Sep-tember to 8.6 in October and 8.3 in November according to a Department of Health Statistical Press Notice on 17 January. For non-admitted patients the median wait fell from 4.7 weeks to 4.2 weeks for both months. The 95th percentile time wait for patients entering an RTT pathway stayed at 20.9 weeks before falling to 20.8 weeks in No-vember for admitted patients and from 16.1 weeks to 16.0 weeks then to 15.9 weeks for non-admitted patients.

The number of patients meeting the 18 week target rose from 92.2% to 90.7% in both October and November.

Care and support bill to support Dilnot principles at £75K? A new Care and Support Bill, to be published later in 2013, will incorporate the principles laid down in the 2011 Dilnot Report on long term care funding, ex Lib Dem Health Min-ister Paul Burstow told a thinktank conference in London on 8 January.

It is widely rumoured that the Government plans a cap of £75,000 on long term care costs—significantly higher than the £35,000 limit called for by Andrew Dilnot.

However, on 24 January, Shadow Health Secretary Andy Burnham in a speech to the King’s Fund, called for an “all-in” system to create a level playing field of how care should be provided. His proposal would see the current split between a charged for and a free at the point of use system combined, which he argues would be simpler. But, it would involve people having to pay in to fund it.

NHS surgeon league tables in England within two years NHS medical director, Bruce Keogh, has announce league tables showing the results of individual surgeons working in the NHS in England will be published within two years. This follows the DH’s NHS mandate, published in Novem-ber 2012, that pledged to expose ‘variation and unaccept-able practice’ by publishing the results of consultant-led teams. The BMA has cautiously leant its backing but has warned that surgeons might be deterred from performing complex or high risk procedures if they were judged solely on ‘simplistic league tables’. See: BMJ 2012; 345: e8377.

BMJ 2012; 345: e8617 reveals data for individual surgeons covering survival rates and quality of care from specialities including adult cardiac, vascular and orthopaedic surgery will be published by summer 2013 followed by data from the rest of the ten specialities to be ranked in 2014-15 (interventional cardiology, upper gastrointestinal, colo-rectal, bariatric, urological, head and neck, thyroid and en-docrine surgery). Service user data will begin with a simple question as to whether patients would recommend a ser-vice to their friends or family and commissioners should have mechanisms in place to gather user feedback and comment for all services by 2015.

Dr Pietro Micheli, associate professor of organisa-tional performance at Warwick Business School warned that from a surgeon’s point of view the easiest way to go up the ranks will be to deal with the least risky cases. He warned that publishing league tables may provide a false sense of accountability to the public.

Cancer poll’s hospital comparison A large pilot survey of people in England who have been treated for five different cancers (prostate, breast, bowel, colorectal and non-Hodgkin’s lymphoma) shows the impact of cancer can last well beyond treatment. The survey al-lows a comparison of quality of life following diagnosis for patients treated at different hospitals. There were 3,300 respondents (66%) and eight out of ten reported being free of depression, pain, anxiety, mobility problems and prob-lems with usual activities. However, 47% were worried about a recurrence of their cancer and 27% feared dying. Five years after diagnosis, figures had fallen but still stood at 43% and 22% respectively. A fifth of patients had trouble controlling their bowels following colorectal cancer and for prostate cancer patients, 38% reported urinary leakage and 69% erection problems. See: BMJ 2012; 345: e8506.

New advisory service to help workers back to work The Government is setting up a new independent advisory service aimed at getting people back to work and away from long term sickness benefits, Minister for Welfare Re-form, Lord Freud, announced on 17 January.

The new initiative will give employers bespoke, in-dependent advice and is expected to save them up to £160m a year in Statutory Sick Pay and increase economic activity by up to £900m a year. Currently, only 10% of small firms and half of larger firms use occupational health.

