Friends Life Protection Account Underwriting guide Underwriting information for professional financial advisers

Transcription

1 Friends Life Protection Account Underwriting guide Underwriting information for professional financial advisers This guide should not be distributed to or relied upon by retail customers

2 Contents Underwriting Guide Contents What this guide is for 3 Our underwriting options 4 Tele-underwriting benefits How Tele-underwriting works 6 What to check on application forms 7 Questionnaires 10 Medical tests 11 Appendix: A-Z of common medical conditions 12 Minimum and maximum ages 1 Body Mass Index (BMI) and waist measurement Confidentiality How we administer your client s personal information 2 If you have any questions that are not covered in this guide please call us on and we will be pleased to help. Opening times 8.30am to 6.00pm Monday to Friday

3 Underwriting Guide What this guide is for What this guide is for This guide gives you important information about how we underwrite the Friends Life Protection Account s Life, Critical Illness and Income Protection covers. It also explains how our underwriting procedures can help get your business processed as smoothly and quickly as possible. It covers: our Tele-underwriting Service; overviews of hazardous pursuits, occupation and health conditions; medical tests that could be required; what to check on application forms; common medical conditions; and medical and financial limits. 3

4 Our underwriting options Underwriting Guide Our underwriting options How they work Friends Life Protection Account Paper application forms Online application system Complete the full application form. Send to us with all evidence required, such as the underwriting questionnaire Complete our short tele-app form and send to us Use our online routes to complete your client s application. Our short life cover only application form is available via Dynamic if accepted, case can go on risk To our underwriters. We may need further information If accepted, case can go on risk We call the customer to complete Tele-underwriting interview If accepted, case can go on risk To our underwriters. We may need further information Dynamic route Complete tailored app Classic route Complete full app If accepted, case can go on risk If accepted, case can go on risk To our underwriters. We may need further information If accepted, case can go on risk 4

5 Underwriting Guide Tele-underwriting benefits Tele-underwriting benefits How it works Tele-underwriting is simply underwriting by telephone. It can be fast and effective. We contact your clients and collect their medical details, so you don t have to ask any sensitive questions. They are contacted by our trained Tele-underwriters, who collect the underwriting information we need. If your client is accepted immediately, we can get them on risk as soon as possible. How it could benefit you It is designed to get your business with us processed quickly and efficiently. Here s how: We deal directly with your clients to reduce your workload. We ask your client the relevant health questions. We capture the essential information in one phone call. Gives you more time to spend with other clients. If we can t cover your client right away Each case is different. In some cases you will find that we can t accept your client for cover at the end of the phone call. We will let you know where we go from there. For example, we may need to write to your client s doctor for more information about his or her medical history. If we cannot accept your client at standard rates, we will contact your clients and tell them why. We will then give them details of cover available and a revised quotation. Alternatively, we will give them reasons why cover cannot be provided.

6 How Tele-underwriting works Underwriting Guide How Tele-underwriting works Five simple steps to cover your client Step Short application form Tele-App to us Client contact Tele-underwriting Final steps What Happens Your client completes a short application form called a Tele-App with you. This can be completed on our adviser extranet, or on a paper copy. It covers where your client lives, the preferred start date for cover and your client s bank or building society account details. If it s done online, make sure you print a copy for your client to sign. Send the Tele-App by post to us, unless you have already submitted it online. We send a Tele-underwriting Guide to your client, explaining how it works and what to expect. When we receive the Tele-App, we phone your client to arrange a convenient time for a full telephone appointment. This is because we appreciate that your clients may need time to gather information like medical details and the names of prescription drugs. Our Tele-underwriter asks your client a series of questions that relate only to the Life, Critical Illness and Income Protection Covers applied for. These questions focus on your client s current and past health, family medical history and lifestyle. For joint cover applications we need to speak to all people concerned. We do this in one telephone appointment or if it s easier, we can call each person at a separate time. Each call should take approximately 20 minutes. We let you know how your client s case has progressed when the Tele-underwriting is over. We also need to know about any changes to your client s circumstances since the Tele-underwriting interview took place and before the cover starts. If your client is accepted, he or she receives a Cover details document along with the Friends Life Protection Account Schedule, Cover schedule and Account details. These documents form part of the legal contract between your client and us. We will also send them confirmation of their application details to check that we have collected the correct information. If any details are missing or incorrect, your client will have 30 days to contact us to make amendments. Full details of the process can be found in the Tele-underwriting Guide. 6

