Kathryn (00:04):
Hi everyone. We are episode eight of season five and I have Matt Rann back with me. Hi Matt.

Matt (00:10):
Good morning, Kathryn. How are you?

Kathryn (00:12):
I’m good. Thank you. How are you?

Matt (00:14):
Not too bad at all. The, you know, as usual, I talk about the weather a little bit, I think, in these openings and, uh, believe it or not, the sun is shining. We can attribute away all the damaged trees, gates fences from the, our recent, storm problems. Yeah, there’s, there’s not a breath of wind and bright sunshine, so I’m a happy man today. Thank you.

Kathryn (00:38):
Oh, very good. I’m hibernating. I don’t do the cold, so I’m just well aware. And I was, I was on a webinar yesterday and, um, it was very interesting because uh, it started off with everyone. It was some people in London saying, oh it’s lovely and sunny here. And about 20 minutes it was like, oh it’s hailstone, enlightening. I thought beautiful British weather. That’s what we have.

Matt (00:58):
Oh no amazing. Isn’t it?

Kathryn (01:00):
So, today we’re going to be talking about eating disorders and insurance. So, this is the Practical Protection Podcast.

Kathryn (01:12):
So, as we always do with these things, I’m going to sort of like go through a little bit of statistics and um, some information just to explain in a sense, I’ll highlight why we should be being aware of these conditions, especially as advisors or underwriters. When we are thinking of the amount of people in the UK that might possibly go for insurance that have this as part of their medical history or something that they’re actively living with right now. And then we’ll get into all the, the deep dive into things with, with you matters. We go along.

Matt (01:39):
Sounds good.

Kathryn (01:40):
So, in terms of some statistics, I was looking a few different places for this. So, I had a little look on, the Priory Group and also Beat charity website. And they’re saying that this estimated to be 1.25 between 1.25 and 3.4 million people in the UK that are affected by an eating disorder. So we’re not talking just sort of hand full of people. We’re talking a, a significant amount of people. And um, and I would probably think without a shadow of a doubt that advises at some stage in their career, and underwriters as well probably will come across a situation where they might, you know, speak about somebody with this kind of condition. It might not be something that’s going in front of people’s desks every day, but it is, it’s quite realistic that it be something at some stage, um, in terms of, you know, the eating disorders we are, I think seeing, starting to see could be a bit wrong that, but I think what we’re starting to see is a bit more of a men starting to have eating disorders or at least maybe more awareness of men that have eating disorders.

Kathryn (02:42):
And that is currently about to 25% of people that are diagnosed with an eating disorder are male and, um, eating to salt themselves, come in a range of different titles and names. So there is the, the one that most people be aware of or the, the two, which would be anorexia bulimia. You then also have, um, binge eating disorder. It’s classified as its own, um, condition and then others which are called other specified feedings or eating disorders. And that can include, but doesn’t always, I’m not listening. Absolutely everyone, but there’s something called orthorexia. So avoidant of food intake, Pika and rumination disorder. And when we are talking about, um, eating disorders, uh, it’s about 10% of people that are diagnosed with one will be diagnosed with anorexia and about 40%, bulimia. So when we look at these as well, in terms of when thinking, well, when would we expect these things?

Kathryn (03:41):
I think, I think sometimes in my mind, I, I do think of it as I think you see a lot of things on social media, in the news about quite a lot of young people, um, who having eaten disorders, I think possibly is a, some kind of form of control, as they are growing up and the average age, for an Anex D between the ages of 16 and 17 and for bulimia is the ages of 18 to 19. So I think a good place for us to start Matt would be to talk through some of these conditions that a class is eating disorders, kind of like, what are they, uh, and what’s happening with the body as, as people are living with them.

Matt (04:19):
Okay. Yeah. Thanks. All of the disorders, which you mentioned there, they are defined medically by a list of expected behavioral, psychological physical symptoms. So it’s almost like a tick in a way, but like all ticks, uh, not everything fits into a distinctive category and certainly you’ve already, spoken or highlighted one of those areas, uh, OS fed, which is, um, another wonderful acronym for, other specified eating disorders. And it is the most common eating disorder. In other words, despite the, um, the, the list, um, a lot of things and a lot of medical conditions, of course, don’t fit exactly into a redefined box or, or set of principles. So off us fed is other, uh, specified eating disorders. And it’s certainly most common now having said that the ones that are, uh, the best known if you like, and you’ve, again, you’ve already highlighted it, uh, are certainly, anorexia.

Matt (05:32):
Anorexia nervosa whereby an individual tries to control their weight by not eating enough food, um, either exercising too much, or in fact doing both. Now, if you think of anorexia well, all eating disorders really, but the, the, the two severe ones from an insurance perspective, the ones that insurers focus in on that anorexia and bulimia, these are all about, um, either, uh, not being enough or taking with bulimia, uh, losing control of, uh, how much you eat and then taking drastic action, not to put on weight, but both of these, if you, if you break them back down to the core, they’re actually obviously a, a form of mental illness that let’s be clear about that, but also what you’re doing to your body is, um, effectively taking a, uh, subjecting your body to malnutrition.

Kathryn (06:31):
Right.