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abi new business stats q3 2013

Protection sales edge forward in Q3 but premiums are again flat Mirroring what happened in 2011, long term protection insurance sales in the third quarter of 2012 were ahead of those in the second quarter, according to the latest ABI (Association of British Insurers) new business statis-tics, which were released in December. Compared to the second quarter of 2012, sales volumes were up 0.5%, with new annualised premiums up £5m to £180m:

Table 1. Long term protection sales Q2 2012 vs. Q3 2012 Sales 000s Premiums £m Q2 Q3 Q2 Q3 Whole life 138 143 30 29 Term—non-mortgage 266 251 88 79 Term—mortgage 127 150 47 56 Income protection 48 53 13 14 Standalone critical illness 6 7 2 2 Totals 585 604 175 180 Of which crit illness rider 157 164 63 63 ...menu plans 194 274 57 81 Note: Figures in bold italics are different to last year’s fig-ures in HCIR 129, or the quarter 2 figures in HCIR 147, reflecting changes as the ABI updates figures where new information becomes available. Looking at individual products, all types showed a volume gain, with the exception of non-mortgage term plans. From a smaller base, income protection recorded the largest gain. In terms of annualised premiums, the position was rather different, with only mortgage term and income pro-tection recording any increase. Of 143,000 whole life sales, 116,000 (81%) were guaranteed acceptance plans, although in premium terms, they only made up 55% of new whole life annualised premiums. Guaranteed acceptance sales are now fairly consistent, ranging from 110,000 to 127,000 sales throughout 2011 and 2012.

Compared to quarter 3 of 2011, year on year sales volumes were up 0.5%, with new annualised premiums down by 6.7%. Table 2. Long term protection sales Q3 2011 vs. Q3 2012 Sales 000s Premiums £m 2011 2012 2011 2012 Whole life 142 143 31 29 Term—non-mortgage 261 251 93 79 Term—mortgage 151 150 54 56 Income protection 40 53 12 14 Standalone critical illness 7 7 3 2 Totals 601 604 193 180 Of which crit illness rider 169 164 681 63 Tables 1 and 2 both illustrate that new premiums continue to lag behind sales—and as before this reflects straitened economic times and many products now being cheaper or people choosing less cover or cheaper variants. The third and final quarters of 2012 should also be the last quarters where new business stats are so distorted by the volume of churned and switched business due to the effect of gen-der-neutral pricing, which came into effect on new policies from 21 December 2012.

Protection sales index up again After the peak of 129.9 for the first quarter of 2004, the e-Protection Review Protection Sales Index fell and, for many quarters was below 100, indicating lower sales than in the first quarter of 2000. However, in 2009 the index again rose over 100 and is now 26% higher than in Q1 of 2000 (our benchmark figure). Anything above 100 indicates an increase in sales, anything below, a decrease.

This index looks at numbers of policies rather than annualised premiums, to take premium rate changes and increases or decreases in benefits out of the equation, and is a broad proxy for activity and market penetration. Table 3. Long term protection sales Q1 2000 vs. Q3 2012 2000 2012 Index Whole life 111 143 128.8 Term—non-mortgage 168 251 149.4 Term—mortgage 137 150 109.5 Income protection 41 53 129.3 Standalone critical illness 22 7 31.8 Totals (including LTCI) 479 604 126.1 Of which crit illness rider 141 164 116.3 We no longer regularly monitor long term care insurance (LTCI) sales as the numbers are so low.

In terms of products, the winners since 2000 are term assurance, despite sharp falls on the back of a sub-dued mortgage market since the 2008 credit crunch, whole of life and now income protection too (on sales volumes but not on annualised premiums).

The big question going forward is what effect the implementation of the FSA’s RDR (Retail Distribution Review) gender-neutral pricing and I-E tax changes will result in. Some expect to see a drop in sales volumes after the first quarter as it will be harder to justify switching customers, given that 2013’s products will generally be more expensive than 2012’s equivalents. On the other hand, in-force business levels should stabilise or rise, espe-cially as thousands of wealth advisers may have switched to selling more or all protection business to compensate for lower earnings from investment and pensions business.

