Leo Miles – Cancer & Insurance

Hi Everyone,

We are onto episode 3 of season 2 and this time I have Leo Miles with me.

Leo works for Macmillan Cancer Support and spends her time fighting for equality for people that have had or are living with cancer. Leo has been a mortgage adviser, has worked within the Financial Services Authority and is now a charity advocate.

My 3 key takeaways,

1. Access to insurance for people with a history of cancer has changed due to coronavirus.

2. It is essential that everyone within the insurance sector adheres to the Equality Act, when considering how they offer products and services to people that have had cancer.

3. Two case studies showing potential terms for life insurance and income protection, for people that have had cancer.

Please let us know if you have any thoughts on what we have been discussing.

Next time I have Sue Kinsella from RedArc Nurses joining me. We are going to be talking through a typical day in the life of a RedArc nurse and how they help families through some of the most challenging experiences in their lives.

Kathryn:       Hi everyone, today I have Leo Miles with me from Macmillan Cancer.  Hi Leo!

Leo:             Hi!

Kathryn:       We are going to be talking about cancer and insurance, how insurance is perceived from people on the outside and I’ll be chatting through some case studies where we’ve been able to help people get insurance.  This is the Practical Protection podcast.  So Leo, how are you doing?  How is lockdown treating you?  How was the weekend?

Leo:             Ah, well I’m doing really good today because the sun is shining, I’ve got my lemon dress on, I’m very happy and actually I’ve just had a week’s leave so – which is the first week’s leave since January I think.  So –

Kathryn:       Very nice.

Leo:             Had some lovely time to catch up with the family, been to the seaside twice, seen my Mum and Dad since the first time in February because obviously they’ve been shielding ‘cos they’re quite old and a bit poorly.  So that was really lovely and my little boy was so excited to see them like, ‘Yay, Grandma and Grandpa!’  So I think – yeah, in general, pretty good.  Life is pretty good.

Kathryn:       Brill.

Leo:             And we’re trying to get out a bit more now so that’s great.

Kathryn:       Fantastic.  We took the step yesterday to take the kids out.  Our nearest kind of like zoo area near to us is Flamingo Land and we have annual passes.

Leo:             Ah!

Kathryn:       I’m also going to do a quick cutaway and say I love your lemon dress.  So we took them – we usually go quite regularly and we went and it was just nice, you know, because it was a kind of thing of they’ve obviously been very careful.  They know that we’ve all been in lockdown, that we’re having to, you know, my now six-year old has been – every time he has a cough he just hugs me and goes, ‘Don’t worry Mummy, it’s not corona virus.’  And you just think, ‘Oh bless them.’  You know, sort of what they’re taking in and what they know noticing and it was just nice to take them somewhere and we stayed away from all the rides because we kind of looked at the ride area and could see that distancing wasn’t necessarily being done and we went round all the kiddies area which again, you know, obviously the kids weren’t necessarily distancing but the adults were, you know, they weren’t all close to each other and all the zoo area and it was just so nice to sort of like get them back out and sort of like, ‘It’s okay, we can go out, it’s safe, it’s fine, we’ve been here,’ and that was really, really lovely this weekend and obviously as well, just nice to have a really nice warm day because I just feel like it’s been a little bit [inaudible 0:02:13].

Leo:             Yeah, makes you feel a little bit – you’ve got a little bit of normality back and it’s been nice for us just being able to see a few of our friends, like school friends and things like that and we’re really lucky where we live because we live in Surrey so we’re surrounded by loads of countryside and a million National Trust places and my – we saw my best friend and her little girl’s very good friends with my little boy and they played in a treehouse and, you know, it’s the same, the kids – they know what they need to do –

Kathryn:       Yes.

Leo:             They can’t help kind of creeping a bit closer together but then, you know, Claire and I had a chat two metres apart and across a woodland so, you know, it’s good isn’t it?  It is starting to feel better.

Kathryn:       It is.  It’s starting to not feel as scary now.  I mean, I say that and we’re still very much being very, very cautious and we’ve got masks and everything but –

Leo:             Yeah.

Kathryn:       Yeah, it’s feeling a little bit – a little bit better.

Leo:             Yes, definitely, definitely.

Kathryn:       So, last time I had Roger Edwards on and we had our truth or lie feature.  So it’s your turn to guess who you think was telling the truth and who was telling a lie.  So Roger said that he has taken up cycling again during lockdown, that he he’d got his bike back from his son and that he was really enjoying going out cycling again and mine was that I have read a book every week since March.  So who do you think is telling the truth?

Leo:             Hmm, it’s a really tricky one but I think I’m going to go with Roger on the basis that I know that you have got three children and you’re a super busy mum and frankly if you’ve read a book a week, I am so insanely jealous and I want to know how you did it and I can’t believe that you did ‘cos I’ve only got one and I couldn’t manage it at all.  So I’m going to go with Roger.

Kathryn:       Yeah absolutely, Roger is definitely the one who’s took up cycling again.  No, I have been involved in setting up a virtual book club which is brilliant because it’s like – it’s forced you – I feel like, because now I’m in the group, I feel like I must read the book each month.  So that’s good and we’ve just done month two which is sort of going to do the gin meet-up night this weekend and have our talk about the book but yeah, there’s absolutely no way that I’ve been able to read a book every week.  It’s – yeah, I just don’t have the time to think, you know.

Leo:             No.  I – well I was just – I know you’re superwoman anyway and I don’t want to feel any worse than I already do about just having one and having to home school and still not managing to cope with that and my job.  So yes, anyway, that’s – I just find that tremendously reassuring actually now, but thank you for that.  And great to hear that’s Roger’s cycling, that’s also extremely positive.

Kathryn:       It is, it is.  So Leo, you work for Macmillan Cancer and have been involved in many areas of sort of like the finance world and insurance world for many years.  Can you tell us a bit more about yourself?

Leo:             Yes, so I’ve been at Macmillan – so Macmillan Cancer Support, that’s our full title.

Kathryn:       Right.

Leo:             So I’ve been at Macmillan for about nine years now coming up, it will be nine years in September and before that I was actually – well I was a mortgage adviser to start with, that was my first entry into the financial services world and from there I went to the FSA to become a regulator so I did some supervision, I supervised a major retail group actually and then I decided that I wanted to be more open about social justice and all those exciting things so I went and worked for a charity in financial education.  And then the job at Macmillan came up and actually quite a few people spotted it and said, ‘That’s your job, that’s – you need to do that job.’  So my role was actually set up alongside a new service that we’d established which is the Financial Guidance service.  So I know lots of people know about the Macmillan nurses, our amazing nurses, all our medical professionals, a whole range of medical professionals but I think people know less – a bit less about our other services and one of the primary areas that we look after people in is financial support which is such a huge concern for people after having cancer diagnosis.

Kathryn:       Yeah.

Leo:             So we have a Welfare Rights team which is helping people to access benefits.  We also have a Money and Work team so helping people at work and then the Financial Guidance service was set up in a response to an identified need that people were looking for help with financial products and services so things like – people are really often looking for help with their mortgage which is maybe a deferral just to help them to kind of get things sorted out, you know, while they’re coping with starting their treatment pathway and things like that.  So that’s what our Financial Guidance service does.  They’re specialists – many of them having been advisers as well so they are amazing, so skilled.  I’m always in awe of them and what my role actually does is – the Financial Guidance service come to me and they’ll say, ‘Oh we’ve seen these issues.  So we’ve got some specific cases – some case studies – but actually this looks to us like it might be something even bigger.’  So my job and my team take those bigger issues and say, ‘Okay, well how can we start sorting those out maybe a bit earlier on so that we’re not seeing people who’ve experienced that issue and we have to kind of help them to work through that?’

So what I would be doing is working with Government, with the FCA, with industry as well to kind of look at some of those big picture problems and say, ‘Okay, let’s think about what we can do to resolve those.  What do we need to help you understand about people with cancer?  If there’s issues that we can’t solve in one place, do we look somewhere else?’  So I’m part of our Policy, Campaigns and Influencing area at Macmillan so that’s also where our campaigners sit.  So you might have seen some of our big Forgotten C campaigns that’s – so I work with the Campaigns team as well.  So it’s a really lovely job, it’s really exciting.  I get to meet loads and loads of people and obviously more than anything else I get to advocate for people with cancer and help people to understand more about their needs.  So love it, and also very fortunately in that role, I have the privilege of working on the Access to Insurance working group which has been set up by the Cabinet Offices.  It’s such a difficult thing to say; Disability Champion for the Insurance Sector so I actually chair the Charity and Consumer Reference group which helps to kind of inform some of the work of the working group and to kind of test and challenge about what’s going to be best for consumers in that.

So that’s kind of my current role.  I think some of the challenges that we see particularly in insurance and Financial Guidance tend to do quite a lot of work on is they will see a lot of issues where people are having claims declined or challenged.  They will actually support people with those and do advocacy work and obviously they also see quite a lot of people coming to them and saying, you know, ‘I haven’t been able to get insurance and, you know, I don’t really understand why that is.’  So a whole range of different things that we deal with.

Kathryn:       Obviously one of the big things that stands out for me with that is that you are coming at this from such a kind of like a holistic mindset of what’s going on.  You’ve been an adviser, you’ve been a regulator.  You’re now a consumer cancer champion, you know, and you are involved in so many different things as well within the financial services that you can really – you can see so many different aspects of it and you can understand and have that really unique perspective of pretty much every – almost every area, you know, that is going to need to be working together to be able to really make those good consumer outcomes.

Leo:             Yeah.

Kathryn:       So, you know, following on from what you were just saying there as well, I mean a big thing and I think the main thing to say sort of like straight away, is that what do people who’ve had cancer or currently have cancer – what do they typically sort of like think of the insurance world?

Leo:             So it’s a really interesting question and one thing I should say as well is that I myself have a serious health condition, so I have Type II bipolar so first of all you made me sound much more expert than I think I actually am.

Kathryn:       Don’t put yourself down!

Leo:             I know I shouldn’t have self-doubt but it’s like, ‘Oh gosh, really?’

Kathryn:       It was really good what you were saying, it was incredible everything you’ve done.  I was just – I’m in awe.  I was just like, ‘Wow!’  You’ve literally been everywhere!

Leo:             Well, you know, I get around.  So I mean it’s an interesting thing because obviously my own experience with insurance, having had – I was diagnosed with Type II bipolar so having – it was very interesting as I was diagnosed after I had my son and so I’d started my job with Macmillan and then went on maternity leave and effectively I went through a similar process where, when I was diagnosed, I’d gone from understanding the insurance world and being someone who was included and then suddenly overnight I went to that place where I was totally excluded.  I didn’t understand what my condition meant in terms of how an insurer saw it, so there is an element of this where I will bring my personal experiences to it but –

Kathryn:       Of course.

Leo:             You know, which I think is important but obviously a few things to say are; firstly, I don’t claim to be an expert in cancer.  What I talk about is what people have told me so about their own personal experiences and their own personal views and obviously I think you’re going to hear me like a broken record; the absolute key to this is about individualisation and personalisation.  These are people who have had a cancer diagnosis or have had cancer and they’re people first and foremost.  So unfortunately, I think, you know, we all accept that there’s quite low trust in the insurance industry and there’s lots of reasons for that and possibly protection suffers from some of the practices in general insurance.  So people will have a perception of insurance across all the different lines and classes.  So lots of that will be shaped by their experiences beforehand.  So if they feel that had a claim declined say for motor insurance or for household insurance, they might come to that, you know and not only that negative perception but then they will encounter an industry that really is almost – it’s trying to exclude them because they’re high risk or at least they’re perceived as high risk.

So I think, you know, trust is low and I think, you know, perceptions are very much that, you know, there is – that they are regarded as high risk and that an insurer will go first to decline rather than to accept.  We’ve got unfortunately a stat where one in four people feel that they are discriminated against by financial services so they feel that they’re going to pay more for products or they are going to be declined.

Kathryn:       Yeah.

Leo:             And again, that’s that thing of previous experiences but equally someone who has a good experience will be really delighted, will be, you know, so happy and it’s transformational.  So what you tend to hear about is all the negative experiences but when a claim pays it has such a kind of transformational effect on someone’s life because if you imagine you go from a position where you are really, really worried about finances after a cancer diagnosis and then your critical insurance pays out as it was intended to do and you hear about that or you hear about that experience from someone else then you are going to have a very positive view of it.  So I think it’s not a case of there is one single view.  It’s how people come into it, how they are treated immediately after their cancer diagnosis when they’re already feeling quite vulnerable, because I think that’s another component of it.  You – even if you’re declined, if it’s done in the right way and you’re supported through that process, that’s going to give you a totally different outcome but, you know, insurers need to be aware that what they’re dealing with is a perception that people are discriminated against and the perception that people might have low trust.

You know, and I’ve even heard people say things like, ‘You know, I brace myself before I call the insurer because I know this is going to be so difficult and it’s going to be difficult for lots of reasons.’  And I think that’s quite a sad thing and, you know, people will go to an existing insurer where they’ve had, you know, another product, again particularly on the multi-lines and then they’ll be like, ‘Well okay I’ve got product one with them, why have they declined me for that one?’

Kathryn:       Yeah.

Leo:             So, you know, it’s really complicated for people coming to an industry that they’ve experienced in different ways and previously as an included person.  Quite challenging.

Kathryn:       As I say, I mean straight away – I mean it just, you know, it feels terrible thinking that, you know, that one in four people think, you know – that have had cancer will think they are going to be treated – I don’t know if you think, sort of like in a sense, you know, just that they’ve had that thing where, you know, you’re saying they wanted to brace themselves.  I mean, it’s just not a nice feeling.  I mean, we – obviously people come to us specifically because they have had a medical condition.  A lot – most of our clients are in that situation and I will be honest, you know, there are times where, you know, the majority of the time if people have had cancer, it doesn’t always mean that there’s going to be an exclusion or price increase but there are certain times and, you know, obviously I’m always trying to sort of be as open and honest as possible with these things, there are times when insurers, because of medical data, that they look at years of medical data and that’s how they make their decisions.

