As VitalityLife claims to be the first protection provider to introduce finger-prick testing to the underwriting process, what are other providers doing to speed things up? Harvey Jones reports
Medical underwriting can be a tortuous process, especially if you are scared of big needles.
Even clients who are comfortable with having their blood tested using a hypodermic syringe may find the process time-consuming and inconvenient, and hard to slot into their busy schedule.
The longer it takes to underwrite a protection application, the more frustrating for the broker, insurer and most importantly, the client. Also, the harder it becomes to plug that protection gap.
Insurers have made giant strides in speeding up medical underwriting and VitalityLife has made another step forwards, claiming to be the first to introduce finger-prick testing to the UK.
The simple finger-prick test is quicker and less daunting than a hypodermic syringe, and the test can be held at a place convenient for the client.
Better still, tests are available within seconds, rather than the four to five days it currently takes for a laboratory to process them, eliminating the risk of delayed samples being spoiled and needing a re-test.
Darren Lee, director of underwriting & claims at VitalityLife, says research from research from AnxietyUK shows that up to 10% of the UK population has a needle phobia, mostly caused by hypodermics.
“Those who struggle with blood tests will benefit greatly from having a simple finger-prick instead, and it also means busy clients don’t have to travel for a blood test or take time off work,” he says.
VitalityLife’s next mission is to automate underwriting decisions following a screening or examination.
“Our aim is for the underwriting decision to be available within seconds of the nurse submitting the client’s results and we are on course to launch this next phase later this year,” Lee says.
Game on – so what is the rest of the protection industry up to?
Legal & General is also looking to introduce finger-prick testing, says underwriting and claims director Russell Whitworth.
It is also working on quick and secure transmission of customer medical history, to improve underwriting and claims journeys.
“We are now working with Niche Health to provide GPs with a facility to provide redacted, encrypted, paper-free health reports at the touch of a button,” he says.
Scott Cadger, head of underwriting and claims strategy at Scottish Widows, says the industry has never had so many initiatives in the pipeline.
“Developments such as UnderwriteMe and the XRAE tool from Ipipeline allow advisers to get a clearer view on underwriting decisions and offer more immediate terms to the wider market,” he says.
“This trend will only continue as technology improves and customers and advisers demand transparency throughout the journey.”
Cadger says technology and data security go hand in hand, and work such as Niche Health’s GP report software can transmit data faster and more securely between GP and insurer.
“Clients will get decisions quicker, more people will be covered, and this will help close the UK protection gap,” he says.
Scottish Widows Protect has developed new online underwriting tools as part of its re-entry into the IFA market.
Cadger says: “These help advisers work with their customers to assess the likelihood of getting cover, and the ratings their disclosures would get. The tool mirrors the application journey and reduces the need to contact life offices to get a view on underwriting decisions.”
When IFAs make an online application, Scottish Widows captures more than 10,000 different types of disclosures that can be instantly assessed by a bank of more than 2,000 rules.
Cadger says: “These rules cover medical conditions as well as lifestyle and occupational risk factors, allowing us to give as full a decision as we can automatically.”
Paul Roberts, head of protection at Old Mutual Wealth, says it has reduced underwriting times by removing the GP report as a routine requirement.
“We are also replacing doctor medicals with nurse screenings, as these are less intrusive and generally can be done at the client’s home,” he says.
Where possible, it uses saliva swab testing instead of a blood test for cotinine testing. “We have also removed Resting ECG from routine requirements and introduced tele-interviewing by a qualified nurse, as an alternative to completing the traditional paper application,” Roberts explains.
Roberts says the insurer has also worked towards earlier payment of claims.
“For example, surgery benefit, which covers 11 critical illnesses, is paid when the customer is placed on the NHS waiting list, rather than after the procedure has been carried out,” he says.
Zurich UK Life has redesigned its online system to make it interactive on a full range of electronic devices. Chief underwriter Nicky Bray says advisers can now submit applications on tablets and track their pipeline on our mobile app.
Zurich has built online links to companies arranging medical examinations, so reports and results can be quickly sent to its underwriters.
Bray says: “We also use web analytics to look at where customers drop out of the online application process, plus data on what questions customers are answering and what we subsequently find out about their health from their doctor’s report.”
Zurich is running a pilot on electronic GP reports, which should cut the process from a couple of weeks to a matter of days.
Bray continues: “We have also piloted the use of digital signatures for obtaining the Access to Medical Reports Act (AMRA) consent from customers, allowing us to request GP reports more quickly.”
