Kathryn (00:06):

Hi everybody. We are on season eight, episode six of the Practical Protection Podcast and I have Lisa Balboa from Hanover. We with me. Hi Lisa.

Lisa (00:14):

Hi Kathryn. Good to be here.

Kathryn (00:16):

Lovely to have you back. And today we’re going to be talking about how the insurance world is looking at technology to better understand people’s health and wellbeing. This is the Practical Protection Podcast. So Lisa, how have you been? It’s been a little while since you’ve been on the podcast with us.

Lisa (00:41):

Yeah, I’ve been keeping well, Kathryn, so probably got a few more wearables since the last time we chatted, so I’m sure we’ll be diving into that. And yeah, I’ve been on a few good holidays, so great to be back.

Kathryn (00:52):

Oh, fantastic. I do. So I’m very, very much thinking about Lucid and when we went to the Lucr conference and we met up and I remember you having a ring on as well and you were telling me all about this ring and everything and then I know my husband was there, Alan, and he was straight away like, Ooh, that looks quite, he’s a definite tech guy. So he was all over that and interested in it. Okay then so start things off. I know that you love technology and just mentioning again yeah, there was that ring that I know you said monitored your health and I think it was you said that it even gave you an early alert that you were going to get covid or that you had it and some really early symptoms. So I suppose a good place for us to kick off is what kind of technology is out there to monitor a person’s health? What are we seeing in the market now?

Lisa (01:36):

Yeah, there’s a really wide range that’s selling to be developed here. So the wearables is the one that people think of classically, right? The wearable smartwatch that you have on your wrist. So I think I’ve had those for probably more than 10 years now. So the capabilities of those are quite interesting now going beyond steps and tracking things like the heart rate, maybe even the blood oxygen sometimes as well. And then you mentioned just

Kathryn (02:01):

Seems has fall risks as well I think, doesn’t it? So we wondered about that for my dad with Parkinson’s, is he taking a tumble? Can it alert us? Things like that, which is incredible.

Lisa (02:09):

Yeah, that’s a really incredible use case and great for the insurance proposition side of things as well. It gives great peace of mind for the family and then it can allow people to stay in their own home for longer safe in the knowledge that if something happens they’ll get an alert to the family, the friends, the care team of that individual. So for the aging population, that kind of tech is being developed as well, which I think is really great. Absolutely. There’s actually an interesting one that I came across recently where how in hospital people would maybe be monitored on those machines postsurgery for maybe a few days before they’re able to go home. There’s now some wearables where it’s just a patch that goes on the back of the neck that might be able to replicate that sort of vital sign monitoring, but allow people to actually be in their own home to get that same quality of medical information feeding back through to the doctor and the care team, but hopefully letting people be at home for longer as well. So there’s some clinical trials ongoing with that as well around medical device certificate certification

Kathryn (03:16):

For that. I was going to say that sounds absolutely amazing because I have to say I don’t like the idea of being in hospital in a ward, so the fact that I could maybe do something like that and just be like bye kind of thing, that sounds fantastic to me, but I remember it definitely has changed isn’t it? I know when I started doing a lot of my fitness tracking and things like that, I used to have it where I had a heart rate monitor and it was a band around my chest which had little metal thingies. I had to clip something onto it and which was obviously fine in some ways, but as you say now it’s just a watch I think you said. What does the ring do that you can potentially get? I mean I’m sure there’s a few, but what’s the main kind of ones? What do they do?

Lisa (03:57):

Yeah, the rings are another great way to track different health measures. So the one I have, it can track things like the heart rate. Also the body temperature is one that was really useful when I had covid probably more than a year ago now, but it actually detected just a half a degree rise in my body temperature and then I knew to take a test and I found out I covid probably a little bit earlier than I would’ve otherwise found out. So that kind of monitoring, particularly if you’re wearing it in your sleep, so when people sleep they build up the space liner of themselves. So something like a ring could be more comfortable than a watch to wear at night. So can really compare those abnormalities in your sleep pattern compared to your normal baseline and then alert you to differences when you wake up. So I find that quite helpful knowing if I’m ready to start the day, if there’s anything I should look out for as well when I wake up in the mornings.

