Neurodiversity

Hi everyone, I have Matt Rann back with me and we are focusing upon neurodiversity. We are taking a look at accessing insurance when someone has ADHD, autism, dyspraxia and/or dyslexia.

A big part of this session is focused upon adviser skills and responsibilities, to ensure that clients are supported. We also talk about potential underwriting questions and how insurers can take steps to improve their communications.

The key takeaways:

  1. Statistics over how many neurodiverse people are living within the UK, it’s millions!
  2. To never make assumptions about your client based upon their health.
  3. Ways to adapt your sales approach to support people that require different communication routes.

I will be back in a couple of weeks with Katharine Moxham and Roy McLoughlin to chat about group insurance.

Remember, if you are listening to this as part of your work, you can claim a CPD certificate on our website.

Kathryn:     Hi everyone, this is episode nine of season three and I have Matt Rann back with me.  Hi Matt!

Matt:           Good morning Kathryn, how are you?

Kathryn:     I’m very good thank you, how are you?

Matt:           Yes, yeah, the sun is shining.

Kathryn:     Absolutely, the sun is shining here now.  It wasn’t an hour ago.  I’m going to keep looking out of the window while we chat, I’m not being rude.  Today, we are focusing on neurodiversity, the conditions that often fall within this category and how to access protection insurance when you are neurodiverse.  So this is the Practical Protection podcast.  So Matt, I was contacted by somebody recently and it seemed interesting to find out that I’m not sure where this list is or sort of like whereabouts it is but apparently in the UK insurance podcasts, we’ve been listed on somebody’s blog as being number seven in the top 20 UK insurance podcasts which I think is pretty cool.

Matt:           That’s a fantastic achievement.  Well done!

Kathryn:     Oh well done to you as well, yeah, helping make this.

Matt:           Team effort, I have to say.

Kathryn:     Team effort.  Well I was going to say, the CII were number one so I get that, obviously they are very, very much insurance but then what was interesting is that number two there was a podcast about insurance with Steph McGovern which I found quite interesting.  I thought, “Ooh I’m named somewhere with Steph McGovern, that’s quite good.” [laughs]

Matt:           Oh gracious, I don’t know.  But yeah, it’s a team effort and really it’s testament to all the hard work you put in and honestly, I’m not just saying that either.

Kathryn:     Well thank you, thank you.  Well we’re going to be going on about neurodiversity today.  So there are lots and lots of conditions when it comes to neurodiversity so I’m not going to be – well we’re not going to be able to go through all of them but we thought we’d maybe go through some where maybe it’s something that it’s not just possibly an underwriting consideration but one very much for advisers as well.  So we’re going to talk about potentially how to change your approach and I’ll possibly talk through some examples as well.  So for everybody listening, I am going to go through a little bit of statistics here so just bear with me and then we’ll get on to the fun part where we start having a good natter.  So what we’re going to be chatting about today is going a little bit through the background of conditions known as ADHD, autism, dyspraxia and dyslexia.

So ADHD is a condition that a lot of us, I imagine, have heard of.  It’s known as attention deficit hyperactivity disorder and it’s something where it can be linked with another – with sort of like – say that again, with mental health conditions such as anxiety, depression, bipolar, potentially Tourette’s and also linked with epilepsy as well and it’s something that tends to make people – I’ll go through sort of the symptoms a lot more but it’s one where someone tends to have lots and lots of energy and sort of like maybe appears as if they can’t – in a sense, possibly from an outsider’s point of view, maybe as if they can’t really calm down which would be a very, very basic sort of view as to what was happening.  There is a more rare form of this as well called hyperkinetic disorder.

So something that surprised me when I was going through the research about ADHD was that it’s roughly 3-4% of adults have ADHD which, when you look at the UK – and this was specifically in the UK, that’s about two million people which for me was an incredible number of people.  I didn’t expect it to be that high and it made me really think about the fact that, you know, this is – again, from an adviser space or an insurer space, this is a lot of potential clients that we need to make sure that we’re approaching and supporting in the right way in gaining their insurances.

The next one that I wanted to chat through was autism.  So with autism, it’s known as autism spectrum disorder and also it can be linked with – well it’s also known as autism spectrum condition and linked as well – or potentially known as Asperger’s syndrome and Asperger’s syndrome is known as high functioning autism but that is no longer – apparently Asperger’s syndrome in itself is no longer diagnosed as a specific condition in its own right.  So when you’re looking at that again, so like when I was looking at the British Medical Association, there’s roughly 700,000 people in the UK living with autism and again it can be linked to conditions such as ADHD, dyslexia and other mental health conditions and epilepsy and I think what’s interesting about the autism is that they very specifically say as well when you’re trying to understand it that it is not an illness.  It is just the brain is interpreting things in a different way to what other people are interpreting it as.

