Kathryn:       Hi everyone, this is episode six and it’s all about multiple sclerosis.  I’m Kathryn.

Andrew:       And I’m Andrew.  This is the Practical Protection podcast.  So Kathryn, it’s a question we are more used than ever to asking but how are you in these strange, unprecedented times?

Kathryn:       I’m good and I have to say, there’s part of me – I had a bit of a Twitter interaction with someone this morning.  Don’t worry, it was good, I’m not going to say anything bad about it.  But no, they were talking about mental health, especially in this lockdown and everything and I don’t mean to make light of it or anything, but obviously as someone who’s had agoraphobia in the past a couple of times, I have to say the lockdown, it – part of me kind of finds it quite heavenly, because I’m just like ‘I don’t have to go out, yes!  I can just stay at home.  I’ve got my family here, we’re safe, I’m getting food delivered.’  You know, it’s wonderful but I think, you know, especially we’ve covered mental health a couple of episodes back and we had that conference that we were at on panel at Cover.

There’s just this kind of immense kind of – I think, kind of ticking bomb in a sense that we’re potentially going to see at the end of this and we spoke about this very briefly with Mike Adams didn’t we last week, about, you know, potentially the occupational therapy that’s going to be needed to sort of like correct peoples’ backs and different things because of the amount of strain that’s going to be put on people from working from home.  And I think we’re going to see probably a huge surge in regards to mental health as well because I think there’s going to be lots of people who maybe have mental health conditions who are struggling because they’re now isolated.  It could be that people are now suddenly on their own and have never had a mental health condition but it kind of – being away from people and their social aspect of life which is their, probably their outlet, is going to be a thing.  And I think we’re also going to see potentially a huge reaction within a lot of NHS workers.

Absolutely unbelievably so because one they’re either on the front line and seeing things that no one should have to see.  Even though I know they are trained for that, you know, it’s going to be very, very difficult for them and then there’s the other people who, you know, even locally people who are having to isolate away from their family and their children because of providing this care and I can’t even imagine what that must be like.  But – but no – so for me, this last few days or whatever, the last week or so since we spoke, I’ve just been feeling very, very grateful to be in the position that I’m in and – and moving on to a slightly lighter side of things, I am now starting to learn to play the flute.  So an equivalent everybody, that is your virtually, you know, your six-year-old child coming home with a recorder.  I’m doing payback now to my kids or my eldest child and – and the lovely Lindsay from Cura has been teaching me and she suddenly went off and did this beautiful trill of some kind of classical music and obviously I’ve just sort of like looked completely dumbfounded at her because it was like, ‘Yeah, okay, I’m never going to be doing that.’  But I can do Twinkle, Twinkle, Little Star and Baby Shark so that’s good.  My two-year-old just repeatedly shouts ‘No’ at me until I stop, so that’s really good.  But how are – how are you, Andrew?

Andrew:       Yeah, I’m – yeah, in reality I’m – I’m okay.  It’s – as you say it’s fascinating that how in a way nothing changes.  It’s like, I guess that pseudoscientist in me who finds it fascinating in a – on an individual level how, you know, my life is pretty much exactly the same day to day and yet my mood changes so much.  There are days where, as you say, it’s – it’s quite easy to see the positives and other days where it’s very hard to see the positives.  So I’m glad that it’s the first day back of the working week and that definitely helps us in our house to have structure around –

Kathryn:       Absolutely.

Andrew:       Sort of school and sort of everything.  I think that weekends are harder at the moment, which I wouldn’t normally say.  But yeah it’s – look, it’s – it’s – it’s – it’s difficult and it’s – I think it – it does make me realise being – being more stereotypically male and British, being more stereotypically male than you – being more male and –

Kathryn:       Me?

Andrew:       Being more male and British than you.  I don’t – I don’t miss hugs quite as much as you do but I do miss –

Kathryn:       Yeah.

Andrew:       Coffees, you know, coffees with – with people just to chat and just to – it makes you realise some of the values of those things that I still don’t think we fully get on a, you know, a pub zoom meeting or whatever we enthusiastically proclaim the value of in – on social media.  I still there’s – it – it makes you treasure some of those things.  So I’m looking forward to those at some point this summer.  It’s probably as accurate as we’ll go for.

Kathryn:       Next week, so 20^th April starts Multiple Sclerosis Awareness Week and really wanted to focus on that because I do speak to a lot of clients who have multiple sclerosis.  They have ranges so there’s – you have primary progressive multiple sclerosis, secondary progressive multiple sclerosis and relapsing remitting multiple sclerosis and I think the majority of people that I – well the majority of people I’ve spoken to – and I imagine a lot of advisers speak to are the ones that have relapsing remitting MS.  I’ve also done some work in regards – for people with primary progressive too.  In the UK, there’s more than 130,000 people living with MS.  That is from the MS Society information and women are three times more likely to be affected than men.

