Episode 7 | Stroke

Hi Everyone!

Today we are so pleased to have Steve Casey joining us on the podcast.

Steve has worked within financial services for many years, but that is not the focus of this episode. In 2018 Steve had a stroke, completely out of the blue, in his words it came with a bang.

This episode is focused upon hearing Steve’s story, how it felt to have a stroke, what happened and how his recovery has been. We then venture a little bit into his experience of making a claim on his critical illness insurances afterwards and what he is up to now.

He is an incredible guy and we hope that you enjoy listening to him.

Our 3 key takeaways:

  1. The FAST stroke test.
  2. You do not always experience facial weakness and loss of arm strength, when having a stroke.
  3. Two case study clients that had experienced strokes, that were able to access protection insurance.

As with all of our episodes, we love your feedback! Please let us know what you think and if you have any suggestions for future episodes pop up a message.

Next time we have another mystery guest, focusing upon the importance of income protection.

Kathryn: Hi everyone, this is episode seven and today we have our second guest on the podcast.  It’s Steve Casey from Square Health.  Hi Steve!

Andrew: Hi Steve. 

Steve: Hi everybody.

Andrew: So how are we all doing in these strange, unprecedented – etcetera?  

Steve: Yeah, we’re doing – we’re doing very well thanks very much indeed.  I mean, all four of us are at home.  Two girls, Anne my wife and myself.  Yes, I must say that I’m beginning to get fed up with looking at the same four walls if I’m brutally honest but I’m sure that you guys are experiencing those same sorts of thoughts.

Kathryn: Yep, yep, definitely.  I had to have a little bit of an escape yesterday and I say as somebody with prior agoraphobia, the lockdown is kind of heaven which, you know, could sound bizarre to a lot of people but for me it’s quite like ‘Ooh I like this.’  But my eight-year-old has been having issues with his ear for a few months now and I rang the doctors, we’ve had – we’d done a few things over the phone and everything, antibiotics – and they were like ‘Well we really need to see him,’ and I was like ‘Well I don’t really want to waste your – you know, this precious sort of like safety, you know, this PPE stuff and everything.’  They were like ‘It’s not a waste, come down.’  We went and they’ve set up a gazebo in the local bus station next to the surgery so we drove into this gazebo and pulled up and my son was okay and then they came out obviously fully geared up and you could barely see them and it was kind of like, you know, that kind of imagery you get from like a TV show or something where there’s somebody coming out in all this equipment.  

And he just looked at me and he just told me he was scared and my heart just absolutely went.  So I was like stroking his back and everything and I’m just like ‘It’s okay, it’s okay.’  And then I did the thing of actually popping into Tesco and it’s the first time I’ve actually – bar going on a bike ride, it’s the first time I’ve been away from the house in a month and I went in and got milk and cheese and croissants and I was so proud of myself.  And then I got to the till and discovered that I didn’t have my purse because I’ve not been outside the house for a month.  And I knew exactly where it was at home and I was just doing that thing of like ‘I’m so sorry.’  They were like ‘It’s alright love, happens to the best of us.  Just go home, just come back.’  I was like ‘Oh-ho.’  So then I got back, had to re-queue but they were lovely.  But Andrew, have you had any fun moments?

Andrew: Nothing as dramatic as that, no.  Yeah, but I’m probably closer to Steve and staring at the four walls.  I – I – I have done the – yeah, the – suddenly it feels like a big heroic activity going for a shop, which to say is always in life – when you have lots of things and they’re very busy then funnily enough that’s not worth talking about is it?  I’m sure we’ll look back on this in two years and go ‘How – what on earth was happening?’  But – but yeah, the reality is my trip to Tesco’s now take on a – an unusually exciting time.  But – but no, we’re all okay.  We’re all healthy.  So yeah, we’re – we’re doing fine thank you.

Kathryn: I kind of feel like it’s a Black Mirror episode.  I’ve been saying that since the beginning.  It just feels like really, really strange.  But anyway.  So everybody who listened last time will know that we had a truth or lie feature back and last week I said that I have been in pyjamas since the start of lockdown and Andrew said that he had run a half marathon since lockdown.  So we want to know – who do you believe, Steve?  Who do you think?

Steve: I – I listened again actually to the – to the podcast last time and I would say – I would have to say I think Andrew is true and Kathryn, yours is a lie.  Just really because I – I just cannot see you in pyjamas all – all during the day, setting a bad example for your boys.

Kathryn: That makes me –

Andrew: Not – not because you think I’m incredibly fit.

Kathryn: And that makes me feel –

Andrew: I’m going to keep that up. 

Kathryn: Terribly bad for spending about 90 percent of my time in pyjamas since lockdown [all laugh].  Yeah, I – I’ve literally – Alan sent like a thingy out to everyone at work on Zoom meetings saying ‘Right everybody, let’s get yourselves into the spirit.  You know, do still get dressed for work even though you’re at home.’  And I just keep coming on on the Zoom videos like, ‘I’m still in pyjamas guys.  Yay!’ [all laugh]  So – so yes, I know – I – I am lying.  I have been in pyjamas most of the time but I have changed into joggers at one point and the last two days I’ve worn denims.  So making sure they still fit.  That’s good, they are stretchy ones but they still fit so it all counts, it’s fine.  Okay then.

Andrew: Yeah, and my – my relative excuse for doing – because I can’t do a half marathon in an hour – but I’ve managed to stay half-way fit through winter by training for a half marathon that was cancelled because of Storm Ciara back when that was a stressful thing in our lives.  So that was what, February?  And then rebooked to do the Colchester Half Marathon at the end of March which was kind of the first weekend that events got cancelled so I did go out and do a – about a small a circumference from my house as I could a couple of weekends ago.  And felt very, very good for it, if only because for the next two or three days I – I didn’t want to go out.  But yes, so well done Steve and anyone else who – who got that. 

Kathryn: I’m not a very good liar.  This is getting to me now.

Andrew: So – so moving on then.  Steve, I know at the risk of sounding kind of cliquey, I guess a lot of people listening to this will know you from one guise or another but it would be really good if you could just kind of start – start from the beginning and – and kind of do the overview for those of you – for those people listening who are unfortunate enough not to have come across you so far.  [inaudible 0:05:33] gives you that – gives you that intro.

Steve: Oh right, thanks Andrew.  Well a little bit about myself.  Well first and foremost I qualify for the guaranteed over-50 plans.

Kathryn: Yay!

Steve: I’m married to Anne with two daughters; Charlie who was supposed to take her A-levels and Sophie who was supposed to do her GCSEs this year.  So we’ve had that to contend with.  We live in Cheltenham.  Other than a couple of years in the wholesale fishing tackle and bait industry, I’ve – I’ve spent my career in financial services and – and sort of looking back, I’ve been lucky in many regards in that each time I’ve had a career move, I’ve actually moved a little closer to the customer from my sort of heady days as a reinsurer.  I initially trained as an underwriter although moved into marketing and account development when the claims started coming in.

Kathryn: I didn’t know that – I didn’t know that you were an underwriter originally.

Steve: Oh yes, oh yes.  And again looking at the CV, old Roy McLoughlin likes to take the mickey because there does appear to be several companies on there and looks as though I’ve actually moved around a lot.  But I’d actually argue the other way because through the organisations that I have worked for, Mercantile & General, BUPA Health Assurance and Ageas, I’ve actually been acquired whilst I’ve been working for those organisations by Swiss Re, the Friends Life and AIG Life respectively.  So, I could perhaps leave you guys to decide whether they were due to distressed sales or whether they actually were acquiring local – local knowledge and expertise [all laugh].

Andrew: We’re far too polite to comment, Steve [all laugh].  Although I can confirm, having worked at Swiss Re about 20 years after you, you definitely had made some underwriting decisions [all laugh].

Kathryn: Oh this isn’t fair.  I feel like there’s some inside jokes now that I’m not in on.

Andrew: Yeah, yeah, yeah, it’s the gang.

Kathryn: Yeah.  It isn’t fair.  I’m on the other side.  Don’t want to be on the other side.  No, so Steve obviously we’ve sort of like asked you to come on because there was something happened – obviously it was a couple of years ago now that is incredibly important for people to know about and to talk about and obviously you are the perfect person to talk about this.  So do you mind sharing some of your experiences with us please?

Steve: Yes sure.  Sure, delighted to.  Yes, the 22nd February 2018 is – is the date and basically the gods decreed that they’d give me the opportunity to undertake some really personal market research into our claims industry [all laugh].  Two days before my 54th birthday, I suffered a stroke.  It was absolutely a bolt out of the blue, no risk factors, no warning signs.  I’d just returned from skiing in France with our oldest daughter Charlie and a few hours earlier I’d had dinner with the family and just literally settled down to watch TV when suddenly bang, the whole room went into one sort of massive kaleidoscope.  It was, you know, absolutely worrying.  I was scared in many regards.  I actually started undertaking the FAST protocol myself, so the face, the arm weakness, speech and – and obviously I was worried about the time so – so I called my wife and before you know it, I was in the ambulance all the way across to hospital.

Kathryn: And so – so the – with – sort of like what, you know, when you say the FAST test.  So just for anybody who doesn’t know that.  So the FAST test is something that the Stroke Association obviously promote and it’s to – the main signs of the stroke.  So it’s the facial weakness, it’s the arm weakness, can you not raise both your arms above your head and keep them up there for some time and for your speech to get slurred so – so did you experience all of those different things?

Steve: I was – I was lucky in a regard because the only thing that I really experienced was actually the speech where, whilst I wasn’t slurring I was speaking very slowly and trying to communicate with – with my wife and then the sort of parameds and the ambulance.  So, I didn’t have any sort of arm weakness or – or facial dropping and that but it was just the speech.

