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The Marketplace for Critical Illness Coverage August 2004 Presented by : Jerry Jacobs, CLU 5416 Yale Street Metairie, Louisiana 70003 Ph#(504)888-2242 Fax#(504)889-1753 Email: jerry_in_metairie@msn.comjerry_in_metairie@msn.com 1
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AGENDA Introduction What is Critical Illness Insurance? U.S. Marketplace Trends Need for Critical Illness Protection Product Design Marketing Applications Global Perspective U.S. Critical Illness Marketplace Why Sell C.I.I. Q&A/Discussion – Open Forum – Issues/Concerns
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Approximately 1.5 million Americans suffer a heart attack each year. Of these, 1.1 million survive at least three (3) years. Over 40% of the population will develop breast, prostrate, or some form of cancer at some point in their lives. The probability of surviving a critical illness before age 65 is almost twice as great as dying. Source: 1987 Employee Benefits News And Views Magazine FACTS
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What Is Critical Illness Insurance? Critical illness insurance (C.I.I.) has characteristics of both life insurance and health insurance. C.I.I. pays a life insurance-type lump sum benefit, upon diagnosis of one of a number of critical illnesses rather than upon death.
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C.I.I. Coverage C.I.I. will pay a lump sum benefit after the insured is diagnosed with a critical illness. Virtually all products cover the “Big Three”: Heart Attack Stroke Life Threatening Cancer Nearly 70% of all deaths under age 75 are associated with heart disease, stroke and cancer.
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The “Big Three” Heart Attack Death of a portion of the heart muscle(myocardium) from a blockage of one or more coronary arteries. Stroke Any acute cerebrovascular accident producing permanent neurological impairment resulting in at least thirty (30) days of paralysis or other measurable neurological deficit.
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The “Big Three” Life Threatening Cancer Only those types of cancer shown by the presence of a malignancy identified by the uncontrolled growth and spread of malignant cells and the invasion of tissue that could result in death.
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World Growth Concept developed by Marius Barnard Introduced South Africa in 1980s United Kingdom Japan Continental Europe Australia Canada Ireland United States
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Types of Critical Illnesses Heart Attack Stroke Life Threatening Cancer Coronary artery (bypass) Surgery Angioplasty Renal (kidney) Failure Major Organ Transplant (heart, lung, liver, bone marrow)
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Types of Critical Illnesses Alzheimer Disease (before age 65) Brain Damage Coma Loss of Hearing Loss of Independent Existence (before age 65) Loss of Sight Loss of Speech
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Types of Critical Illnesses Loss of use of two or more limbs Multiple Sclerosis Muscular Dystrophy Parkinson’s Disease Rheumatoid Arthritis (before age 65) Total Permanent Disability (before age 65) Benign Brain Tumor Diabetes
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Illnesses Types of Critical Emphysema (before age 65) Heart Valve Surgery Severe Burns Terminal Illness
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U.S. Marketplace Trends Medical technology is keeping people alive longer The concern today is not dying too soon – it’s living long
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People Living Longer 65 year old male can expect to live to age 83 65 year old female can expect to live to age 87
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Attitudinal Trends Consumers have greater fears than premature death, such as: The cost of health care Cost of nursing homes Having enough income to retire
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LIFE INSURANCE INDUSTRY TRENDS Demographics favor living benefits over death benefits THE RESULT: Individual life sales have declined 30% over the past ten (10) years. Source: Marketing Edit LIMRA 1997
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Why C.I. Coverage? Probability of surviving C.I. before age 65 is almost twice that of dying Costs associated with C.I. are not covered by traditional insurance
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Why C.I. Coverage? EXAMPLE: Two-thirds of all cancer-related costs are indirect, non-medical expenses, such as: Lost income for C.I. Survivor Lost income and work time for spouse or care giver Housekeeping and child care expenses Home health care needs Home or car modifications Non-covered experimental treatments Expenses not covered by insurance (including co-payments and deductibles)
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Life Insurance – with rare exception, not available while the sufferer is alive. Intended for dependents or beneficiaries. Health Insurance – Possible limited benefits deductibles/co-pays. May be limited in scope of portability if the sufferer leaves his/her employment. If you survive a critical illness, what will you do?
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Disability Insurance – pays a percentage of the sufferer’s monthly income and benefits are dependent upon ability to work. Long Term Care – limited to a daily benefit available subject to a hospital stay or home nursing requirements. Accumulation Products – intended to provide supplemental retirement income.