So when you sort of have a look at those figures as well, that’s roughly one in every 500 people will have multiple sclerosis.  And I know that may seem like quite a small figure but when I think of like our local secondary school, which is not the biggest secondary school in the world, it’s quite small, there is absolutely at least 500 students there.  I would imagine quite a few more and that’s quite scary I think when you sort of think of it and apply it to more sort of like practical terms of exactly just how many people it can affect.

Andrew:       Yeah and trying not to get too technical – I’m aware that probably – and listening back to a couple of these where I need to be reminded this is the Practical Protection podcast not the Technical Protection podcast so to try and keep it at a level that’s helpful for everyone.  I think some of the observations – some of the honest observations are that protection, so life insurance, critical illness in particular and IP has probably had a tough relationship with MS, with multiple sclerosis over the last couple of decades really.  And two different reasons for that.  One is the underwriting and one is the claims.  So under – as an underwriter, it can be a very difficult condition to underwrite when people are potentially being diagnosed with MS and so we can talk a lot more about that but – but the fact is as well as those numbers, and you’ve mentioned the female domination in – in diagnosis, you also have the fact that diagnosis tends to be, or is most common in people in their twenties and thirties which, by chance, and less importantly, is when people are often buying life insurance.

So you often, as a – as an underwriter or as someone – or as an adviser or as someone who is applying for cover, are applying at a time where diagnosis isn’t quite settled or symptoms are still moving or, you know, you may be at suspicion of.  So I think that’s an important thing to acknowledge, that, you know, that is just the reality.  And then probably related to that you have kind of the claims side.  So – so, you know, back in – back almost 15, 20 years now but when I started in underwriting and kind of the two main ways that insurers were losing money were through early claims for cancer and early claims for MS.  And because of that, application forms really got tightened around that and that’s why on underwriting questions for MS specifically, we kind of ask questions about things like fatigue and numbness and tingling which for most advisers and for most applicants are – are, you know, are very hard to understand quite what we mean by those.

Kathryn:       I think that’s good.  I think it’s – it’s good to sort of focus on those kind of symptoms and understanding them as well because there’s plenty of times that I have spoken to people and I’ll say to them, you know, “Do you have fatigue?” and at the same point I’ve just spoken to them about how they have two kids, it’s like a one and a half-year old and a three-year-old.  It’s not easy for the client and it’s not easy for the adviser.  But it’s not easy for the insurer and the underwriter either because, you know, what is, you know, sometimes the fatigue?  What is just the fact that, you know, it’s the MS or what is the fact that you’re a parent or what is the fact that you are out working maybe 12-hour days because some people with MS obviously can work and, you know, don’t have, you know, problems working.

Andrew:       I think for me it’s where I come to a slightly different conclusion to other conditions where for other conditions we’ve talked quite a lot about the importance of customer disclosure and possibly more important than GPRs.  I guess the third bit of the difficult relationship that the protection industry has with MS is it – that there are a higher number of claims that are declined for misrepresentation, for not telling us things on application and you’ve highlighted some of the reasons why that could happen.

Kathryn:       Yeah.

Andrew:       And, you know, if you end up getting evidence at claim stage from a GP then it can look, you know, frankly – mentions of fatigue or tiredness can be littered through anyone’s –

Kathryn:       Yeah.

Andrew:       GP.  It probably is that the main condition where, in my honest opinion, I would always rather see a GP obtained – a GP report obtained at outset.

Kathryn:       Yeah absolutely.  I mean, I think that there’s a bit of a mix with it and I think it depends upon the insurances as well.  So say like for life insurance for multiple sclerosis obviously we see that most people have to go for GPRs as proof, which is obviously completely understandable for like what you said but there is some insurers where you can just go straight through without a GPR.  And that’s on the standard market.  Critical illness is the trickier one.  But so with some – well with an insurer you can get I say critical illness cover and it is – but they must have been – had a stable MRI for at least four to five years, I believe no symptoms or very, very mild symptoms for them to be able to cover it and it would exclude multiple sclerosis and blindness.

When you’re getting into certain covers and stuff that it is probably a GP report – it just clarifies everything and makes it probably feel a little bit safer and I think from an adviser’s point of view it makes me feel as if my recommendation is safer because then I know that if something happens, I’ve actually done the right job for them and we’ve got all that information there to the GP.  But for critical illness cover, that’s something that really frustrates me with MS and this will be something that, if underwriters – obviously more than happy to hear what you have to say, but if underwriters do want to contact me and let me know sort of like my – the lack of my knowledge and where, you know, sort of like they can fill in any spots, that would be fantastic.

But I get confused with things like MS and some other conditions as well, it’s to say like why we can’t do something, maybe a bit like, I don’t know, like – possibly a bit like the AIG Key 3 policy.  You know, where they can maybe say ‘Right, you can have, you know, a – so – you can’t have full critical illness cover for everything and anything however, you know, you can have access to cancer, heart attack,’ and I want to say stroke but obviously MS is neurological so I’m not sure if stroke would be okay.  I was going to say Parkinson’s disease then but then obviously that’s neurological as well.  I’m trying to think of something else.  Third degree burns, there we go.  Why don’t we say cancer, heart attack and third-degree burns?  You know, why can’t we do something that would maybe – that would be available to the people who are in this situation?  It – it seems like it’s a missed opportunity.