Matt (06:32):
Okay. And I think it’s goes that saying that everybody listening will know, um, that’s incredibly important to, to eat healthily, um, and eat good, good quality food. Now, if you think, if you don’t eat properly, um, and it impacts your weight effectively, you are malnourishing your body. And, and the biggest killer of, um, of an, of, of people who suffer from anorexia OSA is in fact, heart related matters, closely followed by suicide, but maybe of interest and maybe a little bit of a surprise that in fact, um, it is disease of the heart that actually kills most anorexic. And this really is because the heart it’s a muscle and it, it, it needs nutrients just like any of the muscle and the heart and anorexic has become smaller and weaker. And, of course that will not surprisingly because in circulating, um, blood around the body and, and at a healthy rate as well. Right. So typical signs of somebody who is, uh, who is, I suppose one would say a severe anorexic, um, is something called bradycardia. And, uh, you, many of our listeners will probably know that means a slow pulse, um, and also low blood pressure as well. And these are all indicators that, um, that the heart is struggling to do its job properly because effectively and simply put it is, it is malnourished. That’s

Kathryn (08:17):
Really interesting. It just, I P sorry.

Matt (08:20):
That’s really,

Kathryn (08:21):
Yeah. I was going to say it’s really interesting in terms of the, the Brocard side of things, because some people, when obviously they’re exercise and they become in a sense, very fit and health. Well, I was going to say become very fit and healthy, but that’s my kind of, um, take on it, but maybe it’s not, they can become a bit Brocard can’t they, because of the fact that they’re, they’re so acting of the, in some ways their heart rate becomes quite low sense. I know, because a has obviously been a big fitness person and, and we’re complete opposite. I seem to have a super fast house and you know, his is the opposite way his is, you know, borderline Brady just because the fact that I think, because he is so fit his, that’s just like, oh, I’m just going to pump every now and then, you know, because you’re doing all right on your own kind of thing. Um, so it’s really interesting to know that that’s actually, you know, in the sense for some people it’s maybe seen as, as a result of quite a positive life that I was going to say, I know exercise can become a neck lifestyle well at times, but in generally it can be sometimes associated with a positive lifestyle choice, but then I know this isn’t a lifestyle choice and I’m certainly not saying that for people that are living with these eating disorders, but it’s also connected to what can be a very negative, um, circumstance for the body.

Matt (09:31):
Absolutely. I mean, uh, and as indeed, um, local blood pressure, of course it can, you’ve often seen in, in, in people as a positive, depending on how you define low of course, in that circumstance. But yeah, I mean, I, I, you’re absolutely right. Um, a slow pulse and lowish BP can be a positive thing, but it, the Brady and low BP has to be taken into the context of what we are talking about. Obviously, somebody who is suffering from anorexia, not, not, not the, not the, Alan Knowles of this world who are super fit, not doing Americans. Um, you can pay, you can, uh, ask him to give me 10 pounds later for saying that,

Matt (10:14):
Um, either which, um, I thought it was interesting for people to, to, to, um, uh, to hear that the harp slowly shutting down from malnutrition was the key reason for death in, in people with severe anorexia, um, and suddenly suicide, um, is, is second most high. Um, so effectively, um, what, what I also maybe say it fits in with, um, heart slowly shutting down, um, as well, you will get multi something called multiorgan failure. So it’s where all, all of the organs, um, slowly shut down because they, they are, they are not getting the right nutrients to function properly. And that’s effectively, of course, um, the, the challenge for the doctors who, who treat people from, from this condition, it’s also interesting that the, that the brain parts, the brain also undergo structural changes and, uh, and, and have abnormal activity. Um, you’ve got the reduced heart rate and it’s possibly, you can put two and two together and say that the brain also, because the, the blood isn’t being pushed around the body enough, the brain also gets deprived of oxygen. Um, and, and nerves get damaged. And it can because seizures disordered thinking and numbness or, or, or odd nerve sensations in the hands or feet. So these are all classic signs, of course, of, um, of, of malnutrition and the B body slowly closing down. So we can, we, we, we come up with the terminology, but basically that’s sadly what kills people with the most severe form of eating disorder, which of course is, um, which is anorexia.

Matt (12:09):
We talked, I talked about bulimia briefly, and, and again, losing control over how much you eat and, um, taking drastic action, not to put on weight. So those are the people who, uh, a sign of this would be the people that, that make themselves, uh, vomit after eating, um, which is, is obviously not, uh, nice at all.

Kathryn (12:32):
Yeah. But it also be people, um, because obviously I’ve, I’ve heard at times that sometimes people will take medication

Matt (12:38):
To laxatives

Kathryn (12:39):
Laxatives and things like that, but that also be sort of potentially linked, I suppose, with that being linked with either of, or bulimia

Matt (12:45):
Could be both. Yeah. Yeah. Okay. Yeah. Bulimia, I think is possibly more common with that, but I think, you know, people who were you to control their weight and that, that being the, the key eight or a keyword control, um, you certainly would use laxatives. So I think you can probably apply to both. You also mentioned bed, um, binge eating disorder, um, eating large portions of food. It’s defined as eating large proportions, sorry of food until you feel uncomfortably full. Right. Um, sometimes I think, you know, I, I, as, as I do, um, just doing a little bit of research on, on these topics and I think to myself gracious, how many times have I done that?

Kathryn (13:31):
Yeah, I was going to say because no,

Matt (13:34):
It’s,

Kathryn (13:34):
It can make people question couldn’t it? Because I mean, it,

Matt (13:37):
It can do very much. Yeah.