Kathryn (04:55):

That’s really, really good. I was going to say I’m straight away thinking again about my dad because people with Parkinson’s can lose their ability to temperature regulate. So it would be so good because it means that obviously it could alert for things like that. But obviously it’s interesting when you saying about wearing things at night because I’m one of those people who’s just like, I’m no technology near me kind of thing. So I think a ring probably wouldn’t stand out to me too much, but obviously a watch would do. But I remember as well when, I can’t remember if it was just before the conference or at the conference that you mentioned to me about an app on your phone and I did it and I can’t remember everything that it showed me, but I obviously remember the most important thing was that it said that my skin was 10 years younger healthwise than I actually am. So that’s the main thing that I remembered, but it was incredible. I remember there was some imagery there, was it, I think you put it up didn’t you, about the way that it looks the face and the different colors and things like that. So can you take us through that kind of thing?

Lisa (05:50):

Yeah, this transdermal optical imaging technology, it’s really quite exciting, right? Because you don’t need a wearable or a separate, you can actually just use your smartphone to get a lot of health information there. Even things as sort of more I guess lifestyle related like the skin age, which is great as well. It’s a great compliment. There’s

Kathryn (06:08):

More important things. I was going to say,

Lisa (06:11):

Priorities there. So yeah, for sure there’s sort of, technology is quite an exciting development as well. So it’s the capability to track things like the heart rate or the breathing rate just through this video selfie. So just holding up the camera for 30 seconds and then it can track the flow of blood through the skin and the algorithms have been developed to then use that to identify these different vital sign measures. Things like the heart rate, things like the breathing rate, even things like blood pressure and blood glucose are in development as well. So yeah, it’s really quite exciting potentials there. Maybe even saving on some sort of medical testings or getting that first indication that perhaps something might not be right or might be different for that person on that day if they do that face scan. So that can really have quite a lot of potential and it doesn’t need an extra wearable device. It’s accessible to anyone with a smartphone.

Kathryn (07:10):

Absolutely. And just, sorry, going on from there, for people who maybe aren’t familiar with some of the medical terms, so we’re talking about blood glucose, we’re talking about things that can be indicating diabetes, so being able to capture that really easily on someone’s phone to just go right, instead of having to have blood tests and things like that. It’s obviously it’s massively going to save pressure on the NHS in terms of the test and the resources for that. But I think one of the things that we do know, and I’m sure obviously you’ll definitely know as an actuary is the amount of people who have these kinds of things like the high blood pressure or the raised glucose in the background and they’re just completely unaware and obviously if you can catch it early, you can prevent a lot of the long-term damage that they can cause to the body.

(07:52):

I think a lot of people think of maybe high blood pressure, sometimes I speak to people, it’s just kind of think, well it’s just one of those things I’ve got to that age and sometimes it is that obviously blood pressure does change with age and things like that, but we do account for that and obviously doctors account for that. But obviously if it is high blood pressure then there can be real implications like the kidneys and other organs and things like that. So it is so essential. So I suppose in the insurance world, and for you as an actuary, why is InsureTech exciting? What could this potentially be doing to our industry? Yeah,

Lisa (08:24):

I think there’s lots of exciting opportunities. So that preventative healthcare approach that you were just talking about, detecting those conditions a bit earlier and then people feeling confident maybe to go to the doctor to get that onwards diagnosis and treatment, that’s a really exciting opportunity. We’re almost empowering people in their day-to-day to have access to some indication about their health that they might not have seen before and then have that confidence to get it checked out in the case that they wouldn’t have regularly gone to the doctor in any case. So from the insurance point of view, I mean there could be good appetite to support that as well. So helping to manage what we would term sort of morbidity risks. So risk of ill health or mortality risk, which is risk of death. So to actually detect some of those conditions early on, that’s great for the insurance terms of helping people live healthier and longer. So supporting the claims ratio for the insurer and most importantly supporting customers day-to-day as well to improve their health.

Kathryn (09:24):

I was going to say it’s really interesting because I love the way that you said that as well had for the majority of people when you explain stuff like this to them, absolutely get it, but I’ve definitely had it. So it’s interesting potentially for advisors to just hear my experience explaining some of these things to people where sometimes you get people going, oh, so these insure will do anything, won’t they to just try and it’s just like no, they’re actually, they’re taking steps to try and really help you with your, it’s not trying to avoid a claim, it’s not trying to avoid different things and ultimately for you as an individual it’s much better if you don’t get to this level. So it’s a really, really positive thing for everybody involved. So obviously really, really great to see that we’re going to have that preventative side of things. So in terms of where we think it might sit, do we think that, I imagine it might come a little bit into underwriting sometimes policies, but do you think it’s more going to be sat within the, once the policy’s alive that we are then going to have stuff like the things of saying maybe a prompt from the insured say, do you want to just double check things and if your readings are like this or showing this we can point you to a good place to get support? Where do you think it’s going to sit?