Andrew:       Well I guess it’s – so with all of these there’s the – is it a risk issue or is it a business and profit issue?  I guess it’s the blunt – it’s the blunt two main things again and kind of honestly speaking in this practical way then yeah, so you have the risk issue which is – which is challenging for areas of MS because to go through – I guess to quickly go through those examples – third-degree burns, I don’t think anyone is going to say there’s going to be a significant difference.  I mean, you guess there’s a possibility that it could affect, you know, your ability to pick up a kettle or your, you know, your dexterity at times.  So I think the bigger reason does then become business and – and there you have issues around I guess understanding – I guess the first ones are the customer-facing ones, so that they really understand that they aren’t getting the full critical illness that they might know that their partner or their friends might have, so that they’re getting this different thing and – and does that create –

Kathryn:       Yeah.

Andrew:       More risks at claim stage?  Is it financially viable to get the extra evidence on these, knowing that you will end up disappointing customers, bluntly, that there are less, you know, it’s a numbers game and if you don’t have thousands of people rather than tens of people then – then kind of the whole principle of insurance and grouping people together starts to erode.  Looking forwards and in a world where, you know, in a global insurance market and with microinsurance and different things that you can do, it does still seem odd that we’re so tied to the kind of three big solid products; life, critical illness and income protection and there’s not more variety.  It – it is possible, as I say, to come up with those priced products so then the challenge is how do you have a business that works where you only “write 1,000 –” “underwrite 1,000 people a year,” not 10,000 or 100,000 and yeah, whether that’s going more global or whether it’s bringing in other similar conditions and having that more nimble product.  I’d be fascinated to hear from people either publicly or privately if they – if they think they have – if they think they’re closer to solutions on that.

Kathryn:       Yeah.  The thing is – I get sort of the business point of view of it.  You know, you don’t want to build a product and then – I don’t even want to imagine the amount of money it takes to compliance approve and get everything sorted for a brand new policy and all that kind of thing but you know, ultimately we are speaking 130,000 people in the UK and I’m sure that insurers have offshoots or sister companies across the world so you’re probably going to end up running into the millions at some point of people, you know, that would be accessed and like lessons could be learned and transferred over to – to other organisations, you know, in different areas.  The one thing that sort of stands out for me – I think Alan maybe came up with this a couple of years ago so I’m going to mention him because obviously if not then I’ll get it afterwards when he listens to it and goes ‘Oh, I had that idea, stealer.’

So I think he came up with this idea of basically like why not develop – instead of critical illness cover being as it is – and I know this is completely revolutionary and it’s probably not going to be something that’s feasible in many sort of like ways – but I think if there was any kind of new entrants or anybody wanting to do something really kind of revolutionary, it could be quite good.  How about like allowing people to pick and choose in a sense their cover for critical illness cover?  So you could have, you know, one – you could have critical illness points so one unit covers the cancers with your list of cancers it covers, another unit covers heart conditions and it lists, another one covers neurological and it’s kind of in a sense – you know, if you can imagine Vitality’s list of, you know, different things that they have their sections.  You know, you could have all those sections and then you could just say, if someone applies and they’ve had cancer then they know ‘Right, okay, cancer isn’t going to be available but I can buy the unit on heart conditions.  I can buy the neurological conditions unit and I can do this.’  And they could build the package that way.

I think it makes sense in many ways because, you know, I’m speaking to people at the moment.  I’ve got somebody who wants critical illness cover and she had a skin melanoma, a really small skin melanoma on her back about a year ago and the prices are ridiculous.  You know, she is quite happy to have the cancer exclusion and, well and the standard insurers – I’ve got other options for her because obviously, Cura, this is what we do – but you know, on the standard market it’s so ridiculously expensive and you just think ‘Why is her having cancer, why is that making her more at risk of having a heart attack or a stroke, Parkinson’s disease, multiple –’

You know, it just – and it was a little, tiny skin melanoma.  It just – and I know that’s just one example but there will be thousands of people who are in that kind of boat.  I mean there’s bound to be and it just feels like such a shame that we’re not doing something.  And I think, you know, there’s that whole thing of the confusion as to whether or not people know what they’re getting.  Well to me – I’m not saying this, you know, just because I’m a broker but if you’re that worried about it then only provide it through brokers.  You know, there is certain – all group insurance pretty much is provided through intermediaries.  We’ve got the mental health option through Royal London that’s only provided through three brokers in the UK.

There are ways about doing it, it’s just going to take someone I think to – and I’m not saying that’s the perfect scenario what I’ve suggested but I just think it needs someone to take that kind of step and go ‘You know what?  Let’s try and broaden this more than what we are doing at the moment.’  You know, realistically, as I say, cancer – a small skin cancer is not going to cause someone to have a heart attack.  You know, and I don’t think – I’m sure I’m going to completely kick myself for saying this, I don’t think there’s a medical professional that’s going to come round and tell me that that’s the case.  But obviously, you never know, needless to say I’m going to get flooded with messages now saying that that is the case.