Kathryn (13:39):
Yeah, because I, you know, if you go up for a meal somewhere yeah. And you can end up having, you know, obviously starting a main course or something by the end of, towards the end of the main course, you’re thinking, oh, I’m really, I’m pushing it now, you know, kind of thing. And then you’ll maybe be there for another 10 minutes or something, and then they’ll come up with the dessert menu and you think, you know, kind of thing. Um, but you know, how many of us do that? But I, I would obviously a lot of us aren’t then I think with a lot of these things, it’s always that fine balance of when does it become a binge eating disorder, you know, so everybody can binge eat at certain points, but there’s clearly a very defined and, and, and I’m sorry, I don’t want to make it seem as if we’re role. Well, everyone can do this a little bit and, and to then make it seem as if it’s

Matt (14:20):
The, I think it’s important to raise the point though, Kathryn, so you’re absolutely right. Yeah, yeah. Yeah. I think it’s the extreme here. You know, I think you, you hit the nail on the head by saying occasionally, or I thought that’s what you said, um, that we know occasionally we’ve done all this, but if, if it becomes a very common part of your eating habit, then I think that’s when, um, the alarm bells should, uh, should start to ring. Yeah. Um, you also talked about, uh, RFI, uh, we’ve mentioned, um, which is, which is avoiding or, or, uh, taking a, a restrictive food, um, intake. Yeah. Um, and here you’ve got somebody who avoids certain foods or limits how much they eat or do both. Um, now with this one, what I haven’t directly touched on with you with your anorexia and U bulimia is that the, the, the people who suffer from these disorders often will have, it’s not surprising potentially what we’ve been talking about, but they, they have beliefs about their weight or body shape. Um, and that, that is another part reason of why they want, they, they want to lose weight. Um, and I suppose controversial subject of, um, of the, the supermodel who are very, very thin, uh, both male and female, I would say there. And, um, maybe pressure that, that youngsters, uh, feel that they want to be like that and therefore have to be that thin absolutely slim. Um,

Kathryn (15:56):
I was going to, is that obviously we’re going to a bit of body dysmorphia there, which is probably more of a symptom rather than and I don’t know, if it is a condition in itself when I was looking into things and, and that, from things I know it seemed to be almost like it, in some ways it cannot be described as a certain kind of Condit, but then also seems to be symptomatic, you know, a symptom of the others.

Matt (16:15):
Yeah. Symptom, I would say rather than, um, you know, you, you would apply it to a, um, a definition. So anorexic or AMIC may, may ha might, might feel that they, they dysmorphic or have a dysmorphia. Yeah.

Kathryn (16:32):
Yeah.

Matt (16:34):
Now interestingly with, um, RFI these, uh, and again, it goes back to your tick box, um, type of diagnosis, but beliefs about the weight or body shape are not reasons why people develop RFI. Okay. Um, quite why is, is, is largely unknown, but then it kind of comes into that, that some difficult area of, um, of, of mental health. But with these again, um, you’ve got negative feelings over the smell, taste, or texture of whatever. You’re eating a response to a past experience with food that was upsetting, or simply not feeling hungry or, or, or general lack of interest in eating. And those are the three kind of areas that would tend to lend themselves to, to a, uh, a diagnosis of RFI. Yeah. Now I have to say yet again, and maybe, maybe I’m, um, over, um, simp it, but, um, there are certainly foods where I’ve had a bad experience over the years. Um, and, and, um, liquids as well. Yeah. Where I’ve, I’ve never touched them again. Um, absolutely. But again, I think it’s, it’s the elements of, um, how extreme you take and I think not eating, um, a meat where you, where you’ve felt that you’ve had, um, um, poisoning food poisoning. Absolutely. Um, is one thing, but, but

Kathryn (18:06):
I suppose it’s when it’s adding to more and more thing and, and possibly where it starts to actually affect your health and absolutely your life. I mean, immediately I’m thinking I, um, so when I was younger, I had, um, a ridiculous amount of gallstones and almost anything and everything I yet would because incredible pain. So I had my gallstone out. And yeah, it was awful. I was 15. So like now I, so I don’t eat takeaway food, like, well, I was going to say, I say that I will sometimes get like a vegan pizza, but you know, the thought of, so something like fish and chips or, you know, which is obviously, it seems bizarre, sort of in a seaside town. So everyone just like, how can you not eat fish and chips? Um, but, or like, um, potentially a Chinese or an Indian takeaway for me in, in my head, I really struggle.

Kathryn (18:56):
I mean, I can absolutely eat those foods away from a takeaway situation. Um, but when it becomes like a takeaway and I’m, I’m kind of convinced myself that the using very strong, um, oils and things like that, I’m really worried about obviously potentially the pain that I might feel. Um, but obviously that doesn’t affect, I mean, obviously that might be considered by some, to be something like that. But ultimately for me, it’s just a case of what I know that I could feel very significant pain afterwards. Absolutely. Um, so I avoid that, but obviously it doesn’t affect me not being able to eat them. I don’t, I don’t feel sort of like it restricts my life in any way. Um, so as you see, I think it comes down to probably with quite a lot of these things is that there is, there’s a time when, I suppose a bit the same terms of anxiety thinking about that as well, anxiety and depression, you know, we can all feel anxious. We can all feel depressed at times, but actually when it becomes anxiety or becomes depression, it’s when it’s reached a stage where it isn’t something that’s, that’s manageable

Matt (19:54):
A hundred percent agree. Yeah. You, I think you summed up very, very well really it’s um, these things certainly, um, we shouldn’t belittle these conditions whatsoever. In fact, I don’t think we are, we’re assuming is that, um, you highlighted the fact that, um, a lot of people have, uh, um, or, or could identify, or some of the things that, or some of these symptoms, which I’ve outlined, but it’s the extreme it’s taking it to the extreme yeah. That’s um, is when it can lead into a, a problem.