But again, 700,000 people – we’re talking, you know, a large, large portion of people and then going on to dyspraxia.  So this is also known as DCD or developmental coordination disorder and it’s expected, when they’re sort of estimating out, that about 5% of the population is affected by dyspraxia which again is roughly 3.3 million people in the UK and of that there will be 1.3 million people that would be significantly affected with symptoms of dyspraxia.  That is more to do with motor skills and physical movement rather than anything to do with mental health or any kind of cognitive development.

But again, looking from that, we’ve had two million for ADHD, we’ve had 700,000 for autism, we’ve now got 3.3 million people with dyspraxia – we’re up to six million people now already that have a condition that really should be – we make sure that people within obviously, well any aspect of society should know, but obviously people within insurance, whether or not that’s underwriters, claims handlers or people on the front line, you know, anybody who’s speaking, because there can be different ways that we need to communicate sometimes.  The other thing I would say is there maybe needs to communicate slightly differently but it’s also really important not to make assumptions.  Just because somebody has a health condition, it doesn’t necessarily mean that they are vulnerable.  It doesn’t necessarily mean that you have to put in really, really sort of like massive adaptations to what you are doing.  The important thing is to listen to that person and to listen to their needs of what they’re telling you that they require.

The last one for me to just mention is dyslexia which is known as a learning difficulty that often involves difficulty in terms of reading and/or writing and when you look at that, that is 6.5 million people in the UK are having this.  So whilst I know – obviously while I was adding up the numbers before, I’ve just been adding it on rather than – that’s sort of like my crude attempt to sort of like add up the numbers without taking into account that some of these conditions would have people who are experiencing all of them and the numbers may be slightly lower but still, that’s – we’re talking millions of people within the UK that are having these conditions.

So a key part of what we’re going to be chatting about today is about these health conditions.  We can understand potentially how a person may need to have things adapted to them when they’re applying for insurance and what potentially might be the considerations for an underwriter and then also to maybe understand what we would maybe expect in terms of symptoms and again, not an assumption that people would have these symptoms but just to be aware so that when we experience and come across them as an adviser, as anybody else, that we’re not necessarily shocked, that we very quickly understand and can see that there is possibly some symptoms there that would maybe suggest a health condition and for us to then react in the right ways to really support that person.

So Matt, first of all, let’s have a bit of a chat about ADHD then please.  So from an underwriter’s kind of mindset and your knowledge and everything, can you in a sense tell us a bit more about ADHD and then we can sort of like chat going forwards if that’s okay?

Matt:           Yeah, absolutely.  I think one of the interesting things to start off with from my perspective is, as an underwriter now of 40-something years, I’m not going to put it exactly, it seems incredible to me with the numbers that you’ve mentioned that I have very, very rarely seen cases either at a new business underwriting stage or indeed at a claims stage that would fit into the categories that we’re talking about this morning and I do have to ask myself why.  It could well be that the insurance-buying population is a select group in its own right with people who have money, want to insure things for a particular reason – mortgage being the obvious one, family protection for children etcetera, etcetera but as I say, it’s possibly a little bit worrying for me really why I haven’t seen people in these groups hit my desk over the years.

Anyway, going back, ADHD – I can’t quite remember the number that you mentioned but certainly I’ve seen studies showing that 8% of the population have a form of attention deficit hyperactivity disorder, of course is its long name.

Kathryn:     I had 3-4% and that was about two million so 8% obviously is increasing it obviously quite a lot higher.

Matt:           Yeah.  I believe I got that from the website, one of the websites that’s available – one of the health websites.  So it is quite remarkable really.  The causes – really not clear.  People haven’t – the scientists etcetera – unusually for them these days, haven’t really come up with a definitive cause and as you’ve already said, we often see this associated with children – always manifests itself usually at a young age but behavioural therapy and medication can help a lot in these areas and it certainly can – it does progress into adulthood but the symptoms can be very subtle in adults and again that might be one of the reasons why I haven’t seen too many cases – that in fact they haven’t necessarily had to seek medication or see a GP or medical professional.

But nevertheless, I think, looking at the symptoms again, you’ve already mentioned some of them – frequent mood swings, hot temper, low frustration tolerance, impulsiveness, history of suddenly quitting your job, you know, it’s interesting where somebody would ultimately actually fit into a diagnosis of ADHD.  Some of those things I think I could recognise in myself, let me put it – that’s what I was trying to say there.