Bray says technology is supplying more detailed information on individual patients and allows underwriters to stratify risk in a much more detailed way.
“Sophisticated MRI scanning and targeted treatment methods produce better information on likely patient outcomes and more personalised underwriting decisions,” he says.
Wearable devices for certain groups of customers, for example epileptics, can show who is likely to suffer severely from their condition.
“Patients can struggle to recall their epileptic fits, which makes it more difficult for underwriters to determine which are the better or poorer risks,” he says.
Andrew Doran, underwriting philosophy manager, protection at Aviva, says it is continually refining its protection underwriting process to build interactive application asking the minimum number of questions to offer immediate acceptance where possible.
Doran says Aviva does not request blood tests for the vast majority of its customers. “There is the odd exception, for example, a 35-year-old wanting more than £2m of life cover,” he explains.
Aegon’s protection director Dougy Grant says obtaining medical information is key to getting clients on risk swiftly.
“It’s a thorny issue that has long proved contentious, but by accessing medical reports electronically we expect to dramatically reduce the time it takes,” Grant says.
This has the advantage of being secure, boosting patient and doctor confidence that medical records are kept safe.
“It also means we only have access to the information we need to make an informed decision,” he says.
Grant adds: “Removing paperwork and reducing delays during the electronic transfer of medical records is a big step forward, but just the start of our journey to become a fully digital business.”
Chris McNab, protection product manager at LV=, says technology is a great way of delivering more efficient underwriting.
“An ever-decreasing number of customers now have to provide any additional medical evidence outside of the initial application, and it is vital this continues,” McNab explains.
LV= has used new advances in online underwriting engines to increase the number of customers it can accept without any underwriting, McNab says.
In a virtuous circle, greater automation leads to more data gathering, which drives future efficiency.
“It allows providers to offer a much more tailored approach to underwriting, and could lead to shorter application forms for consumers,” McNab says.
Jeremy Chadwick, managing director of VSP Vision Care EMEA, says comprehensive eye exams can provide insight into health conditions that impact blood vessels, and in a non-invasive way.
“The blood vessels in the back of the eye can be seen during an examination, and an increasing number of conditions such as diabetes, high blood pressure and high cholesterol are being diagnosed earlier as a result,” Chadwick explains.
Les Schroeter, head of individual protection at brokers Premier Choice Group, welcomes VitalityLife’s finger-prick test.
“Nothing is worse than having to ask a busy client to redo a blood test because a previously taken batch has become contaminated,” he says.
While underwriting is vital many clients see it as intrusive, time consuming and frustrating.
“Providers are now working hard and making radical changes to eliminate these perceptions,” he says.
Schroeter lists changes such as increasing cover levels before a GP report or medical is required, greater use of nurse screening, more home and workplace medicals and screening, and faster electronic transmission of results.
“Insurers have also introduced large case teams to handle more complex cases and provide cover while waiting for the application to be completed, which helps provide speedier cover,” he says.
Schroeter says the ultimate aim is to speed up the process, reduce fuss and inconvenience for the client, while obtaining even more accurate data to arrive at the correct underwriting decision.
GP reports remain the big sticking point, with a desperate need to make the process more efficient, he says.
Gwilym Morrison, senior analytics manager at Royal London, predicts that healthcare analytics will trigger the next protection revolution.
US researchers can now assess the risk of any individual having a potentially life-threatening condition by passing their health records through trained machine-learning algorithms.
“This could lead to cheap and efficient way of screening for rare diseases, including certain forms of cancer, post-stroke complications and even undiagnosed injuries in professional football players,” Morrison says.
These algorithms may also predict which patients are at risk of relapse or complications after a hospital visit.
“This heralds a new data-driven age in medicine, that will help treat complex chronic disorders and delivery more tailored and personalised care,” Morrison says.
Insurers can also apply machine learning to client health data to personalise the underwriting journey, Morrison continues.
“This will have a profound impact on the protection industry, leading to dynamic application forms and journeys and a much-improved customer experience,” Morrison says.
It may also allow providers to offer cover to individuals with conditions that they would otherwise struggle to cover.
He says the revolution will spread to other parts of the protection industry, including pricing, customer insight, fraud detection, product design and marketing.
Morrison says this is an exciting time: “Technology has reached a state of maturity that allows relatively easy adoption. Most providers will be making significant investments in this area over the next few years.”