Kathryn (20:25):
Yeah, I think, um, so something,

Matt (20:27):
Sorry, go

Kathryn (20:27):
On. No, I was going to say, so something that’s really key as well is that people don’t as assume that an eating disorder means, um, a very low weight and obviously people that are living with bulimia that they’re not necessarily going to, to show us a significantly low BMI with anorexia, we would be seeing that, you know, so it can be a very low weight, but not always. Um, and when we do, um, applications for people that have had an eating disorder, one of the things that we often come across, um, in the questions from the underwriter is, um, obviously what is the current BMI? And obviously, you know, the standard things that we always mention in, in these podcasts, which is, you know, what were the symptoms and when do they best experience symptoms and what was the specific diagnosis. But there is usually that question as well of like, what was the lowest weight of BMI that someone was. And when was that in order to assess the application? So, so going back to you saying before, so I’m assuming what, by knowing the lowest BMI, the lowest weight, um, that the person has had, and when it was, that is in terms of data and the history that, of, of, um, people in this situation before that the underwriters have the, the information for, that’s probably giving like that indication as to how much strains being put on the, the heart and the other organs. Is that right?

Matt (21:40):
Yes, that’s right. It’s, it’s time to build an overall picture. Um, I think there with the, um, from an underwriting point, um, and as in a, and I would have to say it is an indicator and only an indicator potentially of how severe the disease was, um, to ask about the lowest weight that, uh, somebody, um, has, um, got to, if you want. Um, I think from an underwriting perspective, I think we’ll go on to it a little bit later, but, um, these, if, if you want, all underwriter will want to do a very good job on any case that they look with somebody who’s got a preexisting medical condition, but I think unless you have a, uh, a very well documented, um, specialist set of reports, then it is very difficult to actually, um, come up with a, a, a definitive decision on one of these cases.

Matt (22:40):
And I think sometimes, uh, and it is the way of the world when, when underwriters don’t have all the information. And I know that those, uh, three words, all the information can drive, uh, our Fren in broken completely potty. Um, then what will happen is the underwriter will, um, sign on the, um, on, on a cautious approach and, uh, increase the noting or not give terms at all. So they, these are quite difficult. What I’m trying to say, these are quite difficult and to a degree, a little fairly subjective cases to underwrite, they’re not easy.

Kathryn (23:20):
No, I can quite imagine that it’d be quite hard,

Matt (23:23):
Cause everybody is different as well. Here. It’s like mental health, mental health as I’m sure, you know, because I know you’ve been doing awful lot of work yourself and, um, you know, and with others, um, on, on, uh, looking at mental health and uh, so on and so forth and, and, and trying to, um, underwrite these far more accurately in getting the information. Um, and, and, you know, all of these eating disorders are a form of mental health, mental illness. And, you know, you can very, very broadly, um, I can say that they, they’re not easy and nor is mental health either. And they’re, that’s, that’s a big challenge for underwriters. Yeah.

Kathryn (24:01):
Anyway, I was going to say, that takes us into start, right? The next point hour is going to be up quite, quite well. So obviously as an advisor, it can be quite hard, obviously when I’m asking questions and insurance application, um, you know, especially as you say, like mental health wise, it can be, it can feel very intrusive. Some of the questions, depending upon how someone asks them can feel quite blunt, which obviously there’s very specific training that advisors should go through to ask some of them. I think, um, I think what people can sometimes be surprised at and advisors eventually if they’ve experienced this would be prepared for it. But obviously in terms of the people that we are speaking to and supporting, you know, they might say to us, oh, well, you know, I’ve had bulimia, we could be discussing bulimia and you know, it might be something in the, in the, in the grand scheme of things might something that’s quite mild old.

Kathryn (24:45):
It’s something that, that they know they have, but they’ve, they’ve managed it. Well, it’s a bit of a say managing it. Well, you know, it’s been a bit of a coping mechanism maybe in terms of, um, you know, some stress difficulties of stress, you know, like a bit of workplace stress and things like that. And yeah. And in terms of the application questions, it can quickly go from, oh, you have an eating disorder to write. Okay. So how many times have you tried to, um, commit suicide or taking part in self harm? And I think, you know, as, as advisors and as the brokers, you know, we have to prepare people, those questions are coming up, but I don’t think people automatically assume that, you know, or automatically know that it’s going to jump to that. Um, and, and I think sometimes when we ask these questions, as well, depending upon the application, as people who do these applications, no, we have to ask very early on a lot of the time, have you had any kind of condition that’s caused you to, um, you know, sort commit, try to commit suicide or see a psychiatrist being inpatient and hospital.

Kathryn (25:43):
And we might answer that question and the answer could be no, but then when we put in something, then like an eating disorder, we might actually end up being asked to ask those questions again, which can be quite difficult. And obviously I think that’s, that’s partly to do with the underwriting systems and what, you know, what questions are available and where, um, and what, uh, triggers along. But, um, but obviously I think that is, yeah, absolutely something that brokers need to be very of, but I’m assuming, you know, could say that lots of data showing that eating disorders are, as we’ve said before, you know, they are, um, a mental health related condition and that there is, is clearly data that’s showing that. Um, because I think I even looked at it somewhere on the, the, um, in the charity and it said that all the psych yeah. Of all the psychiatric disorders, eating disorders have the highest mortality rate. And I don’t know whether or not that is suicide, you know, people trying to commit suicide or if they’re eating

Matt (26:45):
S of yeah, yeah.