Kathryn: Okay.  And you said that the room had become a kaleidoscope as well so your vision had changed.  So was it literally like a kaleidoscope or is it gone –

Steve: It was, it was literally like a kaleidoscope.  You could look at a certain aspect and things were almost zooming in and out of focus.  I mean I was actually watching TV.  It was the – it was the Winter Olympics and, you know, I could see it and then I couldn’t.  It was a really, really bizarre feeling.

Kathryn: Okay.

Andrew: And can you, as Kathryn turns into a tele-underwriter –

Kathryn: Sorry.

Andrew: Oh no, not at all.  It fascinates me how well you can recall it and the bits you can recall.  I guess as a, you know, again from an underwriting or a practical perspective, you – almost I presume you – you can recall all the events very clearly?  Or are there bits that you’ve – you’ve forgotten or – or that you – I don’t know.

Steve: Yeah.  I – I – I – it’s still pretty vivid in my mind and there are certainly aspects where you – you sort of lose maybe an hour of time so I can – I can remember going into the – initially the A&E and then the next thing I can remember is actually being up in the – in the stroke ward.  So there’s certain aspects but I can still remember talking to the parameds.  They were fantastic.  I mean the time element, I was so lucky in terms of a paramed turned up in less than five minutes.  They just happened to be almost round the corner.

Andrew: Wow.

Steve: So that was fantastic.  I remember them putting the cannula in etcetera whilst they called the ambulance.  I remember the – the – getting into the ambulance.  I suppose thinking about it, I don’t really remember the journey actually in the ambulance because whilst living in Cheltenham, Gloucester Royal Infirmary which is about eight miles away has a specialist stroke ward and that’s what they – they initially did the diagnosis.  They took me there to confirm that.  So I don’t remember that journey but yeah, it’s still pretty vivid I have to say.

Andrew: And then the – the days and weeks after that Steve?  How – what happened next?

Steve: Well I mean I spent a week in the hospital and so – a week in hospital and once I recovered from the initial seven days of the hospital food [all laugh] –  Which is –

Kathryn: That’s a feat in itself.

Steve: Almost a feat – absolutely.  You can – you can almost claim it’s only like that I believe.  I sort of – sort of got home and then, you know, I knew that I had a minimum of a month off work because living in Cheltenham, although I’m based in Windsor for Square Health, I couldn’t drive for a month.  That was an absolute prerequisite.  So I knew I was going to be having to be spending some time at home.  So I have to say, again, the – the early stroke team who visit you post-stroke etcetera, they were fantastic and let’s be very clear guys, I dodged a bullet.  I was very, very lucky indeed and it was – I was doing my exercises.  I was doing all the tests etcetera.  That was all going very, very well.  Using the Wii, the Wii was the great thing because they’ve got balance games.

Kathryn: Yes of course.

Steve: And I was – I was using that to practice and I must say, to start off with I was pretty rubbish, I have to say.  Regularly getting beaten by the kids and trying to do the ski jumping.  

Kathryn: Oh dear.

Steve: That was hilarious as well [all laugh].

Kathryn: I know exactly which one you mean, yeah [all laugh].

Steve: But – but using those types of things, you know, very quickly I was able to score – I remember this, 38 out of 39 in all the tests so I was – I was lucky enough to – to recover very, very quickly from – from that regard.  And that, you know, a lot of that goes down to the support I did receive.

Kathryn: I was going to say, your recovery has been phenomenal.  It’s like last year we did a virtual – an online virtual exercise thing didn’t we where it was from – was it Brighton to Brompton for a cystic fibrosis charity?  And – and you provided the most miles out of everybody on that.  It was just like – my sister, she did it as well and obviously she –she’s not aware of you in a sense.  You know she – she’s based in Italy so and everything and she was just like ‘Who is Steve?  He’s managed to get I think it was over 50-odd miles or something?’  I was like ‘Yeah.’  I was like – and she was like – she goes ‘I’ve only managed to do 10 on my bike.’  I was like ‘I’ll make you feel worse.’  I was like ‘He had a stroke last year,’ and she just went ‘Ah, ah thanks.’ [all laugh]  You know, it really is incredible.

Steve: That – that – that was good because that – that – that timing – that challenge and timing was fantastic because a friend of mine who’s a cancer survivor – him and I were training for the London Prudential 100-mile bike ride so that became part of our training so I’m not sure I would have done it normally but anyway.

Kathryn: Oh well I definitely couldn’t have done it so it’s absolute hats off to you.  I thought it was incredible.  And did you get – obviously – sorry, go on Andrew.

Andrew: Yeah, no – it’s really – it’s always struck me since we first spoke after it Steve, that how often you use the word ‘lucky’ about what happened or how it happened to you and – and I think that mentality is so revealing and – and differs so much and isn’t something that we ever take into account in underwriting, whether that’s for, you know, whether it’s predicting recovery or anything like that or for looking at income protection not just for stroke but other things.  It’s, you know, it’s – it’s – it’s a great mindset to have, right?  And I – I don’t know if you’d have known you’d have that before.  I guess I’d have always thought of you as a positive person but – but I think it must have been a big part of your recovery to just have that, you know, attitude throughout.

Steve: Thank you.  Yeah I think so.  I mean, you know, you go through all the emotions, you know.  ‘Could I have done something different?’  You know, ‘Did I bang my head skiing the previous weekend?’  And I hadn’t, I wear a helmet etcetera.  ‘Why me?’  Etcetera.  ‘What’s going to happen?’  But I think the overriding thing as much as anything was ‘Okay it’s happened.  I’d like to find out why it’s happened,’ etcetera but the reality of it is, is like ‘Right, okay, well I’m not going to let it beat me.’  And I’m lucky in the regard I’ve got very, very minimal permanent symptoms left.  I mean, most people wouldn’t know, the biggest one being is that when I get into the shower I always have to get in through the left hand side to test the temperature of the water because I can’t really feel that on the right hand side of my arm and my body etcetera. 

Kathryn: Okay.

Steve: And if that’s the worst thing I’ve got to do then again, I’m lucky.

Andrew: Yeah.

Kathryn: Yes.

Andrew: Yeah.

Kathryn: So it’s some of the – say it’s the positivity and you can see it.  I know other people can’t see you but I can see you on the video and you can just see the positivity and – and generally that – that gratitude that you kind of have that it wasn’t worse.  So obviously we’re in the insurance world and everything and do you have then – obviously you are within a company that offers like a lot of help and support to people.  Have you found that, in your experience after having had the stroke, did you find that you had lots of support there from – within our industry?  And – and – or did you not have anything?  What – what kind of – what was your experience of that?

Steve: Well there’s two things really around that Kathryn.  One is the – obviously the claiming experience which I’m sure we’ll talk about shortly but as I said, I wanted to understand why it happened and, you know, I’ve been a very big proponent of – of second medical opinions ever since I joined BUPA Health Assurance when I first came across it.  And I’m thinking, you know, ‘You’ve given me this diagnosis of – of a stroke etcetera.  I’ve got the hospital discharge, it’s all there etcetera, but it doesn’t actually tell me why – why it occurred.’  So I was very keen to understand why it occurred so I undertook a second medical opinion and actually I eventually went from a neurologist who was obviously looking very much at – at the brain and the stroke etcetera but I was actually put in touch with a cardiac arrhythmia specialist.

Kathryn: Yeah.

Steve: And it’s actually – that – it’s a slight heart arrhythmia that I have which is pre-atrial fibrillation and all that type of stuff but they think that’s the reason why the – the stroke occurred and as a consequence, my treatment protocol was changed.  And I – I now take a drug to help protect against that arrhythmia so – so absolutely – that second opinion was absolutely vital.

Kathryn: And that – it was the second opinion that led to that thing of you knowing more to do – it was to do with your heart rather than anything to do with your mind?

Steve: Absolutely.  Yes.

Kathryn: That’s incredible to know that, that you’ve got that medication to prevent that as well.  So what’s – what was the claims experience then for you like with it all? [all laugh]  I don’t know if that’s a good laugh or a bad laugh [all laugh].

Andrew: I’m looking forward to the transcript of that laugh [all laugh].

Steve: Oh well, I mean, you know, I – as part of my own sort of rehabilitation, I dusted off the old policy documents and we had a couple of critical illness policies on – on my life and we – we put the claims in.  And these were old policies.  One was in 1993 when it was first taken out and I – I’ve got to thank a guy in particular called Andy Fox who – who came back from a client company when we were reinsurers and said ‘You guys have got to take out this policy,’ and we all did, which was – which was – which was great.  And the second one was in 2001.  So, you know, they were old policies.  Andrew, you can explain about the sort of selection period and all that good stuff.  But I mean those policies had been in force a long time and I – I put two – two claims in with those companies.

Kathryn: And hopefully everything went smoothly?

Steve: Chalk and cheese.  

Kathryn: Okay.

Steve: Chalk and cheese [all laugh].  So one thing I hadn’t realised that, you know, perhaps I – I shouldn’t have realised, is that I didn’t appreciate that everybody is basically given a discharge summary when you – when you leave hospital –

Kathryn: Yeah.

Steve: Outlining everything that has occurred etcetera and what, you know, what’s going to appear on your medical records.  And so I – I basically made contact with provider one, gave them a call, absolutely greeted with empathy and support but then the individual explained that the claims documents they issue would be sent via post but it would take five to 10 working days for this to occur because the customer service team had a backlog.

Kathryn: Ah, wonderful.

Steve: Oh absolutely, but when these forms did arrive, it was in my view an onerous pile of documents.

Kathryn: Yeah.

Steve: A poorly formatted Word claims form, a proforma that I had to take to my GP for completion, consent to undergo a medical exam if required, a request for a paper bank statement.  I mean, that was just a few of the things that came along.

Kathryn: That doesn’t even seem to make – I can’t even understand why that would even be relevant.

Steve: Absolutely.