7 Underwriting Guide What to check on application forms What to check on application forms Help your clients to get on risk quicker A quick guide to help you spot potential issues with your client s application Our application form s questions are specifically worded to extract the essential information from your client. If these questions are not answered fully and accurately, there could be delays while we refer back to your client or get medical evidence from another party. Below is a quick guide to the information that we are looking for. Information we need Lifestyle Hazardous pursuits UK residence and travel Occupation Poor health What you should look out for Your client's: Height, weight and waist measurement. Alcohol consumption. Smoker status. A non-smoker is someone who has not used tobacco, tobacco-related products or tobacco replacement products such as nicotine patches for 12 months. Our questionnaires cover some of the more common pursuits. If enough detail is given on the application form, a separate questionnaire may not be needed. Some critical illness conditions may need to be excluded if they are associated with a high accident risk. For example, loss of limbs, coma, loss of sight or hearing. UK resident This means that your client is physically present in the UK for 6 months or more in any tax year. We can offer the account to your client if they are living in England, Scotland, Wales or Northern Ireland. Your client s time spent overseas You should check the applicant s travel plans, destinations, and the time spent outside the UK. Travel to countries that represent a health or safety risk may warrant special terms. It can even affect our ability to offer any terms at all. We need details of any past or intended travel outside of Western Europe, North America, Australia and New Zealand, excluding holidays of less than three months. Your client might have a vague job title. For example, driver could mean an oil tanker driver or a taxi driver. We will need details of the industry and the client s duties to assess any special risk. In some cases, the client has a history of ill health or a family history of illness. In this case, medical evidence may be necessary. We need information about: Details of consultants/specialists visited. Dates and details of treatment received. Results of tests and investigations. Any follow up or current medication. 7

8 What to check on application forms Underwriting Guide Lifestyle Weight, smoking and risk Being overweight is known to affect the cardiovascular and respiratory systems. It is particularly associated with coronary artery disease, raised blood pressure, stroke, diabetes, respiratory diseases and osteoarthritis. We might ask for medical evidence. It all depends how underweight or overweight your client is. The evidence could also point out other medical problems. Smoking is known to be a contributory factor in coronary artery disease, lung cancer and chronic obstructive pulmonary disease. That s why smokers pay higher premiums. Again, we may ask for medical evidence if the person is a heavy smoker. Hazardous pursuits Sport, hobbies and risk Most pursuits are acceptable at ordinary rates for Life Cover. A small number will be rated or need an exclusion for Critical Illness, Income Protection, Mortgage Income Protection or Total and Permanent Disability Cover. It will depend on a number of factors such as amount of time spent on the activity, training and experience, location and membership of a recognised club or body. One-off events such as activities carried out on holiday or for charity can be ignored. To make sure we have enough information to make a decision we need your client to answer some additional questions about their specific pursuit. These questions are an integral part of the application on our adviser extranet. If you use the paper application method, you will need to download these questionnaires from the literature library on our adviser extranet. Here are some of the hazardous pursuits to look out for: Motor sport - car, motorcycle and powerboat racing. Aviation - private flying, hang gliding and parachuting. Mountaineering. Caving and pot-holing. Scuba diving. UK residency and travel Health and safety risks Although most of the developed world is considered relatively safe, many countries in Africa, Asia and the Middle East are not. This is not just because of war and terrorism, but also health risks (including HIV) and limited medical facilities. We need details of any past or intended travel outside of Western Europe, North America, Australia and New Zealand, excluding holiday of less than three months. 8