Kathryn (26:47):
Is it the, is it organ failure? Is it that it’s what they’re doing is class self harm. Um, and possibly even knowing if that’s the right way to answer that question, I’m not asking you to give us a definitive answer on that. Max. I know it’s hard, you know, someone says that you’re causing self harm. Well, how do you know, do we, as an advisor, you know, it’s quite hard to go, well, do I, do we put this in here? Do we put this elsewhere? And, um, it can be very tricky.

Matt (27:12):
I, again, um, we had a conversation yesterday, I think about some of my, my big pet areas of challenge for this, for this, um, industry that we have. And, and you’ve touched on another one with underwriting systems. Um, I genuinely believe, and it’s very controversial, but I think sometimes, uh, underwriting systems actually can lead to, um, information being missed and important information be being missed because they tend to be a bit tick box, you know, that, that dreaded, um, um, use of use of, uh, of my terminology anyway, which basically means if, if, if you can’t put a tickle cross, then you you’re stuck. You can’t put anything else in. Yeah. Now I, I you’ll probably have to help me, um, with how insurers actually offer, um, uh, as part of the electronic solution, um, a, a, a question which says, have you got anything else to tell us and that’s, and is, you know, and it’s free for match. You put anything in there you want, I don’t know if those exist that much these days, I

Kathryn (28:24):
Don’t have a, we don’t really have any free, well, I say you don’t have a free text box system generally in the application forms there isn’t a free text box. They’ll maybe say something, is there anything you’ve not told us about at which point you’d maybe say yes, and then it’ll say, well, what is it? And then at that point you would then put in this, but with an eating disorder that captured elsewhere in the application form, generally in the application before, before that, um, there are times though with some insurer systems where you may be put in a condition and, um, and either they, they know that they’re going to need a lot more information. So they say, oh, can you tell us more about this? Um, so that we can try and, you know, write it yeah. Or some to times it is a case of, we don’t recognize that condition because obviously we speak to a lot of people and sometimes the conditions, aren’t something that’s automatically recognized by the system. So be case of right, we don’t recognize that condition. Can you just write in this free text box, what you’re trying to tell us? Um, so, so we have that,

Matt (29:22):
Okay. As I say with, um, it, a little, a bit better than I thought then, to be honest with you, um, you know, you, you’ve got, um, the ability to, to, to put something or add something that you think is important, or sometimes more importantly, that the client, your client in this contact, um, feels as important that they want to get over as well. And again, um, you can always drop an email to the underwriters at, at an insurance companies to say, with reference to policy number X, Y, Z, please also note this following information. So I think there’s always that is available as far as unaware, by the way. Um, not, not being a, not being a, um, an if myself, um, that can always be done, but it’s, it’s, it’s one of those challenges. I think, you know, the, again, I know you and I have spoken about it.

Matt (30:13):
One of the challenges of the, um, of the industry wanting to automate and make everything streamlined and easy and core that doesn’t lend itself necessarily to a, a fair outcome for people with preexisting conditions, maybe medical conditions. So I think that that’s the big challenge, I think, for, for the industry, that type of subject either which way I’m getting onto a hobby horse, and that’s not really what we are here for we’re to talk about, um, eating disorders. So, so you were talking there incredibly importantly, about the, um, um, the difficulties and the, and the surprise that if an eating disorder is, is, um, mentioned by a client, a customer, um, that sometimes these questions will be asked and, um, you know, right at the very beginning, you’re absolutely right. That, um, suicide is the second biggest killer of people who suffer from anorexia. Um, so that is why the insurers will ask those questions. Um, if, uh, an eating disorder, one of the most severe eating disorders let’s be on here, um, comes up.

Kathryn (31:26):
Yeah. I think it’s quite important as well at this stage to say that, um, anybody who’s listening who has, or is living with, um, an eating like anemia, um, you know, please don’t in a sense, feel like you are being singled out in terms of the mental health questions, because the questions that do ask about things like being an patients, or, um, any kind of, um, uh, suicide attempts, um, or, um, any kind of self harm they asked in a sense of, you know, soon as anybody kind of really puts in any information about even mild anxiety or stress or depression, it kind of automatically becomes a, a run through of that. Um, so it’s, it’s not something that’s going to be, you know, people aren’t being put in a, in a very, very narrow box to say, oh, you know, we’re going to ask you all these questions.

Kathryn (32:15):
It’s a case of, right. There’s a mental health related condition here. Let’s all, um, let’s all bring it together. And I have realized as well, and I C I’ll be, um, very upfront about I’ve realized that I’ve made a, a huge mistake as I’ve been talking through these, um, through this as well. I have said a couple of times commit suicide, um, which is, it’s something I train people not to say it is a huge, no, um, to refer to it in, in that kind of a way it’s always, we, we always focus on saying attempt suicide because, um, to, to use a phrase commit suicide, um, harken back to the time when it was an illegal act and some kind of religious connotations, um, that come with it. So it is something that we, um, we don’t use some, I’m very sorry for listeners for, for saying that so far, but it just shows that we’re not all perfect. And, um, but recognized that I’ve done it wrong. And, uh, and, uh, obviously very, very sorry for saying that way. And I will make sure I don’t for, especially at least the rest of this episode.