So not just with cancer but with a number of conditions if it means that that person is more likely to maybe have cancer again or another condition which means that they are potentially likely to die at an unexpected age in a sense and, you know, in the way insurance is set up and the way that risk is set up, you know, the insurers have that kind of – I don’t want to say right to sort of like offer insurance, do it differently or a different premium or anything but I think it’s important to say that there are times as well where somebody who’s had cancer very recently is possibly still within quite a – what would be classed as a high risk time of something recurring.  But I think it’s not necessarily clear when someone is declined or when there’s an increase of premium or when there’s an exclusion or something like that, exactly why that is happening.

So obviously the insurer will have lots of data as to why they’re doing something and obviously I don’t have access to that data and I cannot say whether or not – I’m not medically trained, so I have no idea if it’s right or wrong or whatever, but there’ll be some kind of a basis why they’ve done that and I just think sometimes that, you know, it’s – if there was kind of a very clear explanation put down then that would make it not okay, but maybe people would maybe understand a little bit better why insurers have made the decisions that they’ve made.  Maybe a bit more transparency in that kind of a process.

Leo:             Yeah, I mean I think you’re 100% right.  Sorry, there’s a lot of things there.  Maybe I’m not going to say you’re 100% right on everything.  No sorry, you are, I might just give a slightly alternative view.  I mean, I think –

Kathryn:       Of course.

Leo:             Going back to the kind of people feeling discriminated against, it’s absolutely that, I think – you know, people expect to pay more because they understand that they pose a higher risk and that that is completely reasonable.  Now it is reasonable for insurers to underwrite looking at the data that they have but one of the challenges of that is that is so opaque that we don’t really understand whether that data is actually fair and representative.  So people, you know, people with cancer are protected by the Equality Act.  It’s an automatic disability under the Equality Act and that means that insurers must use data that is relevant to that individual and which – on which it is reasonable to rely but – and on that basis you make an objective judgement.  But at the moment, we only have the insurer’s word that that data is reasonable to rely on and that it is relevant to an individual and I think if there was an explanation as you say, that’s much more transparent about exactly what it is about that person’s individual circumstances, firstly they’d feel a lot more confident and actually, you know, people don’t necessarily know that they are covered by the Equality Act.

In fact it’s one of the things that Macmillan – we put in our – we have pages on the website that tell you about going to apply for insurance, what it might mean, very much so if you’ve been recently diagnosed or if you’ve recently finished treatment that it is likely that you might be declined or postponed or the cost will increase.  So, you know, we are perfectly aware of that and we make people aware of that.

Kathryn:       Yeah.

Leo:             But I think it’s, you know, what we see and the real challenge is people who have no idea that that might just be one insurer’s view and it might be one insurer’s data being used.  So there’s that problem.

Kathryn:       Yeah.

Leo:             And when they are offered a quote, they’re offered a deferral or whatever – that decline, they don’t know where that’s – well obviously they don’t know what the data are being used but also they don’t know if it’s value for money.  So it might be that they pay an increased premium but is that fair?  Are they getting what they deserve for what they’re going to pay?  So it’s important, you know, so people have a range of choice to understand the value of what they’re getting and whether it really does reflect their situation.  So people are quite often left with an impression about their wellbeing and their health that’s different to what they’ve been told by their clinician and I think that insurers possibly don’t realise quite how much impact they have on people with those discussions that they have because if someone’s clinician has said to them, ‘Yep, you know, you’re well, recovered, I don’t see any chance of there being a recurrence,’ or they’re many years after diagnosis too and they’ve recovered, to have an insurer say, ‘Well no, you’re still a really high risk,’ or, ‘We don’t want to cover you,’ you know, can actually have quite a significant impact on someone’s, you know, emotional wellbeing, you know, and so that’s – it’s really important that we don’t let people go off with the impression that that’s, you know, that insurer’s view is the entire market’s view or everybody’s view and particularly not if it’s kind of different to their clinician’s view.

Kathryn:       Absolutely.  I mean we, obviously we are specialists, so there are times, you know, where people come to us and they’ve said they’ve been to multiple insurers, they’ve been to multiple brokers and they’ve been declined everywhere and they come to us and we’ll get them standard rates at a different insurer just because of the different access that we have and it’s not that, you know, it’s not that we’ve got sort of any specifically, you know, there’s no funny wordings or anything like that, it’s just purely understanding and having, you know, there’s some brokers have limited panels and some people just, you know, they don’t have the knowledge that, you know, they haven’t experienced being able to arrange cover for people that are living with cancer.  But we have a couple of like really interesting kind of examples that go with that as well.  So, completely appreciate with you that, you know, it’s really hard as to what you can do and sort of how you can say these things to people living with cancer and potentially change the way their mind is, you know, and then how they’re feeling about themselves and feeling so good about the stages that they’re at.

So as an adviser, that’s something that we’ve had to do on multiple occasions and it’s been for a couple of different reasons.  So one of them, as an example we had somebody who had tonsil cancer and their specialist had said to them, ‘I got your tonsils out, the cancer’s out, everything’s done, you are not getting cancer again.  You are definitely not getting cancer again because, you know, I would literally bet my house, my car, my living – everything on you never getting cancer again.’  Which is brilliant for that person to hear, they are so confident but then when you go to the insurance side of things, the insurer from their data and the different things that they have, well quite a bit of the time will be very – the case of, ‘Well no, you’re actually – because you’ve had tonsil cancer, there’s pretty much a really good chance you’re going to get cancer again, so no, that’s not the case.’  And that’s really hard as an adviser to be able to buffer that ‘cos you’re hearing both sides.

Another thing that we have quite regularly – and this isn’t like a – I’m not being funny towards the NHS or any kind of doctors or anything like that, I’m just obviously – again, talking from our experience but there’s been quite a few times where people have had the incorrect cancer information recorded in their medical records so there’s times where people have come to us and, you know, they’ve been to other people and been declined here and there and different things and they’ll come to us and they’ll tell us what cancer they had, the staging and the grading and different things and we’ll say to them, ‘Right, we’ll be able to get you with Insurer X and it should be around about this premium and we’ll have to go through the medical information.’  And then it will come back and it could be that the premiums have been doubled or tripled and then they think – they’re saying to us, ‘Well why?’  And we’ll say to them – so you’ll end up getting obviously – chatting with the insurer about the different, you know, the different permissions in regards to data protection now especially, and it’ll end up that we’ll say to the person, ‘Look, we can’t know everything that’s gone in your medical report from your GP to the insurer,’ unless, you know, sort of like we go through data protection requests and different things like that or they get copies of the medical reports which can be really, really helpful if people can do that.

But we’ll say to them, ‘Look, from what, you know, obviously, we understand that you’ve had cancer and you understand it to be this staging and grading and we have to take advice and – but we’re really, really sorry but the way that the insurer is pricing this is – basically it’s kind of meaning as if your GP’s recorded it as actually this staging and grading which would have been a much higher, much more invasive cancer.’  And there’s been quite a lot of situations where we’ve done that and the person’s gone back to their GP and found that the GP’s records and medical report has actually been incorrectly completed for the insurer and, you know, they’ve faced all these declines.  They’ve faced being turned away so much and it’s because that medical report wasn’t being completed correctly.  And I say, I’m sure this isn’t like a standard, you know, thing that’s happening to everybody but it is something that we have seen on multiple occasions and it is – in a sense it is – it’s good with our knowledge that we’re able to stand there and go, ‘Hang on a minute, there’s something – just isn’t adding up here.’  You know, we need to figure out what’s going on in these medical reports or maybe this person hasn’t understood the diagnosis that they’ve been given which, either way, is very, very hard as an adviser to know how to handle that because it’s not sort of as if you’re justs an insurer issuing a decline letter in a sense.

You are there, you’ve invested in people and they’ve come to you with such trust.  It can be very, very difficult.  So when it comes to things like the insurances, I think, you know, it can be quite hard for people to understand what is potentially going to be available.  I think some people can come and think, ‘Right, you know, I’ve had cancer I won’t get life insurance,’ or, ‘I’ve had cancer, I’m going to get life insurance but with a higher premium or exclusion.’  And then some people may come and just go, ‘Well I had cancer but it was, you know, 10 years ago so I’m absolutely fine and I should just be able to get life insurance or any of the other insurances,’ you know, and there’d be no in a sense queries or issues or high premiums.

So, as an example, I do have some case studies as well to go through but as an example, so someone who has had leukaemia – so say that person wanted like a critical illness contract.  So critical illness for anybody who’s listening who’s not familiar, they would typically within the UK cover you for at least 50 life changing diagnosable conditions.  So that would be cancer, strokes, heart attack – are probably your main three that tend to be claimed on.  There are other things, like Parkinson’s disease is covered, there can be like traumatic head injuries, third degree burns, you know, there’s quite a few different things in there.  Some of them cover multiple sclerosis as well.  But it’s important to know as well, when you get these policies, if you have cancer, it would be cancer of a specified severity.  So I sometimes say to people when they ask me, I say, you know, ‘If you have sort of a mild skin melanoma that’s, you know, obviously no matter what it’s cancer and it’s going to have been quite a shock to whoever’s had it, but if you’re able to go into the GP surgery and they’re able to remove that, it’s not what an insurer would probably class as a life-changing version of cancer.  You know, it’s going to be something that is probably much more invasive.  But there are things known as partial pay-outs as well for cancers that are of what would be classed in the insurer’s mind as kind of a lesser severity.

But for say something like leukaemia, you probably need to be clear of the cancer for about 20 years before critical illness cover may be available and it could be possible that some insurers will never offer critical illness cover for somebody who has had leukaemia.  But then, say you might get breast cancer which is obviously far more common I believe than leukaemia and that is something that, you know, depending upon the staging and the grading, the life insurance could be available with some life insurers within a matter of months and, you know, not – it’s not always at silly prices.  I don’t want to say it’s never at silly prices, you know, there’s sometimes where the prices do get to be a little bit out of budget, but it’s important at that point, that’s where advice really stands out because we can help you sort of figure out where that premium, if it’s going to increase, is going to be increased the least, if that makes sense.  I hope that makes sense, that seemed a bit of a tongue twister saying it like that.

But again as well, critical illness cover could potentially be available after a few years with some exclusions.  You may find, if someone’s had stages three or four cancer that they may not be able to get critical illness cover on what we’d say is on the standard market.  You know, there are some specialist options that can be looked at and again, that’s not to say that they’re going to be silly prices.  So just think, if you hear the words specialist insurance or something or specialist broker, it doesn’t mean that you’re getting anything with like I say dodgy wording or anything like that or say silly prices, it just means that you’re going to a more unique offering because of the situation that you’ve had.  I mean, what’s your thoughts on that kind of side of things in, you know, in regards to the timeframes between somebody being diagnosed with cancer and then insurances being available or not available or the exclusions, different things like that?

Leo:             It’s, you know, as you say, it’s a really – well it’s a hugely complicated picture isn’t it?  I mean it’s, you know, as you described, if you think about a customer journey through that, their starting point is, ‘I’ve,’ you know, ‘I’m recovered 20 years from this cancer.’  And I again, you know, I’ve had conversations with people where they sort of say, ‘Oh, you know, I had leukaemia in childhood and yet I still have to go through full medical underwriting,’ and, you know, a lot of the time, I think it’s back to sort of the customer-centric point where, if you think about the times that people are taking out new insurance, a lot of those times are the kind of quite positive times, you know, maybe if you’re getting married or if you’re buying a new house or things like that.  So it’s kind of understandable when those are the times that people are moving on, they’re, you know, they are confident and they are covered so it’s, you know, I think it’s very difficult to understand why, from a layman’s perspective, you know, after 20 years someone should still present such a high risk that they’re paying a lot more.

However, when you talk about breast cancer, you know, and again I’m no medical expert, but it can be highly recoverable and people are living longer.  You know, there are better treatments, so again, further out from a cancer like that, you would expect to see people I think paying a lot less.  Obviously if it has advanced then, you know, people are a higher risk.  It’s – but there are so many permutations, I think that’s the challenge – is it’s very difficult for someone to understand when different insurers are taking a different view and there’s massive levels of inconsistency and someone might get totally different outcomes from different places, whether that is representing, you know, a fair, good value approach.  So it’s not just about the cancer itself but it’s about actually how that’s judged by the industry and there is no one single answer.  So I think that would be my kind of repost to that or what might – what I would put back is like, ‘How can you take such different views and on what basis?’  So maybe you could just be really transparent or say, you know, ‘It’s 20 years for leukaemia and that’s that.’  You know, so people coming know what to expect.

Kathryn:       Yes.

Leo:             But in terms of making a judgement, not being on the inside of the industry, it’s really hard to say because, you know, we’re on the outside looking in saying, ‘Well, you know our financial guides will see people coming with leukaemia – a long time recovered from leukaemia and also with breast cancer.  That’s quite a common scenario for them and they’re sort of saying, ‘That just doesn’t feel quite right to us.  Why are you so high?  Why a no?  Why is such a long time out from diagnosis before they will be covered?’  So, you know, it’s really challenging.

Kathryn:       I think it is, you know, and as you say, for someone who’s outside of the industry, it’s got to be challenging. For someone who has had a cancer diagnosis, I imagine the last thing they want to do is necessarily talk about it at length with multiple insurers and multiple brokers and I think that’s a really important as to why things known as signposting in our industry is becoming so much more important so that people just get directed to the right brokers or insurers straight away that can really step in and help but it’s, you know, for advisers in our industry, you know, it’s sort of – it’s very confusing for us and we’re in there amongst it all every day anyway.  So for someone else who doesn’t have that kind of knowledge, it must be absolutely – like you say, that kind of bracing yourself.  I can actually sort of like feel myself doing that for them.  You know, I can sort of like sympathetically think that way.