But you know, there are so many things – I get it, you know, multiple sclerosis, you know, I get the fact that maybe you’d possibly be worried that there was more of a risk of a stroke because it’s neurological but then I – I don’t even know the statistics for that.  I don’t know if anyone’s really – in the insurance world maybe looked at it.  If you have, please let me know, it would be fascinating.  You know, I mean what’s the likelihood if you’ve got multiple sclerosis that you are going to develop Parkinson’s disease?  I don’t even know if there’s a connection there at all.  There’s – I think sometimes business-wise yes I think it’s sometimes easier to say, ‘You know what, let’s just say no there.  Or let’s just put like a bit of a blanket decision over there.’

But I really do think that it’s insurers that are innovating, especially we’re seeing some huge innovations with some insurers at the moment responding to the corona virus pandemic and it’s – it’s absolutely hats off to them for what they’re doing in an age of adaptation because more and more people are being diagnosed with conditions and I think it’s inevitable that this is just going to happen more and more.

Andrew:       Let me – let me quickly try and run through I guess the – the how I would think about those things and then –

Kathryn:       You love them don’t you?

Andrew:       And leave it open.

Kathryn:       You love them, they’re brilliant ideas.

Andrew:       Leave it open to other [inaudible 0:19:06].  Yeah so – so again, I guess it comes back to risk.  Risk and business as the top two but then probably a third one in this but risk for me here – I think we have to acknowledge that comorbidities or both – not just insurers, medical science and charities tend to be focused on one condition at a time –

Kathryn:       Yeah.

Andrew:       Working out what goes on across conditions bluntly is – is a kind of they – you can apply common sense to but there’s not a lot of big studies often.  So – so for example you can say MS, you do have a, you know, potentially increased chance of mental health conditions and vice versa and there seems – certainly there seems to be some studies that show that.

Kathryn:       Can I pop in with a little bit of a suggestion as to why that might be?  Is that okay?

Andrew:       Yeah.

Kathryn:       I’m not going to ruin your –

Andrew:       Of course, of course.

Kathryn:       I think a lot of the time – I think that can be said of pretty much anybody, well not anybody but I think that can be said for any condition, the mental health side of things.  For a number of reasons, so I obviously – again, I’m not going to witter on again, but I was diagnosed with hypermobility syndrome when I was 12.  I had over five years’ worth of injuries where doctors disbelieved me –

Andrew:       Yeah.

Kathryn:       They tried to accuse my Mum of Munchausen’s Syndrome.  They said I was a hypochondriac.  I was breaking bones, I was spraining, I was in ridiculous amounts of pain and these were happening regularly and we were just not listened to.  And I think sometimes your mental health is obviously so affected because of the fact that you’ve just – nobody’s believed you and you’re scared.  And I know it sounds daft but you are relieved when you are told the name of your condition and someone says to you ‘You are not insane, you were right to feel this way you have,’ the relief you get is immense.  But then you have the mental health side of things like ‘Well what’s this going to mean?’  And then you start looking at things and you get these scare stories and then you get people saying it’s fine and you’re left with kind of, you know, this kind of world that suddenly you’re in it.  You’ve been it but now it does feel like it’s changed because you’re kind of – you’re crying out to say to people ‘Well listen to me, you know, I am right, I have been right all this time,’ and then you’re also not wanting everybody to know that you’ve got something because you are – you don’t want to be labelled.

Friendships are very, very hard when you do have a chronic condition because like the pettiness and the squabbles of the world feel so insignificant because for the fact that you’re dealing with so much inside anyway and I think – I think it’s very understandable for – and I don’t think it can say – I completely appreciate what you’re saying, that MS has a link to mental health conditions – but I think that can probably be said for anything.  Cancer’s bound to have a link to mental health conditions.  Parkinson’s disease –

Andrew:       Absolutely.

Kathryn:       I think anything where someone’s diagnosed with something, there is that link potentially with mental health conditions.  But sorry, that’s me just going off on one so –

Andrew:       No, no, no, look – and it’s a challenge with –  Let’s be clear, it’s a challenge and we’ve fallen into the same trap right?  Only we – we don’t stick to the topic in the – in these podcasts.  But it’s exactly the same way and certainly, you know, I think charities are aware of it but they – but it’s very hard to almost get attention without starting from a condition.

Kathryn:       Yes.

Andrew:       But then you enter the – the actuaries’ and the underwriters’ world where – where – well there are these overlaps and in – if you’re trying to come up with a product that almost pretends there’s not then that – that’s where I guess from a risk point of view it becomes challenging because there obviously are overlaps and understanding where those are but where there’s not great data can make people nervous.  So I guess that’s – I think – I think that’s kind of the main risk one.  The business one, again I think is, from an insurance point of view, it’s uncertain volumes and – and from an adviser point of view I think there are – it’s – it’s whether the product could be secure enough that people would feel comfortable from a compliance perspective.