Kathryn:     So it’s really hard actually, isn’t it, you know, some of this – especially I imagine it’s especially difficult with children ‘cos some of the main symptoms are short attention span, excessive talking, interrupting, losing interest in tasks and obviously I’ve got three boys – they’ve all obviously had that at different stages of their life so it’s something more than just those things.  It’s sort of like – it’s quite a marked and probably very, very consistent sort of situation where it’s happened I imagine.

Matt:           I think you’re absolutely right.  I think the point I suppose I was trying to make was, you know, a marked behavioural issue but 8% of the population have it?  Or even 3-4% of the population have it?  I wonder quite where those – the parameters for defining actually come in.  Now, I’ll put that down for a minute.  That, I think, also creates a challenge for underwriting.

Kathryn:     Yes.

Matt:           Because unless somebody has actually been diagnosed formally with this, then a lot of the symptoms would not even be – come up on a proposal form.

Kathryn:     Yeah.

Matt:           They wouldn’t be asked and there is nothing wrong with that, the proposal form – if you – what everybody needs to do is to answer the questions on the prop.  If they’re not answerable, then you don’t answer them.

Kathryn:     Exactly, yes.

Matt:           The challenges with ADHD in terms of underwriting again is really how it impacts that person’s lifestyle. Can they look after themselves?  Do they feed themselves properly?  Are they able to socially interact in a reasonable way?  All of those things kind of – well do play a part in mortality.

Kathryn:     Yes.

Matt:           Okay?  The lifespan of an individual.  What you will get, and I know you spoke about – you’ve mentioned it already of course, is depression is a very common associated disorder with ADHD.  You also get anxiety and sleep disorders as well and an underwriter will obviously be very interested in the depression and how that impacts them.  Just because somebody suffers from depression obviously doesn’t mean that they’d even get rated terms but we need to know the severity of that depression, how long it’s gone on for, how it’s been treated etcetera, etcetera.  So ADHD, as I say, just to summarise really, I’m amazed that I’ve not seen many cases over the years or they’ve been brought to my attention from other members of the teams that I’ve worked with.

The symptoms – you hit the nail on the head really, the symptoms are mood swings, temper – I’m assuming must be very marked in order to get this diagnosis ‘cos to try and differentiate I think between some of those – particularly and as you say, in children, and I recognise all those years ago those issues in mine as well, those challenges, how you draw a line in the sand to say somebody has ADHD and someone hasn’t is pretty damn difficult.  And underwriters of course will work on diagnoses.

Kathryn:     Absolutely.  Well I don’t think they can do anything else can they really?  You’ve got to go by what’s been told by a GP.

Matt:           Absolutely.  That is certainly the way of looking at it, yeah, or a way of looking at it.

Kathryn:     So we do speak with a number of people at Cura who have ADHD and usually when they say it to us, it’s usually more like an aside.  Like they’re telling us about something else and then they’ll just go, “Oh, by the way, I have ADHD as well,” which, you know, obviously we then take it on board.  I think something to be very aware of is the fact that there are certain things like making mistakes on forms, you know, it’s important not to – it’s really important not to talk down to anybody obviously with any kind of health condition.  You should never talk down to them as if they don’t understand something but it’s also important to make sure that you are in a sense empowering them to understand the forms and everything as best as possible.  So just like with anybody, you know, make sure that the forms that you’re giving them are clear, you know, if need be, something that we do all the time and it’s not just for people with ADHD, it’s generally for everybody because insurance documents as we all know are not the simplest things to look at.  We put little sticky notes on it, you know, saying, “Fill in this question here, ignore this question.”

You know, depending upon the situation, you know, it could be that they interrupt you which can be – if somebody is interrupting you quite consistently when you’re chatting to them, that can be very, very agitating for yourself and obviously you can start to get your own emotions sort of riled up a little bit.  So I think what could be interesting is if you are getting that kind of a situation, if someone is talking a lot, they’re interrupting you a lot, maybe their thoughts – what you would maybe think of as like jumping from place to place a little bit, maybe at that point just try and have like a little thing in the back of your mind to think, “Hang on a minute, is there maybe something here in terms of communication?”  And it could be that you maybe, you know, sort of take a slightly different approach, whether or not you’re in person or if you’re doing it over the telephone.