Something I just wanted to quickly point out as well, it’s just popped into my mind, I think it’s really important as well to tell any listeners that if somebody has had – somebody has the BRCA gene, that’s not something that you need to disclose to insurers but it’s very, very clear in a sense the specific wording around that.  So if you’ve had a predictive test to see if you carry the gene or an activated version of the gene, then you don’t have to tell insurers about that.  If you’ve had the diagnostic test because you are symptomatic then that’s different but it’s something that’s really, you know, it’s important for people to know because again we get people coming to us saying, ‘Oh well, I’ve been found out that I’ve got this gene.  It’s going to make it really hard for me.’  And it’s a case of, ‘Well, no, you know, it’s not going to make it really hard, you know, it should be okay.’  But obviously, what would happen in probably a lot of places though is that the insurers will ask about cancer within the immediate – what I call the blood-related family members, so siblings and parents.  So at some point, the family history of cancer can come out in these insurances but having these, you know, specific genetic tests, you know, if someone was thinking, ‘Oh I shouldn’t have a test because it will affect my insurances,’ you know, don’t worry in a sense about that, you know, do whatever feels right for you if you do want to have that genetic test or not.

So, as an adviser – so when I’m speaking to people and they’ve had cancer, there’s quite a lot of information.  So this is something that I think is useful for other advisers, like myself and also for people who are listening who have had cancer and are just wondering what in a sense they’re going to be asked and I’m not saying this is an exhaustive list but it’s hopefully going to give quite a good amount of information that people could use in that kind of first initial chat.  So, the insurer is going to know what type of cancer the person’s had and when it was diagnosed, the staging and grading of – it’s the Gleeson Score, PSA levels, obviously blood cancers are different so any kind of readings or levels, excuse me, that you have really, really helpful especially for an adviser to have straight away.  The treatment that’s been had, whether or not it was surgery, chemotherapy, radiotherapy, hormone replacement therapy and the dates that those happened so, you know, if it started in the May, when did it finish?  Was it a couple of months, you know, sort of like did it last longer than that?  When were you given the – in a sense the all-clear and discharged from the reviews?

They’re the main things really that can be really helpful in the first place for an adviser to help you.  I mean, what I would say is that, you know, there are some insurances that we have access to where in a sense the medical information doesn’t even need to be detailed.  So, you know, in a sense having had cancer doesn’t affect the eligibility for the policy but there are some in a sense quirks with those insurances which must be very, very clearly talked about with the people who are wanting them.  So you don’t have to always have that information to-hand but even though I have access to those insurances, I would always want to try more than the standard market first so, you know, if you were going to speak to an adviser, it’s one of those things as well where, you know, you want them to do the research, you know, you want them to sort of like really do that bit to get you the best advice that they can so we always say to people, you know, like, you know, ‘Are you going to, you know, please just give us a few days, you know, we’ll have all this information to-hand.  We absolutely, absolutely need to know the staging and the grading, you know, sort of those readings, those levels of how big the cancer was or any of the other readings.’  You know, they are absolutely essential so we can get an accurate representation for what that person may get when they apply for the insurances.

So one of the things I was wondering, Leo, is that obviously something that we do very regularly at Cura and all of our advisers are specifically trained by me to do this and, you know, in a sense I don’t let them loose until I am happy with the way that they’re able to ask these questions and sort of like get this information so I know their knowledge and also their approach is going to be right I would say, for the majority of people obviously.  Would you have any kind of information in regards to – is there anything missing from that list that you think is like a key indicator of the way that somebody’s health is after cancer?  Or is there anything in particular that’s, you know, really a no-go for advisers.  Any kind of like terminology?  Like I know sometimes I’ve seen things on social media saying, ‘Oh, I’m a cancer survivor or I’m a cancer warrior,’ and then someone else will come along and said, ‘I don’t like the term cancer survivor or cancer warrior because that means that if someone hasn’t been able to survive the diagnosis, then that means – are you saying that they didn’t try hard enough or they weren’t warrior enough?’  So it’s really hard sometimes to know what the terminology is and do you have any tips?

Leo:             Gosh, I mean – I’m the broken record.  It’s really personal, it’s really individual isn’t it and I think that thing, I mean I know how expert you are and how hard you work and Cura work at kind of really trying to meet the customer where they are and I think that’s the point.  You’re absolutely right; some people really don’t like the term survivor, warrior because, as you say, you know, it implies something about how they have dealt with their cancer.  We try and avoid the term – and we hear it all the time, sufferer.  So we talk about people living with cancer.  So if you’re living with cancer or you had cancer, you know, quite simple just, you know, really upfront and I think going back to that point of, you know, if you – you just reeled off a very detailed list and not everybody thinks of their cancer in terms of that medical terminology.  Some people will, that’s – again it’s everybody’s different.  It depends obviously again how far out they are from their cancer because, you know, knowing how I keep my medical records, they’re usually somewhere in a drawer, you know, and so everybody will be at a different place and yet some people we speak to, you know, our guides speak to and they’ve got all the information they need in front of them, you know, they’re ready to go and obviously at Macmillan what we try and do, again on our webpages, it will tell you a little bit about the process and so say maybe have your most recent letter to-hand.

So sometimes it might be a case of working backwards, you know, what’s the most recent interaction you’ve had and what information did you get from that and then sort of work backwards I guess and then, you know, sometimes it might be helpful to remind someone, you know, if they’ve maybe had a Macmillan nurse, what information did the Macmillan nurse give them?  Because sometimes, you know, when they’ve had the diagnosis, actually it takes a while to process and so it’s when they maybe speak to their nurse and they explain it later and so something about helping people to remember the points at which they’ve been given that information if they haven’t got it immediately to-hand.  So, you know, having to say it’s very much about having that – almost more about the approach to customer –

Kathryn:       Yeah.

Leo:             Than actually the approach to the medical information because it’s so personal and it’s so individual, you know, and people will be in different frames of mind as well.  You know, it’s back to what I said about, you know, it might be because of buying a house or sadly it might be because they’re thinking about the future and needing life insurance and how to support their family.  So, a lot more is about the wraparound and I think you’ve really got to the crux of it with that – how do people feel about their cancer but ultimately what you are trying to achieve is to get that really detailed medical information that you need.  So I don’t think you can ever go wrong with asking someone have they got some paperwork or something that they can refer to which is a starting point, or what’s their most recent medical interaction?

Kathryn:       Absolutely.  One thing we do as well at Cura sometimes, depends upon the situation obviously, is we’ll say to people, if they have those kinds of letters to-hand from specialists and different things, you know, sometimes it can make things a little bit quicker when you’re applying for these insurances because if it needs to go to the GP, obviously especially in the current times of corona virus and everything, we’ve kind of got like a weird dynamic at the moment where with some GPs, you know, they’ll say, ‘We are snowed under, we just can’t do anything at the moment.’  And then other GPs are saying, ‘Well we’re barely seeing anybody so actually yeah we can fill this form out much quicker than usual.’  And what we’ll say to people is we have, you know, very secure systems and we’ll say to people, ‘If you have the facility to be able to scan that and you feel comfortable, there’s no pressure at all but if you feel comfortable sharing that letter with us,’ it means that we have kind of very early on proof that, with their permission, we can then share with an insurer the details of that information.  It can sometimes speed things up a little bit.  It’s absolutely not essential at all but it’s the kind of thing of that if someone is prepared to be able to do that then that can just speed things up a little bit.

So, sort of going on like a little bit from that and just kind of moving to the C-word that I just mentioned there, corona virus.  I don’t think there was any way that we could have this chat and not talk about changes that have happened with corona virus and I think, you know, it’s one of those things that, you know, I’ve been quite vocal in our industry saying that, you know, it’s really important as an adviser that we’re kept up to date with insurance decisions because then, you know, we are that buffer to the client so then we can help people and keep their expectations at a reasonable level as to what is going to be available or not and also, again asking those questions to sort of say, ‘Well is this actually – what’s this based on?  You know, we understand that this change has been made, we’re not going to – we’re not asking sort of to know all the background kind of strategies and mechanics and whatever is going on with these decisions but just, you know, can you just explain it to us so that we in our minds have a good idea as to what’s going on?’

So what we have seen is that insurers have become particularly cautious for people who are living with diabetes, high blood pressure, high BMIs because in the very limited amount of data that we have on corona virus at the moment – very, very little amount and about the – obviously the very, very unfortunate deaths, there has seemed to be a bit of a correlation that people with those conditions are at a higher risk of dying if they do get corona virus.  But one thing we’re also seeing as well is that there seems to have been some kind of blanket decisions made at times as well which will – insurers – so people who are listening who don’t know the insurance world, when insurers sort of like assess somebody’s risk for life insurance, what usually happens is that there’s a number of things – they’re either accepted at what’s known as normal terms or non-standard terms.  And the non-standard terms would be a case of usually – most of the circumstances, it’s a premium increase.

Now that premium increase is a multiple of that base premium that is initially seen if you do onto like an online search comparison site or something and it’s depending upon how much it’s increased depends upon how, you know, much the insurer sees that person’s health as being a risk and what we’re seeing is that instead of, you know, offering these higher percentages that insurers were doing before.  So in a sense the more risk they were prepared to take on, they reduced these percentages which kind of – I’m not saying it specifically does but it kind of means that in quite a few circumstances, people with say cancer, people who are living with HIV or people that have, you know, I mean we’ve seen an instance, you know, even with someone who has been clear of cancer for nine years and is now declined by insurers because they’re above that new maximum percentage of, you know, multiple of the premium.  And it does seem as if, you know, there’s a very – I say blanket approach to sort of like anybody who doesn’t meet – like I was saying before in the beginning part of this, you know, insurers in a sense commercially have a right to say what their maximum percentage is.  If they don’t want to go above a certain percentage of premium then, in a sense that’s their – kind of their decision to do so.  It’s in their right to do so, commercially – obviously very carefully there – commercially in a sense their right to do so.

But from very much a moral kind of point of view, it does seem as if people who have had cancer have been – kind of suddenly had this barrier put up from being able to fairly access insurances with – in a lot of insurers.  And I’m not saying – because I know there’s going to be some underwriters listening, possibly some actuaries who aren’t particularly pleased with me saying that but I’m not saying it to say that I fully understand insurers’ decisions but obviously as an adviser and someone who works very much with people in the higher health risk kind of situations, it’s something where it’s not been particularly clear and I was mentioning to you before we spoke on here that we saw a decision letter from an insurer where – and I think I mentioned this in the podcast not long ago – where they basically said to somebody living with HIV that, you know, ‘We don’t really have any data at the moment to say that people living with HIV are at a higher risk of corona virus or, you know, of dying from corona virus but we’re kind of making the assumption that it is so we’re just going to blanketly say no, we can’t offer.’  Which to me didn’t sit particularly well and obviously it’s something we’re challenging and we’re supporting that person.

But I know you’re going to have plenty of views on this, Leo, so I will let you loose in a second but I think for me what I’ve got to – what I would like to say is that, you know, in a sense that I think commercially there’s going to be people who completely sit in the commercial side of the decision-making things and there’s going to be people who completely sit in the moral side of, you know, decision-making and I think we need to have very much a clear and transparent conversation with all the people who are kind of sat in the middle who are coming from either side to sort of go, ‘Right, okay, we understand that insurers see this risk.  We understand that people over here think that people with cancer should, rightly so, have a very fair access to insurance.  How can we make this work and fairly work?’  I shall let you speak now, Leo, you go for it.

Leo:             Well it’s, you know, corona virus is absolutely ingrained into all of us at the moment and it’s all we ever talk about but, you know, for people with cancer who prior to the pandemic really struggled to access and understand how they were being treated by the insurance industry, there are so many things here for us to be really alarmed by.  You know, I think from what – I’m really interested to hear you describe the commercial versus moral argument in effect Kathryn because, you know, it’s – so for us what is most concerning is we had a big concern at the outbreak of the pandemic which was when we were hearing that there was no medical underwriting taking place because some insurers were just deciding that it was appropriate to take pressure – and in fact the ABI as well that it was to take pressure off the NHS frontline and so they weren’t calling for medical evidence for people which meant that actually there were a lot of people with cancer who were completely locked out of the market, whereas other people were able to access insurance because they didn’t need medical underwriting and there’s a fundamental here, and I’ve talked about it before, but the people with cancer are protected by the Equality Act.

Now actually this isn’t a moral argument or a commercial argument, it’s a legal entitlement and what that means for insurers is again that they need to make an individualised assessment using data on which is relevant to that individual customer and on which it is reasonable to rely.  And, you know, it seems to me that every single day we’re hearing something new about corona virus and our understanding of it is developing so it doesn’t sit right that there are blanket approaches being taken in anything to do with Covid.  I mean, I think you said it yourself Kathryn, that actually we understand a little bit that some people with diabetes might be at higher risk, you know, but actually there’s still evidence coming from across the world about different, you know, different impacts of Covid-19.  So, you know, actually it’s alarming to see a) blanket decisions being taken which, you know, yes insurers are entitled to make commercial decisions but there are, you know, there is a fine line about what is legal and what, you know, how people’s legal entitlements are being upheld but there’s, you know, there’s also just a huge question about the future.  Is this going to get worse, you know, based on – this is what’s happening on what we know now, what’s that going to look like in the future.

And I think it’s really interesting that the Institute and Faculty of Actuaries have already released some great papers looking at the consequences of Covid for the industry and obviously, you know, we’ve seen the business interruption cases, we’ve seen all the challenges.  The industry is, you know, not exactly that popular at the moment based on those things and the public consciousness so to see already restricting access for people who are already facing challenges and let’s not forget that there were people who were in the shielding group – there were 250,000 people with cancer, maybe more, within the shielding group who were extremely vulnerable but then there were also people in the wider group.  So to not even look at that differential as well is kind of an interesting factor if insurers aren’t looking at those sorts of things.

So, you know, it just feels like there is a potential breach here of the law but what the Institute and Faculty of Actuaries was saying is, you know, we are going to move to a place where it’s likely that there will be excluded groups.  Now, at the moment it’s really unacceptable that people with cancer should be excluded already as a blanket group when they are not a group, you know, this will probably be about people with multiple conditions, you know, we just don’t know yet.  And again, the Institute – what was interesting was that was posed as a kind of social – that goes back to your moral question.  What kind of society do we want to be?  What do we need to do when we’re really sure what’s happening so that if there are people who can’t get insurance, how do we facilitate that for them?  So that was a question we were asking before the pandemic and now it’s a question that’s so much more pertinent, so much more scary because of, you know, what’s happening already and what the consequences could be.