Kathryn: Yeah.

Steve: Absolutely.  And, you know, it was just sort of like, when you’re the claimant you should be focusing on the rehabilitation.

Kathryn: Yeah.

Steve: You know, the process of preparing all this information is – is no small undertaking really.  And I returned the paperwork on the same day, opting to actually put a copy of the discharge summary in with the GP report as I felt it contained the relevant information.  And I have to say, I’ve got a bit of inside track here, my wife is a claims assessor.

Kathryn: Ah.

Steve: So, it does help.

Kathryn: Yeah.

Steve: And I sent that all back but then obviously no acknowledgement or update and it was me contacting them over three weeks later to see how the claim was progressing that I was told that the claim had been approved the day before but that it would take a further two or three weeks for the payment to be processed.  

Kathryn: Yeah.

Steve: And I finally received a letter about 18 days later to state the money had been transferred to my bank account which – don’t get me wrong, I don’t wish to appear ungrateful.  The claim was paid in a relatively short period of time, although the process was somewhat cumbersome, but you know, I, you know, perhaps I would have accepted that if I just had the one policy but my experience of the second was remarkably different.

Kathryn: But I’m assuming better.

Steve: Absolutely.  Absolutely.  You know, it was so radically different I could – I could hardly believe that it was the same process.  I mean again, I got notification of the claim.  They collated all the information via a tele-interview meaning that it could really tailor the questions to the actual circumstances of the claim and have all this information documented on file at the time of the notification.  As a result I think that, you know, the claims process for them actually started on day one when I actually called them up.  They actively encourage to send any medical reports they have, saving time, blah blah blah.  So I was able to take a photo of the document – of the discharge summary on my phone, email it to them and then two days later I get a request saying when I want the money paid.

Kathryn: I mean, that’s brilliant and a big thing from that as well comes from the fact that, you know, where you’ve said, you know, you’ve been left with relatively minor lasting symptoms and obviously have your wife there as well who can help but what about someone who’s had a stroke, who’s been left with very marked symptoms who probably even more so is very, very much needing that money as quickly as possible so that they can adapt and they maybe are on their own and they maybe don’t have anybody there to help them and they’re faced with these documents that they may not physically be able to complete.  They may not physically be able to speak over the telephone and – and obviously as you say, in some ways – I appreciate what you’re saying there – sometimes about you’re saying how you feel quite lucky.  

In a sense you were quite lucky, especially in that claims regard that you could do all of that and follow that step but not everybody would be in the same position as yourself where they would be able to – to actually physically go and possibly emotionally go through all that on top of going through the rehabilitation and everything which could be quite extensive for some people.

Steve: Well absolutely.  I mean when you – when you look at the – the guys in the stroke ward, I mean there was eight beds.  They were – they were constantly full.  I mean, when I was discharged, I was told I could be discharged and basically in the nicest possible way I was turfed out the bed to wait in the dayroom because the bed was required for somebody else.  But – but some of the poor souls in the – in that ward, I mean they had some very severe symptoms and rehabilitation would take a long, long time for them.

Andrew: It’s amazing how, when you have an experience or you or someone in your family does, you suddenly become aware of some of those bits in the process, the discharge letter or whatever that you frankly as a – as a reinsurer or insurer you – you don’t always know exists right?  Which I guess, not that we need to be generous to the first company, but it feels like they haven’t taken the time to understand what those different bits of evidence over and above the obvious things like tele-interviewing rather than sending a form, but where there are those bits.  I think – I think that’s something that where there is big difference between insurers and the medical officers or where they’re look – you know, other than waiting for something bad to have someone in – you know, to happen to someone in their team and then learning from that to be more proactive about it by working with charities, by working with others.  I know Macmillan Cancer have done quite a lot of stuff with Aviva and others, I think Lloyds Banking Group in terms of getting their nurses involved in the claims piece.

Steve: Yeah.

Andrew: But – but that is one condition and – and there are undoubtedly for less frequent conditions than stroke and cancer, I’m sure there are bits in that process which could just, yeah, take weeks and months off claims journeys, which as we all are –  So again well we’re recording this four weeks into Covid, you know, at a time where lots of people are now without income and that kind of thing and I think just, you know, it really does make you realise that – that so many people don’t have three months’ or six months’ savings and – and in your situation Steve there where you can’t drive.  You know, in the best case scenario or in a pretty good case scenario where you suddenly can’t drive for a month recovering, you can see why, you know, every day, every week matters in that process as well as the common courtesies of keeping you informed with stuff which is – yeah, just basic.

Steve: Yeah.

Andrew: Basic.

Steve: Very much so that is.

Andrew: Yeah.  Remembering there’s a human there. 

Kathryn: And have you Steve – since, have you – have you needed to or tried to go for any insurances again or are you quite – have you been okay with everything?

Steve: That’s a really good question.  Obviously Square Health were covered by a group arrangement which is fantastic.  We still have the – the – some of the life covers in force so they will be maintained and despite what I said, I haven’t purchased a guaranteed over-50s product yet [all laugh].

Kathryn: Ooh ‘yet’ [all laugh].

Steve: So I – I haven’t actually myself gone to take insurance but I have helped one or two people and pointed them in the directions of people like yourselves in terms of – we’ve had friends who’ve had conditions.  The guy I cycle with who’s a cancer survivor etcetera, so not myself, no.

Kathryn: Well what I think we’ll probably do now is just have a little chat about some case studies, just to give some advice and some examples which is what we often do to sort of say like ‘This is what could potentially be available,’ and then chat – give you a chance to chat a bit more about Square Health and what it is that you’re doing especially now in the whole pandemic and that we’re facing.  So just a couple of case studies to go through then.  So the first one I’ve got is a male who’s in his late 20s and he’d had a minor stroke about a year and a half prior to chatting to us.  He’d had a bleed on the brain during a half marathon and they found no underlying cause.  Obviously if he’d maybe had a second medical opinion Steve, they may have found another cause but from what everything was tested so far, there was no underlying cause.  He’d had 10 days in hospital and had to have a further week off work.  He’d been on medication for a year and had to have annual reviews.  

So what he had is, we managed to get him the life insurance and it was at what they call plus 250 percent on the premium so for anybody who’s listening, that means you take the base premium and you times it by three point five.  Now, I know when we’ve said this before, I’ve not given examples of what the actual premium becomes and I think some can maybe wonder what that could be.  So for this person, we were getting him decreasing life insurance of £137,000 over 35 years and with the premium loading included, that came to £15 per month.  So I think the premium is actually probably less than what people generally think if you’re saying “Well actually we’re going to increase it by this 100 percent.”  The next example I have was a male who is in his –

Andrew: Sorry Kathryn, just on that first one.  So I guess to me, I mean first and foremost as a human the response to that premium is still ‘Wow,’ right?  And I appreciate that’s not the technical underwriting answer.

Kathryn: I hope that’s a good wow, is that a good wow?

Andrew: Yeah, no, no, it’s a good wow.  I – I think honestly and I think – I think then sort of merging back into an underwriting world, it’s interesting because underwriters will normally – just the last thing they see will be that rating rather than the premium.

Kathryn: Yeah.

Andrew: And are quite blind to that.  But I think it really does emphasise that, you know, almost even in – even in advice or manuals, if we – if we see plus 250 we think it’s probably quite unlikely that someone would take up that offer because it would be so much more expensive and – and kind of the stats prove that but especially at younger ages obviously life insurance is normally cheaper and if you say, you know, if in reality there you’re saying ‘You’re paying a tenner extra a month,’ then I think, you know, that feels very – a very compelling offer frankly to someone who’s had that scare.  On – in terms of what’s gone into that underwriting decision and I think we touched on it in some of Steve’s stuff, this – this ‘What’s the cause?’ is obviously, you know, when you’re looking at the underwriting factors, the time since stroke is important.  Obviously the number of strokes but there are so many different reasons that strokes happen and so many different types of stroke that all of those factors do go into that – that rating.  

But clearly you have, you know, ultimately you have good cases and bad cases and – and where you have a good case and no other risk factors etcetera then we are able to do some – some instinctively impressive things I think around strokes.

Kathryn: Yeah.  I think as well that, you know, there’s – don’t – I think it’s not necessarily the – the standard approach but don’t necessarily rule out critical illness cover as well, you know, there are options sometimes with critical illness cover so it is always worthwhile just having a look at each case individually and not – never make an assumption when you’re looking at things.  The next person that we’ll spring to again was a male and this time was in his mid-20s.  He’d been a bit younger and he’d fractured and dislocated his spine two years prior to speaking to us and he’d done that abroad and had suffered a full stroke during the operation.  I believe he’d had to have a metal plate fitted possibly in his brain as well during this had all gone on and he’d actually been left with partial vision loss – vision – sorry, vision loss so he could see straight and left but he couldn’t see right at all because part of his brain had died where the visual fields and connections are all based.  

So we got a plus 300 percent on that premium.  So again, that means that the premium – base premium was timesed by four.  So for this gentleman, again we were looking at the level life insurance of £150,000 over 35 years and the premium was £27 per month.  Now again, I hope that’s maybe another wow factor but it comes down to – again, that you’re looking at that one, you’re thinking ‘Right okay, this person has had a full stroke.  They’re actually left with quite marked, you know, symptoms.  You know, there’s sort of like quite a lot of loss of vision,’ and if you hear that thing of part of the brain has died, I think a lot of people would think ‘Ooh, not so, you know, not so sure about what’s going to happen with this one,’ but – but relatively again, £27 per month, it’s not – it’s not sort of unfeasible the premium.  It seems like quite – I think quite a nice premium but I think another thing to point out as well is that there isn’t always percentage increases.  