Lisa (10:31):

Yeah, so I think first of all, the data privacy, the data consent, the choice of customer for when and how they want this to be used is very important. So in the preventative space, I think to have that post policy issue and to partner with companies that are experiencing that health space to really take the lead backed by the insurer to then support customers here, that’s in a great opportunity because it’ll make very clear to the customer that this technology is being used to help live healthier and longer can help compliment the services available and things like the NHS as well. So sort of supporting people at that stage before they would go to the NHS. So to have that opportunity to have the synergies with the healthcare system there and think how this will fit in is quite important. I think there’s uses for underwriting as well.

(11:22):

So from the insurance point of view, if people would normally need to go for traditional medical screenings and have that time with a nurse to have some tests taken, maybe as this technology develops more and starts to get the right kind of medical certifications in terms of detecting things like the high blood pressure, which might be a common nurse screen at the moment, then you could also look at opportunities that, right, how can we make lower barriers when it comes to the medical underwriting? So helping to support testing at home for more people as well using this technology that we might have available.

Kathryn (12:01):

Fantastic. So as an actuary, how do you see this InsureTech kind of helping to build the data that you need to be able to work with mean? Obviously I’ve never seen the data that an act would see. I imagine it’s absolutely mind boggling the amount of data and different things and cost referencing that you guys need to do. So we can do all this to really help people, but what’s it going to mean in the background into those decisions and different things that you’ll be making to obviously advise and guide and insurer?

Lisa (12:29):

So as you can imagine with this sort of digital data, there’s a really high volume of data that would be available as people maybe wear that wearable go about their daily lives or even from something like that, that video selfie where it’s giving this different data input and also things like electronic health records coming online more and more. I know for myself I can see my own health record back to when I was born now in the NHS app and my father as well, he could also see it, right? So I think it’s really starting to onboard. There’s more to do, but starting also to get health data in an electronic format as well so that the key challenge then is to really structure this data in a way that can be helpful to underwriters also to actuaries when it comes to looking at overall mortality and morbidity risks.

(13:16):

So I think there is a role for InsureTechs there as well to assist with this data management to create a customer view across all these different measures. Whereas before maybe it was sort of a more limited set of measures at point of underwriting. Now there’s also this lifestyle data that could be brought in, could be for underwriting but could also be for enforce management, helping those people live healthier and longer or also for claims. So perhaps with something like the electronic health record, if that’s able to link through to an insurer in the future to validate that claim, that might then be less paperwork that a customer might need to fill out at point of claim as well. If some of that could be auto-populated from a health record,

Kathryn (14:00):

Oh that would be good. Especially just I think anything we can do to the claims process because that’s obviously where people really feel the most vulnerable and most emotional and anything we can do on that sounds absolutely fantastic. So in terms of, I can see that technology is going to be helping get the data to support actuaries and that that’s then going to support underwriters to make the decisions about assessing claims and things like that. But I suppose in the wider impact for society, I say this technology can often alert people to hidden conditions that are going to be developed. They can go to a doctor earlier. I know we mentioned this a little bit before, but as I say, it is just a good thing all around, isn’t it? It’s making sure that insurers have, obviously that insurers work off data. I don’t think there’s any way that we can avoid that. It is decades worth of data and this is just going to give more and more to give that really broad understanding of societies as much as a whole as possible. But it can only be a good thing, can’t it?

Lisa (15:02):

That’s right, Kathryn. So I think to demonstrate that potential sort of beyond underwriting, there’s an example, for example in the genetic space, it’s very clear in the UK insurers have subscribed that they’re not going to use any sort of genetic testing except for one small exception around the Huntington’s disease. They’re not going to use that for underwriting. So then taking that off the table, you can then think what could opportunities for predictive genetic testing B actually to help people live healthier and longer? So could there be opportunity? And we’re already starting to see some providers that are doing this partnering with insurance companies to offer some predictive genetic tests that can help people to understand their own risk of certain conditions. It could be risk of certain types of cancer, it could be risk of certain types of cardiovascular disease. So to then join that up and say for example, if some of that risk of a certain cancer, maybe let’s say bowel cancer as an example, maybe they should then get screened slightly earlier than the normal age that the screening program would start.