A recurrent theme I guess for me in why these things often don’t happen which is a bit of almost an insurer seeing themselves in kind of a nanny state or that kind of paternalistic way of trying to – trying to help people out but – but possibly they see the customer as, you know, possibly it is time on occasions to let that 20-something year old child actually make a decision for themselves.  People might choose the wrong things and then that’s rubbish for the customer but it is also rubbish for the insurance industry because you end up declining more claims and, like it or not, claim stats are understandably important to getting trust in our – in our industry.

Kathryn:       Yeah.

Andrew:       Until you can overcome that, then I think it’s, you know, it’s difficult – it’s difficult to get a story out that says ‘We – we are being more flexible.  We’re allowing more people stuff,’ without – without acknowledging the risk that it may lead to more confusion at the end and the more you tighten and say ‘Oh but we’ll only sell it through really good brokers,’ like Cura, the more the business case kind of gets eroded.  So that’s – that’s the vicious circle that manages to kill many good ideas like this.  And – and as I say – I think – I think – I think that’s entirely up for challenge and – but it’s just knocking down each of those bit by bit and still having enough numbers left at the end of it that – that’s the challenge for us all.

Kathryn:       Yeah I think, you know, interesting what you were saying there.  Because to me, if you – if insurers are worried about it, is – it’s kind of that thing of like ‘Well we’re worried about what will happen, you know, if brokers don’t sell it right.’  Well, if you put it out to brokers or, you know, that basically people understand it, you know, I have had it before with insurers, I had one not long ago with an insurer where we had to – to be able to sell one of their products, we had to complete a test to be able to sell the product, you know?  That was fine, it was the rule, you know, ‘If you want to sell this product, you have to complete the test.’  It was like ‘Okay then, I’ll do the test then, that’s absolutely fine.’  So you could do that.

I mean, it could just be provided through brokers and in a sense, you know, if insurers are worried then if there’s – if there is an issue, then that’s going to go on the broker, it’s not going to go on the insurer and then the brokers can chose whether or not they feel comfortable providing that product or not, you know, to people.  I mean, as I say, I’m not saying that what I have said is in any way, shape or form the sort of like the ideal world scenario.  It just – as with anything, it’s like, you know, I mean we’ve had some, you know, incredibly huge achievements with – with HIV in regards to income protection and with life insurance as well.  You know, next is hopefully some kind of movement in regards to critical illness cover.  Understandably that there will be, you know, probably an exclusion on there for cancer I imagine.  I would hope it would probably just be very specifically, you know, detailed cancers but, you know, I imagine there will probably be a blanket one but again it’s just that kind of – it just feels wrong to sort of like, you know, have a condition and go ‘Right absolutely blanket, you can’t have anything.’

‘You know, there’s 50 conditions here, you’re likely to get one of them so you’re not allowed any of them.’  It just – it just feels a little bit wrong.  But – but moving on from the critical illness side of things then.  So what are your things on income protection?  Because obviously income protection, fully appreciate MS is a progressive condition and it’s likely that symptoms will get worse.  I mean, obviously at the moment most people are restricted to accident and sickness cover if they’re wanting any form of sort of like income replacement type of coverage.  Do you think that there will be any kind of development, or even if there is any kind of feasible way of being able to offer some kind of income protection to people living with MS?

Andrew:       It’s – it’s hard to see, right?  Because – and the progressive nature of it is key to that and the difference in rate of progression.  And as you say, there are different types of MS and that you can move from one to another and the rate of progression for an individual can seemingly speed up or slow down and some of that is medication-related and – and – but others, you know, isn’t.  So it’s not an easy one to be able to kind of give a convincing ‘This is a case for resilience and looking at, you know, how well you’ve responded to previous incidents or episodes or – you know, traditionally or normally income protection would be written to retirement age but the possibility that, you know, you pull the term down obviously again reduces – reduces the ultimate risk and should increase your ability to be able to predict.’  But I – I guess I – I struggle to see the science changing significantly on this kind of immediately to get people comfortable enough to go there in a big way.  For the vast majority of people with MS, you can get life insurance cover.

Kathryn:       Yes.

Andrew:       And I think that’s important to reiterate and get that message out and that’s, you know, both for people who are diagnosed with MS and indeed probably easier for people who are diagnosed with MS than people who are currently experiencing early symptoms.

Kathryn:       Definitely.

Andrew:       But yeah for income protection I – I wouldn’t want to raise expectations for anyone.

Kathryn:       So I’ve got two case studies for you.  So the first one is a female, obviously I anonymised the details and everything as we’re going along.  But basically I had a female, she was in her early thirties when we spoke to her and she’d been diagnosed in her late twenties with relapsing remitting MS.  She’d had two relapses.  The latest one had been at the four years – so four years prior to chatting to us which is when she had been diagnosed and before that I think it had been about 10 years prior to speaking to us.  So she’d had the thing of, you know, some tingling, some numbness at the time of the relapse but she was at that kind of stage now where she hadn’t had – because she had no medication, she self-managed, she didn’t work evenings so – because obviously that would sometimes aggravate symptoms and she was regularly exercising.