9 Underwriting Guide What to check on application forms Occupation Health and safety risks There are some industries or activities that require special consideration due to accident or health risks. For Life Cover most occupations are acceptable at ordinary rates. For other account covers such as Critical Illness, Income Protection, Mortgage Income Protection, Total and Permanent Disability and Payment Protection Cover, the terms we can offer depend on many different factors. For example, it s not only the type of job or industry that is important. It s also about other aspects, such as the amount and type of manual work and the amount of business travel and driving. Some activities to look out for include: Working with explosives Aviation Diving Oil and gas industry work Tunnelling Racing Fishing Armed forces. Health Medical conditions and risk Your client s medical history Your client s medical history is a prime consideration in underwriting. The severity of any health conditions will determine what the underwriting approach will be. We only need relevant medical history. We do not need to be told about common colds, or routine childhood ailments with no complications. If you re not sure whether something is relevant or not, then it should be disclosed. The key questions we need answers to are: What was the medical condition? When was it? How long did it last for? What was the treatment? Is the treatment continuing? How much time did your client take off work? Common medical conditions Our A-Z of common medical conditions section shows common medical conditions together with likely medical evidence requirements and terms. A useful short cut Medic8 ( is a leading UK medical portal for healthcare professionals and consumers. All of the content is reviewed by a qualified UK doctor before being listed. If your client has a complex or significant medical history you may wish to take a look at this website for background information. Then you can contact our Underwriting Helpline with as much detail as possible on * Friends Life accepts no responsibility for information provided by third parties as any links to third party sites are provided solely as a convenience to you and at your own risk. 9

10 Questionnaires Underwriting Guide Questionnaires Help us to get your client covered Why and how we use questionnaires We use questionnaires to avoid the need for a GPR (General Practitioner s Report). We have a wide range of questionnaires covering common medical conditions, occupational and recreational activities. They are an integral part of our adviser extranet underwriting process meaning your client's will only be asked questions relevant to their personal circumstances. If your client has a complex or significant medical history or unusual and risky occupation/pastime that you are unsure of, you can contact us on for confirmation. Medical questionnaires Arthritis; Asthma, Bronchitis and Other Respiratory; Back and Joint Trouble; Colitis and Crohn s Disease; Diabetes; Drugs; Ear Disorders; Eye Disorders; Faints, Blackouts and Epilepsy; Genitourinary Disorders; Growths, Cysts and Lumps; Gynaecological; High Blood Pressure; Polycystic Ovaries and Polycystic Ovarian Syndrome; Raised Cholesterol; Stomach and Bowel; Tension, Stress, Nerves, Anxiety and Depression. Non-medical questionnaires Armed Forces; Aviation; Mountaineering; Diving; Gliding; Hang-gliding; Microlighting; Motor Racing; Parachuting; Yachting. 10