The other factor going forward is that insurers now have more scope to increase their margins which, in turn, justifies greater marketing and acquisition spending. How-ever, that could be largely neutralised if price remains the dominant adviser choice factor going forward.

Looking at the group market, Table 4 shows sales of plans in terms of new annualised premiums. Table 4. Group protection sales 2011 and 2012 £m Product Q3 2011 Q2 2012 Q3 2012 Group life 35 60 50 Group critical illness 1 3 2 Group income protection 21 35 29 We are cautious of the group risk numbers and the third quarter of 2012, on the face of it, saw a fall compared to the previous quarter. However, the numbers look better across the board compared to those of the third quarter of 2011.

We now await the fourth quarter stats, which should confirm just how strong an end to the year the in-dustry actually enjoyed.

14


blogs

Blogs In this section of e-Protection Review we feature some of the blogs that were first published on the www.protectionreview.co.uk website. You’ll find blogs covering a very wide range of issues, products and markets. That’s the aim. We want every blog to challenge and question, to inform and to stimu-late. Our bloggers are a mixed bunch (we mean that nicely) but they are all people we like listening to and learning from. We hope you will too.

This month we feature three blogs. First, on 21 November, Steve Walker of Medical Insurance Advisers looks at professional integrity:

There’s been a lot of comment recently on the HI LinkedIn forum regarding the apparent discrediting of brokers by direct sales agents who deliberately bend the truth in or-der to persuade clients to take a policy direct from the insurer, rather than via the broker. It would appear that when times are hard, professional integrity and ethical standards are ignored.

But why is this happening; why are industry sectors undermining each other; aren’t we, after all, working to the same end – to build and strengthen the industry?

During my three years as AMII chairman (2004 – 2006) we had a very proactive committee who worked tirelessly to build and nurture strong working relationships between the intermediary sector and insurers. Relation-ships were gradually built on trust, through regular meet-ings and as a result we were able to discuss various issues and problems in a civilised manner as they arose, generally resulting in an agreeable solution.

As a part of this building process, I began producing a regular AMII newsletter which, as well as keeping mem-bers informed about the various projects the committee were working on, also included regular input from provid-ers about products and latest developments. The newslet-ter was circulated to AMII members and throughout the industry, including insurers. The newsletter carried the strap line ‘Bringing the health insurance industry together’ – and we did.

The AMII Exhibition and Conference was another factor in cementing relationships within the industry. Over the four years that I was involved in introducing and ex-panding the event, it generated over £130,000 clear profit for the Association, which in turn enabled us to engage Concise, a PR consultancy, who made a very positive con-tribution to the PMI industry as a whole by organising an active media campaign to promote both AMII and PMI. It also enabled us, amongst other things, to fund our own meetings without going cap-in-hand to our insurer partners.

In my first year as chairman I formulated and wrote the association’s Code of Ethics and Conduct. Now that AMII is considering the enrolment of ‘provider members’ [since agreed by members, Ed], it may be an idea to suggest that they, and in fact all AMII members – both current and fu-ture, should read and agree to abide by the code, especially paragraph 3.2 – ‘members should act in an ethical and so-cially responsible manner when dealing with others within the industry’, and paragraph 4.1 – ‘members should ensure a transparent relationship with the association based on

trust, respect, responsibility and integrity’. Believe it or not, this is not a rant about me and

what I achieved during my term as AMII chairman, but a plea for some positive action from both sectors of the in-dustry to forge a better working relationship for the com-mon good.

Maybe then AMII and insurers could (again) address this sort of situation by sitting down together when neces-sary to discuss issues as they arose; it is, after all, the origi-nal reason for the formation of AMII back in 1998 – to provide a voice for the intermediary community and work hand-in-hand with insurers to the benefit of everyone - intermediaries, providers and most of all – the consumer.