So, you know, fundamentally for us it, you know, it’s about consistently – there must be a personalised assessment.  You mustn’t be using data that is potentially unreliable that’s new, you know, that isn’t certain and, you know, it was really interesting because I was watching the news last night, you know, a very reliable source of data, and they were showing this new thing about the Covid age.  You can calculate someone’s Covid age based on certain risk factors and again it was very blunt, you know, and the news presenter sort of said, you know, ‘We can’t give – we can’t make a personalised risk assessment so here’s some guidelines.’  So if we can’t do it, then don’t – don’t put a blanket assessment on.  You know, be honest, be transparent about what’s happening.  So there needs to be a discussion and, you know, really from our perspective it’s absolutely not acceptable that people with cancer should be blanket excluded at this point in time.

Kathryn:       Absolutely and I completely agree and I’m not going to say that sort of we – that we have sort of like every single solution out there but one of things that – especially because we are specialist brokers and, you know, we know what we’re doing – I’m not saying that others don’t know what they are doing but, you know, it’s just – that sounds terrible.  You know, obviously we understand like the medical conditions to an extent – obviously we do have quite a lot of medical training, obviously not to the level of a doctor or a nurse or anything but we do understand these conditions so like during the corona virus, when those GP reports were all getting stopped in a sense, you know, we were able with some insurers still to do GP reports at times.  You know, there was times that we were able to get people that individual look at their cover rather than just that blanket kind of exclusion and the thing is, that’s brilliant and I was so happy we were able to do that but obviously that’s if people come to us.  If people just go generally to a broker, they wouldn’t have had that experience and it would have continued that kind of, you know, I know there seems to be that thing in the media as well of people saying, you know, not necessarily specifically people with cancer but, you know, people with lots of health conditions basically saying, ‘Well hang on a minute, you know, this corona virus has hit and it’s really made us think about how much we need insurance and things like that.  Just because it’s scared us and now we just can’t even access it.’

And I think there’s kind of that – when I see the commercial agreements in my head, I kind of imagine – and it sounds terrible – I imagine sort of like a middle aged man in a suit with a briefcase in London who’s just like completely expressionless in a sense and – I know that’s absolutely terrible but that’s what I see and I see like devoid of emotion in a sense.  So I think to make some of those decisions, you know, you would have to be – you wouldn’t be able to do them if you’ve had that kind of emotional invested side of things to see where people are at.  And I do want to say to people that are listening, I know that these things are happening but, you know, there are many of us – not just advisers but many people within insurers and reinsurers who are really working extremely hard to try and either get things back the way they were – kind of towards the way they were so that, you know, obviously there was, you know, not necessarily perfect access to insurance but a lot more options than there are now and, you know, so if you can, don’t give up.  You know, don’t give up on the insurance world completely.  I know that’s such a massive ask for some people, but hopefully I can encourage some people to stick with us a little bit.

I’ve got some case studies to share because I think, one of the big things for me as well is that people just don’t really know what to expect and, you know, when you’re saying to people there’s going to be a premium increase, as I would think, you know, you have no idea what it’s going to look like so – or an exclusion, you know, it’s just – it’s a bit kind of mindboggling to think.  So I’ve got two examples here to sort of like share with everybody and one of them is life insurance and the other one is income protection, okay?  So for the first person, it was a 35-year old non-smoking female.  She’d had acute lymphoblastic leukaemia and she was diagnosed at the age of 10 and she also had a relapse at the age of 12.  She’d had chemotherapy, total body radiation and bone marrow transplant and her treatment, when she spoke to us at the end of 22 years prior to speaking to us but she still had yearly follow-ups.  As you say, like the life events, she was now married with two children and she had a mortgage so there was a couple of different things that we did in a sense.  So what we did was, we did some decreasing life insurance which is – when you have a capital and repayment mortgage – so if you have a mortgage that in a sense you are paying it off and at the end of the mortgage you own it, it’s completely yours, the house, that’s usually capital and repayment and you would usually do a decreasing life insurance for that.  So for her we did a decreasing life insurance of £100,000 to cover the mortgage over 12 years and that came to a premium of £7.19 per month.

Now I think an important thing to demonstrate there to people is that that includes a premium increase.  So when we say a premium increase, it doesn’t mean that you’re suddenly going to be paying, you know, someone’s paying £5, you’re suddenly going to be paying £50 a month.  This is literally, you know, £7.19 per month.  We also did a bit of family protection for her so we did what is known as level life insurance of £100,000 to the age of 70 which is when she felt obviously her family would be fine – she would be retired by that point and it was – level life insurance means it would always be £100,000 so it would be £100,000 as well when she’s aged 70 if she hasn’t obviously passed and claimed – there had been a claim on it and that was £13.92 per month.  So there you can see she’s got 35 years’ worth of cover for £13.92 per month.  Again, that has a premium increase.  So I just wanted to give that as an example to people just to – again, just to say, it’s not going to necessarily be silly, silly pricing and what was really good for this lady is that she actually did have a recurrence of cancer during the application process but with the insurer that we had placed the policy with – the application with – they specifically state that they don’t need information.  They don’t need to be updated.  Once the application is with them, they don’t have to be updated with new medical information so it was ignored that she’d actually had a recurrence of the cancer.  So that was really, really positive – especially in this situation.

What a lot of people may see when they go for the insurances, is that there is that mix, so I say, you know, it’s often that it’s a percentage.  So it could be that the premiums are multiplied by two or three or a few different options.  There’s – sometimes it gets a little bit crazy as well.  Sometimes these percentages are a little bit –you have to sometimes sit back, even as someone who does it quite often, you have to sit back and try and figure it out.  But some people may see what is known as a per mille loading and for the majority of people, a per mille loading is going to see – that’s when you’re going to see the big prices in the premiums because what essentially happens there is that the insurer increases the premium for every £1,000 worth of cover taken out.  So as an example, a very, very kind of broad example, so if you were taking out £20,000 worth of cover, the premium – the, in a sense what we call the loading – the increase would be far smaller than if you were taking out £100,000 worth of cover because you’ve got like another 80 £1,000 worth of cover included within that policy.  It can get quite confusing.  That tends to happen where people have had more recent cancers and have been more of a higher staging and grading.

The next one I wanted to talk about was an income protection policy.  Now, we have been having – and I think across the industry, income protection has been something that people have really, really wanted to look at especially with everything that’s going on and the job uncertainties.  So something I wanted to be clear on is that income protection isn’t redundancy cover.  So some people have said, you know, they’ve maybe come to us and said, ‘Well I want to protect my income, I want income protection just, you know, I’m worried about being made redundant,’ and it’s awful to have to say to people, especially when something’s happened like corona virus – it’s awful to say that that’s not what income protection does.  So you can – well I say you can, you used to be able to get unemployment insurance and that used to be a policy that was on offer and that would repay your income for 12 months if you were – well up to 12 months if you were made involuntarily redundant.  All of those policies have been removed from the market now after corona virus has hit.  So the unemployment cover side of things is no longer open to new policies.  So income protection itself, that is when you have a health condition develop that means that you are unable to work or something happens, you know, say when you are unable to work due to your health.

So an example for this one – so, now this one, just bear with me because for this one the premium is a bit higher but I’ll explain why it’s quite a bit higher okay when we get there.  So this was a 54-year old smoker.  She’d had breast cancer, carcinoma in situ for 14 years prior to speaking with us.  She’d had no lymph node involvement and it had been quite a large tumour so that in a sense the core of the tumour had been about two centimetres but with kind of the outreach that came from it, it totalled about 10 centimetres.  She’d had a single mastectomy and that had been – and she’d had nine months off work at that time but she’d been back at work, obviously not having any issues with the cancer for the last 10 years.  She’d been told by multiple insurers and brokers that she could never have income protection.  She came and spoke to us and we had a couple of insurers that were possible so what we did is, we arranged for her to have £2,000 per month of income protection.  It was – had what was known as a three-month deferred period.  So when you set up income protection, you tend to have – with most of them you tend to have something like a four-week deferred period which means that you have to be ill for four weeks before the claim can be paid.  With this lady, due to savings and different things, a three-month period was absolutely fine for her and it does also mean that the premiums aren’t as expensive.  It was known as what’s own occupation and it was to age 65 because that was her retirement age.

Now, this came to £135 per month for the cover and the reason I want to say bear with me with the premium there a little bit is that income protection is definitely far more expensive than life insurance because people are far more likely to claim on income protection than they are on a life insurance policy.  So people sometimes – and they think it’s going probably to be a similar pricing and then when they see the pricing for income protection they get a little bit kind of like, ‘Ooh, I’m not sure about that.’  It’s just simply because you are so much more likely to claim on it.  The important thing that I wanted to point out for this one is that, you know, this is a 54-year old lady which means that she’s in, in insurance kind of ways, she’s probably more in like a prime age for maybe having a health condition that would cause her to be unable to work.  Not saying that’s for everybody so please don’t assume that I’m saying that for everybody who’s 54 but, you know, just from the statistics and everything – and that £135 per month was guaranteed right up until – for the next 11 years and what I want to say is that there was no premium increase and there was no exclusion.  That was the price that any 54-year old smoker would have been given.  So that’s why I just wanted to include that one.  It is a good thing to point out as well, because she was a smoker, that pretty much meant that her premiums had been doubled anyway, so if she’d been a non-smoker, you could probably halve those premiums.  But yeah, I just wanted to give those as some examples.  Is there anything that you would like to add, Leo, and anything potentially to those case studies or anything else that we’ve not yet covered?

Leo:             I think it’s just, you know, those case studies are fascinating and they’re so helpful because for a start they illustrate, you know, how complex peoples’ situations are.  So it’s not – I think that is the challenge sometimes, it seems very kind of binary.  It’s a yes or no and it’s just not at all so I think, you know, for me as someone who’s kind of lurking on the fringes of being more educated about insurance, I can see that but as people – you know, it’s important to understand that people coming to the industry might just, you know, have quite a simple view of it so – but what’s really positive and perhaps that’s what we need to get the message out then more is the fact that it is accessible.  You know, particularly that last case – expensive but actually accessible if people want it and I think – or, you know, I hear you tweet about silly premiums versus sensible premiums.  I think that’s quite an interesting point as well because actually, again something I see a bit with the industry is this kind of tendency to shy away from offering things that they think people might not want or might not take.  It’s very much about what the customer’s circumstances are, so is it affordable for them?  Do they want to have that choice to take it because it’s more important to them and they feel like that’s money that is well spent and good value?

So I think, you know, there’s that, which sort of quite significant points – is, you know, what does the customer really want and what are they prepared to accept and what is good value and fair for them?  And I think the other thing is, you know, obviously I always feel very guilty that I talk very negatively about, you know – because I see sort of lots of injustice and lots of people who’ve had very difficult conversations and difficult things but actually, working on the Access group has, you know, it’s seeing that positive effort, seeing, you know, companies like yours where you’re really taking care of the customer, really absolutely trying to take it to the nth degree to make sure they get some cover and get the best cover that’s available for their circumstances.  You know, there’s a huge amount of positives, there’s a huge amount of progress and I think it’s important that we focus on that and I think some of the work that’s coming out of the Access working group, you know, the signposting work, things that are really going to support people to get to what is available to them and, you know, some work that we’re doing on explaining underwriting decisions which is something that we talked about before, you know, enabling people to navigate what is a complicated market but understand that the likelihood is there is something out there for them and also that if there isn’t, you know, that that is explained to them in a way that, you know, shows that it’s fair and actually even better than that, if as part of the working group and part of this work is that we can actually extend the cover available to people, you know, that is the direction that we’re going in or we were going in so apart from everything else, let’s not let Covid stop that.  Let’s, you know, kind of hold that core of we’re trying and working towards kind of widening access and trying to include people rather than looking to exclude them.

So, I think, you know, positive and negative.  I don’t want to be the kind of complete naysayer all morning but that’s I guess where we’re at.

Kathryn:       Absolutely.  And the thing is, I think it’s very valid and I think, you know, anybody listening will hear that you’ve got such passion for helping people that have obviously been living with cancer now or have had it in the past and, you know, I don’t think anybody could – well, I don’t think anybody could have a negative to say about your points of view on it.  I’m not everybody though but, you know, I think, you know, like you said though, it’s kind of like that society thing like what kind of society do we want to live in?  Do we want to live in one that supports people and does as much as possible?  Not saying it makes necessarily the absolute, you know, perfect options and doesn’t have the answer straight away but I think that thing of just at least trying, you know, as hard as possible to be as fair as possible and as you rightly say as well, making sure that, you know, insurers and, you know, anybody else in our industry – make sure that we’re not doing anything that goes against what the law says that we can’t do.  So obviously thank you so so much for giving your insight.  So we do have our truth or lie feature that I have yet to fool anybody with so I’m starting to take it as a personal challenge now that people – I am clearly just very, very easy to read.  So I shall start it off and I will say that for my truth or lie, the weirdest thing that I have ever eaten is crocodile.

Leo:             Hmm, interesting.  So for my truth or lie, I have abseiled down the Spinnaker Tower which, if anyone’s been to Portsmouth, is the sort of pointy tower that looks a bit like a sail that’s really very, very high.

Kathryn:       Yes, so I remember my sister went to university there so I do, yes, absolutely.  Well thank you everybody for listening and thank you Leo for joining me, it’s been absolutely great obviously to hear about your side of things.  You know, I’ll be back in two weeks with Sue Kinsella from RedArc Nurses where we’re be chatting about her experiences offering support to people.  I imagine quite a lot of support potentially to people who have accessed Macmillan support as well.  If you’d like a reminder of the next episode, please drop me a message on social media or visit the website www.practical-protection.co.uk and please don’t forget, if you are within the industry or even if you are somebody else and you’re not in our industry, if you would like a CPD certificate for having listened to this, just go on the website again and all the information is there, easy for you to access.  So thank you very much, Leo.

Leo:             Thanks so much, Kathryn.  Great to talk to you.

Kathryn:       Thank you, bye.

