Head of underwriting Aviva Life & Pensions

Transcription

1 Jean Larkin - QFA, DLDU, AMS Head of underwriting Aviva Life & Pensions

2 Your health IS your wealth.. What would YOU do in the event of long-term absence from work? Rely on employer Rely on the State Rely on savings Rely on partner Take out income protection

3 Some stats from Aviva 1 in 20 chance of dying before age 65 1 in 8 chance of suffering a serious illness before age 65 1 in 6 chance of being absent for > 6 months Average IP claim duration is 5.5 years Just 15% of private sector workers are entitled to sick pay > 6 months Current social welfare benefit is 9,776 P.A. and is not available to the self-employed employed

4 Some stats from other sources. National Consumer Agency 23% of consumers surveyed report that not being able to meet unexpected expenses was their biggest financial worry for 2011 Increased to 29% in the age group Small Firms Association 3,900,000 working days were lost in Ireland due to absenteeism Cost to small business = 563,000,000,

5 Why chose income protection Individual Executive Group The purpose of fthe contract tis to protect tagainst tthe loss of earned income in the event of incapacity due to sickness or accident. The aim is to provide regular cash payments so that the person does not suffer from financial hardship during their incapacity The maximum benefit allowed is usually restricted to 75% of salary (less social benefit and other entitlements), ensuring a financial incentive to return to work. Payment commences after the deferred period ceases Some contracts allow for the protection of pension contributions

6 Definitions of disability. Own occupation due to incapacity, the person is unable to carry out the essential duties of their normal occupation and is not engaged in any other gainful employment. Essential duties are those which cannot reasonably be omitted without preventing the person from carrying out their occupation. Own or suited due to incapacity, the person is unable to carry out the duties of their normal occupation or one that they are suited to by training or experience. Any occupation due to incapacity, the persona is unable to carry out any occupation whatsoever. Work tasks the person must demonstrate that they are unable to complete certain work-related criteria i (walking communicating rising i unaided d fine hand control vision) Each company will have it s own definitions i i and variations. i

7 What s the difference between Individual & Group? Individual / Executive Individual policy Choice of benefit basis No free-cover Group Group policy Standard benefit basis Free cover (within criteria) Class 1 4 Class 1 5 Individually priced Individual medical limits Optional Group rate applied Group medical limits Usually compulsory for all Group members below free cover are accepted regardless of medical conditions. Group past claims experience impacts on the pricing so the Employer should have strong absenteeism controls

8 Occupation classes Occupation classes vary between companies* Class 1 professional, managerial, administrative or clerical Class 2 occupations involving occasional manual work Class 3 skilled non-manual or manual Class 4 partly skilled and unskilled manual Class 5 Heavy manual duties (usually only available on group schemes) Some occupations carry too high a risk and are automatically declined for IP or offered restricted cover for example: Cabin Crew Defence force members Working at heights Professional athletes Some occupations requiring licences Heavy manual

9 Underwriting considerations. Age Gender Medical history Occupation Income replacement ratio Extent of manual duties NRA N.R.A. Number of hours worked Extent of business mileage Travel or residence Previous absence from work Standard exclusions Maximum IP benefit between 200, and 250, Maximum PP benefit up to 50,000 or a % of salary

10 Underwriting decisions.. 1. Accept at standard rates 2. Accept with an additional premium 3. Accept with an exclusion 4. Accept with a change in NRA 5. Accept with a change in deferred d period 6. Accept with a change of disability definition 7. Accept with a change to occupation class 8. Postpone 9. Decline

11 Typical exclusions Generally any condition that increases the likelihood of absence is excluded Back exclusion Joint exclusion Mental health exclusion Loss of sight Past-times Higher % of non-standard decisions for IP compared to any other risk contracts.

12 Claims Claim form submitted to insurer roughly half-way through the deferred period Requirements will include claim form, medical evidence from GP and or specialist, financial evidence. Claim is typically paid 1 month in arrears and net of tax A pay-slip is issued to the claimant each month Regular review of the claim takes place frequency will depend on the nature of the disability that caused the absence. Most contracts include rehabilitation and proportionate benefits designed to support and encourage a return to work. Claim continues until the earliest of Disability ceases or Cessation date of the policy or Normal retirement age or Death

13 Financial evidence at claim stage Financial justification is generally required at claim stage rather then at u/w. Employees and company directors* Evaluate average annual earnings from employment (excluding discretionary bonuses, employer dividends and over-time) Deduction made for other income sources including state benefit, other IP policies, earned income, sick pay or ill-health early retirement income received during the claim period No deduction made for pension income from previous employment or investment or rental income. (Sample only - each insurance company will have it s own rules and requirements)*

14 continued Self-employed* Evaluate average annual net relevant earnings for the 3 most recent years, prior to disability Net relevant earnings is net profit assessed for income tax purposes. (Sample only - each insurance company will have it s own rules and requirements)*

15 Typical claims experience by product type Life Cancer 47% Heart 18% Stroke 6% Other 29%

16 Typical claims experience by product type Serious Illness Cancer 69% Heart 19% MS 6% Other 6%

17 Typical claims experience by product type Income Protection Mental Health 23% Musculoskeletal 29% Cancer 19% Heart 10% Neurological 5% Other 15%

18 Claims experience in a recession. Previous downturns indicate a relationship between higher unemployment levels and disability claims. Income protection claims rates increase, with a time-lag of between 2 and 3 years. Possible explanations include Employers using IP as a means to reduce expenses Claimants wanting to get their money s worth Fewer visits to doctors result in diagnosis delays medical condition becomes chronic rather then acute Greater levels for work-stress Recovery rates also exhibit a reduction - indicating that economic downturn makes it harder to return claimants to work.

19 Coming down the IP track. Gender equalisation (Test Achat) Neutralisation of rates must be implemented by December 2012 (European Court) Cost of medical evidence IP is an expensive contract to underwrite as requirements are higher then for Life or SI. VAT to be charged on medical reports Short-term contracts Lower premiums for shorter term (10 years?) Tax relief not available so price difference is reduced.

20 Continued Early absenteeism management Employers looking to use the Insurance company s skills at absenteeism management Identify trends and ultimately reduce claims. European-style contracts Payment depends on the extent of disability <25% disability No payment 25% to 67% disability Proportionate benefit >67% disability Full claim.

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