Critical illness insurance Canada and the U.S.

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1 Critical illness insurance Canada and the U.S. Gary Mooney Actel Resources Inc. IAAHS 2007 IAA Health Section Colloquium 13 th 16 th May 2007 CTICC

2 Overview -- Canada CII was introduced ~1994 Life insurance companies Financial advisor channel Both affiliated & independent producers Almost all standalone policies Very few sold for mortgage protection Banks -- creditor mortgage

3 Financial advisor channel Almost all standalone policies Average issue age high 30s 22 conditions similar to the U.K. 30-day survival period 90-day wait for cancer Return of premiums on death Definitions not standardized but similar Fully underwritten (like preferred risk)

4 Product chassis 10-year renewable term to 75 Level term to 75 Level term to 100

5 What s notable Premium rates are fully guaranteed One reinsurer predominates Maximum coverage per life = CA $2M Return of premium rider is offered On expiry and/or surrender

6 Premium rates are fully guaranteed Financial advisor channel only To age 75 or age 100 Very popular with producers Virtually no reviewable premium business No interest by producers When offered, only modest discount (10-15%)

7 One reinsurer predominates Reinsurers provided considerable support First dollar coinsurance of 50% or more One reinsurer has ~90% market share Because of support for fully guaranteed rates Two other reinsurers accept FG selectively

8 One reinsurer predominates /2 Reinsurer increased rates ~20% Concerns about future incidence rates New cessions only All companies repriced Sales have flattened

9 Maximum per life = CA $2M = US$ 1.7M = GBP 900K Average size < $100K Average premium ~$10 per thousand Personal insurance up to 250K Only 1% of policies for $500K or more

10 Return of premium rider Basic premium is A, rider premium is B Get back total premiums paid = A+B But forfeit total B if policy terminates early Originally on expiry only (ROPX) Pure endowment, usually at age 75 Now on surrender as well (ROPS) e.g. 70% at dur % at dur 20+ e.g. 100% at duration 15+

11 Return of premium rider /2 Rider premium can be substantial Very attractive IRR on rider premium But taxability of ROP benefit is uncertain Extremely popular with producers Actuaries hate it

12 ROP premium increase & IRR on additional premium ROPS 70% at dur 10 ROPX 100% at age 75 Age 30 Age 40 Age 50 IRR IRR IRR +40% +56% +75% 15.6% 11.9% 8.8% +6% +26% +56% 9.8% 7.6% 7.2%

13 Sales history since 1994 History Minimal for first 5 years Then rapid growth for 5 years (30-60%) Now zero growth in sales Penetration is only about 3% Why flat sales? Partly due to premium rate increases Maxed out the early adopters (20%) Can t convert the remainder (80%) Still limited consumer awareness

14 Experience to date No intercompany study yet Average duration is only ~5 years Two reinsurers with most of the inforce Indications that actual is close to expected

15 Areas to watch Multiple sclerosis Early cancer claims Informed buyers e.g. medical profs Large amounts Heart attack incidence

16 Banks -- creditor mortgage Banks place 2/3 of residential mortgages And sell creditor life, disability & CI insurance One bank is extremely successful Very simple acceleration product 3 conditions only Limited underwriting Premiums are reviewable Experience has been good

17 Overview -- U.S. Introduced about 6 years ago Financial advisor channel -- no traction yet Workplace marketing good growth Only 2 active reinsurers

18 Financial advisor channel Limited number of companies Mostly regional Two national, but one withdrew Main problems are: Lack of awareness consumers, advisors Impediments due to state-by-state regulation Concern about litigation Lack of validation by the majors

19 Product Both standalone and acceleration conditions No survival period (standalone) Limited wait for cancer Full underwriting (like preferred risk) Premium rates are reviewable No ROPX or ROPS

20 Workplace marketing channel Well-established distribution channel Voluntary insurance Payroll deduction Broker offers multiple products Endorsed by employer & on company time Periodic visits, a few products each time Personal enrolment process (15-20 min) High takeup rate Average size ~ 35K Lapse when leave the employer

21 Prognosis Canada & U.S. Huge potential in both countries Aging population concerned about health Problems with the healthcare system Consumers want to buy CII Challenges are mostly marketing Making consumer aware of the product Convincing financial advisors to offer it

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