So say like if somebody’s had a stroke because they’ve had a traumatic brain injury, depending upon the circumstances of it obviously and the time since and also if the stroke has been caused by the mini pill then that can sometimes be that there isn’t a percentage loading put on and that sometimes standard terms can be arranged.  So – so there’s lots and lots of different intricacies and things to look at with these things and as I say, I think it’s always best to not take things at sort of like face value when you’re given that information from a client.

Andrew: Yeah and I think genuinely obviously we really wanted to get Steve on to get the personal side of it and to hear for us both selfishly [all laugh] – for us both to get that – those extra insights.  But, I mean, yeah, to go through every different – every different angle on this probably is a separate episode on its own at some point in the future.  But as you say, in simple terms you do kind of have the – the harsher ratings are going to be where it appears that a stroke’s been triggered by lifestyle factors or comorbidities or other things which were there before and are still there after.  And I think, you know, that – that seems or that is both fair and common sense really whereas if there’s a trauma or – or, as you say, something that’s been prompted by – whether it’s an operation or medication, then clearly if you take that away then – then the prognosis is much better.  

So yeah, it’s definitely a condition – I think – I think in fairness that – that the medical tool that sticks in my mind is actually on – on heart attacks and myocardial infarctions where, you know, you have the cardiologist saying, ‘Really you should be thinking of this in the same way as you think of cancer, there are 30 different types and – and that’s how you need to underwrite,’ and it’s exactly the same for stroke.  You know, we need to talk about stroke because that’s what people hear but we need to actually underwrite and – and take risk decisions based on that much more detailed level while then still kind of repeating it back to the customer in a language they understand.

Kathryn: Absolutely.  So Steve, do you want to tell us about Square Health then?  What it is that you do there, what it is that Square Health does and what’s happening now with the current – in this pandemic?  I know you’ve been making some – some huge steps recently to continue to support people.

Steve: Yes sure.  I mean, yeah, I joined Square Health in August ’16 as the marketing director and we’re really a health technology provider that operates in several markets.  Within the protection sector, we’re probably best known for provision of doctor and nurse screenings for the underwriting process but as you can imagine at this moment in time, that’s – that has basically gone down to zero but we’ve got – we’ve come up with solutions which I’ll talk about in a minute.  But also what we do is we provide a range of medical services such as remote GP consultations, digital physiotherapy and mental health support, second medical opinions, health MOTs etcetera and we provide that to the customer by the provision of app technology whether it’s IoS or Android.  So a bit like you – you take out a policy with a certain company, maybe LV or The Exeter etcetera.  You’ll have access to a range of services that they effectively ask us to provide so you download the app, you authenticate and then you have access.  It really is as simple as booking a consultation as it is maybe putting in a meeting in your – your Outlook calendar, something like that.  We’re not a financial services company, we’re a medical company so we’re not regulated and we don’t have the fun with the SCA but we are actually regulated by something known as the Care Quality Commission, CQC, and this is an independent body that looks at the primary care, i.e. the GP services, so we have to be effectively authorised by them – and audited as well so they do audit us on a regular basis.  In fact, if you go on the CQC website which I think is cqc.org.uk you can put in your own GP practice and you can see what their latest audit reports are, which sometimes is quite interesting I have to say.

Kathryn: Okay.  I’ll have a look after this.

Steve: So yeah – so we’re – so we, yes, so we’re audited there and we’re very pleased because our last audit report was very, very positive indeed but the thing that we’re really proud about which is testament really to the guys back at the ranch, Joe Saunders and the team, is that we were noted as outstanding with regard to patient safety so we’re very, very good at that.  But going back to the screenings, yes, obviously with the Covid government directions and restrictions etcetera, medical screenings, whether it’s by a nurse or a doctor in – in your own home or at work are basically finished.  So we’ve come up with a solution which, let’s be honest, it’s not a direct replacement for a physical screening but I think it goes some way and helps people.  Maybe part of the 15 percent that you – you’ve outlined last – 

Kathryn: Yeah.

Steve: Podcast Kathryn, whereby we will send them a – a test kit, a self-administered blood test kit which they will receive.  We then ask them to contact us to make a video screening consultation whereby one of our nurse or doctors will actually go through asking specific questions relating to them or maybe their condition.  At the same time, we ask them to take the blood themselves which is a pinprick and a good squeeze shall we say, into the pod and then that pod is actually sent in a self-addressed – stamped addressed envelope sorry, to the lab for the various blood tests.  We then marry the two up and then provide that as a – as a screening report to the relevant provider.  So we – we’re trialling and piloting this at the moment in other parts of our business, non-life insurance related.  The virtual screenings that are going very well and we’re just now in the forefront of doing that in the – in the life and health sector.

Andrew: And just – it’s probably worth just talking about the kind of people who apply for life insurance who we ask for those tests on Steve.  So I guess – I guess in short it’s either people who are applying for very large sum assureds?  In non-Covid times or in non-corona virus times, it would be either people applying for large sums assured whether that’s life, critical illness or income protection or where there’s a specific medical condition where either they don’t know their latest results or – or they don’t have their latest results.  So let’s say for diabetes or for high blood pressure, I think in the UK unlike in other countries, we – we tend to go to the GP first because in theory the medical records through the NHS are very, very good.  In other countries there’d be far more kind of reliance on blood tests and screenings and things like that.  

But for a, you know, as we – as we’ve discussed and we kind of can throw numbers around and percentages, but it’s always worth remembering that every – well, in the UK every 10 percent of the insurance population is 150,000 people a year so the numbers add up very quickly.  But in the UK, yeah, there – there’s still those people who insurers don’t – can’t offer cover to or don’t offer cover to without some of this.  So I think that’s why it’s so good that Square Health are doing it and impressive that insurers seem to be taking it up now and – and trying to – to work with, as you say, what’s, you know, not a perfect solution but – but gets you most of the information that you’d have otherwise.

Steve: That’s absolutely right, Andrew.  I mean, we’re working with four partners at the moment on – on a pilot basis.  Yeah, don’t get me wrong, we have some slight reservations.  You know, the blood going via the postal system.

Andrew: Yeah.

Steve: Will that – will that take longer than normal and therefore haemolyse and not be any good?  We just don’t know yet but, you know, as I said, let’s get there fast, let’s try it, let’s pilot it.  If we need to change things slightly then we can do so.  But I mean for anybody who requires that insurance coverage, whether it’s to cover a mortgage or what have you, let’s – let’s see how quickly you can get these through the process.

Kathryn: I think, just to say as well, that the doctor services – I know from personal experience that they’re brilliant.  A couple of years ago we were in Malta and my – my eldest who was six at that time wasn’t – there was nothing sort of like majorly going on but something just wasn’t right and what was perfect is that, you know, we – we sort of like logged on to the system and then it was the next morning at 10 o’clock, you know, we were there in the sunshine in our bikinis doing a video conversation with a GP in the UK, absolutely brilliant and, you know, what was fantastic with that as well was, you know, they could then – he could look at the GP, chat away to them, we could show the areas where we had a bit of concern and it was just fantastic to be able to have that rather than thinking – especially with being abroad – sort of like thinking ‘Oh if I go to a local pharmacy, are they going to understand me?  Am I going to be able to translate properly what I need to get across to them?’  

And it just – it really provided some comfort to be able to speak to somebody in your own language that you knew that they were really there and you could just chat exactly like you needed to.  It was brilliant.

Steve: Yeah, and I mean a lot of our consultations are in many regards reassurance.  Unfortunately, you know, the – the, you know, in the UK at the moment it’s – you know, pre-Covid days I should say, an average of 13 days to see your own GP.

Kathryn: That’s – that’s quick.

Steve: And whereby –

Kathryn: That’s quick for me [all laugh].

Steve: Whereas, you know, you know, you had 10 o’clock the following morning.

Kathryn: Yeah.

Steve: And it is, you know, it is fantastic.  Some of the providers we’ve worked with have now actually gone 24/7 so – so that’s – that’s great news as well and just looking at the MI for the month of March comparing it to February that we provide our clients, I mean as you would expect, we have seen a massive spike in the number of remote GP consultations that we’ve undertaken.  Circa about 20 percent of them were Covid-related so we had to follow the government guidelines and protocols about 111 and what have you, which we did, but 80 percent weren’t.  So there were non-Covid-related issues that people had concerns about that perhaps they weren’t able to get to see or talk to their GP for some time that we were able to help with and perhaps just, you know, release the pressure a wee bit on the – on the system.

Kathryn: Which is fantastic and absolutely brilliant, especially at the current time.  So – so we’re coming towards the end of the podcast now.  So we’re going to have our first guest’s truth or lie feature which is going to be brilliant.  So I will start it off.  So everybody if – if you’re not familiar with this, one of us is telling a lie and you have to figure out who and we’ve established that I’m a terrible liar so that’s just a bit of a hint there.  So mine is that during the lockdown, I have taken up playing the flute.

Andrew: And mine is during the lockdown, I have taken up unicycling.  

Steve: And mine is, I have nutmegged Kevin Keegan whilst playing football against him.

Kathryn: Mmm –

Andrew: Very good.

Kathryn: We’ll leave you all there to fester with that for a couple of weeks then.  So thank you very much for coming on Steve, it’s been an absolute pleasure having you and to everybody listening, we really hope that you’ve found this useful and if you do have any questions at all or want to discuss anything, please do send us a message.

Andrew: Yeah, thank you.

Steve: Thanks guys.

Andrew: Yeah, thanks everyone.  Well we’ll be back in a couple of weeks but – and I think we’ve got another guest then.

Kathryn: We do.

Andrew: We’re – we’re on a good run [all laugh] with a similar real-life experience that – that kind of brings – again, hopefully brings this true to life so we’d really appreciate any feedback you’ve got and – yeah, look forward to speaking to you all soon.  Take care.  

Kathryn: I agree.  Thank you Steve.

Andrew: Bye.

Steve: Bye.

