The 2003 Healthcare Conference abcd The 2003 Healthcare Conference 5-7 October 2003 Scarman House, The University of Warwick
IMPORTANT NOTES What is the most important Underwriting Decision? What is the biggest concern to applicant & Policy Holder? Public perception of Insurance Industry Non Disclosure The Role of the Actuary Linking Underwriting & Claims (complete the loop) Legislation / Regulation – European Community Up to date & useable data Quality of Risk Assessment (Underwriting & Claims) Otter Risk Solutions
Where have we come from? (I) No, or little restrictions on Underwriters. - Evidence Requested - Costs involved - Service Standards - No Transparency - Arbitery Decisions - Heavy Loading - Little concern about “Lifestyle” - High Level of Occupation & Avocational loading - Little supporting evidence - No confidentiality Philosophy - No Industry or Company Philosophy Otter Risk Solutions
Where have we come from? (ii) - Directing writing offices holding risk - Ineffective Industry Representation - Unaware of implications of fraud - No Proactivity with Media - Good all round support from reassurers - “Churning” I could go on !! Otter Risk Solutions
Where are we today? (I) Underwriters work in a restrictive environment - Medical Inflation - Rejection of request for Medical Evidence - Process led environment - Challenging service standards - Companies run by Accountants - Possible less influence from actuaries (personal observation) - Regulation / Legislation e.g. D.D.A D.P.A A.M.R.A European Legislation (more later) Otter Risk Solutions
Where are we today? (ii) - Client base with better understanding of their medical situation - Genetics - Confidentiality - Low Level of Occupational and Avocational loading - Churning still going on to even greater degrees - Complex products - Still no transparency Otter Risk Solutions
Where are we today? (iii) - Varying levels of non-disclosure - More effective Industry representation - Only a little pro-activity with media - Greatly reduced support from reassurers - Concern of quality of Underwriting & Claims - Quota Share – 90/10 arrangements - Pressure on Health Services - Ombudsmen - Money Laundering - Increased Churning Otter Risk Solutions
- Less reliance on Medical Evidence Where are we going? (I) - Less reliance on Medical Evidence - Greater emphasis on applicant disclosure - Improved working relationship and understanding between Industry and F.S.A including the Ombudsmen - Greater integration between Underwriting and Claims - Process led environment - Role of Chief Underwriter & Claims Manager - Post Acceptance Validation - Implication of E.U. Directives Otter Risk Solutions
Where are we going? (ii) - Non-disclosure – Decline - Greater Transparency - Quota share continuing? - Improved Data – C.M.I - Genetics - Lifestyle Issues - Reversion to simple products - Link with Sales & Distribution - Health Service (Ownership of Health Records) Otter Risk Solutions
Future Implementations, I.T Solutions & Outsourcing Expert Underwriting 1. Point of Sale (Quotations) 2. Telesales 3. Internet 4. Head Office Outsourcing 1. Underwriting 2. Claims 3. Consultancy Medical Data (N.H.S) Otter Risk Solutions
SUMMARY Changes must happen (Underwriting & Claims) Increases understanding of clients requirements An increased presence from Actuaries Expert systems for Initial Underwriting will be the norm T.P.A’s will (hopefully) increase their market promise Whatever happens Actuaries have an essential role to play within the future Underwriting And Claims arena. Otter Risk Solutions