11 Medical tests Underwriting Guide Medical tests What we might need from your client Medical reports and health tests are obtained to establish an accurate picture of your client s health. Below is a summary of evidence we might request. Medical evidence Biochemistry Cotinine test Briefly, what is it? A blood test to measure blood cells and tissues. A test to determine whether a person has recently used tobacco products. The test is sensitive enough to be able to distinguish between passive and active smoking. Your client should be told that there is now a reliable means of checking recent tobacco usage. ECG (Electrocardiograph) A graphic recording of the heart. It enables doctors to understand far more about the condition of the heart muscle, its rate and rhythm. It is a valuable tool in detecting past and present problems due to heart disease or disorders. An ECG is normally performed whilst resting but can be performed during exercise to assess how the heart reacts under an increasing workload. GPR (General Practitioner s Report) Haematology test HIV (Human Immunodeficiency Virus) test LDR (Letter to Doctor) Lipid profile test LFT (Liver function test) MER (Medical Examination Report) A report from a client s own doctor detailing medical history, previously known as a Private Medical Attendant s Report. It is subject to the Access to Medical Reports legislation. A blood test that identifies abnormally high or low levels of given substances such as cells and proteins in the blood. A blood or saliva test for the HIV virus. The nurse or doctor sends the samples directly to the laboratory and the results are then sent to us. A letter to a client s own doctor requesting specific information which may be used rather than requesting a full GPR. It is subject to the Access to Medical Reports legislation. A blood test to measure cholesterol levels. A blood test that measures enzymes and proteins produced by the liver. Abnormal levels, as well as indicating liver disease, can also be symptomatic of other serious organ disease such as kidney or heart disease. A clinical examination carried out by an independent doctor or the client s GP. The examination is used for larger amounts of cover or when an individual has a medical condition about which we need more information or a current snapshot of their condition. MSU (Microscopic Urinalysis) PSA (Prostate Specific Antigen) test Screening The examination consists of: Detailed questioning by the doctor of the client's medical and family history, drinking and smoking habits. A full examination of the major body systems including heart, chest, blood pressure and urinalysis. A test which checks for abnormalities of the urine, such as blood cells which could indicate kidney disease or infection. This is a prostate screening test. This is usually only required in connection with high amounts of cover in males over age 0 years. A basic examination carried out by a nurse, usually in your client s home or workplace. Height, weight, blood pressure and urine are checked. We use an independent service provider to arrange our screenings which are conducted by registered nurses. They will contact your client directly to arrange a time and place convenient for the screening to be done. 11

12 Appendix Underwriting Guide A-Z of common medical conditions How we are likely to assess your client How we assess common conditions The table below gives a guide to some of the common conditions that we see. There are of course many more conditions that we are unable to cover here, so if your client has a complex or significant medical history or unusual and risky occupation/pastime that you are unsure of, you can call us on for confirmation. Whilst we will often be able to underwrite on the information given by the applicant we may need additional information, examples of which are shown in the table below. Medical Condition What is it? Medical evidence we may ask for Life Cover terms Critical Illness Cover terms Income Protection & Mortgage Income Protection Cover terms Anxiety & Depression Covers a range of disorders from mild emotional reactions to severe mood and personality disturbances. 3 Questionnaire 3 LDR or GPR Mild: Usually Standard Moderate or Severe: Rated Mild: Standard Moderate: Usually Standard Severe: Rated Rated/Exclude Asthma Narrowing of airways, which causes wheezing and shortness of breath. Mild forms of asthma are treated with inhalers. More severe forms may require treatment with oral steroids or use of a nebuliser. Smoking is an adverse feature. 3 Questionnaire 3 LDR or GPR Mild: Usually Standard Moderate or Severe: Rated Mild: Standard Moderate: Usually Standard Severe: Rated Mild: Standard to Rated Moderate: Rated Severe: Usually Decline 12

13 Underwriting Guide Appendix Medical Condition What is it? Medical evidence we may ask for Life Cover terms Critical Illness Cover terms Income Protection & Mortgage Income Protection Cover terms Back problems Back pain is common and one of the main reasons for sickness absence. This is prevalent in many occupations particularly those involving manual work and lifting. 3 Questionnaire 3 LDR or GPR Standard Standard (may need to exclude for TPD) Usually Exclude Bowel disorders The most common form is Irritable Bowel Syndrome, which is usually accepted at standard terms. Ulcerative Colitis or Crohn s Disease is always likely to attract a rating. 3 Questionnaire 3 LDR or GPR Mild: Standard to Rated Moderate: Rated Severe: Rated Mild: Standard to Rated Moderate: Rated Severe: Individual consideration Mild: Standard to Rated Moderate: Rated/ Exclude Severe: Individual consideration Cancer It is difficult to predict the course of recently treated cancers. It is likely that terms will be postponed for the first few years following treatment. A decision will depend on the exact histology of the illness. 3 LDR or GPR Rated (following initial postponement period) Usually unable to offer cover. Individual consideration / Rated (following initial postponement period) NB. Short deferred periods (4 or 8 weeks) would be unavailable. Diabetes Mellitus Diabetes Mellitus is a collective name for a group of metabolic disorders. Type 1 is due to failure of the pancreas to produce sufficient insulin and requires treatment with insulin. Type 2 is due to glucose intolerance and can normally be controlled with diet and/or oral drugs. Smoking and circulatory disorders are significantly adverse features. 3 LDR or GPR Rated NB. the presence of any diabetic complications or adverse features may result in decline. Decline Individual consideration but most cases will be declined. Terms may occasionally be available for long deferred periods 13