There are different things that you can do so, you know, it could be sometimes that you maybe need to repeat yourself a little bit.  It could be that you need to just take slightly different approaches in the sense of writing something down via email and taking that approach, giving the person time to complete the forms, you know, just giving them the chance to go through things.  It’s the kind of things where I would be saying – I would have thought and I hope that everybody would do that for somebody regardless of a health condition or not or their age or anything like that, that if somebody was having difficulty, that you would really try – and I know we all work in really sort of like fast-paced lives now but it really can make a difference to somebody if you pause and wait and I think from the numbers that we’ve been talking about as well, you’ve probably come across a lot more people than you expect with this condition and it might be that there’s been absolutely nothing for you to notice or it might be that there has been something and you’ve walked away thinking, “Do you know what, they just weren’t getting it were they?”  But actually, that’s not their fault.  As an adviser, it’s your fault because you need to adapt.

Matt:           Yeah.

Kathryn:     So I think that’s really important.  Now, autism – going onto that one, now this is something that for me, I have found personally – I’ll be honest, in the insurance world, so many years ago, it doesn’t happen now but many, many years ago it was something that absolutely I was ready to go to an insurer and tell them exactly what for as I’m sure most people can imagine me doing.  And we were speaking to somebody – this was years ago and they had autism and we spoke to the insurer and the insurer said to us, “You need to find out their IQ.”  I found that – I’ll just say, I found it disgusting.  I found it incredibly insulting to ask somebody with autism what their IQ was because quite frankly I really wanted to turn around to that person and say, “Well, can I have your IQ because theirs is probably higher.”

There’s different levels of autism and there’s different levels of symptoms and understanding and I appreciate from an underwriting point of view that there are some people living with autism that the insurers will possibly wonder what’s known as the insurable interest.  Now for any charities that are listening, the insurable interest is something where – that’s kind of what advisers and insurers work on in the sense of what’s going to be the financial impact of somebody – of that person no longer being there.  Say that we’re looking at life insurance, so say like for parents, there would be the financial impact of the child that they’re no longer there if they were to die, they’d be no longer there to bring in the income to the household, to raise the child, they would need somebody to look after them.  So that’s kind of like one of the things that’s looked at.

So for somebody who has very significant autism who isn’t able to work, who maybe requires full-time care, that’s not to say that insurances aren’t available, it’s just to say that sometimes there would be a question as to what the insurances are there for and that’s for a number of reasons in the sense of not only establishing why that money is needed, possibly for funeral expenses would be a potential that would be looked at but it’s also to safeguard the person that is living with autism, to make sure as well that insurance is being taken out upon their life when it shouldn’t be in a sense for somebody’s benefit when they really shouldn’t have that insurance in place.  I’ve gone off on a bit of a side tangent there.

Matt:           It’s absolutely valuable.  You’ve highlighted those challenges, you’re absolutely bob-on with everything you say.  As regard – sorry to cut you off for a second –

Kathryn:     No, of course.

Matt:           But the comments that you made about the IQ I’m afraid I find disgusting.

Kathryn:     Yes.

Matt:           I’m ashamed of the industry for asking that type of question and I can only hope that it was somebody who just didn’t think about what they were doing which sadly, we’re all human and we do make mistakes but I’m very glad to say I’ve never asked that question but I wonder if a member of my team in the old days would have asked that question of anybody.

Kathryn:     Yeah, and I’m really glad to hear that and it was such a shock when we came across this and we just said at the time as well, it was just thing of, “Wow, Access to Insurance were trying so hard and then there’s this question,” and you just thought, you know, obviously you kind of think, “As advisers, we can kind of be here to buffer those questions and go back to the insurer and just go, ‘You’re wanting me to ask what now?  I’m not doing that.’”  But then you think of people who’ve gone direct and I’m not saying that – obviously this is something that’s going to happen with insurance, insurers are – to be very clear, they are – the wording that’s being used in questions now is absolutely amazing compared to where it used to be and there’s so many things that have changed through learning and, you know, insurers are in a much, much better place but there is still that thing sometimes of thinking, “Actually, put yourself in that person’s – you’re that person’s Mum maybe and you’ve just – the Mum’s just rung you –”  Me, as a Mama Bear, I’ve just rung up an insurer about one of my children who has – obviously, I was going to say my children has autism as an example but they don’t, I just want to be very clear about that and someone turns around to me and says, “What’s the IQ of your child?”  I would not be happy at all and I would have choice words with somebody who asked that because an IQ is not someone’s worth.

Matt:           No.  If that question had been asked, they don’t actually understand how intelligence quotients are worked out anyway.