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Episode 7 | Stroke

Hi Everyone!

Today we are so pleased to have Steve Casey joining us on the podcast.

Steve has worked within financial services for many years, but that is not the focus of this episode. In 2018 Steve had a stroke, completely out of the blue, in his words it came with a bang.

This episode is focused upon hearing Steve's story, how it felt to have a stroke, what happened and how his recovery has been. We then venture a little bit into his experience of making a claim on his critical illness insurances afterwards and what he is up to now.

He is an incredible guy and we hope that you enjoy listening to him.

Our 3 key takeaways:

  1. The FAST stroke test.
  2. You do not always experience facial weakness and loss of arm strength, when having a stroke.
  3. Two case study clients that had experienced strokes, that were able to access protection insurance.

As with all of our episodes, we love your feedback! Please let us know what you think and if you have any suggestions for future episodes pop up a message.

Next time we have another mystery guest, focusing upon the importance of income protection.

Kathryn: Hi everyone, this is episode seven and today we have our second guest on the podcast.  It’s Steve Casey from Square Health.  Hi Steve!

Andrew: Hi Steve. 

Steve: Hi everybody.

Andrew: So how are we all doing in these strange, unprecedented – etcetera?  

Steve: Yeah, we’re doing – we’re doing very well thanks very much indeed.  I mean, all four of us are at home.  Two girls, Anne my wife and myself.  Yes, I must say that I’m beginning to get fed up with looking at the same four walls if I’m brutally honest but I’m sure that you guys are experiencing those same sorts of thoughts.

Kathryn: Yep, yep, definitely.  I had to have a little bit of an escape yesterday and I say as somebody with prior agoraphobia, the lockdown is kind of heaven which, you know, could sound bizarre to a lot of people but for me it’s quite like ‘Ooh I like this.’  But my eight-year-old has been having issues with his ear for a few months now and I rang the doctors, we’ve had – we’d done a few things over the phone and everything, antibiotics – and they were like ‘Well we really need to see him,’ and I was like ‘Well I don’t really want to waste your – you know, this precious sort of like safety, you know, this PPE stuff and everything.’  They were like ‘It’s not a waste, come down.’  We went and they’ve set up a gazebo in the local bus station next to the surgery so we drove into this gazebo and pulled up and my son was okay and then they came out obviously fully geared up and you could barely see them and it was kind of like, you know, that kind of imagery you get from like a TV show or something where there’s somebody coming out in all this equipment.  

And he just looked at me and he just told me he was scared and my heart just absolutely went.  So I was like stroking his back and everything and I’m just like ‘It’s okay, it’s okay.’  And then I did the thing of actually popping into Tesco and it’s the first time I’ve actually – bar going on a bike ride, it’s the first time I’ve been away from the house in a month and I went in and got milk and cheese and croissants and I was so proud of myself.  And then I got to the till and discovered that I didn’t have my purse because I’ve not been outside the house for a month.  And I knew exactly where it was at home and I was just doing that thing of like ‘I’m so sorry.’  They were like ‘It’s alright love, happens to the best of us.  Just go home, just come back.’  I was like ‘Oh-ho.’  So then I got back, had to re-queue but they were lovely.  But Andrew, have you had any fun moments?

Andrew: Nothing as dramatic as that, no.  Yeah, but I’m probably closer to Steve and staring at the four walls.  I – I – I have done the – yeah, the – suddenly it feels like a big heroic activity going for a shop, which to say is always in life – when you have lots of things and they’re very busy then funnily enough that’s not worth talking about is it?  I’m sure we’ll look back on this in two years and go ‘How – what on earth was happening?’  But – but yeah, the reality is my trip to Tesco’s now take on a – an unusually exciting time.  But – but no, we’re all okay.  We’re all healthy.  So yeah, we’re – we’re doing fine thank you.

Kathryn: I kind of feel like it’s a Black Mirror episode.  I’ve been saying that since the beginning.  It just feels like really, really strange.  But anyway.  So everybody who listened last time will know that we had a truth or lie feature back and last week I said that I have been in pyjamas since the start of lockdown and Andrew said that he had run a half marathon since lockdown.  So we want to know – who do you believe, Steve?  Who do you think?

Steve: I – I listened again actually to the – to the podcast last time and I would say – I would have to say I think Andrew is true and Kathryn, yours is a lie.  Just really because I – I just cannot see you in pyjamas all – all during the day, setting a bad example for your boys.

Kathryn: That makes me –

Andrew: Not – not because you think I’m incredibly fit.

Kathryn: And that makes me feel –

Andrew: I’m going to keep that up. 

Kathryn: Terribly bad for spending about 90 percent of my time in pyjamas since lockdown [all laugh].  Yeah, I – I’ve literally – Alan sent like a thingy out to everyone at work on Zoom meetings saying ‘Right everybody, let’s get yourselves into the spirit.  You know, do still get dressed for work even though you’re at home.’  And I just keep coming on on the Zoom videos like, ‘I’m still in pyjamas guys.  Yay!’ [all laugh]  So – so yes, I know – I – I am lying.  I have been in pyjamas most of the time but I have changed into joggers at one point and the last two days I’ve worn denims.  So making sure they still fit.  That’s good, they are stretchy ones but they still fit so it all counts, it’s fine.  Okay then.

Andrew: Yeah, and my – my relative excuse for doing – because I can’t do a half marathon in an hour – but I’ve managed to stay half-way fit through winter by training for a half marathon that was cancelled because of Storm Ciara back when that was a stressful thing in our lives.  So that was what, February?  And then rebooked to do the Colchester Half Marathon at the end of March which was kind of the first weekend that events got cancelled so I did go out and do a – about a small a circumference from my house as I could a couple of weekends ago.  And felt very, very good for it, if only because for the next two or three days I – I didn’t want to go out.  But yes, so well done Steve and anyone else who – who got that. 

Kathryn: I’m not a very good liar.  This is getting to me now.

Andrew: So – so moving on then.  Steve, I know at the risk of sounding kind of cliquey, I guess a lot of people listening to this will know you from one guise or another but it would be really good if you could just kind of start – start from the beginning and – and kind of do the overview for those of you – for those people listening who are unfortunate enough not to have come across you so far.  [inaudible 0:05:33] gives you that – gives you that intro.

Steve: Oh right, thanks Andrew.  Well a little bit about myself.  Well first and foremost I qualify for the guaranteed over-50 plans.

Kathryn: Yay!

Steve: I’m married to Anne with two daughters; Charlie who was supposed to take her A-levels and Sophie who was supposed to do her GCSEs this year.  So we’ve had that to contend with.  We live in Cheltenham.  Other than a couple of years in the wholesale fishing tackle and bait industry, I’ve – I’ve spent my career in financial services and – and sort of looking back, I’ve been lucky in many regards in that each time I’ve had a career move, I’ve actually moved a little closer to the customer from my sort of heady days as a reinsurer.  I initially trained as an underwriter although moved into marketing and account development when the claims started coming in.

Kathryn: I didn’t know that – I didn’t know that you were an underwriter originally.

Steve: Oh yes, oh yes.  And again looking at the CV, old Roy McLoughlin likes to take the mickey because there does appear to be several companies on there and looks as though I’ve actually moved around a lot.  But I’d actually argue the other way because through the organisations that I have worked for, Mercantile & General, BUPA Health Assurance and Ageas, I’ve actually been acquired whilst I’ve been working for those organisations by Swiss Re, the Friends Life and AIG Life respectively.  So, I could perhaps leave you guys to decide whether they were due to distressed sales or whether they actually were acquiring local – local knowledge and expertise [all laugh].

Andrew: We’re far too polite to comment, Steve [all laugh].  Although I can confirm, having worked at Swiss Re about 20 years after you, you definitely had made some underwriting decisions [all laugh].

Kathryn: Oh this isn’t fair.  I feel like there’s some inside jokes now that I’m not in on.

Andrew: Yeah, yeah, yeah, it’s the gang.

Kathryn: Yeah.  It isn’t fair.  I’m on the other side.  Don’t want to be on the other side.  No, so Steve obviously we’ve sort of like asked you to come on because there was something happened – obviously it was a couple of years ago now that is incredibly important for people to know about and to talk about and obviously you are the perfect person to talk about this.  So do you mind sharing some of your experiences with us please?

Steve: Yes sure.  Sure, delighted to.  Yes, the 22nd February 2018 is – is the date and basically the gods decreed that they’d give me the opportunity to undertake some really personal market research into our claims industry [all laugh].  Two days before my 54th birthday, I suffered a stroke.  It was absolutely a bolt out of the blue, no risk factors, no warning signs.  I’d just returned from skiing in France with our oldest daughter Charlie and a few hours earlier I’d had dinner with the family and just literally settled down to watch TV when suddenly bang, the whole room went into one sort of massive kaleidoscope.  It was, you know, absolutely worrying.  I was scared in many regards.  I actually started undertaking the FAST protocol myself, so the face, the arm weakness, speech and – and obviously I was worried about the time so – so I called my wife and before you know it, I was in the ambulance all the way across to hospital.

Kathryn: And so – so the – with – sort of like what, you know, when you say the FAST test.  So just for anybody who doesn’t know that.  So the FAST test is something that the Stroke Association obviously promote and it’s to – the main signs of the stroke.  So it’s the facial weakness, it’s the arm weakness, can you not raise both your arms above your head and keep them up there for some time and for your speech to get slurred so – so did you experience all of those different things?

Steve: I was – I was lucky in a regard because the only thing that I really experienced was actually the speech where, whilst I wasn’t slurring I was speaking very slowly and trying to communicate with – with my wife and then the sort of parameds and the ambulance.  So, I didn’t have any sort of arm weakness or – or facial dropping and that but it was just the speech.