14 Appendix Underwriting Guide Medical Condition What is it? Medical evidence we may ask for Life Cover terms Critical Illness Cover Terms Income Protection & Mortgage Income Protection Cover terms Epilepsy Caused by a disorder of brain function. Minor seizures result in brief loss of consciousness only. Major attacks cause convulsions. 3 Questionnaire 3 LDR or GPR Mild: Standard Moderate: Standard to Rated Severe: Rated Standard to Rated Decline if fits or convulsions are regular and frequent Standard to Rated Heart attack Also known as Myocardial Infarction. Terms not available for the first six months after return to normal activities. Smoking is a significantly adverse feature. 3 GPR Rated (following initial postponement period) Decline Individual consideration (usually decline but will depend on length of time since incidence) High blood pressure The blood being forced through the arteries at an increased pressure. Often symptomless and without apparent cause but can be secondary to renal and circulatory disease. Smoking is a significantly adverse feature. 3 Questionnaire 3 LDR or GPR 3 SCR Standard to Rated (Ratings will depend upon level of control and any underlying cause.) Standard to Decline (Ratings will depend upon level of control and any underlying cause) Standard to Decline (Ratings will depend upon level of control and any underlying cause) Hepatitis Inflammation of the liver caused by viruses or toxic substances. 3 GPR 3 LFT Standard to Decline (depending on type) Standard to Decline (depending on type) Standard to Decline (depending on type) Kidney stones Also known as renal calculus, it is the formation of stones in the kidneys. Can be recurrent and result in damage to the kidneys. 3 LDR or GPR 3 Questionnaire Single episode with no underlying disorder: Standard Moderate/severe: Rated Standard to Rated Single episode with no underlying disorder: Standard Moderate/severe: Rated 14

15 Underwriting Guide Appendix Medical Condition What is it? Medical evidence we may ask for Life Cover terms Critical Illness Cover Terms Income Protection & Mortgage Income Protection Cover terms Multiple Sclerosis This is a degenerative disease which can result in weakness and numbness in limbs and loss of co-ordination. 3 LDR or GPR Rated to Decline Decline Decline Peptic ulcer Caused by excess acid. Antacids and/or diet usually control the condition. 3 Questionnaire Usually Standard unless severe Usually Standard Mild: Standard to Rated Moderate: Rated Severe: Individual consideration Rheumatoid Arthritis Chronic inflammatory disease of the joints. A variety of other complications including eye and lung disorders can also occur. 3 Questionnaire 3 LDR or GPR Mild: Usually Standard otherwise Rated Exclusion Decline Skin disorders Most skin disorders such as Eczema or Dermatitis will not cause the premium to be loaded. 3 Questionnaire Usually Standard unless complications Usually Standard but may result in an exclusion for TPD Mild: Usually Standard otherwise may result in an exclusion Stroke Also known as Cerebrovascular Accident (CVA). 3 GPR Rated (after initial postponement period) Decline Usually Decline Minimum and maximum ages Minimum/maximum ages Cover Minimum age at entry Maximum age at entry Life Cover 83 Life Cover Year Renewable 64 Life or Earlier Critical Illness Cover 64 Critical Illness Cover 64 Income Protection Cover 9 Mortgage Income Protection Cover 9 Payment Protection Cover 9 1