Kathryn:     Exactly and there is that kind of question then of well, where do we draw the line as to asking somebody’s IQ because –

Matt:           Does anybody actually know what their IQ is anyway?  Can you tell me how many people really know what their IQ is?

Kathryn:     I know, it’s very, very strange.

Matt:           Very few of my kind of friends and work colleagues etcetera so it’s an absolutely nonsense question –

Kathryn:     Absolutely.

Matt:           And I’m embarrassed.

Kathryn:     It is.  I was going to say though, slight tangent, I do know of one insurer that does ask for highest qualification status in their application which for me is something that, again, I don’t particularly understand.

Matt:           Again, it’s a nonsense question isn’t it?  How many people have left school – Mr Branson for instance?

Kathryn:     Yes.

Matt:           Didn’t he leave school at –

Kathryn:     Exactly.

Matt:           Very young.

Kathryn:     I don’t even think he got his GCSEs did he?  I think he – didn’t he leave beforehand?

Matt:           He left certainly before A-levels I think.

Kathryn:     Yeah.

Matt:           And look at him and yet, isn’t Mr Branson a – isn’t he autistic?

Kathryn:     Oh I can’t remember.  I remember seeing something now, I’m not sure.  I remember seeing – yeah, I’m going to have to go look at that now.

Matt:           Yeah, look it up.  There’s a very lovely letter he wrote to a nine-year-old –

Kathryn:     Oh how lovely.

Matt:           Who had autism.

Kathryn:     I shall – I will absolutely get that –

Matt:           A little bit from memory I have to say but – she was saying about how she found it a bit difficult and he was saying, “Well I’ve got – autism is what has helped me get where I am today.”

Kathryn:     That’s such a lovely sentiment to send to somebody so young as well.  I’ll have to get tissues.  I’ll have to get myself ready.  But with autism, so again, just for advisers to be aware, it could be somebody who is – they may come across as quite blunt and rude.  They may seem a bit anxious.  They’re not likely to understand sort of like turns of phrase, so they’re very literal so if you were to say something like, “Oh, break a leg,” they possibly won’t understand that.  They’re probably going to think that you actually are saying to them, “Go and break your leg,” which is obviously so far from the truth of what you’d be saying.  So it’s just being careful.  They may avoid eye contact.  They may talk over people.  They may also be very uncomfortable about being touched and I know that can sound very strange because everybody sort of doesn’t like being touched in many ways.

But – so this is kind of like a bit of a side-step as well to – I was explaining this to – someone said that it really surprised them, they’d never thought of it before.  So my Mum has fibromyalgia and when she meets people, obviously not Covid times but it’s our thing isn’t it to sort of – we shake hands or maybe give somebody a little big of a hug if we know them.  Both of those things are extremely painful for my Mum to do and someone shaking her hand will cause her significant pain for a long time so she doesn’t shake hands.  It’s not her being rude but she feels like she has to explain it each time and she’ll be like, “I’m sorry, I can’t shake hands because it actually causes me pain to do so.”  And she kind of gets a bit embarrassed about it but she does have that kind of awareness to be very open to say, you know, “This is what’s happened.  This is why.”  But obviously somebody with autism may not think to say something like that.  So again, it may be you’re getting what feels like quite a rude conversation, someone’s being quite standoffish with you physically, they’re maybe not sat in a kind of open – well we’re taught as advisers that open stances, sort of like the open question stances and different things, you know, welcoming kind of stance –

Matt:           Yeah.

Kathryn:     And obviously if they’re not making eye contact with you, that can also be considered to be very, very rude from what we’re brought up to be used to.

Matt:           Cultural issues, yeah.

Kathryn:     But again, that’s something where if you’re starting to see some of these signs as an adviser, especially if you’re face to face, obviously I imagine some of these are much easier to spot but, you know, it’s just something to try and be aware of and again, if you’re starting to see these things and you think, “Hang on a minute, is there maybe a health condition here and I maybe just need to be slightly more aware and maybe this isn’t anything about rudeness?  Maybe this is just this person and I need to just sort of like change my own mindset at the moment.”

Talking about as well, on a sort of like the telephone, because we’re telephone-based, I was speaking to somebody last year and she has autism and she is very much an auditory person so she was very clear with me from the start.  She said, “I have autism.  I’m an auditory person.  I would like to do – I would like to chat by phone and try and keep emails to a minimum,” which was absolutely fine.  We do obviously quite a lot by emails because I think, again, everybody has busy lives, emails are quite easy and quick to do but then what I made sure I did was I made sure that when it was time to do contacts and updates, I made sure it was a phone call that I did to her and then if I didn’t manage to get her on the phone, I would try and leave as much detail as possible via voicemail without any kind of identifying information because obviously we have to be very, very careful as to the information but to try and give her as kind of like a generic update about what was happening and, you know, not even talking about the fact we were talking about life insurance but just sort of like saying on the phone, “Right, I just wanted to ring up and give you an update about the insurance that we were discussing recently,” because again, you can’t necessarily sort of like say ‘life insurance’ on a voicemail and –

Matt:           Sure, sure.