(16:10):

So it’s about that early diagnosis and perhaps being a bit more targeted in terms of who would go for screening when based on some of these genetic risk factors. Another good example would be the cardiovascular disease. So if someone’s at higher genetic risk of that, maybe they can make lifestyle adjustments to diet and exercise to offset some of that. Maybe they have their blood pressure screen more regularly, maybe even using some of these smartphone apps that we’ve been talking about as well to keep that monitored. So it’s about empowering people to help get the support they need to manage the health risks as best they can.

Kathryn (16:48):

I mean that sounds absolutely ideal. I was thinking in terms of the cardiovascular wellness, it’s always a fun one to say, but familial hypercholesterolemia, which for an advisor, I always recommend that you practice try and saying that a few times before you try and do it with a client or anyone else because not a natural set of words to sort of say, but things like that, there’s so many times that when you speak to people and it’s like, oh well, so how many people in your family have had high cholesterol? And you kind of sat there thinking there’s possibly a link here. And I know that we knew somebody personally who one of them, there’s so many implications in the sense that there was somebody who’d had a heart attack quite young that we knew and we knew that someone else had been having some specific fertility problems in the family and it was just that kind of thing you just gently suggested, does anybody check that side?

(17:38):

Because it can really fall into that and cause quite a few issue. And it did end up being that that was there, but obviously you can’t just go around suggesting that to people. So I don’t advocate that it’s just that we are very, very aware of this situation very close to them. So we’re able to have that discussion. But in terms of like you’re saying the bowel cancers, things like that. So it’s identifying potentially the links for lynch syndrome, other obviously genetic factors that can make that more risky. And I think what’s important is that whilst we might be doing that at the moment especially, and assuming this wouldn’t change in a sense, it can only still be a positive because as you say, with the exception of Huntington’s disease, where the insurers can ask about a genetic test for that, if it’s over 500,000 pounds of life insurance, you’re applying for around 300,000 for critical illness, they can’t ask about the other ones.

(18:25):

So that’s something that we often see quite a lot of people, especially with the breast cancer gene and the rackner gene people saying, well, I need to say it. It’s like, well actually the rules are at the moment the majority of insurers, you don’t need to say it. So whilst this is happening, and I think there’s part of me as an advisor, I initially go, hang on a minute, the questions going to change so they can ask about it and things like that. And does that means it’s going to be negative? But from the way that it’s all being sounding and the way that things are being suggested is that it wouldn’t necessarily be a case of, oh, if you find out all this, then it’s going to affect future things. And I think, I’m sure there’d be very careful data protection rules in a sense of, oh well we can potentially offer you this enhanced testing, but we won’t get the information maybe, I dunno. How would that work? Do you think the information would potentially go back to insure or do you think it’d be a bit of a voluntary thing to say to allow it to go back? Are we so early stages that there’s just no way of knowing?

Lisa (19:21):

Yeah, I think where this has been implemented with a few insurance companies there in Europe, in the us it’s been done by providers that are very specialist providers and they are the data owner for that genetic data. So that genetic data doesn’t get shared with the insurance company, but rather the insurers partners with these companies to make clear that they’re never going to see any of this genetic data. What they really want to do is to support the customer to understand their own risks. And then with some of these providers, they can also collect things like the lifestyle data, so the number of steps, maybe the blood testing information as well where that’s applicable. So some of that more lifestyle type data perhaps that could be shared back with the insurer to see are people making a change to their lifestyle guided by the fact that they’ve had this initial test, but the actual genetic data in the cases I’m aware of, it’s not shared back with the insurer, which can then give a lot of confidence to the customer. That data’s not being shared with the insurer. It’s really about embedding this more preventative healthcare approach to support the customers, but to use the specialist genetic providers or health providers available to enable that.