Our second blogger, on 9 January, was Peter Bar-nett, who is an adviser to Baroness Greengross. My favourite Christmas present was: Insurers’ Creed: Protec-tion World – Protection Past; Protection Present and Protection Yet to Come: (for Xbox -360, Playstation and Nintendo - £39.99). In the comfort of my own home, I was able to share the virtual experience of illness and unemployment.

As I moved through the game levels I saw actual examples of real-life episodes that could happen, and have happened, to people just like me and how the benefit of having protection insurance came to my rescue right on cue. It seemed very real because the game characters had the names of my family and colleagues and the game had automatically downloaded the faces and details of these people from Facebook, Linkedin etc and also, with my per-mission, my health records from the NHS and other insur-ance applications. Naturally at the end there is a weblink for me to easily get advice as to what to do next in the real world with a downloadable ‘Application’ App!!

Before you all rush to Amazon to get one, I have to confess that this game has yet to be invented. But surely such games or apps can’t be far away as a consumer front end to the many portals that are being developed to access adviser and customer driven acquisition platforms. This new world of advice will become the norm for all types of business including protection and Generation Z, born since 1995 and who start to come of age in 2013, will demand nothing less. These are technology wise and immune to most traditional marketing and sales pitches...as they not only grew up with it all, they’ve seen it all and been ex-posed to it all since early childhood. They have never known a world without the internet, mobile phones or iPods. They have lived their entire life with instant access to mountains of data on any topic. They've never known the frustration or sheer physical effort of rifling through the I-L volume of the encyclopaedia to find out about Insur-ance – and never will.

This gets to the heart of one of Gen Z's key differ-entiators: They crave constant and immediate feedback.

This is the result of having every whim addressed with a few keystrokes. Want to know who plays bass on the new Bruno Mars album: Unorthodox Jukebox? Google it! Forgot which chapters to read for History? Text or twitter a classmate!

They need information now, and they have the tools to get it and they are better at handling it as coded words and abbreviations on a screen from a trusted confidant, rather than from the disembodied voice of ‘the expert’.

15


statistics

To give you some idea of the rate of change here, accord-ing to mobile analytics firm Flurry (1), App. download records for iPhone, iPad and Android devices were shat-tered on Christmas Day 2012, with 328m downloads worldwide. This is a 332% increase over the December baseline and is more than 2.5 times larger than Christmas 2011, which surpassed its own baseline by more than 300%. Based on the same data, the company estimates that 17.4m new iOS and Android devices were activated on 25 December, up from 6.8m in 2011, and 2.8m in 2010. Flurry expected downloads for the week up to New Year's Day to surpass more than 1.5bn, and to get close to breaking through the 2bn download barrier for the first time ever.

The moral is: No App – no hope! So, a simple ques-tion - do your 2013 business comms plans give any consid-eration at all to these devices as marketing, sales or acqui-sition tools – and if not why not?

Or I can lend you my game! Re: smh @EScrooge blog ¦#bahhumbug? (1) Blog. Peter Forago –Flurry Analytics - 27 December 2012 http://blog.flurry.com/bid/92719/Christmas-2012-Shatters-More-Smart-Device-and-App-Download-Records.

Stats Deaths England & Wales 2011 484,367 deaths were registered in England and Wales in 2011, down 1.8% on 2010 and giving the lowest ever age-standardised mortality rate of 6,236 per million population for males (234,660 deaths) and 4,458 per million for fe-males (249,707 deaths). The top ten causes of death were:

Males 1. Ischaemic heart disease, 37,723 (16.1% of male deaths). 2. Malignant neoplasms of trachea, bronchus and lung, 16,881 (7.2%). 3. Cerebrosvascular diseases, 14,335 (6.1%). 4. Chronic lower respiratory diseases, 13,539 (5.8%). 5. Dementia and Alzheimer’s, 11,995 (5.1%). 6. Influenza and pneumonia, 11,072 (4.7%). 7. Malignant neoplasms of prostate, 9,671, 4.1%. 8. Malignant neoplasms of colon, sigmoid, rectum and anus, 7,758 (3.2%).