Kathryn:     Leave it somewhere for potentially anybody could grab the phone and then learn –

Matt:           Absolutely.

Kathryn:     There’s so many things to think about.

Matt:           Yeah, yeah.

Kathryn:     But I think from my understanding, especially when I was doing obviously all the research and everything, again it comes down to – again, anybody from the charities who are listening, it comes down to in a sense what is the insurable interest?  With the lady that I spoke to who had autism, she was working, she had a mortgage, she had children.  There was lots of what’s known as an insurable interest so that would be loss of income – so her household, for her if she was ill or seriously ill or potentially if she were to pass away, the ability to repay the mortgage if again something were to happen to her and also potentially funds to help raise her child until the child had reached an age of independence.  So there was very, very clear what we class as like the insurable interest in the insurance world.  There were very, very clear needs there and that’s the kind of thing that people would be looking for.

But as far as I’m concerned and as far as I’m aware, Matt, it’s probably quite a standard sort of approach as it would be to any health condition.  So it will be wanting to know when the diagnosis was made, the symptoms, possibly any medications or treatments but I don’t think there’s lots of things – obviously with some conditions there are lots of things that stand out that we need to know about and that can potentially have an influence on the terms but I don’t know specifically with autism if that’s necessarily the case.  It would seem – for me, it kind of feels like it could be quite straightforward?

Matt:           Yes Kathryn, you mentioned it should be relatively straightforward and I would go along with that.  From an underwriting perspective over and above the normal questions, if you want to call them that, then we really want to know the background to the individual.  The case that you mentioned earlier is obviously somebody who is holding down a decent job, has a mortgage, potentially has children and those are all very, very positive signs from an underwriting perspective, i.e. they themselves have the same as anybody else in terms of their ability to look after themselves, look after their health, eat properly, exercise, etcetera, etcetera so in that circumstance, yes it would be very simple.  If somebody’s got 24/7 care – needs care, then that’s the other end of the spectrum really and obviously we would need to look at that very, very carefully.

Kathryn:     Yes.  No, I think that’s right and I think as well, that kind of – that’s not just the insurers obviously, that’s to do with also as I say in terms of safeguarding that individual because the last thing we would want to do with somebody trying to take out insurance for somebody when they really shouldn’t do and trying to profit if something were to happen to that individual, so I think that also comes down to the advice side of things as well and that could be why if people have had some difficulties in the past in terms of being able to access things, it could have just been a bit more – sometimes maybe a little bit more clarity as to why the cover was needed or was felt to be needed.

So going on to dyspraxia then, so as far as I’m aware, dyspraxia is more to do with like the physical movements and I think this is possibly one where there probably would be more consideration in terms of the underwriting side of things because I understand that there can be sometimes difficulty in terms of driving and doing like household chores and day-to-day tasks and I know that driving sometimes – the ability to hold a driving licence can sometimes factor into sometimes with medical conditions as to understanding the strength of the symptoms.  Am I right in thinking that?

Matt:           Yes.  Excuse me, I think again what – the way that I would approach this anyway as an underwriter would be how the moving difficulty – how it impacted their day-to-day life.

Kathryn:     Yeah.

Matt:           And I wouldn’t be too worried about driving but I would be more focusing in on how – what their lifestyle is, whether they can look after themselves, whether they can get about, can feed themselves properly, etcetera, etcetera from a lifestyle perspective.  I think those are the key issues.  It was interesting, just in researching for today, I found a study, it was a very, very small study.  It actually came up with – and this was April 2019 so it wasn’t very long ago, people within – who have these conditions are probably about twice as likely to die than those in the general population.

Kathryn:     Oh right.

Matt:           Which is quite staggering from an underwriting perspective but very much depends where you got those kind of opposites right at the – different scales where severe will require drastic, different lifestyle to the general population, specific living arrangements, plenty of help from those around them.  That’s at the more difficult end.

Kathryn:     Yeah.

Matt:           And a measure of that obviously is the score of their social ability and daily living skills.  That’s how an underwriter will actually look at all of these types of case to be perfectly honest with you.