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Leo Miles - Cancer & Insurance

Hi Everyone,

We are onto episode 3 of season 2 and this time I have Leo Miles with me.

Leo works for Macmillan Cancer Support and spends her time fighting for equality for people that have had or are living with cancer. Leo has been a mortgage adviser, has worked within the Financial Services Authority and is now a charity advocate.

My 3 key takeaways,

1. Access to insurance for people with a history of cancer has changed due to coronavirus.

2. It is essential that everyone within the insurance sector adheres to the Equality Act, when considering how they offer products and services to people that have had cancer.

3. Two case studies showing potential terms for life insurance and income protection, for people that have had cancer.

Please let us know if you have any thoughts on what we have been discussing.

Next time I have Sue Kinsella from RedArc Nurses joining me. We are going to be talking through a typical day in the life of a RedArc nurse and how they help families through some of the most challenging experiences in their lives.

Kathryn:       Hi everyone, today I have Leo Miles with me from Macmillan Cancer.  Hi Leo!

Leo:             Hi!

Kathryn:       We are going to be talking about cancer and insurance, how insurance is perceived from people on the outside and I’ll be chatting through some case studies where we’ve been able to help people get insurance.  This is the Practical Protection podcast.  So Leo, how are you doing?  How is lockdown treating you?  How was the weekend?

Leo:             Ah, well I’m doing really good today because the sun is shining, I’ve got my lemon dress on, I’m very happy and actually I’ve just had a week’s leave so – which is the first week’s leave since January I think.  So –

Kathryn:       Very nice.

Leo:             Had some lovely time to catch up with the family, been to the seaside twice, seen my Mum and Dad since the first time in February because obviously they’ve been shielding ‘cos they’re quite old and a bit poorly.  So that was really lovely and my little boy was so excited to see them like, ‘Yay, Grandma and Grandpa!’  So I think – yeah, in general, pretty good.  Life is pretty good.

Kathryn:       Brill.

Leo:             And we’re trying to get out a bit more now so that’s great.

Kathryn:       Fantastic.  We took the step yesterday to take the kids out.  Our nearest kind of like zoo area near to us is Flamingo Land and we have annual passes.

Leo:             Ah!

Kathryn:       I’m also going to do a quick cutaway and say I love your lemon dress.  So we took them – we usually go quite regularly and we went and it was just nice, you know, because it was a kind of thing of they’ve obviously been very careful.  They know that we’ve all been in lockdown, that we’re having to, you know, my now six-year old has been – every time he has a cough he just hugs me and goes, ‘Don’t worry Mummy, it’s not corona virus.’  And you just think, ‘Oh bless them.’  You know, sort of what they’re taking in and what they know noticing and it was just nice to take them somewhere and we stayed away from all the rides because we kind of looked at the ride area and could see that distancing wasn’t necessarily being done and we went round all the kiddies area which again, you know, obviously the kids weren’t necessarily distancing but the adults were, you know, they weren’t all close to each other and all the zoo area and it was just so nice to sort of like get them back out and sort of like, ‘It’s okay, we can go out, it’s safe, it’s fine, we’ve been here,’ and that was really, really lovely this weekend and obviously as well, just nice to have a really nice warm day because I just feel like it’s been a little bit [inaudible 0:02:13].

Leo:             Yeah, makes you feel a little bit – you’ve got a little bit of normality back and it’s been nice for us just being able to see a few of our friends, like school friends and things like that and we’re really lucky where we live because we live in Surrey so we’re surrounded by loads of countryside and a million National Trust places and my – we saw my best friend and her little girl’s very good friends with my little boy and they played in a treehouse and, you know, it’s the same, the kids – they know what they need to do –

Kathryn:       Yes.

Leo:             They can’t help kind of creeping a bit closer together but then, you know, Claire and I had a chat two metres apart and across a woodland so, you know, it’s good isn’t it?  It is starting to feel better.

Kathryn:       It is.  It’s starting to not feel as scary now.  I mean, I say that and we’re still very much being very, very cautious and we’ve got masks and everything but –

Leo:             Yeah.

Kathryn:       Yeah, it’s feeling a little bit – a little bit better.

Leo:             Yes, definitely, definitely.

Kathryn:       So, last time I had Roger Edwards on and we had our truth or lie feature.  So it’s your turn to guess who you think was telling the truth and who was telling a lie.  So Roger said that he has taken up cycling again during lockdown, that he he’d got his bike back from his son and that he was really enjoying going out cycling again and mine was that I have read a book every week since March.  So who do you think is telling the truth?

Leo:             Hmm, it’s a really tricky one but I think I’m going to go with Roger on the basis that I know that you have got three children and you’re a super busy mum and frankly if you’ve read a book a week, I am so insanely jealous and I want to know how you did it and I can’t believe that you did ‘cos I’ve only got one and I couldn’t manage it at all.  So I’m going to go with Roger.

Kathryn:       Yeah absolutely, Roger is definitely the one who’s took up cycling again.  No, I have been involved in setting up a virtual book club which is brilliant because it’s like – it’s forced you – I feel like, because now I’m in the group, I feel like I must read the book each month.  So that’s good and we’ve just done month two which is sort of going to do the gin meet-up night this weekend and have our talk about the book but yeah, there’s absolutely no way that I’ve been able to read a book every week.  It’s – yeah, I just don’t have the time to think, you know.

Leo:             No.  I – well I was just – I know you’re superwoman anyway and I don’t want to feel any worse than I already do about just having one and having to home school and still not managing to cope with that and my job.  So yes, anyway, that’s – I just find that tremendously reassuring actually now, but thank you for that.  And great to hear that’s Roger’s cycling, that’s also extremely positive.

Kathryn:       It is, it is.  So Leo, you work for Macmillan Cancer and have been involved in many areas of sort of like the finance world and insurance world for many years.  Can you tell us a bit more about yourself?

Leo:             Yes, so I’ve been at Macmillan – so Macmillan Cancer Support, that’s our full title.

Kathryn:       Right.

Leo:             So I’ve been at Macmillan for about nine years now coming up, it will be nine years in September and before that I was actually – well I was a mortgage adviser to start with, that was my first entry into the financial services world and from there I went to the FSA to become a regulator so I did some supervision, I supervised a major retail group actually and then I decided that I wanted to be more open about social justice and all those exciting things so I went and worked for a charity in financial education.  And then the job at Macmillan came up and actually quite a few people spotted it and said, ‘That’s your job, that’s – you need to do that job.’  So my role was actually set up alongside a new service that we’d established which is the Financial Guidance service.  So I know lots of people know about the Macmillan nurses, our amazing nurses, all our medical professionals, a whole range of medical professionals but I think people know less – a bit less about our other services and one of the primary areas that we look after people in is financial support which is such a huge concern for people after having cancer diagnosis.

Kathryn:       Yeah.

Leo:             So we have a Welfare Rights team which is helping people to access benefits.  We also have a Money and Work team so helping people at work and then the Financial Guidance service was set up in a response to an identified need that people were looking for help with financial products and services so things like – people are really often looking for help with their mortgage which is maybe a deferral just to help them to kind of get things sorted out, you know, while they’re coping with starting their treatment pathway and things like that.  So that’s what our Financial Guidance service does.  They’re specialists – many of them having been advisers as well so they are amazing, so skilled.  I’m always in awe of them and what my role actually does is – the Financial Guidance service come to me and they’ll say, ‘Oh we’ve seen these issues.  So we’ve got some specific cases – some case studies – but actually this looks to us like it might be something even bigger.’  So my job and my team take those bigger issues and say, ‘Okay, well how can we start sorting those out maybe a bit earlier on so that we’re not seeing people who’ve experienced that issue and we have to kind of help them to work through that?’

So what I would be doing is working with Government, with the FCA, with industry as well to kind of look at some of those big picture problems and say, ‘Okay, let’s think about what we can do to resolve those.  What do we need to help you understand about people with cancer?  If there’s issues that we can’t solve in one place, do we look somewhere else?’  So I’m part of our Policy, Campaigns and Influencing area at Macmillan so that’s also where our campaigners sit.  So you might have seen some of our big Forgotten C campaigns that’s – so I work with the Campaigns team as well.  So it’s a really lovely job, it’s really exciting.  I get to meet loads and loads of people and obviously more than anything else I get to advocate for people with cancer and help people to understand more about their needs.  So love it, and also very fortunately in that role, I have the privilege of working on the Access to Insurance working group which has been set up by the Cabinet Offices.  It’s such a difficult thing to say; Disability Champion for the Insurance Sector so I actually chair the Charity and Consumer Reference group which helps to kind of inform some of the work of the working group and to kind of test and challenge about what’s going to be best for consumers in that.

So that’s kind of my current role.  I think some of the challenges that we see particularly in insurance and Financial Guidance tend to do quite a lot of work on is they will see a lot of issues where people are having claims declined or challenged.  They will actually support people with those and do advocacy work and obviously they also see quite a lot of people coming to them and saying, you know, ‘I haven’t been able to get insurance and, you know, I don’t really understand why that is.’  So a whole range of different things that we deal with.

Kathryn:       Obviously one of the big things that stands out for me with that is that you are coming at this from such a kind of like a holistic mindset of what’s going on.  You’ve been an adviser, you’ve been a regulator.  You’re now a consumer cancer champion, you know, and you are involved in so many different things as well within the financial services that you can really – you can see so many different aspects of it and you can understand and have that really unique perspective of pretty much every – almost every area, you know, that is going to need to be working together to be able to really make those good consumer outcomes.

Leo:             Yeah.

Kathryn:       So, you know, following on from what you were just saying there as well, I mean a big thing and I think the main thing to say sort of like straight away, is that what do people who’ve had cancer or currently have cancer – what do they typically sort of like think of the insurance world?

Leo:             So it’s a really interesting question and one thing I should say as well is that I myself have a serious health condition, so I have Type II bipolar so first of all you made me sound much more expert than I think I actually am.

Kathryn:       Don’t put yourself down!

Leo:             I know I shouldn’t have self-doubt but it’s like, ‘Oh gosh, really?’

Kathryn:       It was really good what you were saying, it was incredible everything you’ve done.  I was just – I’m in awe.  I was just like, ‘Wow!’  You’ve literally been everywhere!

Leo:             Well, you know, I get around.  So I mean it’s an interesting thing because obviously my own experience with insurance, having had – I was diagnosed with Type II bipolar so having – it was very interesting as I was diagnosed after I had my son and so I’d started my job with Macmillan and then went on maternity leave and effectively I went through a similar process where, when I was diagnosed, I’d gone from understanding the insurance world and being someone who was included and then suddenly overnight I went to that place where I was totally excluded.  I didn’t understand what my condition meant in terms of how an insurer saw it, so there is an element of this where I will bring my personal experiences to it but –

Kathryn:       Of course.

Leo:             You know, which I think is important but obviously a few things to say are; firstly, I don’t claim to be an expert in cancer.  What I talk about is what people have told me so about their own personal experiences and their own personal views and obviously I think you’re going to hear me like a broken record; the absolute key to this is about individualisation and personalisation.  These are people who have had a cancer diagnosis or have had cancer and they’re people first and foremost.  So unfortunately, I think, you know, we all accept that there’s quite low trust in the insurance industry and there’s lots of reasons for that and possibly protection suffers from some of the practices in general insurance.  So people will have a perception of insurance across all the different lines and classes.  So lots of that will be shaped by their experiences beforehand.  So if they feel that had a claim declined say for motor insurance or for household insurance, they might come to that, you know and not only that negative perception but then they will encounter an industry that really is almost – it’s trying to exclude them because they’re high risk or at least they’re perceived as high risk.

So I think, you know, trust is low and I think, you know, perceptions are very much that, you know, there is – that they are regarded as high risk and that an insurer will go first to decline rather than to accept.  We’ve got unfortunately a stat where one in four people feel that they are discriminated against by financial services so they feel that they’re going to pay more for products or they are going to be declined.

Kathryn:       Yeah.

Leo:             And again, that’s that thing of previous experiences but equally someone who has a good experience will be really delighted, will be, you know, so happy and it’s transformational.  So what you tend to hear about is all the negative experiences but when a claim pays it has such a kind of transformational effect on someone’s life because if you imagine you go from a position where you are really, really worried about finances after a cancer diagnosis and then your critical insurance pays out as it was intended to do and you hear about that or you hear about that experience from someone else then you are going to have a very positive view of it.  So I think it’s not a case of there is one single view.  It’s how people come into it, how they are treated immediately after their cancer diagnosis when they’re already feeling quite vulnerable, because I think that’s another component of it.  You – even if you’re declined, if it’s done in the right way and you’re supported through that process, that’s going to give you a totally different outcome but, you know, insurers need to be aware that what they’re dealing with is a perception that people are discriminated against and the perception that people might have low trust.

You know, and I’ve even heard people say things like, ‘You know, I brace myself before I call the insurer because I know this is going to be so difficult and it’s going to be difficult for lots of reasons.’  And I think that’s quite a sad thing and, you know, people will go to an existing insurer where they’ve had, you know, another product, again particularly on the multi-lines and then they’ll be like, ‘Well okay I’ve got product one with them, why have they declined me for that one?’

Kathryn:       Yeah.

Leo:             So, you know, it’s really complicated for people coming to an industry that they’ve experienced in different ways and previously as an included person.  Quite challenging.

Kathryn:       As I say, I mean straight away – I mean it just, you know, it feels terrible thinking that, you know, that one in four people think, you know – that have had cancer will think they are going to be treated – I don’t know if you think, sort of like in a sense, you know, just that they’ve had that thing where, you know, you’re saying they wanted to brace themselves.  I mean, it’s just not a nice feeling.  I mean, we – obviously people come to us specifically because they have had a medical condition.  A lot – most of our clients are in that situation and I will be honest, you know, there are times where, you know, the majority of the time if people have had cancer, it doesn’t always mean that there’s going to be an exclusion or price increase but there are certain times and, you know, obviously I’m always trying to sort of be as open and honest as possible with these things, there are times when insurers, because of medical data, that they look at years of medical data and that’s how they make their decisions.