Kathryn: Okay.  And you said that the room had become a kaleidoscope as well so your vision had changed.  So was it literally like a kaleidoscope or is it gone –

Steve: It was, it was literally like a kaleidoscope.  You could look at a certain aspect and things were almost zooming in and out of focus.  I mean I was actually watching TV.  It was the – it was the Winter Olympics and, you know, I could see it and then I couldn’t.  It was a really, really bizarre feeling.

Kathryn: Okay.

Andrew: And can you, as Kathryn turns into a tele-underwriter –

Kathryn: Sorry.

Andrew: Oh no, not at all.  It fascinates me how well you can recall it and the bits you can recall.  I guess as a, you know, again from an underwriting or a practical perspective, you – almost I presume you – you can recall all the events very clearly?  Or are there bits that you’ve – you’ve forgotten or – or that you – I don’t know.

Steve: Yeah.  I – I – I – it’s still pretty vivid in my mind and there are certainly aspects where you – you sort of lose maybe an hour of time so I can – I can remember going into the – initially the A&E and then the next thing I can remember is actually being up in the – in the stroke ward.  So there’s certain aspects but I can still remember talking to the parameds.  They were fantastic.  I mean the time element, I was so lucky in terms of a paramed turned up in less than five minutes.  They just happened to be almost round the corner.

Andrew: Wow.

Steve: So that was fantastic.  I remember them putting the cannula in etcetera whilst they called the ambulance.  I remember the – the – getting into the ambulance.  I suppose thinking about it, I don’t really remember the journey actually in the ambulance because whilst living in Cheltenham, Gloucester Royal Infirmary which is about eight miles away has a specialist stroke ward and that’s what they – they initially did the diagnosis.  They took me there to confirm that.  So I don’t remember that journey but yeah, it’s still pretty vivid I have to say.

Andrew: And then the – the days and weeks after that Steve?  How – what happened next?

Steve: Well I mean I spent a week in the hospital and so – a week in hospital and once I recovered from the initial seven days of the hospital food [all laugh] –  Which is –

Kathryn: That’s a feat in itself.

Steve: Almost a feat – absolutely.  You can – you can almost claim it’s only like that I believe.  I sort of – sort of got home and then, you know, I knew that I had a minimum of a month off work because living in Cheltenham, although I’m based in Windsor for Square Health, I couldn’t drive for a month.  That was an absolute prerequisite.  So I knew I was going to be having to be spending some time at home.  So I have to say, again, the – the early stroke team who visit you post-stroke etcetera, they were fantastic and let’s be very clear guys, I dodged a bullet.  I was very, very lucky indeed and it was – I was doing my exercises.  I was doing all the tests etcetera.  That was all going very, very well.  Using the Wii, the Wii was the great thing because they’ve got balance games.

Kathryn: Yes of course.

Steve: And I was – I was using that to practice and I must say, to start off with I was pretty rubbish, I have to say.  Regularly getting beaten by the kids and trying to do the ski jumping.  

Kathryn: Oh dear.

Steve: That was hilarious as well [all laugh].

Kathryn: I know exactly which one you mean, yeah [all laugh].

Steve: But – but using those types of things, you know, very quickly I was able to score – I remember this, 38 out of 39 in all the tests so I was – I was lucky enough to – to recover very, very quickly from – from that regard.  And that, you know, a lot of that goes down to the support I did receive.

Kathryn: I was going to say, your recovery has been phenomenal.  It’s like last year we did a virtual – an online virtual exercise thing didn’t we where it was from – was it Brighton to Brompton for a cystic fibrosis charity?  And – and you provided the most miles out of everybody on that.  It was just like – my sister, she did it as well and obviously she –she’s not aware of you in a sense.  You know she – she’s based in Italy so and everything and she was just like ‘Who is Steve?  He’s managed to get I think it was over 50-odd miles or something?’  I was like ‘Yeah.’  I was like – and she was like – she goes ‘I’ve only managed to do 10 on my bike.’  I was like ‘I’ll make you feel worse.’  I was like ‘He had a stroke last year,’ and she just went ‘Ah, ah thanks.’ [all laugh]  You know, it really is incredible.

Steve: That – that – that was good because that – that – that timing – that challenge and timing was fantastic because a friend of mine who’s a cancer survivor – him and I were training for the London Prudential 100-mile bike ride so that became part of our training so I’m not sure I would have done it normally but anyway.

Kathryn: Oh well I definitely couldn’t have done it so it’s absolute hats off to you.  I thought it was incredible.  And did you get – obviously – sorry, go on Andrew.

Andrew: Yeah, no – it’s really – it’s always struck me since we first spoke after it Steve, that how often you use the word ‘lucky’ about what happened or how it happened to you and – and I think that mentality is so revealing and – and differs so much and isn’t something that we ever take into account in underwriting, whether that’s for, you know, whether it’s predicting recovery or anything like that or for looking at income protection not just for stroke but other things.  It’s, you know, it’s – it’s – it’s a great mindset to have, right?  And I – I don’t know if you’d have known you’d have that before.  I guess I’d have always thought of you as a positive person but – but I think it must have been a big part of your recovery to just have that, you know, attitude throughout.

Steve: Thank you.  Yeah I think so.  I mean, you know, you go through all the emotions, you know.  ‘Could I have done something different?’  You know, ‘Did I bang my head skiing the previous weekend?’  And I hadn’t, I wear a helmet etcetera.  ‘Why me?’  Etcetera.  ‘What’s going to happen?’  But I think the overriding thing as much as anything was ‘Okay it’s happened.  I’d like to find out why it’s happened,’ etcetera but the reality of it is, is like ‘Right, okay, well I’m not going to let it beat me.’  And I’m lucky in the regard I’ve got very, very minimal permanent symptoms left.  I mean, most people wouldn’t know, the biggest one being is that when I get into the shower I always have to get in through the left hand side to test the temperature of the water because I can’t really feel that on the right hand side of my arm and my body etcetera. 

Kathryn: Okay.

Steve: And if that’s the worst thing I’ve got to do then again, I’m lucky.

Andrew: Yeah.

Kathryn: Yes.

Andrew: Yeah.

Kathryn: So it’s some of the – say it’s the positivity and you can see it.  I know other people can’t see you but I can see you on the video and you can just see the positivity and – and generally that – that gratitude that you kind of have that it wasn’t worse.  So obviously we’re in the insurance world and everything and do you have then – obviously you are within a company that offers like a lot of help and support to people.  Have you found that, in your experience after having had the stroke, did you find that you had lots of support there from – within our industry?  And – and – or did you not have anything?  What – what kind of – what was your experience of that?

Steve: Well there’s two things really around that Kathryn.  One is the – obviously the claiming experience which I’m sure we’ll talk about shortly but as I said, I wanted to understand why it happened and, you know, I’ve been a very big proponent of – of second medical opinions ever since I joined BUPA Health Assurance when I first came across it.  And I’m thinking, you know, ‘You’ve given me this diagnosis of – of a stroke etcetera.  I’ve got the hospital discharge, it’s all there etcetera, but it doesn’t actually tell me why – why it occurred.’  So I was very keen to understand why it occurred so I undertook a second medical opinion and actually I eventually went from a neurologist who was obviously looking very much at – at the brain and the stroke etcetera but I was actually put in touch with a cardiac arrhythmia specialist.

Kathryn: Yeah.

Steve: And it’s actually – that – it’s a slight heart arrhythmia that I have which is pre-atrial fibrillation and all that type of stuff but they think that’s the reason why the – the stroke occurred and as a consequence, my treatment protocol was changed.  And I – I now take a drug to help protect against that arrhythmia so – so absolutely – that second opinion was absolutely vital.

Kathryn: And that – it was the second opinion that led to that thing of you knowing more to do – it was to do with your heart rather than anything to do with your mind?

Steve: Absolutely.  Yes.

Kathryn: That’s incredible to know that, that you’ve got that medication to prevent that as well.  So what’s – what was the claims experience then for you like with it all? [all laugh]  I don’t know if that’s a good laugh or a bad laugh [all laugh].

Andrew: I’m looking forward to the transcript of that laugh [all laugh].

Steve: Oh well, I mean, you know, I – as part of my own sort of rehabilitation, I dusted off the old policy documents and we had a couple of critical illness policies on – on my life and we – we put the claims in.  And these were old policies.  One was in 1993 when it was first taken out and I – I’ve got to thank a guy in particular called Andy Fox who – who came back from a client company when we were reinsurers and said ‘You guys have got to take out this policy,’ and we all did, which was – which was – which was great.  And the second one was in 2001.  So, you know, they were old policies.  Andrew, you can explain about the sort of selection period and all that good stuff.  But I mean those policies had been in force a long time and I – I put two – two claims in with those companies.

Kathryn: And hopefully everything went smoothly?

Steve: Chalk and cheese.  

Kathryn: Okay.

Steve: Chalk and cheese [all laugh].  So one thing I hadn’t realised that, you know, perhaps I – I shouldn’t have realised, is that I didn’t appreciate that everybody is basically given a discharge summary when you – when you leave hospital –

Kathryn: Yeah.

Steve: Outlining everything that has occurred etcetera and what, you know, what’s going to appear on your medical records.  And so I – I basically made contact with provider one, gave them a call, absolutely greeted with empathy and support but then the individual explained that the claims documents they issue would be sent via post but it would take five to 10 working days for this to occur because the customer service team had a backlog.

Kathryn: Ah, wonderful.

Steve: Oh absolutely, but when these forms did arrive, it was in my view an onerous pile of documents.

Kathryn: Yeah.

Steve: A poorly formatted Word claims form, a proforma that I had to take to my GP for completion, consent to undergo a medical exam if required, a request for a paper bank statement.  I mean, that was just a few of the things that came along.

Kathryn: That doesn’t even seem to make – I can’t even understand why that would even be relevant.

Steve: Absolutely.