Now I think she was in that kind of stage where if she continued to not have symptoms or relapse for a number of years then it would be considered the benign multiple sclerosis, which I believe is where they’ve not had any symptoms or flare-ups for – well the relapses for about 10 years I believe that’s right?  Is that correct?

Andrew:       Yeah.

Kathryn:       So for her we were able to get her a 55 percent loading on life insurance which means that you take the basic premium and you times it by 1.55 to get what a 55 percent loading is and it was a multiple sclerosis and blindness exclusion on the serious illness cover side of the policy as well.  So obviously we were really happy with that and she was really happy obviously, thrilled with that as well.  But it does make you think though, you know, I put this one on because we did manage to get the serious illness cover side of things which probably immediately shows us which insurer we went to but it makes you wonder why, if one insurer can do it, why the rest can’t as well?  And I know it’s different risks and everything and I know the reinsurers are involved and everything like that.

Andrew:       On that – on that case then, I think it does work well as a – as a – you know, to highlight that – that really very small extras can be applied for even people who have a confirmed diagnosis of MS and that’s entirely in line with, you know, kind of I guess known and charity – charity kind of approved stats that would say that on average someone with MS kind of would have potentially five – five to 10 years’ reduced life expectancy and clearly with any average there will be people better than that –

Kathryn:       Yeah.

Andrew:       People worse and the plus 50 within underwriting is kind of saying, you know, ‘You’re around – your life expectancy may be three or four years worse than someone who’s healthy enough to go through the insurance application without any – without triggering any ratings.’

Kathryn:       What’s interesting about that, just suddenly dawned on me as well as I was looking at it, with that one we did have the MS and blindness exclusion.  We didn’t have any exclusions for cancer, heart attack or stroke.

Andrew:       Yeah.

Kathryn:       So that was quite interesting.  So the other case study that we have is someone who has more marked multiple sclerosis.  So it was a male who was in his late fifties.  So I chose a male because obviously wanted to get a nicer switch-up between female and male.  So when he came to speak to us, he was in his late fifties.  He’d been diagnosed in his late forties so he’d been about 10 years diagnosed with relapsing remitting and he’d had two recent relapses.  I think one had been about five years before speaking to us and one of them was only six months before we arranged the cover.  He did experience fatigue, slurred speech, had balance difficulties and muscle pain.  So he was on regular medication, he had to take – do physiotherapy as well and sometimes required mobility aids.

Now we were getting life insurance and that was at a 200 percent loading so that means you take the basic premium and times it by three.  So if it had been £20 it would become £60 and I thought that was a good one as well to do an example of, just for the basis to say that even if somebody does have more of a significant symptoms or even sort of recent kind of flare-ups or difficulties that that doesn’t mean to sort of like, you know, if anyone’s listening, you know, don’t assume that you can’t get them cover.  It may take obviously a bit more research and there’ll probably be some – obviously there’ll definitely be some medical sort of requirements around the side of that in regards to GP reports but it’s – it is doable.

Andrew:       I think it’s important to say.  So in that initial period of diagnosis, then potentially you’ll have some insurers who would be postponing while not sure as to whether, you know, whether it’s MS at all or if it’s MS then what the prognosis will be.  As you go through, once you’ve had that diagnosis, certainly I – I would say overall for a year or more, then it’s understood and expected that you will have good days and bad days, good months and bad months throughout and so I don’t think, you know, it’s not something where you, you know, where that should stop or make you apply for insurance at a particular time.  It – it’s a condition that’s, I guess, quite hard to do an underwriting summary of because as those cases explain well, it does quite quickly become a decisions range from standard to declined and pretty much every rating along the way based on – on – on the severity and – and ultimately that’s going to be – the key factor is ability to work, impact on mobility and things like that are the main indicators that we would look for as to current and – and kind of ongoing sort of severity that – that would broadly do it.  I think those two would help – those two cases really do help give a fair indication of about where things would – would settle down.

Kathryn:       So obviously they were my – sorry main things, I think probably a bit of a recap on our thoughts in regards to how the industry is responding in regards to corona virus.  So – so one of the things that I obviously want to – to say is that obviously, I’ve mentioned briefly, you know, there are some insurers who are doing like really, really big steps and big strides to adapt to having to change obviously a lot of their work because they’re having to work from home.  We can’t suddenly have nurses screenings or medicals anymore, you know, there really has to having to be a huge change and obviously some workers are ill so some people’s workloads are going up, you know, incredible amounts at the moment and I think, you know, there’s been a lot of things going around sort of saying that, you know, insurers are now not going for GP reports, they’re not doing this, they’re not doing that, they’re not doing this.