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Critical Illness Insurance Insured has options The money provided by the C.I.I. empowers the insured to exercise choice. C.I.I. is a consumerist product
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Essentials Essential ingredient of a life insurance product = probability of death (qx) Life Insurance Product Investment Expenses (qx)
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Essentials Essential ingredient of a C.I. insurance product = probability of diagnosis of a critical illness (ix) Critical Illness Product Investment Expenses (ix)
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Essentials Any life insurance product design can, in principle, be be duplicated in a corresponding C.I.I. product by exchanging the key probability of death (qx) for the key probability of a diagnosis of critical illness (ix)
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Basic Types of C.I.I. Coverage Acceleration Benefit Rider Pays all or a portion (usually 25-100%) of the life face amount upon diagnosis of a critical illness. Additional Benefit Rider Pays the rider face amount upon diagnosis of a critical illness. Stand Alone A health product which pays a lump-sum benefit upon the diagnosis of a critical illness.
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Product Design Options Covered Diseases Definitions must be consistent with incidence rates used in pricing. Waiting Period First diagnosis must be made following some specified time after the issue date of the policy. Survival Period Built on assumptions that the purpose of C.I.I. coverage is to help cover the costs of living with a critical illness. Example: Must survive 30 days after after diagnosis to be eligible for C.I. benefit.
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Product Design Options Premium Guarantees Acceleration Amount Pre-Existing Conditions Maximum Age Maximum Face Amounts Reduced Amounts
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Family/Individual Perspective Replace reduced earnings Pay off personal debts Cash for medical treatment or associated expenses Education
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Business Perspective Buy/Sell Agreements Provide ill shareholder with benefit Enable working shareholders to buy out ill shareholder Key Person Pay off creditors Executive perquisite Recruit replacement with similar talent
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C.I.I. Product Critical Illness Insurance is Flexible Life Health Disability Other products
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C.I.I. Global Perspective South Africa Concept – Marius Bernard 1983 – introduced – Abbey Life
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C.I.I. Global Perspective U.K. Success Story 1987 – Introduced 1993 – 70 companies sell C.I. (12 billion in force in 1995) 1997 – 626,584 new policy sales (33% over 1996) Two million policies in force C.I. policy sales have increased in each of the last six years as a percentage of overall individual life sales (22% in 1997) 83% of sales are mortgage related Source: Financial Times 1998
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C.I.I. Global Perspective Australia 1990 – introduced 1997 – 31 out of 33 Australian Life Companies offer C.I.I. Japan 1993 – introduced (sold over 500,000 policies in first 10 months) 1994 – over two million sold 1997 – over six million sold covering many more medical conditions since first introduced Source: Life Insurance Selling 1997
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C.I.I. Global Perspective Developing Asian Markets 1985 Singapore 1988 Hong Kong, Malaysia 1990 Taiwan, Thailand 1992 Indonesia
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Total Dread Disease Policies 1997 Net Premiums written by U.S. Companies N = $5,161,545,733
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United States C.I. Marketplace Individual Life Arena Product Type (advance payment of death benefit) U.S. Companies Accelerated Benefits38 Accelerated Benefit Riders72 Accelerated Benefits for life- sustaining organ transplant 13 Accelerated Benefits to beneficiaries when insured is terminally ill 7 Accelerated Benefits to insured when insured is terminally ill 11 Accelerated Benefits to owners upon diagnosis of specific critical illness 12
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United States C.I. Marketplace Product Type (advance payment of death benefit) U.S. Companies Accelerated Benefits for life- sustaining organ transplant 5 Accelerated Benefits to beneficiary when insured is terminally ill 8 Accelerated Benefits to insured when insured is terminally ill 37 Accelerated Benefits to owner when insured is terminally ill 13 Group Health Arena
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Why Sell C.I.I.? Insurance Company Replace declining life sales Global sales success Fits into health, disability arenas Distribution channels Emphasis on living benefits..demographics Potential higher return on capital Leverage distribution GROWTHS$
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Why Sell C.I.I? Producer Fits marketing organizations (career, independent agencies, producer groups) Fits market segments Living Benefits (ex., LTC) Another financial planning tool for client Consumer appeal is growing – wide acceptance GROWTH$
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Why Sell C.I.I.? Consumer Choice Flexibility Fills gaps for calamitous events Concern about living longer vs. mortality Related to C.I.I. no matter what economic level Asset protection
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Open Forum – Issues/Concerns Now ask yourself the question: Is there a market for C.I.I.?
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