Partners Papers
Things left unsaid...
It can be scary to contemplate what might be around the corner. Mentally
we try to stay positive about the future, and avoid thinking about the
worst that could befall us or our loved ones. Even for those of us who
work in the insurance industry, death and disaster are not pleasant or
common dinner table conversations. But as one of our staff found out, not
talking about the worst that could happen can leave you regretting your
words – or lack of them.
In December of 2017 Steve Wright, our General Manager of
Professional Development, received the sort of phone call
that we all hope to avoid – his cousin’s husband had
suffered a heart attack and was in hospital. Naturally,
his mind immediately turned to wondering what help
they would need – and whether they had any
insurance cover in place.
As Steve and his family waited for more news, the recovery process rollercoaster
began. Bill was unconscious and non-responsive. After two days he had woken
up and was alert and aware. The doctors were preparing for his heart surgery the
next day. Then Steve got another call – expecting good news about the surgery, he
answered.
This time it was not my cousin but my sister – Bill had passed away in the
morning. I was shocked. I called to give my condolences but as nice and as
appreciated they may be, all the flowers, condolences and other well wishes
don’t really do anything to help my cousin.
Steve knew that there would be many expenses piling up for his cousin – thousands
of dollars for the funeral, catering, domestic and international airfares to fly grieving
family members to the service. Adding these financial stresses to the anguish of
losing someone close to you, the resulting burden is more than kind words or
tokens of sympathy can counter, however well-meaning they may be. And that was
just the immediate costs – for the surviving family members, the death of a pivotal
Bill had died on arrival at the hospital and although he was revived, he
remained unconscious. It was clear to me that any recovery would be slow
and possibly mean a very large financial loss for them. It may be that Bill
would never be able to work again. A decent trauma insurance pay-out
would no doubt be very welcome, if not essential.
figure has repercussions that continue well into the future.
My cousin is now a single woman on a single income. Not only has she lost
her husband and her children a father, but her financial future is potentially
precarious. Even under the best scenario, she will not be retiring as I am sure
Does my insurer understand me?
I am fine, I am healthy. Aren’t I? easy, keep hydrated, and watch my diet. When I applied they are assessing the life-long likelihood of something
Health can be a complex issue in life’s journey
of bumps, bruises and illnesses. Your doctor is
there to look out for your best medical interests
and their advice is invaluable. So why is it that
insurers and your trusty General Practitioner
sometimes agree, disagree or agree to differ?
Why do some people have exclusions and
loadings placed on their cover when their GP
assures them everything is fine? for insurance they asked me huge amounts of questions happening based on your present-day state of health. If
and wouldn’t give me cover until I had been for more half the people who have mild chest pains today go on to
tests. If my doctor is happy, why isn’t the insurance have major coronary conditions in the future, an underwriter
company?” needs to assess that risk correctly today.
In this scenario the doctor is assessing the risk in front Balancing the scales through specific terms and exclusions
of him – what is the immediate danger the patient is in allows an insurance company to offer cover on the
and do the symptoms indicate some underlying condition fairest, most sustainable basis. At its core, insurance is
that requires treatment? Your doctor’s focus is to uncover built to be a life-long contract and careful, insightful,
exactly what you are suffering from at the point of your nuanced underwriting ensures clients have the protection
consultation. They are adept at deciphering your symptoms they need today and well into the future. This focus on
and initiating treatment with the singular goal of getting insightful assessment of risk allows a company to revise
you back to your healthy best. its assumptions if conditions improve in the client’s favour
To answer that question, we need to examine the
differences between doctors and underwriters. Doctors
have a singular focus – your health, wellbeing and treating
you appropriately to resolve whatever is ailing you. They
are dedicated, passionate and do amazing work focusing
on each patient. Underwriters assess each individual while
maintaining a larger focus on the client base to ensure
fairness, consistency and undue risk.
The word risk is important here and is key to understanding
the difference between the decisions a doctor and an
underwriter will make. Let’s look at a practical example:
(stopping smoking, losing weight, lowering cholesterol etc.)
Underwriters have a slightly different focus when it comes
to assessing your health. When quantifying your risk, an On a macro level, improvements within the medical industry
underwriter is looking not only at what your present state is, can allow underwriters to more favourably assess clients
but the risk for the lifelong duration of your policy. The chest over time. Conditions such as hepatitis and HIV were once
pains you experience while jogging may mean you are classified as impossible to cover. Decades on, with the
predisposed to conditions that may only present themselves advances in modern medicine, such illnesses are not only
later in life. If the condition is serious and potentially manageable but are now more easily quantifiable from a
debilitating, an underwriter needs to assess the likelihood of risk standpoint.
it occurring and adjust their assumptions accordingly.
General Practitioners are the backbone of our health system
“I went for a jog one morning, felt some chest pain Underwriters assess risk through multiple factors: sometimes and assist greatly with the development of a healthier
and thought just to be safe I’ll see my doctor and see based on the condition; sometimes based the cover applied society. Whilst there may sometimes be disagreement
if there’s anything to worry about. After a few tests my for and sometimes a combination of both. The specific between insurers and your doctor, it is important to
doctor concluded it is probably just overexertion and requirements an underwriter calls for, or the terms they remember that they do not function in the same role or
nothing to be worried about. He advised me to take it apply, may seem strange or unwarranted. The reality is that work towards the same outcome.
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