Kathryn:     Yeah.

Matt:           Where somebody is leading what in modern parlance is a normal life, everything will be pretty simple.  There’s no two ways – but straightforward to use your expression.

Kathryn:     Yeah.

Matt:           But nevertheless, that statistic which I gave, I’ll say it again – people within these groups are more than twice as likely to die than that of the general population.

Kathryn:     Yeah.

Matt:           Those people will generally have pretty severe forms of these disorders.  There’s no two ways about it.

Kathryn:     Yeah.

Matt:           And part of that reason is their general lifestyle, you know, you need to look after yourself or people have to help you to look after yourself.

Kathryn:     Yes.

Matt:           That’s the kind of key areas there.

Kathryn:     I think as well, probably going on from that as well a little bit so with the dyspraxia, obviously in terms of the movements, I imagine on the stronger end of the scale – the condition, that people could possibly be wheelchair-bound –

Matt:           Yes, absolutely.

Kathryn:     And obviously being lifelong in a wheelchair – obviously that in itself, being in a wheelchair isn’t necessarily a significant immediate risk insurance-wise but it does come with certain aspects in terms of it can lead to other potential conditions that insurers obviously like to know about and to be aware about but I think, you know, if somebody’s got dyspraxia and it’s the kind of thing where they have symptoms where essentially they’re not able to run or jump but, you know, they’re working, they’re able to drive, they’re sort of like living life, just like so many people with health conditions, they just know, sort of like, “Right, I can’t run, I can’t jump but I can do everything else and I don’t need to run and jump to live so that’s fine.”  Then really, you know, I would hope that, you know, people wouldn’t be too apprehensive about going for insurance if that was the case.

Matt:           I would completely agree with everything you’ve said there and I would encourage people to go to at least ask about insurance – protection insurance and there is a very good chance that in the vast majority of people with these conditions, insurance terms would be able to be given and insurance would be available.

Kathryn:     Yes.

Matt:           Certainly don’t be put off whatsoever.

Kathryn:     Yeah, that would be my thought too.  And the last one we’re talking about is dyslexia so that’s the one where we have is it 6.5 million people in the UK living with dyslexia.  So one of the things that we do at Cura is we’ve got the Recite Me accessibility and language software on the website where people with dyslexia or a number of different either health conditions or potentially language barriers are able to adapt the website so it’s accessible for them.  Now that could be that the – everything is set up so it’s read aloud.  It could be changing the background and font colours to match what that person is able to see most easily but some things to bear in mind is that, you know, it could be that you maybe need to do more of a telephone call.  You know, it has to be more of a conversation rather than written documentation and I’m sure that advisers and compliance managers everywhere in the UK are sort of cringing at the thought that somebody might not be able to read a suitability letter or read the key features documents and terms and conditions policies correctly but at the same point, the level of technical information that is in those documents, it isn’t particularly feasible to expect somebody who struggles to read to be able to go through that document and completely understand it.

I did a podcast a while ago with the person who founded the Recite Me software and he just said when he looked at his insurance documents at first, when he was looking at them he was just like, “Well I just can’t be bothered.  There’s no way –” it completely just turned him off straight away.  Even though he needs it, he was just like, “I just do not – there is nothing about me that wants to go through all that documentation because it’s going to make me feel ill.”  And I think that’s something we need to be very aware of so as an adviser I would say obviously be able to do things over the phone.  Maybe, if you feel comfortable, to do videos and then you can even maybe – whilst providing obviously for regulatory requirements – providing the demands and needs letter for the client in terms of your advice and recommendation, you could then also do a video that accompanies it so the person can actually – you’ve done the regulatory requirements of putting everything in writing but then you’ve also done it in the way that’s actually accessible to them.  You may need to adapt the documents and print them in a different colour style and everything for the person to be able to access.  It’s more difficult obviously when we come to insurance documents and key features documents because they usually – they’re often in a format where that can’t be necessarily done to them.

And also bear in mind as well something that I think we often think as dyslexia as reading and writing but it is also potentially that there can be a struggle in remembering things after a certain timeframe.  So for some people, they may be able to recall information for say like 20 or 30 minutes without written prompts but they may need some kind of written or, you know, a different type of prompt of some sort so they can refer back to the conversation that they’ve already had.  You know, it may also be as well providing copies of call recordings for the client so they can refer back and listen to it and make sure that they understand what’s been asked of them.  But I think from my understanding with the dyslexia side of things, I really don’t believe that’s going to be coming into any kind of play really with insurances.  Am I correct with that, Matt?