Matt (33:13):
Very interesting point, Kathryn. Um, thank you for pointing that out because, um, I need to learn about that as well. So, uh, you’re not the only one

Kathryn (33:21):
It’s a big it’s I think, I don’t know why, but I think a lot of us automatically say commit suicide and it, it is something that you have to very specifically train yourself not to do. And obviously today I’ve just, uh, just for some reason, gone back to, to the way that used to fit is it so, um, but we, uh, it’s a, it’s a good one to point out for everybody not to do no,

Matt (33:44):
No, thank you. Yeah, absolutely. I, I I’ll, uh, I’m listening and learning because I always do conversations.

Kathryn (33:51):
Do I, uh, in terms of things like arranging life insurances, critical illness cover in protection potentially, and I will go onto a case study soon, um, for everybody. Um, what are, what would, what would you be expecting for insurers to be able to offer terms wise? Now? I, I know that we’re saying this and, and there’s probably a never-ending mix. Because you say everything’s so individual, but let’s say, um, if we take an example maybe and say that we’ve had somebody who has had bulimia and, um, you know, they’ve, they had it when I don’t know, maybe five years ago. And um, and now they’re the, you know, it was the last symptoms and the last feelings of it were five years ago. And now they’re wanting these insurances now, obviously I, I appreciate you one to tell us specific pricing or specific sort of like percentages or anything like that. If there are to be any premium loadings, but what would you be kind of thinking that we’d be looking at terms wise.

Matt (34:50):
Okay. Um, I have to refer back, um, to, to the actual data that you gave me there. Yeah. Can I assume that we have a, what would be considered an acceptable BMI?

Kathryn (35:04):
So, so let’s assume this person is around, I don’t know, let’s say 26 BMI. They have bulimia though. They had bulimia, there’s been no kind of, um, mental health, uh, situations in, in case, in terms of like being any kind of inpatient, seeing a psychiatrist, um, there’s been no care under community mental health team. There’s just been something that they have lived with, um, that they have managed that they obviously did things like probably some talking therapies, cognitive behavior therapy. And, um, and it’s just something that’s due to that’s well, based upon what we see sometimes reactive to some work stress, um, that, you know, it became a bit of like a, a con control mechanism for them a little bit, but essentially, so excuse me, essentially the last five years have been fine.

Matt (35:52):
Okay. Well, I, I, I, I smile when you told me that, um, that I think, think I heard by the way, we are a long way across the pens from each other. Aren’t we, um,

Kathryn (36:02):
Sorry, I just started to, um, started to choke us a bit. So I think it’s sound like I was crying, started to cry, but I’m just trying to take some water.

Matt (36:09):
Well, ill in don’t you worry? Um, I, I think you said a of 26. Yes. Which of course, as you know, in this, in this, this wonderful classification that we, uh, that we live in, um, 26 is actually isn’t is class as overweight, you know, can you believe, so we healthy weights are generally seen, um, uh, between 19 and 25. So let’s say, let’s say under, by the way, a weight of 26 is absolutely fine from underwriting perspective. No, no problems at all. Really what I was just referring back to is the, um, the way the clinicians term people with BMIs over the, uh, over 25, um, the case that you mentioned going back to the question that you asked me, the, you asked me, I, from a life insurance perspective, I would be looking at standard rates. Okay. Simple as that. Um, if somebody had anorexia in their teens, you mentioned the, uh, the average, um, age range there for, for people who suffered from anorexia. Um, and it was five years ago and they add a decent BMI and they’ve overcome all of those issues then again, um, if they’re completely okay. Now I would probably be looking at, excuse me, standard rates for life insurance. Yes.

Matt (37:35):
Critical illness, um, would be a little bit more for anorexia because you want to make sure they have no complications from some of the, um, problems that I mentioned earlier. Um, you know, particularly the heart, that heart isn’t damaged in any way, um, putting suppose

Kathryn (37:56):
Yeah, I was going to say at this, I was going to say at this stage, I wonder if it’s quite good for people who are familiar with these contracts, just to sort of say the critical illness cover the no, it’s, I think it’s just, um, good to sorry, pipe in and, and hopefully I I’ll mention as many as possible, you know, in terms of critical illness cover, obviously as with anything, the insurers are trying to establish the risk of somebody making a claim. So obviously anything that can potentially, or heighten the chance of a risk, they do tend to, to look at more closely and they might increase PMs to reflect that sometimes, or sometimes they do put exclusions on, but that’s usually so, like, I wouldn’t necessarily say in, in this, um, area, um, but you know, we’re based upon what you’ve said, obviously heart attack is on there. I imagine stroke could potentially be linked into a certain level, um, major organ transplants, depending upon how strong the, the, the symptoms had been at some stage. And I imagine there’s, there’s quite a few others as well, but straight away we’ve got in terms of the three main clinical areas that cancer heart attack and stroke. So straightaway two of the really key areas that the insurer might pay out on are kind of seen as maybe possibly being a bit more enhanced here. Is that, is that right to say that

Matt (39:09):
Couldn’t tell you better myself, Kathryn. Absolutely true. I probably just caveat that slightly by it probably won’t be at risk of the heart attack so much as a heart failure.

Kathryn (39:18):
Ah, yes. Yeah.