Well we have seen obviously AIG and Guardian have adapted to virtual medical screenings where they can and there are some insurers who still, kind of on a case by case basis and depending upon the condition and different things like that, they are prepared to still maybe go for GP reports but I think there’s certain things as an adviser that you can do to maybe help that.  So if you are speaking to a client and you know they’ve got a medical condition and you’ve pretty quickly realised that, you know, they are – it’s going to need a GP report, that it’s probably a good idea to ask the client if – if they’re happy to speak to or if they’re happy for you to speak to the surgery and say to them, ‘Obviously we fully appreciate the NHS is under significant strain at the moment but can you let us know, you know, basically would you be able to complete something like a GP report at this time?’ because we’re seeing very, very mixed responses at the moment.

Some GPs are saying ‘Absolutely no, we are inundated.  We cannot possibly do them.’  There’s other GP surgeries that are saying ‘Well we’re not seeing patients so actually we don’t really have much work to do so yeah, we can complete that.’  And it’s – I’ve seen it reported that some of them are coming back even quicker than they used to do.  So I think there needs to be again that kind of fine balance and not that blanket approach.  I don’t like blanket approaches to things.  I always think that there needs to be a little bit of a wiggle room.  But as an adviser, that is a – sorry, my tip for sort of like saying, you know, trying to improve as much as possible your ability to be able to – to support somebody with a medical condition is just find out what their opinions are.  You know, ask the client what they’re comfortable with and, you know, because some clients aren’t comfortable with you speaking to their GP because they say ‘Well no, there’s – they’re under so much pressure, I don’t want you speaking to them at the moment.  This is going to need to wait.’  And others are sort of like ‘Well let’s see what happens.’

Andrew:       Yeah look, I – I entirely agree that – that there’s lots of good stuff going on and that’s at a time when people are also probably working harder than they ever have and in different situations than they ever have.  Equally I think it’s fair and right that – that if we see things that, you know, that cause risks to – to individuals such as those with MS that could see cover restricted, that we voice those concerns or that I voice those concerns that –

Kathryn:       I voice them too.

Andrew:       And the GP – and the GP – and the GP – the GPR example is a good one, right?  And you’re absolutely right to stress, most insurers are still willing to try and get evidence from GPs but to be clear for any that aren’t, it probably means that at the moment they’re not going to be able to underwrite someone with MS or other conditions.  I did read – I think your point on if people can get medical reports for themselves is always good.  I – an amazing thing happened at the weekend and I learned something on LinkedIn.

Kathryn:       Ooh.

Andrew:       Which is rare, I normally just, you know, normally –

Kathryn:       Skim, skim, skim.

Andrew:       Another social media thing.  So – but I put something up about – so now only seven percent at the moment of GP referrals are happening face to face.

Kathryn:       Right.

Andrew:       I think it’s 80 percent are phone-based now and there’s this usual ‘Oh will this – will this mean change in the future?’

Kathryn:       Yeah.

Andrew:       And there’s – I guess the two interesting things, one where how important indemnity insurance is to GPs and that in effect they’ve been assured that – that it’s okay to do stuff over the phone for now –

Kathryn:       Yeah.

Andrew:       But that – that assurance may not last beyond so that may see a route back.

Kathryn:       That’s interesting.

Andrew:       And the second was around the fact that people aren’t using the NHS as normal at the moment and I think we’re going to see increasing pushes from Government that people should be.  So the specific thing there that a doctor came on and told me but I’ve since seen verified was that there has been 70 percent less cancer – suspected cancer referrals from GPs in the last three weeks.

Kathryn:       No.

Andrew:       Into cancer specialist services, i.e. people aren’t going to the doctors with –

Kathryn:       Yeah.

Andrew:       Lumps or bumps or – and I hypothesise on this so that is –

Kathryn:       Yeah.

Andrew:       You know, there is data to show that but I would suggest also potentially with fatigue and numbness –

Kathryn:       Absolutely.

Andrew:       And tingling, that those things aren’t being seen and aren’t being picked up.

Kathryn:       Well people are going to think it’s corona virus aren’t they?

Andrew:       But I think –

Kathryn:       They’re just going to think that they’ve got symptomatic of it.

Andrew:       That broader picture stuff while, you know, you and I might get worried about insurances, again both for people, normal people but also thinking about what that might mean for insurers is – is interesting and frankly worrying to the health of the population as a whole.

Kathryn:       Absolutely.

Andrew:       But yes, I know we don’t need more things to worry about but I guess if you’re listening, you know, if I could try and do something good for one individual, if I guess the overwhelming end of that report is always ‘You should still be at least speaking to your doctor and at least – you know, if you are worried about anything then don’t just assume it’s corona virus –’

Kathryn:       Yeah.

Andrew:       ‘And don’t just wait ‘til this is over because frankly it’s not going to be over for a long time.’

Kathryn:       Yeah.

Andrew:       And the difference between finding symptoms early and finding them late is massive.