Kathryn (20:36):

Well that sounds really good. I was going to say, I imagine, I suppose for me, if it was me, I’d be kind of on the lines of if it was my test, it’d be a case of, well, I don’t want them to be able to see that that test is to me. But I suppose if it’s a broad sort of in all the people we’ve checked, 40% have this genetic marker or something, I suppose that would possibly be okay. And obviously as you said, that would help in terms of linking it up with lifestyle changes and everything like that. I actually had genetic testing done not long ago, and I paid to get it done because I was chatting to my mom and I’d known that my granddad had had a quadruple heart bypass and we were chatting around and she was just like, oh, well he always had bad cholesterol. And I just looked at her, I was like, so he’s always had bad cholesterol. The reason that this really triggered it, it was after the Lucid conference and we were there and somebody was talking about it and they mentioned about these little bules that you get near your eye if you have high cholesterol. And I’d come home and I’d looked at my mum, she’s had something near her eye for a while and the doctor said, that’s fine, don’t worry anything. And I looking at her, I like,

(21:39):

I was, it’s okay. I was like, I like, I just wanted to double check your eyes. There’s nothing cholesterol there. And she was like, oh, well they have told me that this is cholesterol. At which point I just went, oh my word. I was like, that’s it. I said, I need to have genetic tests done. So we need to rule out that popular word, familial hypercholesterolemia. And luckily my genetic test came back. It was cancers, it was cardiovascular, oh, come back completely, no higher risks. So touch. I’m very, very happy about that and it did give a real peace of mind. I think especially with the line of work that we work in, it really gave me peace of mind. Obviously it doesn’t say that it’s never going to happen, it just means I’m not as likely to develop it. So as we’re getting towards the end of the podcast, then this is going to be a really tricky question for you, I think because I know that you love tech and I know you love the gadgets, but if you had to choose one piece of InsureTech, and I dunno, let’s say you had, I dunno, a million pounds and you could throw, I mean I assume it takes a lot more money than that, but let’s just say minute pounds is the greatest amount of money in the world and you could throw it at a certain piece of tech to really give it that chance to become popular, to do everything that we’re wanting it ideally to do.

(22:46):

What would it be that you would really want to see?

Lisa (22:49):

Yeah, for me, I think it would be empowering people to have their own centralized personal health record. So there’s so much different data out there. There’s this genetic data, there’s sort of the data that you get when you see the doctor that’s being generated in some sort of medical record. There’s this lifestyle data where things like the ring that I have, it tracks the temperature or you can track things like the steps or even the heart rate with these video selfies. So just some way to get that in one central view I think would be great, right? It’s great for the customer. They have that in one place. And also, I guess from the insurance point of view, I mean personally I wouldn’t mind to then share that with an insurer, particularly if they could help me get products that best fit my needs. If I might be at risk of certain things or if they could support this preventative healthcare approach. If I ever needed to claim on a policy it was there, ready for that claim to be paid out, I think that would be quite exciting. So building up all that data in one place in a way that obviously protects the customer’s data privacy as well and gives that choice to the individual. I think that would be where I’d like to put some money behind that if I had some to do that.

Kathryn (23:58):

Absolutely. I was going to say, I was just thinking from an advice point of view. I was just thinking, and I’m sure underwriters exactly the same is just that thing of how nice would it be if when you needed to get somebody’s details, they could just look and go, here it is, here’s the letter from the specialist, I can access it. That would be amazing. It would just speed things up phenomenally, which would be fantastic for all of us. Okay, well thank you Lisa for coming on and talking and teaching us about insurtech. It’s one of those things where personally, I’m a little bit of a technophobe. Alan is all about technology, and I’m like, he wants to understand it inside out, and I’m just there kind of like, look, I don’t even want to know how it works. Just tell me how I use it. I’m fine with that kind of thing. But it’s really, really fascinating to just see how much this could really, really help people. So thank you for giving us that insight. Oh,

Lisa (24:48):

My pleasure, Kathryn. It’s always a pleasure to be on the podcast and share a few insights. So yeah, really

Kathryn (24:53):

Pleased. Brilliant. Well, hopefully we can schedule one in, I don’t know, maybe a year’s time, so, and see what’s happened, see what the differences is, which would be absolutely fascinating. So next time I’m going to have Matt Ram back with me and we’re going to be talking about total parent disability, which is a part of critical illness contracts, why it’s there, why it’s sometimes an add-on, and how the claims work. If you’d like a CPD for listening to this podcast, please visit our website, practical protection.co uk, and you get those certificates from the fantastic Octa members who sponsor us. Thank you so much for your time, Lisa.

Lisa (25:24):

Thanks Kathryn.