Kathryn: Yeah.

Steve: Absolutely.  And, you know, it was just sort of like, when you’re the claimant you should be focusing on the rehabilitation.

Kathryn: Yeah.

Steve: You know, the process of preparing all this information is – is no small undertaking really.  And I returned the paperwork on the same day, opting to actually put a copy of the discharge summary in with the GP report as I felt it contained the relevant information.  And I have to say, I’ve got a bit of inside track here, my wife is a claims assessor.

Kathryn: Ah.

Steve: So, it does help.

Kathryn: Yeah.

Steve: And I sent that all back but then obviously no acknowledgement or update and it was me contacting them over three weeks later to see how the claim was progressing that I was told that the claim had been approved the day before but that it would take a further two or three weeks for the payment to be processed.  

Kathryn: Yeah.

Steve: And I finally received a letter about 18 days later to state the money had been transferred to my bank account which – don’t get me wrong, I don’t wish to appear ungrateful.  The claim was paid in a relatively short period of time, although the process was somewhat cumbersome, but you know, I, you know, perhaps I would have accepted that if I just had the one policy but my experience of the second was remarkably different.

Kathryn: But I’m assuming better.

Steve: Absolutely.  Absolutely.  You know, it was so radically different I could – I could hardly believe that it was the same process.  I mean again, I got notification of the claim.  They collated all the information via a tele-interview meaning that it could really tailor the questions to the actual circumstances of the claim and have all this information documented on file at the time of the notification.  As a result I think that, you know, the claims process for them actually started on day one when I actually called them up.  They actively encourage to send any medical reports they have, saving time, blah blah blah.  So I was able to take a photo of the document – of the discharge summary on my phone, email it to them and then two days later I get a request saying when I want the money paid.

Kathryn: I mean, that’s brilliant and a big thing from that as well comes from the fact that, you know, where you’ve said, you know, you’ve been left with relatively minor lasting symptoms and obviously have your wife there as well who can help but what about someone who’s had a stroke, who’s been left with very marked symptoms who probably even more so is very, very much needing that money as quickly as possible so that they can adapt and they maybe are on their own and they maybe don’t have anybody there to help them and they’re faced with these documents that they may not physically be able to complete.  They may not physically be able to speak over the telephone and – and obviously as you say, in some ways – I appreciate what you’re saying there – sometimes about you’re saying how you feel quite lucky.  

In a sense you were quite lucky, especially in that claims regard that you could do all of that and follow that step but not everybody would be in the same position as yourself where they would be able to – to actually physically go and possibly emotionally go through all that on top of going through the rehabilitation and everything which could be quite extensive for some people.

Steve: Well absolutely.  I mean when you – when you look at the – the guys in the stroke ward, I mean there was eight beds.  They were – they were constantly full.  I mean, when I was discharged, I was told I could be discharged and basically in the nicest possible way I was turfed out the bed to wait in the dayroom because the bed was required for somebody else.  But – but some of the poor souls in the – in that ward, I mean they had some very severe symptoms and rehabilitation would take a long, long time for them.

Andrew: It’s amazing how, when you have an experience or you or someone in your family does, you suddenly become aware of some of those bits in the process, the discharge letter or whatever that you frankly as a – as a reinsurer or insurer you – you don’t always know exists right?  Which I guess, not that we need to be generous to the first company, but it feels like they haven’t taken the time to understand what those different bits of evidence over and above the obvious things like tele-interviewing rather than sending a form, but where there are those bits.  I think – I think that’s something that where there is big difference between insurers and the medical officers or where they’re look – you know, other than waiting for something bad to have someone in – you know, to happen to someone in their team and then learning from that to be more proactive about it by working with charities, by working with others.  I know Macmillan Cancer have done quite a lot of stuff with Aviva and others, I think Lloyds Banking Group in terms of getting their nurses involved in the claims piece.

Steve: Yeah.

Andrew: But – but that is one condition and – and there are undoubtedly for less frequent conditions than stroke and cancer, I’m sure there are bits in that process which could just, yeah, take weeks and months off claims journeys, which as we all are –  So again well we’re recording this four weeks into Covid, you know, at a time where lots of people are now without income and that kind of thing and I think just, you know, it really does make you realise that – that so many people don’t have three months’ or six months’ savings and – and in your situation Steve there where you can’t drive.  You know, in the best case scenario or in a pretty good case scenario where you suddenly can’t drive for a month recovering, you can see why, you know, every day, every week matters in that process as well as the common courtesies of keeping you informed with stuff which is – yeah, just basic.

Steve: Yeah.

Andrew: Basic.

Steve: Very much so that is.

Andrew: Yeah.  Remembering there’s a human there. 

Kathryn: And have you Steve – since, have you – have you needed to or tried to go for any insurances again or are you quite – have you been okay with everything?

Steve: That’s a really good question.  Obviously Square Health were covered by a group arrangement which is fantastic.  We still have the – the – some of the life covers in force so they will be maintained and despite what I said, I haven’t purchased a guaranteed over-50s product yet [all laugh].

Kathryn: Ooh ‘yet’ [all laugh].

Steve: So I – I haven’t actually myself gone to take insurance but I have helped one or two people and pointed them in the directions of people like yourselves in terms of – we’ve had friends who’ve had conditions.  The guy I cycle with who’s a cancer survivor etcetera, so not myself, no.

Kathryn: Well what I think we’ll probably do now is just have a little chat about some case studies, just to give some advice and some examples which is what we often do to sort of say like ‘This is what could potentially be available,’ and then chat – give you a chance to chat a bit more about Square Health and what it is that you’re doing especially now in the whole pandemic and that we’re facing.  So just a couple of case studies to go through then.  So the first one I’ve got is a male who’s in his late 20s and he’d had a minor stroke about a year and a half prior to chatting to us.  He’d had a bleed on the brain during a half marathon and they found no underlying cause.  Obviously if he’d maybe had a second medical opinion Steve, they may have found another cause but from what everything was tested so far, there was no underlying cause.  He’d had 10 days in hospital and had to have a further week off work.  He’d been on medication for a year and had to have annual reviews.  

So what he had is, we managed to get him the life insurance and it was at what they call plus 250 percent on the premium so for anybody who’s listening, that means you take the base premium and you times it by three point five.  Now, I know when we’ve said this before, I’ve not given examples of what the actual premium becomes and I think some can maybe wonder what that could be.  So for this person, we were getting him decreasing life insurance of £137,000 over 35 years and with the premium loading included, that came to £15 per month.  So I think the premium is actually probably less than what people generally think if you’re saying “Well actually we’re going to increase it by this 100 percent.”  The next example I have was a male who is in his –

Andrew: Sorry Kathryn, just on that first one.  So I guess to me, I mean first and foremost as a human the response to that premium is still ‘Wow,’ right?  And I appreciate that’s not the technical underwriting answer.

Kathryn: I hope that’s a good wow, is that a good wow?

Andrew: Yeah, no, no, it’s a good wow.  I – I think honestly and I think – I think then sort of merging back into an underwriting world, it’s interesting because underwriters will normally – just the last thing they see will be that rating rather than the premium.

Kathryn: Yeah.

Andrew: And are quite blind to that.  But I think it really does emphasise that, you know, almost even in – even in advice or manuals, if we – if we see plus 250 we think it’s probably quite unlikely that someone would take up that offer because it would be so much more expensive and – and kind of the stats prove that but especially at younger ages obviously life insurance is normally cheaper and if you say, you know, if in reality there you’re saying ‘You’re paying a tenner extra a month,’ then I think, you know, that feels very – a very compelling offer frankly to someone who’s had that scare.  On – in terms of what’s gone into that underwriting decision and I think we touched on it in some of Steve’s stuff, this – this ‘What’s the cause?’ is obviously, you know, when you’re looking at the underwriting factors, the time since stroke is important.  Obviously the number of strokes but there are so many different reasons that strokes happen and so many different types of stroke that all of those factors do go into that – that rating.  

But clearly you have, you know, ultimately you have good cases and bad cases and – and where you have a good case and no other risk factors etcetera then we are able to do some – some instinctively impressive things I think around strokes.

Kathryn: Yeah.  I think as well that, you know, there’s – don’t – I think it’s not necessarily the – the standard approach but don’t necessarily rule out critical illness cover as well, you know, there are options sometimes with critical illness cover so it is always worthwhile just having a look at each case individually and not – never make an assumption when you’re looking at things.  The next person that we’ll spring to again was a male and this time was in his mid-20s.  He’d been a bit younger and he’d fractured and dislocated his spine two years prior to speaking to us and he’d done that abroad and had suffered a full stroke during the operation.  I believe he’d had to have a metal plate fitted possibly in his brain as well during this had all gone on and he’d actually been left with partial vision loss – vision – sorry, vision loss so he could see straight and left but he couldn’t see right at all because part of his brain had died where the visual fields and connections are all based.  

So we got a plus 300 percent on that premium.  So again, that means that the premium – base premium was timesed by four.  So for this gentleman, again we were looking at the level life insurance of £150,000 over 35 years and the premium was £27 per month.  Now again, I hope that’s maybe another wow factor but it comes down to – again, that you’re looking at that one, you’re thinking ‘Right okay, this person has had a full stroke.  They’re actually left with quite marked, you know, symptoms.  You know, there’s sort of like quite a lot of loss of vision,’ and if you hear that thing of part of the brain has died, I think a lot of people would think ‘Ooh, not so, you know, not so sure about what’s going to happen with this one,’ but – but relatively again, £27 per month, it’s not – it’s not sort of unfeasible the premium.  It seems like quite – I think quite a nice premium but I think another thing to point out as well is that there isn’t always percentage increases.  

