Some may consider 30 years in the health insurance industry to be a life sentence. But not Les Curson, general manager at Clinicare, who is currently celebrating three decades in private medical insurance. He says he thrives on the constantly changing demands of the market and is always on the lookout for new challenges.
Like so many others in private health today, Curson began his career at BUPA. And, along with numerous ex-employees, he feels he benefited from the high standards of training that he received there.
During his 25 year stint at BUPA, he rose through the ranks to become director of marketing services and general manager responsible for sales through intermediaries and the direct sales force.
The Liverpool office, where he first joined as head of accounts department, no longer exists, and its disappearance is just one of the changes Curson has witnessed: “Twenty five years ago, not a lot of people were aware of PMI. It was the last Labour Government which made people realise there was an alternative to the NHS.”
He explains: “Barbara Castle’s plan to abolish pay beds led to two years massive growth in PMI, culminating in 30% in 1980.”
Although Curson has seen the steady growth and progression of private health – 20 companies hold 99% of the market now, compared with BUPA taking 78% 20 years ago – he is not convinced that all change has been for the best.
He laments “the disappearance of the art of underwriting” and would prefer to return to the days when companies assessed the risk of questionable cases – and took a chance on a borderline client.
Curson’s role as general manager at Clinicare allows him to be part of an insurance firm which takes an occasional risk. He is proud of Clinicare’s commitment to covering pre-existing conditions, which applies to all plans, and he is puzzled as to why more companies do not offer such an important benefit.
Providing cover for asthma sufferers is accompanied by a higher premium, but Curson considers a service which is flexible to an individual’s needs to be a chief priority: “If someone has high blood pressure, we assess the risk and put a price on it. Most companies don’t even assess the risk.”
Curson has a desire for Clinicare to provide the best possible customer service and the claims helpline it runs plays an pivotal role in achieving this goal. He points out that although most firms offer enquiry lines, not many have trained nurses manning the phones. He believes claimants benefit from being guided through the process by a nursing professional.
“People are frightened when they go into hospital, especially if it’s for the first time, says Curson. “ Imagine a rugby player who needs a hernia operation but doesn’t understand what the treatment involves and wants to know how long the pain will last. He may be frightened to ask the doctor but can phone a Clinicare nurse and she will explain.”
Clinicare’s helpline forms an integral part of Curson’s endeavour to build relationships with clients. Claimants know the name of the employee they are dealing with, enabling the nurse to “hold the person’s hand at the other end of the phone”. Curson recounts how the staff at the claims helpline regularly receive thank you letters, a direct result of striving to be “caring and warm” in the PMI market.
But it is not just customers who are at the forefront of Curson’s mind. A two year spell as a management consultant and specialist healthcare intermediary, prior to joining Clinicare, means he feels well placed to understand the needs of intermediaries. And he hopes that by focusing on their requirements, he may encourage more brokers to trust in Clinicare.
“Most IFAs sell one or two products they’re comfortable with because they know the company. For example, Norwich Union has a big IFA network and an intermediary might promote them because they know other products. It’s very restrictive and there is no broad choice for the client.”
In an effort to establish itself as an up and coming player in the PMI market, and thereby attract the interest of brokers, Clinicare is in the process of building up the number of hospitals available to its clients in order to provide a quality service.
Curson is opposed to following the path he believes major insurers have taken: the consolidation of a hospital network. He believes that making deals with hospitals, and arranging discounts for the privilege of being on an insurer’s preferred list, only serves to limit patient choice.
Members of Clinicare can choose from 700 hospitals, with approximately 150-200 having negotiated a special deal for cheaper treatment.
Although Clinicare prefers its patrons to use the selected hospitals, Curson is adamant an individual can go to a hospital of their own choice, at no extra charge. Which is not to say the pressure to keep costs down is not a major consideration. Behind the scenes work, including negotiating and checking claims thoroughly, is one way of achieving this.
Curson is particularly critical health insurers which say they pay claims without providing the evidence. He points to Clinicare’s tough stance on negotiating with doctors over invoices that seem unnecessarily high.
“If we think a bill is unreasonable, we will challenge the doctor and try and persuade them to reduce it. Sometimes they agree.”
But, he explains: “The Clinicare member knows nothing about what happens, we give them a full refund.
“Others, for example, don’t challenge at point of claim. They provide operations with price limits and have also introduced end of year bonuses for doctors who stay within the recommended charging limits. It is then up to the patient to sort out the short fall,” he says.
In his view, BUPA’s policy of working with approved surgeons is a matter of concern. He wonders if this policy is designed to control more consultants, and thereby exert more influence over the PMI market. And in the long term he believes that this type of system could lead to less choice for patients.
Curson’s greatest challenge in the 30th year of his professional life is to make sure Clinicare continues to expand on its continuing growth in a relatively stagnant market. It is a tall order and it will take dedication and lots of hard work. But it is clear that Les Curson would not want to have it any other way.