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Editor’s View: ‘The medical condition I’m most worried about getting is…BLANK’

Critical illness insurance was so much better in the 1980s

Remember the eighties? Simpler, happier times. Twenty eight million people watching a royal wedding, 19 million watching Blankety Blank, 18 million watching Big Daddy duffing up Giant Haystacks on a Saturday afternoon on ITV, Sinclair C5s almost (if only) selling like hot cakes, Boy George and Culture Club strutting their stuff.

And of course Madonna, Samantha Fox and Margaret Thatcher showing off real girl power before it was even invented. What was there not to like?

Cultural historians, however, tend to overlook another important event that took place during that decade: the invention in 1983 of critical illness (CI) insurance.

When the late Dr Marius Barnard – the renowned heart surgeon – first developed the concept of CI (then known as “dread disease” insurance) it was designed to cover four major conditions: cancer, stroke, heart attack and coronary bypass surgery.

So far, so simple, so good.

Fast forward to 2019 and we seem to have got ourselves into a bit of a mess. The so-called CI “conditions race” has meant that most life offices have rushed to add as many new illnesses to their contracts as possible – and the rarer the condition, the better, it seems.

There are some horrible illnesses out there, for sure. I wouldn’t wish neuromyelitis optica – also known as Devic’s Disease or Devic’s Syndrome – even on Stalin, should that monster still be alive.

But should conditions like that be included in CI contracts, as is the case currently? It’s a terrible condition, yes, but the inclusion of an extremely rare illness like that in CI products is something that bewilders many advisers and confuses many consumers.

In terms of value for money and customer experience, it might also be doing the consumer – and the protection industry – a disservice.

Savvy consumers, of course, raise an eyebrow and know in their gut that the likelihood of them or their family being affected by, for example, Devic’s Syndrome is slim. After all, the condition affects an estimated 250,000 individuals across the world; it’s a horrible condition but it’s a drop in the global ocean of 7.7 billion people.

Savvy consumers know, too, that the inclusion of a condition like Devic’s Syndrome isn’t going to make cover for the more common dread diseases – the ones they’re really worried about – any cheaper.

Savvy consumers know when insurers are pulling a fast one.

But should a product stand still? Great though the eighties were, things move on. Medicine evolves – and so does society. So how should the insurance industry respond? I’m not sure that adding more and more conditions to protection contracts is doing anyone any favours.

Sure, it seems anathema to say that more conditions being added to CI contracts is not in the customer’s best interests.

But where should it end? After all, “diseases” are swamping us, even when they’re not, well, diseases. The current problems around knife crime are awful and, rightly, more resources are being dedicated to tackling them. And while the “public health” approach taken by authorities in Glasgow seems to have had some positive results, when the Home Secretary calls for knife crime across the UK to be treated “like a disease”, we’re getting into dangerous territory.

Knife crime can, of course, prove critical.

But as Frank Furedi, Emeritus Professor of Sociology at the University of Kent, has stoically demonstrated over the years, the over-medicalisation of human behaviour is nothing new. Homosexuality, for example, was widely regarded as an illness until the middle of the 20th century, although two years ago a federal judge in Brazil – an “advanced, emerging economy” – ruled that psychologists could consider homosexuality a disease that could be “treated”. If that’s the case – I’m no expert but it obviously isn’t – can you insure yourself against it? Or against the poisonously-named “gay plague” that was the HIV/AIDS epidemic which proved critical to so many individuals?

Or can you insure yourself against addiction, which many well-meaning but misguided individuals describe as an “illness”? There are a lot of addictions classed as illnesses to choose from, but I’m not sure which ones would sit well on a protection contract. Like HIV/AIDS, many addictions can, of course, prove to be critical.

Maybe video games? The World Health Organisation (WHO) has already proposed including the playing of them for a long time – or “gaming disorder” in the WHO’s lexicon – in the next revision of its International Classification of Diseases manual, categorising it as an illness. But would an – admittedly weird – obsession with Pac Man (back to the eighties again) or Red Dead Redemption 2 (2018, so my nephew tells me) cut the mustard with most paramedics or get you a sick note from your GP? And could you insure against video games?

What about obesity? That same unwieldy monolith – the WHO – first classed obesity as a disease as far back as 1948. Can you insure yourself against obesity? I don’t think so (yet), but you can insure yourself against having a heart attack because you are obese – which makes more sense (but will cost a lot because it’s more likely to happen).

Of course, now there is social media “addiction” too. An all-party parliamentary group on social media and young people’s mental health and wellbeing, backed up by the Royal Society for Public Health, has decided that using social media a lot – or social media “addiction” in its terms – is an “illness”. It may well be doing so in order to find a way to tax and get some kind of control, somehow, of the Silicon Valley tech giants, but I’m not too sure that phrases like “disease” or “illness” in this context are particularly helpful. If that was the case, then surely intense social media use is something that could be “diagnosed” as an “illness” by a doctor – and therefore potentially be a feature of a protection contract.

But it’s not.

The emergence of severity-based serious illness plans has been a welcome development in the world of protection; and calls for insurers to look at outcomes of illnesses as opposed simply to diagnoses of illnesses should continue.

But maybe it’s time to go back to the future. A film of that name – well, Part II – was released in 1989, in the same glorious decade as the invention of CI insurance. The movie, which predicted what our world would be like in 2015, got some things right.

The film might have overlooked a little thing called the internet, there aren’t any hoverboards on the market (yet) and fax machines aren’t our main method of communication. But the movie predicted, quite accurately, the development of thumbprint technology, FaceTime-type communication and voice recognition.

It also predicted the emergence of a seemingly endless number of television stations and if, like me, you spend countless hours trying to track down yet another repeat of Homes Under the Hammer (there’s never enough of them) or the latest episode of the timeless daytime BBC hokumfest Doctors that isn’t worth every penny of our licence fee, you’ll be as bewildered as I am with the valueless, seemingly limitless choices on offer.

It’s a similar headache for individuals looking for a bit of financial protection against ill health; less, perhaps, is more.

Not many consumers or advisers lie awake at night thinking about the latest episode of Doctors, unless they or a friend happen to be an extra in it. Likewise, not many consumers or advisers lie awake at night worrying about Devic’s Syndrome, unless they’ve already got it or know someone who does.

If the late Les Dawson (why no OBE?) or the late Sir Terry Wogan were to ask the Blankety Blank panel “The illness I’m most worried about getting is BLANK” today, I reckon “Devic’s Syndrome” as an answer would only get the contestant a Blankety Blank chequebook and pen – in other words, the consolation prize.

But were they to answer “cancer”, “stroke”, “heart attack” or “coronary bypass surgery”? Well, they might just well find themselves in the Supermatch final.