So not just with cancer but with a number of conditions if it means that that person is more likely to maybe have cancer again or another condition which means that they are potentially likely to die at an unexpected age in a sense and, you know, in the way insurance is set up and the way that risk is set up, you know, the insurers have that kind of – I don’t want to say right to sort of like offer insurance, do it differently or a different premium or anything but I think it’s important to say that there are times as well where somebody who’s had cancer very recently is possibly still within quite a – what would be classed as a high risk time of something recurring.  But I think it’s not necessarily clear when someone is declined or when there’s an increase of premium or when there’s an exclusion or something like that, exactly why that is happening.

So obviously the insurer will have lots of data as to why they’re doing something and obviously I don’t have access to that data and I cannot say whether or not – I’m not medically trained, so I have no idea if it’s right or wrong or whatever, but there’ll be some kind of a basis why they’ve done that and I just think sometimes that, you know, it’s – if there was kind of a very clear explanation put down then that would make it not okay, but maybe people would maybe understand a little bit better why insurers have made the decisions that they’ve made.  Maybe a bit more transparency in that kind of a process.

Leo:             Yeah, I mean I think you’re 100% right.  Sorry, there’s a lot of things there.  Maybe I’m not going to say you’re 100% right on everything.  No sorry, you are, I might just give a slightly alternative view.  I mean, I think –

Kathryn:       Of course.

Leo:             Going back to the kind of people feeling discriminated against, it’s absolutely that, I think – you know, people expect to pay more because they understand that they pose a higher risk and that that is completely reasonable.  Now it is reasonable for insurers to underwrite looking at the data that they have but one of the challenges of that is that is so opaque that we don’t really understand whether that data is actually fair and representative.  So people, you know, people with cancer are protected by the Equality Act.  It’s an automatic disability under the Equality Act and that means that insurers must use data that is relevant to that individual and which – on which it is reasonable to rely but – and on that basis you make an objective judgement.  But at the moment, we only have the insurer’s word that that data is reasonable to rely on and that it is relevant to an individual and I think if there was an explanation as you say, that’s much more transparent about exactly what it is about that person’s individual circumstances, firstly they’d feel a lot more confident and actually, you know, people don’t necessarily know that they are covered by the Equality Act.

In fact it’s one of the things that Macmillan – we put in our – we have pages on the website that tell you about going to apply for insurance, what it might mean, very much so if you’ve been recently diagnosed or if you’ve recently finished treatment that it is likely that you might be declined or postponed or the cost will increase.  So, you know, we are perfectly aware of that and we make people aware of that.

Kathryn:       Yeah.

Leo:             But I think it’s, you know, what we see and the real challenge is people who have no idea that that might just be one insurer’s view and it might be one insurer’s data being used.  So there’s that problem.

Kathryn:       Yeah.

Leo:             And when they are offered a quote, they’re offered a deferral or whatever – that decline, they don’t know where that’s – well obviously they don’t know what the data are being used but also they don’t know if it’s value for money.  So it might be that they pay an increased premium but is that fair?  Are they getting what they deserve for what they’re going to pay?  So it’s important, you know, so people have a range of choice to understand the value of what they’re getting and whether it really does reflect their situation.  So people are quite often left with an impression about their wellbeing and their health that’s different to what they’ve been told by their clinician and I think that insurers possibly don’t realise quite how much impact they have on people with those discussions that they have because if someone’s clinician has said to them, ‘Yep, you know, you’re well, recovered, I don’t see any chance of there being a recurrence,’ or they’re many years after diagnosis too and they’ve recovered, to have an insurer say, ‘Well no, you’re still a really high risk,’ or, ‘We don’t want to cover you,’ you know, can actually have quite a significant impact on someone’s, you know, emotional wellbeing, you know, and so that’s – it’s really important that we don’t let people go off with the impression that that’s, you know, that insurer’s view is the entire market’s view or everybody’s view and particularly not if it’s kind of different to their clinician’s view.

Kathryn:       Absolutely.  I mean we, obviously we are specialists, so there are times, you know, where people come to us and they’ve said they’ve been to multiple insurers, they’ve been to multiple brokers and they’ve been declined everywhere and they come to us and we’ll get them standard rates at a different insurer just because of the different access that we have and it’s not that, you know, it’s not that we’ve got sort of any specifically, you know, there’s no funny wordings or anything like that, it’s just purely understanding and having, you know, there’s some brokers have limited panels and some people just, you know, they don’t have the knowledge that, you know, they haven’t experienced being able to arrange cover for people that are living with cancer.  But we have a couple of like really interesting kind of examples that go with that as well.  So, completely appreciate with you that, you know, it’s really hard as to what you can do and sort of how you can say these things to people living with cancer and potentially change the way their mind is, you know, and then how they’re feeling about themselves and feeling so good about the stages that they’re at.

So as an adviser, that’s something that we’ve had to do on multiple occasions and it’s been for a couple of different reasons.  So one of them, as an example we had somebody who had tonsil cancer and their specialist had said to them, ‘I got your tonsils out, the cancer’s out, everything’s done, you are not getting cancer again.  You are definitely not getting cancer again because, you know, I would literally bet my house, my car, my living – everything on you never getting cancer again.’  Which is brilliant for that person to hear, they are so confident but then when you go to the insurance side of things, the insurer from their data and the different things that they have, well quite a bit of the time will be very – the case of, ‘Well no, you’re actually – because you’ve had tonsil cancer, there’s pretty much a really good chance you’re going to get cancer again, so no, that’s not the case.’  And that’s really hard as an adviser to be able to buffer that ‘cos you’re hearing both sides.

Another thing that we have quite regularly – and this isn’t like a – I’m not being funny towards the NHS or any kind of doctors or anything like that, I’m just obviously – again, talking from our experience but there’s been quite a few times where people have had the incorrect cancer information recorded in their medical records so there’s times where people have come to us and, you know, they’ve been to other people and been declined here and there and different things and they’ll come to us and they’ll tell us what cancer they had, the staging and the grading and different things and we’ll say to them, ‘Right, we’ll be able to get you with Insurer X and it should be around about this premium and we’ll have to go through the medical information.’  And then it will come back and it could be that the premiums have been doubled or tripled and then they think – they’re saying to us, ‘Well why?’  And we’ll say to them – so you’ll end up getting obviously – chatting with the insurer about the different, you know, the different permissions in regards to data protection now especially, and it’ll end up that we’ll say to the person, ‘Look, we can’t know everything that’s gone in your medical report from your GP to the insurer,’ unless, you know, sort of like we go through data protection requests and different things like that or they get copies of the medical reports which can be really, really helpful if people can do that.

But we’ll say to them, ‘Look, from what, you know, obviously, we understand that you’ve had cancer and you understand it to be this staging and grading and we have to take advice and – but we’re really, really sorry but the way that the insurer is pricing this is – basically it’s kind of meaning as if your GP’s recorded it as actually this staging and grading which would have been a much higher, much more invasive cancer.’  And there’s been quite a lot of situations where we’ve done that and the person’s gone back to their GP and found that the GP’s records and medical report has actually been incorrectly completed for the insurer and, you know, they’ve faced all these declines.  They’ve faced being turned away so much and it’s because that medical report wasn’t being completed correctly.  And I say, I’m sure this isn’t like a standard, you know, thing that’s happening to everybody but it is something that we have seen on multiple occasions and it is – in a sense it is – it’s good with our knowledge that we’re able to stand there and go, ‘Hang on a minute, there’s something – just isn’t adding up here.’  You know, we need to figure out what’s going on in these medical reports or maybe this person hasn’t understood the diagnosis that they’ve been given which, either way, is very, very hard as an adviser to know how to handle that because it’s not sort of as if you’re justs an insurer issuing a decline letter in a sense.

You are there, you’ve invested in people and they’ve come to you with such trust.  It can be very, very difficult.  So when it comes to things like the insurances, I think, you know, it can be quite hard for people to understand what is potentially going to be available.  I think some people can come and think, ‘Right, you know, I’ve had cancer I won’t get life insurance,’ or, ‘I’ve had cancer, I’m going to get life insurance but with a higher premium or exclusion.’  And then some people may come and just go, ‘Well I had cancer but it was, you know, 10 years ago so I’m absolutely fine and I should just be able to get life insurance or any of the other insurances,’ you know, and there’d be no in a sense queries or issues or high premiums.

So, as an example, I do have some case studies as well to go through but as an example, so someone who has had leukaemia – so say that person wanted like a critical illness contract.  So critical illness for anybody who’s listening who’s not familiar, they would typically within the UK cover you for at least 50 life changing diagnosable conditions.  So that would be cancer, strokes, heart attack – are probably your main three that tend to be claimed on.  There are other things, like Parkinson’s disease is covered, there can be like traumatic head injuries, third degree burns, you know, there’s quite a few different things in there.  Some of them cover multiple sclerosis as well.  But it’s important to know as well, when you get these policies, if you have cancer, it would be cancer of a specified severity.  So I sometimes say to people when they ask me, I say, you know, ‘If you have sort of a mild skin melanoma that’s, you know, obviously no matter what it’s cancer and it’s going to have been quite a shock to whoever’s had it, but if you’re able to go into the GP surgery and they’re able to remove that, it’s not what an insurer would probably class as a life-changing version of cancer.  You know, it’s going to be something that is probably much more invasive.  But there are things known as partial pay-outs as well for cancers that are of what would be classed in the insurer’s mind as kind of a lesser severity.

But for say something like leukaemia, you probably need to be clear of the cancer for about 20 years before critical illness cover may be available and it could be possible that some insurers will never offer critical illness cover for somebody who has had leukaemia.  But then, say you might get breast cancer which is obviously far more common I believe than leukaemia and that is something that, you know, depending upon the staging and the grading, the life insurance could be available with some life insurers within a matter of months and, you know, not – it’s not always at silly prices.  I don’t want to say it’s never at silly prices, you know, there’s sometimes where the prices do get to be a little bit out of budget, but it’s important at that point, that’s where advice really stands out because we can help you sort of figure out where that premium, if it’s going to increase, is going to be increased the least, if that makes sense.  I hope that makes sense, that seemed a bit of a tongue twister saying it like that.

But again as well, critical illness cover could potentially be available after a few years with some exclusions.  You may find, if someone’s had stages three or four cancer that they may not be able to get critical illness cover on what we’d say is on the standard market.  You know, there are some specialist options that can be looked at and again, that’s not to say that they’re going to be silly prices.  So just think, if you hear the words specialist insurance or something or specialist broker, it doesn’t mean that you’re getting anything with like I say dodgy wording or anything like that or say silly prices, it just means that you’re going to a more unique offering because of the situation that you’ve had.  I mean, what’s your thoughts on that kind of side of things in, you know, in regards to the timeframes between somebody being diagnosed with cancer and then insurances being available or not available or the exclusions, different things like that?

Leo:             It’s, you know, as you say, it’s a really – well it’s a hugely complicated picture isn’t it?  I mean it’s, you know, as you described, if you think about a customer journey through that, their starting point is, ‘I’ve,’ you know, ‘I’m recovered 20 years from this cancer.’  And I again, you know, I’ve had conversations with people where they sort of say, ‘Oh, you know, I had leukaemia in childhood and yet I still have to go through full medical underwriting,’ and, you know, a lot of the time, I think it’s back to sort of the customer-centric point where, if you think about the times that people are taking out new insurance, a lot of those times are the kind of quite positive times, you know, maybe if you’re getting married or if you’re buying a new house or things like that.  So it’s kind of understandable when those are the times that people are moving on, they’re, you know, they are confident and they are covered so it’s, you know, I think it’s very difficult to understand why, from a layman’s perspective, you know, after 20 years someone should still present such a high risk that they’re paying a lot more.

However, when you talk about breast cancer, you know, and again I’m no medical expert, but it can be highly recoverable and people are living longer.  You know, there are better treatments, so again, further out from a cancer like that, you would expect to see people I think paying a lot less.  Obviously if it has advanced then, you know, people are a higher risk.  It’s – but there are so many permutations, I think that’s the challenge – is it’s very difficult for someone to understand when different insurers are taking a different view and there’s massive levels of inconsistency and someone might get totally different outcomes from different places, whether that is representing, you know, a fair, good value approach.  So it’s not just about the cancer itself but it’s about actually how that’s judged by the industry and there is no one single answer.  So I think that would be my kind of repost to that or what might – what I would put back is like, ‘How can you take such different views and on what basis?’  So maybe you could just be really transparent or say, you know, ‘It’s 20 years for leukaemia and that’s that.’  You know, so people coming know what to expect.

Kathryn:       Yes.

Leo:             But in terms of making a judgement, not being on the inside of the industry, it’s really hard to say because, you know, we’re on the outside looking in saying, ‘Well, you know our financial guides will see people coming with leukaemia – a long time recovered from leukaemia and also with breast cancer.  That’s quite a common scenario for them and they’re sort of saying, ‘That just doesn’t feel quite right to us.  Why are you so high?  Why a no?  Why is such a long time out from diagnosis before they will be covered?’  So, you know, it’s really challenging.

Kathryn:       I think it is, you know, and as you say, for someone who’s outside of the industry, it’s got to be challenging. For someone who has had a cancer diagnosis, I imagine the last thing they want to do is necessarily talk about it at length with multiple insurers and multiple brokers and I think that’s a really important as to why things known as signposting in our industry is becoming so much more important so that people just get directed to the right brokers or insurers straight away that can really step in and help but it’s, you know, for advisers in our industry, you know, it’s sort of – it’s very confusing for us and we’re in there amongst it all every day anyway.  So for someone else who doesn’t have that kind of knowledge, it must be absolutely – like you say, that kind of bracing yourself.  I can actually sort of like feel myself doing that for them.  You know, I can sort of like sympathetically think that way.