9. Malignant neoplasms of lymphoid, haematopleietic and related issues, 6,066 (2.6%). 10. Diseases of the liver, 4,787 (2.0%).

Females 1. Ischaemic heart disease, 26,712 (10.7%). 2. Dementia and Alzheimer’s, 25,767 (10.3%). 3. Cerebrovascular diseases, 21,642 (8.7%). 4. Influenza and pneumonia, 15,079 (6.0%). 5. Malignant neoplasms of trachea, bronchus and lung, 13,267 (5.3%). 6. Chronic lower respiratory diseases, 13,209 (5.3%). 7. Malignant neoplasms of breast, 10,328(4.1%). 8. Malignant neoplasms of colon, sigmoid, rectum and anus, 6,428 (2.6%). 9. Diseases of the urinary system, 5,429 (2.2%). 10. Malignant neoplasms of lymphoid, haematopoietic and related tissue, 4,993 (2.0%). Source: Deaths Registered in England and Wales in 2011, by Cause, ONS, 6 November 2012.

Suicides UK, 2011

• In 2,011 there were 6,045 suicides in people aged 15 and over in the UK—an increase of 437 over 2010.

• Of those 4,552 were males (a rate of 18.2 per 100,000 population) and 1,493 female (5.6 per 100K). The overall death rate was 11.8 deaths per 100K population.

• The highest rate was in males aged 40-44 (23.5 deaths per 100K population) followed by males 45-59 (22.2 per 100K). The highest female suicide rate was 7.3 deaths per 100K for females aged 45-49. Source: Suicides in the United Kingdom, 2011, ONS, 2 Jan

Cancer incidence UK 2008-10 In the UK there were 163,100 new cancer diagnoses in males and 159,823 in females in 2008-10. In the same pe-riod, there were 81,802 male and 74,442 female cancer deaths. Breast, prostate, lung and colorectal cancer ac-counted for 53% of diagnoses and 47% of cancer deaths. Source: Cancer incidence and mortality in the UK, 2008-2010, ONS, 6 December 2012.

About e-Protection Review e-Protection Review is a free to user PDF publication and is published ten times a year, usually on the 28th day of the month prior to that issue’s date, every month except at the end of August and December. It is free to download

from www.protectionreview.co.uk.

A range of partnership opportunities are available and to find out more, please contact Andy Couchman at Protection Review Limited, Bank House, Great Rissington, Cheltenham, Gloucestershire, GL54 2LP. Or phone or fax 01451 821982 or e-mail [email protected]. Or contact Peter Le Beau on 07799 074020 or [email protected]. Or contact Kevin Carr on

07887 838811 or [email protected].

16


Protection Review: financial services consultancy and communications solutions We’re passionate about protection and provide bespoke marketing and strategic consultancy and commu-nications services to firms across health and protection insurance, led by three of the best-known names in the industry. Our expertise, knowledge and contacts enable us to help clients maximise their potential in a fast and cost-effective way.

e-Protection Review is published ten times a year as an online PDF on the 28th of the month prior to that issue’s date. Publishing editor: Andy Couchman FCII, FRSA, Cert PFS. Production editor: Marion Franklin BA. Contributors: Peter Barnett; Cluff; Steve walker.. The publishers welcome letters, e-mails, comment, contributions and news, but can take no responsibility for any actions taken as a result of information published herein. All rights reserved. No part of this publication may be copied or photocopied without the express permission of the publishers whose details are below. ISSN 2045-5925.