Matt (39:19):
But, um, but apart from that, um, you’re absolutely a hundred percent, right? No, no wonder you have this reputation of being one of the best friends. What can

Kathryn (39:29):
I, you sorry for jumping in. I just suddenly thought, oh, for people who don’t know what these actually cover, you know, sort, and, uh, you know, obviously usually a good, at least a good 60 conditions that are covered on these policies. But I think it’s just really, you know, sort of key to saying the, the potential link to some of the really high claimed ones of actually, you know, that’s what the insurer is, you know? Because I think sometimes people are wondering like, well, why, you know, why am I at such a risk because I’m now I’ve, I’ve recovered. And, and sometimes it is obviously as well as advisors, we have a very delicate conversation to explain obviously what you know is potentially being seen. And, and it’s hard because you’re like, look, we’re not saying this is you, but in terms of data and what’s happened before, this is what it’s showing. Because then you, you, again, it’s, it’s that really all awkward kind of conversation. In fact, we’re not saying it’s you, but at the same point, we’re also kind of saying yes, that you are at a higher risk and, and that’s really hard, really hard to manage.

Matt (40:27):
Yeah, no, I completely agree. Um, no, no two ways well said, well said, Um, in terms of income protection, then I’m afraid I would have to go in individual consideration on that one that, that free must get out of phrases by, in, uh, by underwriters. Um, if I go back,

Kathryn (40:47):
At least the, at least the mental health exclusion, I would imagine,

Matt (40:51):
Well, that’s the area that I would be. Um, I would be most concerned of if everything else will, all of the, um, the organ side, if you want, um, not was okay. I’d be looking at the, um, the mental illness side. That’s a possibility to, to, um, to provide that. Yeah, it’s, it’s, it’s certainly a, um, an option. Um, I, I, if somebody’s made a fantastic at recovery, there’s always going to be a chance statistically, there was always a chance of reoccurrence that’s one of the challenges, obviously. So an exclusion might be the best way to, to deal with it. Not that I, by personally an exclusion fan, but it is better than not giving any companies certainly best not giving any cover at all. Yeah. Certainly on a product like income protection, um, please, please jump in about income protection and what it is. Yeah. Um, is such an important product and part of the protection armor that, um, you know, getting cover even with an exclusion is in my opinion, is worth, certainly worth getting, sorry, Kathryn, did you want to say something about income there?

Kathryn (42:00):
Yeah, I will do. And I’ll take us on to a case studies we’re coming towards an end. So, so yeah, in terms of the income protection, so it’s, it’s quite difficult because, you know, I speak to a lot of people with mental health conditions and they, you know, income protection can be offered with mental, the health exclusion, and there’s a mix of responses and you know, you will get some people who say, well, I don’t want the policy if it’s a mental health exclusion because I have mental health and it might well because me to not work, which is completely understandable that people think that way. But essentially some, it sounds awful, but in some ways it’s trying to take it sometimes to a completely different condition to explain to people. And so I say, well, look, if somebody, you know, I, I often go to Parkinson’s because I always think of Parkinson’s is my dad as a, with his Parkinson’s.

Kathryn (42:43):
But so I say, right, so if somebody had Parkinson’s and they wanted insurance to cover them for claims right into Parkinson’s, would you think that that would be available? And I think sometimes changing it that way can sometimes, I mean, obviously again, there’ll be some people who still think it should be, but I think a lot of people, if you, if you change the scenario can understand it a bit more. And then I have other people, you know, it’s probably about half in terms of what people feel like the other half of people are just like, well, I’ve I have mental health. It’s never stopped me working. That’s fine. Um, obviously when I say fine, I mean, it’s, I, you know, they’re okay to accept the terms it’s, it’s acceptable to them. Yeah. Um, some insurers will also reduce the premium if mental health is excluded.

Kathryn (43:24):
So it is always worth trying to, to keep an eye out for those, because obviously they are very, um, aware of the fact that it, you know, it is, it is a, in a sense, a big, um, claim exclusion on there. But ultimately, you know, again, going to the Parkinson’s sample, you know, you could have this sink and protection in place and yes, mental health could be excluded. But then if for some reason you are diagnosed with Parkinson’s and, and I’m not saying that people with Parkinson’s automatically don’t work, but it is a progressive neurological condition. So at some stage it’s, it’s likely to affect someone’s ability to work. Somebody, you know, you might have a stroke, you might have a heart attack, you know, and again, people in those situations can sometimes get back to work quite quickly. But there are occasions where people do have a diagnosis where it is very significant and getting back to work is very hard.

Kathryn (44:11):
And, and I think in protection, it’s not always just saying along the lines of right ball, you can never work again. And this will always pay out which, which these policies will do, you know, depending upon how they’re set up. But it’s also, what’s, um, an incredible thing, I think, which is the phased, um, claims as well. So it could well be that somebody use an example there somebody’s had a stroke, they need to take, um, you know, a good six to 12 months off work to recover, um, which is, you know, completely, um, quite, I think quite a potential normal time period on average. Um, and at the end of that, they want to try to get back into work, but there’s also a bit of worry of like, well, at the moment I’m living on of the income protection policy, but if I go back to work, I’m going to, you know, it could be a bit too intense and then what’s going to happen to this.

