1. The 2003 Healthcare Conference
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The 2003 Healthcare Conference
5-7 October 2003
Scarman House, The University of Warwick

2. 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

3. 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
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4. 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 !!
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5. 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)
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6. 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
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7. 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
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8. - 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
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9. 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)
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10. 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

11. 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