16 Appendix Underwriting Guide Body Mass Index (BMI) and waist measurement How we are likely to assess your client These tables are a guide to how we are likely to assess your client using their Body Mass Index (BMI) and their waist measurement. Asking about your client s waist measurement as well as their BMI means we can build a more accurate picture of each individual and can continue to cover as many people as possible - whatever their shape and size. We use your client s waist to height ratio (WtHR) in conjunction with their BMI to give the underwriter an appreciation of whether your client is an increased risk. The WtHR is not used in isolation. BMI is calculated using the following formula: BMI = weight (in kg) divided by height (in metres) squared. i.e. kg/m 2 WtHR is calculated using the following formula: WtHR = waist (in cm or inches) / height (in cm or inches) x 100 Use the table below to find your client s weight and height in metric measurements. Use these metric measurements with the first table on page 17 to determine your client s BMI. For example, someone who is 8kg in weight and 1.7m tall has a Body Mass Index of. Height and weight conversion tables (imperial to metric) Ft Height Ins M Stone Weight Kg lbs

17 Underwriting Guide Appendix Body Mass Index grid M Kg This table shows how we may assess your client based on their Body Mass Index. Body Mass Index Under weight < BMI Risk of illness Underwriting Life Underwriting CI Low - but prone to infections Light rating Light rating Normal range -2 Average Ordinary rates Ordinary rates Overweight 2-29 Mild increased risk Ordinary rates Ordinary rates Obese Increased risk Ordinary rates Severely obese 3-40 Moderate risk Morbidly obese Severe risk Light to moderate loading Moderate to heavy loading Usually ordinary rates Light to moderate loading Decline Super obese 0+ Very severe Decline Decline BMI = height in meters 2 divided by their weight in kilograms. Light loading = 0-7% Moderate = % Heavy = % 17

18 Appendix Underwriting Guide Use the first table below to find a female client s waist measurement based on her dress size. Use your client s waist measurement and height to calculate their waist to height ratio following the formula on page. The second table below demonstrates how we may assess your client based on their waist to height ratio. Dress size (UK) Waist (inches) Waist (cms) Waist to height ratio WtHR Risks Life CI <3% Increased risk of Diabetes and heart disease Nil Nil 36-4% Normal range Nil Nil -60% Increased risk of Diabetes and heart disease Nil 61-69% Moderately increased risk Very light loading Very light loading Light loading >70% Substantially increased risk Light loading Moderate loading Very light loading = 2% Light loading = 0-7% Moderate loading = % Heavy loading = %

19 Underwriting Guide Confidentiality Confidentiality How we look after your client s personal information Make sure your clients understand important information Please make your clients aware that all personal information that we receive from them or third parties such as doctors, will be kept in strict confidence. You should make sure that they understand the Access to Medical Reports Legislation Consent and Declaration on the Application form. If your client requires more privacy about medical issues Most of your clients should be happy to complete the Application form in your presence. Alternatively they could use our Tele-underwriting service. But they do have the right to complete medical information in private on a separate form with their full name, unique reference number and date of birth. They should then send this, in a sealed envelope, marked Addressee only to: Chief Medical Officer Friends Life Protection Account Friends Life Company Ltd PO Box 10 Bristol United Kingdom BS99 SN The remainder of the application form should be completed and dealt with in the normal way and returned to us together with a note confirming that medical information has been sent separately. We are not permitted to discuss with advisers the medical evidence received from third parties or that supplied by clients in confidence.

20 Friends Life, PO Box 10, Bristol BS99 SN. Telephone: Friends Life Services Limited distributes and administers financial products and services and is authorised and regulated by the Financial Services Authority, register No. 746 ( A company limited by shares, registered in England No , registered office: Pixham End, Dorking, Surrey, RH4 1QA. As part of our commitment to quality service, telephone calls may be recorded. PRUG1 10/0/11 (32273)