Kathryn (44:56):
Well, with most insurers, what they will do is they will help you to do a sense of phase return. So if you are normal working week, I’m going to do some really basic math here. So just not to confuse myself, but you know, if someone’s generally working 40 hours a week and it’s like, well, maybe you can go for 10 hours a week at a time. Well then your employer pays for that 10 hours, but then the income protection policy carries on topping you up for however long it needs to, for you to then be able to, well, next time you get to 20 hours. So then it, the employer pays a 20 hours and then the policy will still top you up as you know, to a certain amount. And it’ll make of that. You’re not, you know, that there’s not, they’re not going to punish people for trying to get back to work.

Kathryn (45:37):
It’s all about trying to do the best for the person trying to help people stay active because ultimately as well, if you can get back to work, it’s incredibly important for you in terms of, um, emotional and mental wellbeing and physical wellbeing as well, if you are able to actually get out and about moving and doing things. Um, so I think that’s what I would say in terms of the income protection, uh, matters is that, um, there are far more situations and very, you know, very, very serious situations where income protection can really play a huge part in a person’s life. And also the knock on as well to their families as well in terms of, um, people or maybe needing to get more support in terms of childcare, um, partners, maybe having to give up work to be able to access a care for a certain period of time.

Kathryn (46:21):
And, um, but obviously this all comes into somebody actually seeking some financial advice and, uh, and especially with income protection, I know with all of these policies, people, most of the policies we talk about the life and critical illness think could be action. People can arrange it on their own, but with income protection, there’s so many aspects to it that can be tweaked or built in certain ways. And, um, and I think it’s really, um, important to try and seek advice. And I have been speaking to somebody recently, who is somebody and, um, and she’s been putting insurances in place to really support her children and, um, her, her adult children, she’s been wanting to get them insurances to, to look after them. Because I think they kind of think, well, absolutely, oh, do I need this? And she’s been doing it, um, on their behalf. And, and now she’s, she’s come to me. She’s not one of my clients, but she’s come to me for some advice. And, and unfortunately she has chosen some policies that aren’t necessarily the strongest of these versions that are out. Um, and you know, it’s, it’s a very sad situation because one of the children is now quite ill and, and also young. Um, oh dear. It’s I know it’s, uh, it’s not great, but, um, I’ve only got a couple of minutes, so I’m going to run through the next bits if that’s okay with you, Matt. No,

Matt (47:29):
I just, I was going to say one sentence, sorry. I just, I think everything you just said there just shows you how important income protection is as, as part of your protection overall protection portfolio. End of really. Absolutely. It’s a great policy to get by

Kathryn (47:46):
Everything. Yeah, no everything whenever, if I train people and I do things, um, and I, when I’m saying training people, it’s a protection advisors, market advisors, wealth advisors. I’m always very, very big on income protection and explaining it because my point of view is you can build the best financial packages in the world. You can have the best job and everything you can be so financially secure, but all you need is to far ill and it all crumbles and it’s income protection. That’s the thing that’s there to stop it crumbling. Yeah. So bit of a case study before we go. So I’ve got a man in his early fifties came to us and he was needing some insurances just generally for little bit of a mortgage that was on and a little bit of terms of family protection and some protection for himself. And he’d had some bulimia when he was in his early thirties.

Kathryn (48:32):
So about 20 years ago. Um, but in the last five years he had had some stress and he’d had some increased blood pressure and chest pain following that stress. So that kind of adds into what we were saying that about, you know, in terms of an underwriter, maybe thinking, well, this was 20 years ago, but we’ve got a little bit of a mental health connect here. It was five years ago, but it is showing a bit of a recurrence. We’ve got a bit of in, you know, sort of like chest pains and things like that. Is there maybe something going on that’s as a result of what had happened? Um, that 20 years ago, um, still had quite a low BMIs. It was just under 20. So within the, the range of BMIs, you know, still fine, but just, just boarding into a lot range.

Kathryn (49:11):
Yeah. Um, but what was brilliant is that we were able to get him insurances, um, both of them at normal terms. So to just explain the pricing, um, so for life insurance, we’d gotten him, it was 25,000 pounds worth of cover over 36 years. And that was, um, just under 15 pounds per month. And then for the life and critical illness cover, we did another 25,000, but we did that over the 21 years to match the specific needs. And that came close to 45 pounds per month. And, um, what I like in some ways about that in terms of the premiums, and obviously say they’re both normal terms, there was no exclusions is the fact that that shows often what I say to people. So it was about 15 pounds for life insurance, 45 pounds for the life and critical illness cover. And obviously there was a bigger gap in the term, but I always say to people generally, if you want critical illness cover whatever the life insurance is, we’re going to be multiplying it between three to five times to get the amount that you’ll eventually pay for the critical illness cover. So I think that’s a, a quite nice example of that.

Matt (50:09):
Yeah, absolutely.

Kathryn (50:11):
So thank you everybody for listening and thank you as always for your insights, Matt. Uh, next time I have Roy McLoughlin back with me and from our industry insights and we will be joined by Kevin Carr and he’s going to be giving us his thoughts on public relations, why we do, and don’t see positive stories in the press. And some tips, if you are wanting to stand out at some awards, if you’d like a reminder of the next episode, please do drop me a message on social media or visit the website practical hi and protection dot code UK. And don’t forget that if you’ve listened to this as part of your work, you can claim a CPD certificate on the website to thanks to our sponsors, Okta members. Thank you, Matt, have a lovely rest of the day.

Matt (50:48):
Thank you very much. And you too, and thanks for listening everyone as well.

Kathryn (50:52):
Thank you.