Something I just wanted to quickly point out as well, it’s just popped into my mind, I think it’s really important as well to tell any listeners that if somebody has had – somebody has the BRCA gene, that’s not something that you need to disclose to insurers but it’s very, very clear in a sense the specific wording around that.  So if you’ve had a predictive test to see if you carry the gene or an activated version of the gene, then you don’t have to tell insurers about that.  If you’ve had the diagnostic test because you are symptomatic then that’s different but it’s something that’s really, you know, it’s important for people to know because again we get people coming to us saying, ‘Oh well, I’ve been found out that I’ve got this gene.  It’s going to make it really hard for me.’  And it’s a case of, ‘Well, no, you know, it’s not going to make it really hard, you know, it should be okay.’  But obviously, what would happen in probably a lot of places though is that the insurers will ask about cancer within the immediate – what I call the blood-related family members, so siblings and parents.  So at some point, the family history of cancer can come out in these insurances but having these, you know, specific genetic tests, you know, if someone was thinking, ‘Oh I shouldn’t have a test because it will affect my insurances,’ you know, don’t worry in a sense about that, you know, do whatever feels right for you if you do want to have that genetic test or not.

So, as an adviser – so when I’m speaking to people and they’ve had cancer, there’s quite a lot of information.  So this is something that I think is useful for other advisers, like myself and also for people who are listening who have had cancer and are just wondering what in a sense they’re going to be asked and I’m not saying this is an exhaustive list but it’s hopefully going to give quite a good amount of information that people could use in that kind of first initial chat.  So, the insurer is going to know what type of cancer the person’s had and when it was diagnosed, the staging and grading of – it’s the Gleeson Score, PSA levels, obviously blood cancers are different so any kind of readings or levels, excuse me, that you have really, really helpful especially for an adviser to have straight away.  The treatment that’s been had, whether or not it was surgery, chemotherapy, radiotherapy, hormone replacement therapy and the dates that those happened so, you know, if it started in the May, when did it finish?  Was it a couple of months, you know, sort of like did it last longer than that?  When were you given the – in a sense the all-clear and discharged from the reviews?

They’re the main things really that can be really helpful in the first place for an adviser to help you.  I mean, what I would say is that, you know, there are some insurances that we have access to where in a sense the medical information doesn’t even need to be detailed.  So, you know, in a sense having had cancer doesn’t affect the eligibility for the policy but there are some in a sense quirks with those insurances which must be very, very clearly talked about with the people who are wanting them.  So you don’t have to always have that information to-hand but even though I have access to those insurances, I would always want to try more than the standard market first so, you know, if you were going to speak to an adviser, it’s one of those things as well where, you know, you want them to do the research, you know, you want them to sort of like really do that bit to get you the best advice that they can so we always say to people, you know, like, you know, ‘Are you going to, you know, please just give us a few days, you know, we’ll have all this information to-hand.  We absolutely, absolutely need to know the staging and the grading, you know, sort of those readings, those levels of how big the cancer was or any of the other readings.’  You know, they are absolutely essential so we can get an accurate representation for what that person may get when they apply for the insurances.

So one of the things I was wondering, Leo, is that obviously something that we do very regularly at Cura and all of our advisers are specifically trained by me to do this and, you know, in a sense I don’t let them loose until I am happy with the way that they’re able to ask these questions and sort of like get this information so I know their knowledge and also their approach is going to be right I would say, for the majority of people obviously.  Would you have any kind of information in regards to – is there anything missing from that list that you think is like a key indicator of the way that somebody’s health is after cancer?  Or is there anything in particular that’s, you know, really a no-go for advisers.  Any kind of like terminology?  Like I know sometimes I’ve seen things on social media saying, ‘Oh, I’m a cancer survivor or I’m a cancer warrior,’ and then someone else will come along and said, ‘I don’t like the term cancer survivor or cancer warrior because that means that if someone hasn’t been able to survive the diagnosis, then that means – are you saying that they didn’t try hard enough or they weren’t warrior enough?’  So it’s really hard sometimes to know what the terminology is and do you have any tips?

Leo:             Gosh, I mean – I’m the broken record.  It’s really personal, it’s really individual isn’t it and I think that thing, I mean I know how expert you are and how hard you work and Cura work at kind of really trying to meet the customer where they are and I think that’s the point.  You’re absolutely right; some people really don’t like the term survivor, warrior because, as you say, you know, it implies something about how they have dealt with their cancer.  We try and avoid the term – and we hear it all the time, sufferer.  So we talk about people living with cancer.  So if you’re living with cancer or you had cancer, you know, quite simple just, you know, really upfront and I think going back to that point of, you know, if you – you just reeled off a very detailed list and not everybody thinks of their cancer in terms of that medical terminology.  Some people will, that’s – again it’s everybody’s different.  It depends obviously again how far out they are from their cancer because, you know, knowing how I keep my medical records, they’re usually somewhere in a drawer, you know, and so everybody will be at a different place and yet some people we speak to, you know, our guides speak to and they’ve got all the information they need in front of them, you know, they’re ready to go and obviously at Macmillan what we try and do, again on our webpages, it will tell you a little bit about the process and so say maybe have your most recent letter to-hand.

So sometimes it might be a case of working backwards, you know, what’s the most recent interaction you’ve had and what information did you get from that and then sort of work backwards I guess and then, you know, sometimes it might be helpful to remind someone, you know, if they’ve maybe had a Macmillan nurse, what information did the Macmillan nurse give them?  Because sometimes, you know, when they’ve had the diagnosis, actually it takes a while to process and so it’s when they maybe speak to their nurse and they explain it later and so something about helping people to remember the points at which they’ve been given that information if they haven’t got it immediately to-hand.  So, you know, having to say it’s very much about having that – almost more about the approach to customer –

Kathryn:       Yeah.

Leo:             Than actually the approach to the medical information because it’s so personal and it’s so individual, you know, and people will be in different frames of mind as well.  You know, it’s back to what I said about, you know, it might be because of buying a house or sadly it might be because they’re thinking about the future and needing life insurance and how to support their family.  So, a lot more is about the wraparound and I think you’ve really got to the crux of it with that – how do people feel about their cancer but ultimately what you are trying to achieve is to get that really detailed medical information that you need.  So I don’t think you can ever go wrong with asking someone have they got some paperwork or something that they can refer to which is a starting point, or what’s their most recent medical interaction?

Kathryn:       Absolutely.  One thing we do as well at Cura sometimes, depends upon the situation obviously, is we’ll say to people, if they have those kinds of letters to-hand from specialists and different things, you know, sometimes it can make things a little bit quicker when you’re applying for these insurances because if it needs to go to the GP, obviously especially in the current times of corona virus and everything, we’ve kind of got like a weird dynamic at the moment where with some GPs, you know, they’ll say, ‘We are snowed under, we just can’t do anything at the moment.’  And then other GPs are saying, ‘Well we’re barely seeing anybody so actually yeah we can fill this form out much quicker than usual.’  And what we’ll say to people is we have, you know, very secure systems and we’ll say to people, ‘If you have the facility to be able to scan that and you feel comfortable, there’s no pressure at all but if you feel comfortable sharing that letter with us,’ it means that we have kind of very early on proof that, with their permission, we can then share with an insurer the details of that information.  It can sometimes speed things up a little bit.  It’s absolutely not essential at all but it’s the kind of thing of that if someone is prepared to be able to do that then that can just speed things up a little bit.

So, sort of going on like a little bit from that and just kind of moving to the C-word that I just mentioned there, corona virus.  I don’t think there was any way that we could have this chat and not talk about changes that have happened with corona virus and I think, you know, it’s one of those things that, you know, I’ve been quite vocal in our industry saying that, you know, it’s really important as an adviser that we’re kept up to date with insurance decisions because then, you know, we are that buffer to the client so then we can help people and keep their expectations at a reasonable level as to what is going to be available or not and also, again asking those questions to sort of say, ‘Well is this actually – what’s this based on?  You know, we understand that this change has been made, we’re not going to – we’re not asking sort of to know all the background kind of strategies and mechanics and whatever is going on with these decisions but just, you know, can you just explain it to us so that we in our minds have a good idea as to what’s going on?’

So what we have seen is that insurers have become particularly cautious for people who are living with diabetes, high blood pressure, high BMIs because in the very limited amount of data that we have on corona virus at the moment – very, very little amount and about the – obviously the very, very unfortunate deaths, there has seemed to be a bit of a correlation that people with those conditions are at a higher risk of dying if they do get corona virus.  But one thing we’re also seeing as well is that there seems to have been some kind of blanket decisions made at times as well which will – insurers – so people who are listening who don’t know the insurance world, when insurers sort of like assess somebody’s risk for life insurance, what usually happens is that there’s a number of things – they’re either accepted at what’s known as normal terms or non-standard terms.  And the non-standard terms would be a case of usually – most of the circumstances, it’s a premium increase.

Now that premium increase is a multiple of that base premium that is initially seen if you do onto like an online search comparison site or something and it’s depending upon how much it’s increased depends upon how, you know, much the insurer sees that person’s health as being a risk and what we’re seeing is that instead of, you know, offering these higher percentages that insurers were doing before.  So in a sense the more risk they were prepared to take on, they reduced these percentages which kind of – I’m not saying it specifically does but it kind of means that in quite a few circumstances, people with say cancer, people who are living with HIV or people that have, you know, I mean we’ve seen an instance, you know, even with someone who has been clear of cancer for nine years and is now declined by insurers because they’re above that new maximum percentage of, you know, multiple of the premium.  And it does seem as if, you know, there’s a very – I say blanket approach to sort of like anybody who doesn’t meet – like I was saying before in the beginning part of this, you know, insurers in a sense commercially have a right to say what their maximum percentage is.  If they don’t want to go above a certain percentage of premium then, in a sense that’s their – kind of their decision to do so.  It’s in their right to do so, commercially – obviously very carefully there – commercially in a sense their right to do so.

But from very much a moral kind of point of view, it does seem as if people who have had cancer have been – kind of suddenly had this barrier put up from being able to fairly access insurances with – in a lot of insurers.  And I’m not saying – because I know there’s going to be some underwriters listening, possibly some actuaries who aren’t particularly pleased with me saying that but I’m not saying it to say that I fully understand insurers’ decisions but obviously as an adviser and someone who works very much with people in the higher health risk kind of situations, it’s something where it’s not been particularly clear and I was mentioning to you before we spoke on here that we saw a decision letter from an insurer where – and I think I mentioned this in the podcast not long ago – where they basically said to somebody living with HIV that, you know, ‘We don’t really have any data at the moment to say that people living with HIV are at a higher risk of corona virus or, you know, of dying from corona virus but we’re kind of making the assumption that it is so we’re just going to blanketly say no, we can’t offer.’  Which to me didn’t sit particularly well and obviously it’s something we’re challenging and we’re supporting that person.

But I know you’re going to have plenty of views on this, Leo, so I will let you loose in a second but I think for me what I’ve got to – what I would like to say is that, you know, in a sense that I think commercially there’s going to be people who completely sit in the commercial side of the decision-making things and there’s going to be people who completely sit in the moral side of, you know, decision-making and I think we need to have very much a clear and transparent conversation with all the people who are kind of sat in the middle who are coming from either side to sort of go, ‘Right, okay, we understand that insurers see this risk.  We understand that people over here think that people with cancer should, rightly so, have a very fair access to insurance.  How can we make this work and fairly work?’  I shall let you speak now, Leo, you go for it.

Leo:             Well it’s, you know, corona virus is absolutely ingrained into all of us at the moment and it’s all we ever talk about but, you know, for people with cancer who prior to the pandemic really struggled to access and understand how they were being treated by the insurance industry, there are so many things here for us to be really alarmed by.  You know, I think from what – I’m really interested to hear you describe the commercial versus moral argument in effect Kathryn because, you know, it’s – so for us what is most concerning is we had a big concern at the outbreak of the pandemic which was when we were hearing that there was no medical underwriting taking place because some insurers were just deciding that it was appropriate to take pressure – and in fact the ABI as well that it was to take pressure off the NHS frontline and so they weren’t calling for medical evidence for people which meant that actually there were a lot of people with cancer who were completely locked out of the market, whereas other people were able to access insurance because they didn’t need medical underwriting and there’s a fundamental here, and I’ve talked about it before, but the people with cancer are protected by the Equality Act.

Now actually this isn’t a moral argument or a commercial argument, it’s a legal entitlement and what that means for insurers is again that they need to make an individualised assessment using data on which is relevant to that individual customer and on which it is reasonable to rely.  And, you know, it seems to me that every single day we’re hearing something new about corona virus and our understanding of it is developing so it doesn’t sit right that there are blanket approaches being taken in anything to do with Covid.  I mean, I think you said it yourself Kathryn, that actually we understand a little bit that some people with diabetes might be at higher risk, you know, but actually there’s still evidence coming from across the world about different, you know, different impacts of Covid-19.  So, you know, actually it’s alarming to see a) blanket decisions being taken which, you know, yes insurers are entitled to make commercial decisions but there are, you know, there is a fine line about what is legal and what, you know, how people’s legal entitlements are being upheld but there’s, you know, there’s also just a huge question about the future.  Is this going to get worse, you know, based on – this is what’s happening on what we know now, what’s that going to look like in the future.

And I think it’s really interesting that the Institute and Faculty of Actuaries have already released some great papers looking at the consequences of Covid for the industry and obviously, you know, we’ve seen the business interruption cases, we’ve seen all the challenges.  The industry is, you know, not exactly that popular at the moment based on those things and the public consciousness so to see already restricting access for people who are already facing challenges and let’s not forget that there were people who were in the shielding group – there were 250,000 people with cancer, maybe more, within the shielding group who were extremely vulnerable but then there were also people in the wider group.  So to not even look at that differential as well is kind of an interesting factor if insurers aren’t looking at those sorts of things.

So, you know, it just feels like there is a potential breach here of the law but what the Institute and Faculty of Actuaries was saying is, you know, we are going to move to a place where it’s likely that there will be excluded groups.  Now, at the moment it’s really unacceptable that people with cancer should be excluded already as a blanket group when they are not a group, you know, this will probably be about people with multiple conditions, you know, we just don’t know yet.  And again, the Institute – what was interesting was that was posed as a kind of social – that goes back to your moral question.  What kind of society do we want to be?  What do we need to do when we’re really sure what’s happening so that if there are people who can’t get insurance, how do we facilitate that for them?  So that was a question we were asking before the pandemic and now it’s a question that’s so much more pertinent, so much more scary because of, you know, what’s happening already and what the consequences could be.