So say like if somebody’s had a stroke because they’ve had a traumatic brain injury, depending upon the circumstances of it obviously and the time since and also if the stroke has been caused by the mini pill then that can sometimes be that there isn’t a percentage loading put on and that sometimes standard terms can be arranged.  So – so there’s lots and lots of different intricacies and things to look at with these things and as I say, I think it’s always best to not take things at sort of like face value when you’re given that information from a client.

Andrew: Yeah and I think genuinely obviously we really wanted to get Steve on to get the personal side of it and to hear for us both selfishly [all laugh] – for us both to get that – those extra insights.  But, I mean, yeah, to go through every different – every different angle on this probably is a separate episode on its own at some point in the future.  But as you say, in simple terms you do kind of have the – the harsher ratings are going to be where it appears that a stroke’s been triggered by lifestyle factors or comorbidities or other things which were there before and are still there after.  And I think, you know, that – that seems or that is both fair and common sense really whereas if there’s a trauma or – or, as you say, something that’s been prompted by – whether it’s an operation or medication, then clearly if you take that away then – then the prognosis is much better.  

So yeah, it’s definitely a condition – I think – I think in fairness that – that the medical tool that sticks in my mind is actually on – on heart attacks and myocardial infarctions where, you know, you have the cardiologist saying, ‘Really you should be thinking of this in the same way as you think of cancer, there are 30 different types and – and that’s how you need to underwrite,’ and it’s exactly the same for stroke.  You know, we need to talk about stroke because that’s what people hear but we need to actually underwrite and – and take risk decisions based on that much more detailed level while then still kind of repeating it back to the customer in a language they understand.

Kathryn: Absolutely.  So Steve, do you want to tell us about Square Health then?  What it is that you do there, what it is that Square Health does and what’s happening now with the current – in this pandemic?  I know you’ve been making some – some huge steps recently to continue to support people.

Steve: Yes sure.  I mean, yeah, I joined Square Health in August ’16 as the marketing director and we’re really a health technology provider that operates in several markets.  Within the protection sector, we’re probably best known for provision of doctor and nurse screenings for the underwriting process but as you can imagine at this moment in time, that’s – that has basically gone down to zero but we’ve got – we’ve come up with solutions which I’ll talk about in a minute.  But also what we do is we provide a range of medical services such as remote GP consultations, digital physiotherapy and mental health support, second medical opinions, health MOTs etcetera and we provide that to the customer by the provision of app technology whether it’s IoS or Android.  So a bit like you – you take out a policy with a certain company, maybe LV or The Exeter etcetera.  You’ll have access to a range of services that they effectively ask us to provide so you download the app, you authenticate and then you have access.  It really is as simple as booking a consultation as it is maybe putting in a meeting in your – your Outlook calendar, something like that.  We’re not a financial services company, we’re a medical company so we’re not regulated and we don’t have the fun with the SCA but we are actually regulated by something known as the Care Quality Commission, CQC, and this is an independent body that looks at the primary care, i.e. the GP services, so we have to be effectively authorised by them – and audited as well so they do audit us on a regular basis.  In fact, if you go on the CQC website which I think is cqc.org.uk you can put in your own GP practice and you can see what their latest audit reports are, which sometimes is quite interesting I have to say.

Kathryn: Okay.  I’ll have a look after this.

Steve: So yeah – so we’re – so we, yes, so we’re audited there and we’re very pleased because our last audit report was very, very positive indeed but the thing that we’re really proud about which is testament really to the guys back at the ranch, Joe Saunders and the team, is that we were noted as outstanding with regard to patient safety so we’re very, very good at that.  But going back to the screenings, yes, obviously with the Covid government directions and restrictions etcetera, medical screenings, whether it’s by a nurse or a doctor in – in your own home or at work are basically finished.  So we’ve come up with a solution which, let’s be honest, it’s not a direct replacement for a physical screening but I think it goes some way and helps people.  Maybe part of the 15 percent that you – you’ve outlined last – 

Kathryn: Yeah.

Steve: Podcast Kathryn, whereby we will send them a – a test kit, a self-administered blood test kit which they will receive.  We then ask them to contact us to make a video screening consultation whereby one of our nurse or doctors will actually go through asking specific questions relating to them or maybe their condition.  At the same time, we ask them to take the blood themselves which is a pinprick and a good squeeze shall we say, into the pod and then that pod is actually sent in a self-addressed – stamped addressed envelope sorry, to the lab for the various blood tests.  We then marry the two up and then provide that as a – as a screening report to the relevant provider.  So we – we’re trialling and piloting this at the moment in other parts of our business, non-life insurance related.  The virtual screenings that are going very well and we’re just now in the forefront of doing that in the – in the life and health sector.

Andrew: And just – it’s probably worth just talking about the kind of people who apply for life insurance who we ask for those tests on Steve.  So I guess – I guess in short it’s either people who are applying for very large sum assureds?  In non-Covid times or in non-corona virus times, it would be either people applying for large sums assured whether that’s life, critical illness or income protection or where there’s a specific medical condition where either they don’t know their latest results or – or they don’t have their latest results.  So let’s say for diabetes or for high blood pressure, I think in the UK unlike in other countries, we – we tend to go to the GP first because in theory the medical records through the NHS are very, very good.  In other countries there’d be far more kind of reliance on blood tests and screenings and things like that.  

But for a, you know, as we – as we’ve discussed and we kind of can throw numbers around and percentages, but it’s always worth remembering that every – well, in the UK every 10 percent of the insurance population is 150,000 people a year so the numbers add up very quickly.  But in the UK, yeah, there – there’s still those people who insurers don’t – can’t offer cover to or don’t offer cover to without some of this.  So I think that’s why it’s so good that Square Health are doing it and impressive that insurers seem to be taking it up now and – and trying to – to work with, as you say, what’s, you know, not a perfect solution but – but gets you most of the information that you’d have otherwise.

Steve: That’s absolutely right, Andrew.  I mean, we’re working with four partners at the moment on – on a pilot basis.  Yeah, don’t get me wrong, we have some slight reservations.  You know, the blood going via the postal system.

Andrew: Yeah.

Steve: Will that – will that take longer than normal and therefore haemolyse and not be any good?  We just don’t know yet but, you know, as I said, let’s get there fast, let’s try it, let’s pilot it.  If we need to change things slightly then we can do so.  But I mean for anybody who requires that insurance coverage, whether it’s to cover a mortgage or what have you, let’s – let’s see how quickly you can get these through the process.

Kathryn: I think, just to say as well, that the doctor services – I know from personal experience that they’re brilliant.  A couple of years ago we were in Malta and my – my eldest who was six at that time wasn’t – there was nothing sort of like majorly going on but something just wasn’t right and what was perfect is that, you know, we – we sort of like logged on to the system and then it was the next morning at 10 o’clock, you know, we were there in the sunshine in our bikinis doing a video conversation with a GP in the UK, absolutely brilliant and, you know, what was fantastic with that as well was, you know, they could then – he could look at the GP, chat away to them, we could show the areas where we had a bit of concern and it was just fantastic to be able to have that rather than thinking – especially with being abroad – sort of like thinking ‘Oh if I go to a local pharmacy, are they going to understand me?  Am I going to be able to translate properly what I need to get across to them?’  

And it just – it really provided some comfort to be able to speak to somebody in your own language that you knew that they were really there and you could just chat exactly like you needed to.  It was brilliant.

Steve: Yeah, and I mean a lot of our consultations are in many regards reassurance.  Unfortunately, you know, the – the, you know, in the UK at the moment it’s – you know, pre-Covid days I should say, an average of 13 days to see your own GP.

Kathryn: That’s – that’s quick.

Steve: And whereby –

Kathryn: That’s quick for me [all laugh].

Steve: Whereas, you know, you know, you had 10 o’clock the following morning.

Kathryn: Yeah.

Steve: And it is, you know, it is fantastic.  Some of the providers we’ve worked with have now actually gone 24/7 so – so that’s – that’s great news as well and just looking at the MI for the month of March comparing it to February that we provide our clients, I mean as you would expect, we have seen a massive spike in the number of remote GP consultations that we’ve undertaken.  Circa about 20 percent of them were Covid-related so we had to follow the government guidelines and protocols about 111 and what have you, which we did, but 80 percent weren’t.  So there were non-Covid-related issues that people had concerns about that perhaps they weren’t able to get to see or talk to their GP for some time that we were able to help with and perhaps just, you know, release the pressure a wee bit on the – on the system.

Kathryn: Which is fantastic and absolutely brilliant, especially at the current time.  So – so we’re coming towards the end of the podcast now.  So we’re going to have our first guest’s truth or lie feature which is going to be brilliant.  So I will start it off.  So everybody if – if you’re not familiar with this, one of us is telling a lie and you have to figure out who and we’ve established that I’m a terrible liar so that’s just a bit of a hint there.  So mine is that during the lockdown, I have taken up playing the flute.

Andrew: And mine is during the lockdown, I have taken up unicycling.  

Steve: And mine is, I have nutmegged Kevin Keegan whilst playing football against him.

Kathryn: Mmm –

Andrew: Very good.

Kathryn: We’ll leave you all there to fester with that for a couple of weeks then.  So thank you very much for coming on Steve, it’s been an absolute pleasure having you and to everybody listening, we really hope that you’ve found this useful and if you do have any questions at all or want to discuss anything, please do send us a message.

Andrew: Yeah, thank you.

Steve: Thanks guys.

Andrew: Yeah, thanks everyone.  Well we’ll be back in a couple of weeks but – and I think we’ve got another guest then.

Kathryn: We do.

Andrew: We’re – we’re on a good run [all laugh] with a similar real-life experience that – that kind of brings – again, hopefully brings this true to life so we’d really appreciate any feedback you’ve got and – yeah, look forward to speaking to you all soon.  Take care.  

Kathryn: I agree.  Thank you Steve.

Andrew: Bye.

Steve: Bye.

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