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top 10 in the press

In each issue we choose ten stories from across the indus-try that have appeared in the trade monthlies, weeklies, online or in the national press. They are not necessarily the biggest stories, but those that most grabbed our atten-tion. Many include a supporting or other quote from well-known industry names, illustrating how valuable a good relationship with the media can be, but the power of the media is evident too this month, as we start with: 1. I never thought my claim would be challenged. How L&G has refused an MS sufferer £280,000. On the face of it, a harsh CI declinature, due to non-disclosure of what the article by Jeff Prestridge in This is Money on 12 January claims was due only to a cold virus. There is also an issue around whether the claimant’s condition meets the policy defini-tion. The article also picks up on another non-disclosure case—that of a Friends Life client, Nic Hughes, and the national campaign, backed by Stephen Fry and Miranda Hart, supporting the claim. Both cases proof that declined claims can have far-reaching consequences. http://www.thisismoney.co.uk/money/news/article-2261406/I-thought-claim-challenged-How-Legal--General-refused-MS-sufferer-280-000.html. 2. Comment: Social media attacks—the new threat to the pro-tection industry. Columnist Tony Levene picks up, writing for Health Insurance on 10 January, on the growing issue of the power of the internet, with 587 comments on the above Daily Mail article and a 60,000 signature petition sup-porting Nic Hughes’ claim too. http://www.hi-mag.com/health-insurance/product-area/life-critical-illness/article414335.ece. 3. Protection providers report G-Day sales surge. Paul Thomas’ Money Marketing item on 11 January reported increases of up to 210% (although around 30% was more common) in protection sales in the run up to 21 December. Nice to have a pure good news article to lift winter spirits! http://www.moneymarketing.co.uk/protection/protection-providers-report-g-day-sales-surge/1063973.article. 4. AMII widens membership to include insurers. Writing for FT Adviser on 15 January, Donia O’Loughlin reported how the PMI body’s members had overwhelmingly supported its expansion and how Bupa was set to be the first to join. http://www.ftadviser.com/2013/01/15/insurance/health-and-protection/amii-widens-membership-to-include-insurers-sJUQNtdwyhYmQ1S6o4kLaP/article.html.

5. Workers missing out on benefits: survey. Marc Shoffman’s FT Adviser piece on 10 January reports Canada Life’s find-ing that a third of UK workers get no protection benefits through their employer, and 31% wanting more benefits. http://www.ftadviser.com/2013/01/10/insurance/health-and-protection/workers-missing-out-on-benefits-survey-ElA6pZW1Lt4t7S5PZnOgaK/article.html. 6. Jessica Ennis partners with PruHealth and PruProtect. Paul Robertson’s Cover piece on 11 January adds a bit of glam-our with news that the Olympic star is now a Vitality am-bassador and will share her and her family’s Vitality experi-ence. A great way to get complex benefits across. http://www.covermagazine.co.uk/cover/news/2235707/jessica-ennis-partners-with-pruhealth-and-pruprotect. 7. Ageas highlights lack of IP across the UK. Simoney Girard’s FT Adviser piece on 10 January reports Ageas’ finding that term is most and IP least popular. Although 6% of those in the East Midlands and London had IP, only 2% of Scots did. http://www.ftadviser.com/2013/01/09/insurance/health-and-protection/ageas-highlights-lack-of-ip-across-uk-MAjdzX9rWVA2Pk1qvk1DkK/article.html. 8. Urgent need to check new policy documents, adviser warns. Nicola Culley, writing in Cover on 16 January, reported that IFA Alan Lakey had received out-of-date policy documenta-tion from Aviva relating to some CI policies. We wonder how many other financial advisers would also have ever spotted the difference? http://www.covermagazine.co.uk/cover/news/2236814/urgent-need-to-check-new-policy-documents-adviser-warns. 9. F&TRC launches existing contracts matrix. Writing in Cover on 11 January, Paul Robertson’s piece is a straightforward reporting of F&TRC’s matrix that sets out how insurers will handle post G-Day policy changes and shows the power of a good press release or briefing. http://www.covermagazine.co.uk/cover/news/2235794/f-trc-launches-existing-contracts-matrix. 10. NHS regulator rules out tax breaks for private healthcare providers. Tessa Norman’s 16 January article for Health In-surance reports Monitor’s denial that it is recommending tax breaks for private healthcare providers to give a level playing field with NHS providers. http://www.hi-mag.com/health-insurance/product-area/pmi/article415079.ece.

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