Kathryn:       Absolutely and you’re completely right and just – I wanted to scoot back to something that you said then that just struck a chord with me.  But, you know, you were saying about us maybe saying things if they don’t sound right in a sense that we may be, you know, obviously in a respectful way, say things if we don’t sound right but I think there was something, I can’t remember the exact figure but I think I saw something where someone had said ‘Well it’s okay, you know, that we’re stopping all these things about medicals and all this kind of stuff because we’re still insuring 85 percent of people who apply to us.’  And – and I found that quite – frankly quite insulting because I’m not one of the – I’m one of the 15 percent and Alan’s one of the 15 percent and I was chatting to a few people on Twitter and there’s – you know, a number of people who are, you know, replying to me on Twitter saying ‘Yeah, I’m one of those people as well.’

Yeah, so I’m one of that 15 percent who would not be able to get insurance right now and protect my family and it almost feels like we’re being swept under the rug and it’s a case of well, it’s – it’s not said in that way but the – the hidden message in it is that the 15 percent don’t matter so it’s okay.  What’s happening now is okay because the 15 percent don’t matter.  And – and I think, you know, then the further hidden message is it doesn’t matter because, you know, in a sense they’re at a higher risk to something terrible happening from corona virus.  So it’s – that’s ultimately going to not be good for us, you know.  And I – and I just think the message that’s delivered, it – it just has to be very carefully thought out from all angles if a message like that is being put out there because in some ways it’s a positive message.  But there is two sides to reading those statistics and to reading the message that’s going with them and – and I’m sure that I’m not the only person who would be reading them in that kind of a context.  So –

[0:41:42]

Andrew:       Yeah and look, I guess I’m – so as far as I know I’m one of the 85 percent but that doesn’t stop me thinking it’s, politely, rubbish –

Kathryn:       Yeah.

Andrew:       To say that.  Obviously – so the 15 percent is – is where we get – is where my back of envelope, if you sell two million policies a year then that’s 300,000 people.

Kathryn:       Yeah.

Andrew:       That are being, you know, not considered in the same way.  And I think there’s two reasons that that can happen.  One is – one is genuinely again, back to theme of this that – that people have taken the judgment that they’re of increased risk and if that’s the case then I think then insurers – it’s – it’s – it is what businesses need to do but we should be honest that that’s why we’re doing it.

Kathryn:       Yeah.

Andrew:       And ultimately then we need to be able to explain that as a, you know, under the usual –

Kathryn:       Yeah.

Andrew:       Acts of legislation and everything like that that’s why we’re doing it.  Insurers aren’t saying that at the moment.  They’re more saying, you know ‘This is operationally driven and we’ll – we’ll look at this in the future,’ which is a – kind of a different argument and I think unpicking all of that is – is important, you know, in an age of – of transparency and trust and everything like that.

Kathryn:       I think it’s – it’s as well as making sure that you – it doesn’t make it sound as if you are – as if people – as if you kind of expect people to be stupid as well, like as if people aren’t going to understand and see what’s happening.  You know, it’s very obvious what’s happening.  It’s understandably happening from a business point of view so, you know, the majority of people are going to get it.  You know, there’s always that thing of no matter what anyone does, no matter what business you have, people are going to get it, people aren’t and it’s just making sure that – that we try and keep the – the positive images and the positive messages and try and avoid any of those double meaning messages that seem to be sort of like floating about a little bit at the moment.  But anyway, let’s finish this on a bit of a lighter note.

We’re going to go back to our truth or lie feature because I know our listeners are dying for it.  Absolutely dying for it.  So – so we’re going to do this.  So mine this week and you’ll find out in two weeks’ time if you come back, which you will, because if not I’ll know – is that I have lived in pyjamas every day since lockdown.

Andrew:       Okay and I’m at the other extreme.  So I have done a half marathon since lockdown.

Kathryn:       That’s crazy.

Andrew:       One of us is crazy.

Kathryn:       Across your lounge?  You’re not allowed out, how have you done a half marathon?  That is not your hour’s exercise Andrew!

Andrew:       Well we’ll see.  I think if I could do a half marathon in an hour it would, I’m pretty sure that would beat Mo Farah so, yeah.

Kathryn:       Oh go for it.  Well that’s what we expect now.

Andrew:       Yeah absolutely.

Kathryn:       That’s what I expect from you, I’m going to have to get Lindsey to like impression your face on a body in front of Mo Farah like running somewhere.  Right, so thank you for listening everybody.  So right the next episode, the next big episode is going to be in two weeks’ time and will feature another mystery guest.  I feel like we need the sound kind of thing going ‘ooh’ when I say that – and we really hope that you found this useful and if you do have any questions that you want to discuss or any points you want to make, please do send us a message.

Andrew:       Yeah, so we’ll be back in a couple of weeks’ time.  If you’d like a reminder of the next episode where us and the mystery guest will be talking about strokes, then please do drop us a message on social media or visit our website on www.practical-protection.co.uk.  Until then, thank you for listening and speak soon, take care, bye now.

Kathryn:       Thank you Andrew, bye.