So, you know, fundamentally for us it, you know, it’s about consistently – there must be a personalised assessment.  You mustn’t be using data that is potentially unreliable that’s new, you know, that isn’t certain and, you know, it was really interesting because I was watching the news last night, you know, a very reliable source of data, and they were showing this new thing about the Covid age.  You can calculate someone’s Covid age based on certain risk factors and again it was very blunt, you know, and the news presenter sort of said, you know, ‘We can’t give – we can’t make a personalised risk assessment so here’s some guidelines.’  So if we can’t do it, then don’t – don’t put a blanket assessment on.  You know, be honest, be transparent about what’s happening.  So there needs to be a discussion and, you know, really from our perspective it’s absolutely not acceptable that people with cancer should be blanket excluded at this point in time.

Kathryn:       Absolutely and I completely agree and I’m not going to say that sort of we – that we have sort of like every single solution out there but one of things that – especially because we are specialist brokers and, you know, we know what we’re doing – I’m not saying that others don’t know what they are doing but, you know, it’s just – that sounds terrible.  You know, obviously we understand like the medical conditions to an extent – obviously we do have quite a lot of medical training, obviously not to the level of a doctor or a nurse or anything but we do understand these conditions so like during the corona virus, when those GP reports were all getting stopped in a sense, you know, we were able with some insurers still to do GP reports at times.  You know, there was times that we were able to get people that individual look at their cover rather than just that blanket kind of exclusion and the thing is, that’s brilliant and I was so happy we were able to do that but obviously that’s if people come to us.  If people just go generally to a broker, they wouldn’t have had that experience and it would have continued that kind of, you know, I know there seems to be that thing in the media as well of people saying, you know, not necessarily specifically people with cancer but, you know, people with lots of health conditions basically saying, ‘Well hang on a minute, you know, this corona virus has hit and it’s really made us think about how much we need insurance and things like that.  Just because it’s scared us and now we just can’t even access it.’

And I think there’s kind of that – when I see the commercial agreements in my head, I kind of imagine – and it sounds terrible – I imagine sort of like a middle aged man in a suit with a briefcase in London who’s just like completely expressionless in a sense and – I know that’s absolutely terrible but that’s what I see and I see like devoid of emotion in a sense.  So I think to make some of those decisions, you know, you would have to be – you wouldn’t be able to do them if you’ve had that kind of emotional invested side of things to see where people are at.  And I do want to say to people that are listening, I know that these things are happening but, you know, there are many of us – not just advisers but many people within insurers and reinsurers who are really working extremely hard to try and either get things back the way they were – kind of towards the way they were so that, you know, obviously there was, you know, not necessarily perfect access to insurance but a lot more options than there are now and, you know, so if you can, don’t give up.  You know, don’t give up on the insurance world completely.  I know that’s such a massive ask for some people, but hopefully I can encourage some people to stick with us a little bit.

I’ve got some case studies to share because I think, one of the big things for me as well is that people just don’t really know what to expect and, you know, when you’re saying to people there’s going to be a premium increase, as I would think, you know, you have no idea what it’s going to look like so – or an exclusion, you know, it’s just – it’s a bit kind of mindboggling to think.  So I’ve got two examples here to sort of like share with everybody and one of them is life insurance and the other one is income protection, okay?  So for the first person, it was a 35-year old non-smoking female.  She’d had acute lymphoblastic leukaemia and she was diagnosed at the age of 10 and she also had a relapse at the age of 12.  She’d had chemotherapy, total body radiation and bone marrow transplant and her treatment, when she spoke to us at the end of 22 years prior to speaking to us but she still had yearly follow-ups.  As you say, like the life events, she was now married with two children and she had a mortgage so there was a couple of different things that we did in a sense.  So what we did was, we did some decreasing life insurance which is – when you have a capital and repayment mortgage – so if you have a mortgage that in a sense you are paying it off and at the end of the mortgage you own it, it’s completely yours, the house, that’s usually capital and repayment and you would usually do a decreasing life insurance for that.  So for her we did a decreasing life insurance of £100,000 to cover the mortgage over 12 years and that came to a premium of £7.19 per month.

Now I think an important thing to demonstrate there to people is that that includes a premium increase.  So when we say a premium increase, it doesn’t mean that you’re suddenly going to be paying, you know, someone’s paying £5, you’re suddenly going to be paying £50 a month.  This is literally, you know, £7.19 per month.  We also did a bit of family protection for her so we did what is known as level life insurance of £100,000 to the age of 70 which is when she felt obviously her family would be fine – she would be retired by that point and it was – level life insurance means it would always be £100,000 so it would be £100,000 as well when she’s aged 70 if she hasn’t obviously passed and claimed – there had been a claim on it and that was £13.92 per month.  So there you can see she’s got 35 years’ worth of cover for £13.92 per month.  Again, that has a premium increase.  So I just wanted to give that as an example to people just to – again, just to say, it’s not going to necessarily be silly, silly pricing and what was really good for this lady is that she actually did have a recurrence of cancer during the application process but with the insurer that we had placed the policy with – the application with – they specifically state that they don’t need information.  They don’t need to be updated.  Once the application is with them, they don’t have to be updated with new medical information so it was ignored that she’d actually had a recurrence of the cancer.  So that was really, really positive – especially in this situation.

What a lot of people may see when they go for the insurances, is that there is that mix, so I say, you know, it’s often that it’s a percentage.  So it could be that the premiums are multiplied by two or three or a few different options.  There’s – sometimes it gets a little bit crazy as well.  Sometimes these percentages are a little bit –you have to sometimes sit back, even as someone who does it quite often, you have to sit back and try and figure it out.  But some people may see what is known as a per mille loading and for the majority of people, a per mille loading is going to see – that’s when you’re going to see the big prices in the premiums because what essentially happens there is that the insurer increases the premium for every £1,000 worth of cover taken out.  So as an example, a very, very kind of broad example, so if you were taking out £20,000 worth of cover, the premium – the, in a sense what we call the loading – the increase would be far smaller than if you were taking out £100,000 worth of cover because you’ve got like another 80 £1,000 worth of cover included within that policy.  It can get quite confusing.  That tends to happen where people have had more recent cancers and have been more of a higher staging and grading.

The next one I wanted to talk about was an income protection policy.  Now, we have been having – and I think across the industry, income protection has been something that people have really, really wanted to look at especially with everything that’s going on and the job uncertainties.  So something I wanted to be clear on is that income protection isn’t redundancy cover.  So some people have said, you know, they’ve maybe come to us and said, ‘Well I want to protect my income, I want income protection just, you know, I’m worried about being made redundant,’ and it’s awful to have to say to people, especially when something’s happened like corona virus – it’s awful to say that that’s not what income protection does.  So you can – well I say you can, you used to be able to get unemployment insurance and that used to be a policy that was on offer and that would repay your income for 12 months if you were – well up to 12 months if you were made involuntarily redundant.  All of those policies have been removed from the market now after corona virus has hit.  So the unemployment cover side of things is no longer open to new policies.  So income protection itself, that is when you have a health condition develop that means that you are unable to work or something happens, you know, say when you are unable to work due to your health.

So an example for this one – so, now this one, just bear with me because for this one the premium is a bit higher but I’ll explain why it’s quite a bit higher okay when we get there.  So this was a 54-year old smoker.  She’d had breast cancer, carcinoma in situ for 14 years prior to speaking with us.  She’d had no lymph node involvement and it had been quite a large tumour so that in a sense the core of the tumour had been about two centimetres but with kind of the outreach that came from it, it totalled about 10 centimetres.  She’d had a single mastectomy and that had been – and she’d had nine months off work at that time but she’d been back at work, obviously not having any issues with the cancer for the last 10 years.  She’d been told by multiple insurers and brokers that she could never have income protection.  She came and spoke to us and we had a couple of insurers that were possible so what we did is, we arranged for her to have £2,000 per month of income protection.  It was – had what was known as a three-month deferred period.  So when you set up income protection, you tend to have – with most of them you tend to have something like a four-week deferred period which means that you have to be ill for four weeks before the claim can be paid.  With this lady, due to savings and different things, a three-month period was absolutely fine for her and it does also mean that the premiums aren’t as expensive.  It was known as what’s own occupation and it was to age 65 because that was her retirement age.

Now, this came to £135 per month for the cover and the reason I want to say bear with me with the premium there a little bit is that income protection is definitely far more expensive than life insurance because people are far more likely to claim on income protection than they are on a life insurance policy.  So people sometimes – and they think it’s going probably to be a similar pricing and then when they see the pricing for income protection they get a little bit kind of like, ‘Ooh, I’m not sure about that.’  It’s just simply because you are so much more likely to claim on it.  The important thing that I wanted to point out for this one is that, you know, this is a 54-year old lady which means that she’s in, in insurance kind of ways, she’s probably more in like a prime age for maybe having a health condition that would cause her to be unable to work.  Not saying that’s for everybody so please don’t assume that I’m saying that for everybody who’s 54 but, you know, just from the statistics and everything – and that £135 per month was guaranteed right up until – for the next 11 years and what I want to say is that there was no premium increase and there was no exclusion.  That was the price that any 54-year old smoker would have been given.  So that’s why I just wanted to include that one.  It is a good thing to point out as well, because she was a smoker, that pretty much meant that her premiums had been doubled anyway, so if she’d been a non-smoker, you could probably halve those premiums.  But yeah, I just wanted to give those as some examples.  Is there anything that you would like to add, Leo, and anything potentially to those case studies or anything else that we’ve not yet covered?

Leo:             I think it’s just, you know, those case studies are fascinating and they’re so helpful because for a start they illustrate, you know, how complex peoples’ situations are.  So it’s not – I think that is the challenge sometimes, it seems very kind of binary.  It’s a yes or no and it’s just not at all so I think, you know, for me as someone who’s kind of lurking on the fringes of being more educated about insurance, I can see that but as people – you know, it’s important to understand that people coming to the industry might just, you know, have quite a simple view of it so – but what’s really positive and perhaps that’s what we need to get the message out then more is the fact that it is accessible.  You know, particularly that last case – expensive but actually accessible if people want it and I think – or, you know, I hear you tweet about silly premiums versus sensible premiums.  I think that’s quite an interesting point as well because actually, again something I see a bit with the industry is this kind of tendency to shy away from offering things that they think people might not want or might not take.  It’s very much about what the customer’s circumstances are, so is it affordable for them?  Do they want to have that choice to take it because it’s more important to them and they feel like that’s money that is well spent and good value?

So I think, you know, there’s that, which sort of quite significant points – is, you know, what does the customer really want and what are they prepared to accept and what is good value and fair for them?  And I think the other thing is, you know, obviously I always feel very guilty that I talk very negatively about, you know – because I see sort of lots of injustice and lots of people who’ve had very difficult conversations and difficult things but actually, working on the Access group has, you know, it’s seeing that positive effort, seeing, you know, companies like yours where you’re really taking care of the customer, really absolutely trying to take it to the nth degree to make sure they get some cover and get the best cover that’s available for their circumstances.  You know, there’s a huge amount of positives, there’s a huge amount of progress and I think it’s important that we focus on that and I think some of the work that’s coming out of the Access working group, you know, the signposting work, things that are really going to support people to get to what is available to them and, you know, some work that we’re doing on explaining underwriting decisions which is something that we talked about before, you know, enabling people to navigate what is a complicated market but understand that the likelihood is there is something out there for them and also that if there isn’t, you know, that that is explained to them in a way that, you know, shows that it’s fair and actually even better than that, if as part of the working group and part of this work is that we can actually extend the cover available to people, you know, that is the direction that we’re going in or we were going in so apart from everything else, let’s not let Covid stop that.  Let’s, you know, kind of hold that core of we’re trying and working towards kind of widening access and trying to include people rather than looking to exclude them.

So, I think, you know, positive and negative.  I don’t want to be the kind of complete naysayer all morning but that’s I guess where we’re at.

Kathryn:       Absolutely.  And the thing is, I think it’s very valid and I think, you know, anybody listening will hear that you’ve got such passion for helping people that have obviously been living with cancer now or have had it in the past and, you know, I don’t think anybody could – well, I don’t think anybody could have a negative to say about your points of view on it.  I’m not everybody though but, you know, I think, you know, like you said though, it’s kind of like that society thing like what kind of society do we want to live in?  Do we want to live in one that supports people and does as much as possible?  Not saying it makes necessarily the absolute, you know, perfect options and doesn’t have the answer straight away but I think that thing of just at least trying, you know, as hard as possible to be as fair as possible and as you rightly say as well, making sure that, you know, insurers and, you know, anybody else in our industry – make sure that we’re not doing anything that goes against what the law says that we can’t do.  So obviously thank you so so much for giving your insight.  So we do have our truth or lie feature that I have yet to fool anybody with so I’m starting to take it as a personal challenge now that people – I am clearly just very, very easy to read.  So I shall start it off and I will say that for my truth or lie, the weirdest thing that I have ever eaten is crocodile.

Leo:             Hmm, interesting.  So for my truth or lie, I have abseiled down the Spinnaker Tower which, if anyone’s been to Portsmouth, is the sort of pointy tower that looks a bit like a sail that’s really very, very high.

Kathryn:       Yes, so I remember my sister went to university there so I do, yes, absolutely.  Well thank you everybody for listening and thank you Leo for joining me, it’s been absolutely great obviously to hear about your side of things.  You know, I’ll be back in two weeks with Sue Kinsella from RedArc Nurses where we’re be chatting about her experiences offering support to people.  I imagine quite a lot of support potentially to people who have accessed Macmillan support as well.  If you’d like a reminder of the next episode, please drop me a message on social media or visit the website www.practical-protection.co.uk and please don’t forget, if you are within the industry or even if you are somebody else and you’re not in our industry, if you would like a CPD certificate for having listened to this, just go on the website again and all the information is there, easy for you to access.  So thank you very much, Leo.

Leo:             Thanks so much, Kathryn.  Great to talk to you.

Kathryn:       Thank you, bye.

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