Matt:           Yes, yes you’re absolutely right, Kathryn.  It just wouldn’t – it just doesn’t come into the insurance field at all.

Kathryn:     Yeah.

Matt:           There’s another one actually when I was doing a little bit of research called number dyslexia.

Kathryn:     Yes.

Matt:           Where people find maths challenging.

Kathryn:     Yeah.

Matt:           Dyscalculia apparently is the name for it but you’re absolutely right, neither of those particularly dyslexia should cause an underwriter any concerns at all.

Kathryn:     The thing is, actually I’ve met somebody – I know somebody with dyscalculia actually and it was interesting to me because I wasn’t aware of that side of things and obviously it brought that to my attention as well.  So I think, especially with dyslexia, this is where we’re really talking – it’s kind of like a mix because it’s really on the advisers to make sure that they are providing as much access as possible and making things as accessible as possible in terms of making sure that the person understands or if you say people with dyscalculia, making sure that they understand the processes to what’s being recommended and that the amounts that are being recommended and why and chatting to them.  Chat to the person, find out what it is that they need and what helps them and then adapt yourself to make sure that you are doing it how they need it to be and I think the other thing as well – I did some research on this a little while ago in terms of, you know, what’s available for people in terms of who have – struggle to be able access insurance if they are blind or deaf and the discrepancy between insurers about what they do and don’t do really, really surprised me actually in terms of being able to provide people with support to access documents.

That was one of the biggest things, you know, just having different levels of accessibility to the documents was a massive discrepancy so for any of the insurers or insurance brokers who are listening, I would really suggest that something that would be useful would be to make sure that the documents are wholly accessible.  There are a number of organisations that can be spoken to that can help with this.  It doesn’t, you know, I always think that there’s sometimes this fear of sort of potentially – sometimes of the costs of making things more accessible and the fact that there’s so many documents to do and then also getting it right.

But I think the fact of the matter is that, you know, at the moment, there’s a lot of people – for the dyslexia alone, 6.5 million people who are not going to find accessing insurance documentation – which, from a regulatory perspective, we need them to be able to read and understand for us to have all done our job – insurers, advisers, reinsurers alike – these documents are not in a format with most places that are easy for somebody to really understand and I think that should hopefully be a really big takeaway for anybody who’s listening.

Matt:           Absolutely.  Very wise words indeed throughout the last few minutes.  Again, I do find it very sad that insurers in 2021 don’t help or don’t go as far as they should with people who have – for instance who are deaf or blind.

Kathryn:     Yeah.

Matt:           That’s a shame.

Kathryn:     It is.  As I say, some of them are absolutely – they’re kind of knocking it out of the park, they’re amazing but the majority there is absolutely – there are only a couple that I thought, “Ooh, that really needs to be changed,” but, you know, there’s some who have got some things in place but, you know, there are ways that it could be improved and I think that that’s definitely something that would be worthwhile.  And the fact of the matter is that maybe turn around and – like you say, you know, there’s people, you know, when was the last time you maybe saw a case of somebody with autism or ADHD and people may turn around and say, “Well when was the last case we saw somebody who was blind or deaf going for insurance?”  And I think the biggest question there is that’s possibly a very – there’s possibly a really big answer there and a really obvious one.

Matt:           Yes, I agree.

Kathryn:     They cannot access it.  They just don’t even have the means to come and talk about it because they can’t.  There’s no way for them to be able to do so and, you know, there’s only a certain amount that you can do in terms of explaining why certain documents aren’t available in certain ways and different things before somebody – well just like the guy who was obviously with Recite Me, he just turns around and goes, “Well, they clearly don’t want my business so why would I even bother?”  So I think hopefully that’s sparked some thoughts with different people in different places.  Thank you so much, Matt, for giving your insight into things.  I think what I’ve really enjoyed about this podcast – I know we always have this but with a lot of these conditions, so like the autism, dyspraxia especially – I think a lot of people would possibly instinctively think that there’s maybe a difficulty in getting insurance or maybe even advisers wonder whether or not their clients, you know, are they actually going to be able to do anything and I think what’s been nice is that – just hearing your point of view that there is that hope there, that there should be stuff to be able to be available.

Matt:           Very much so.

Kathryn:     Well thank you so much for joining me, Matt.  Next time I’m going to be chatting with Roy and Catherine Moxon to discuss group insurances and next time after that when Matt, you’re back with me I think we’re going to be chatting about diabetes if that’s okay with you?

Matt:           Sounds excellent, looking forward to it.

Kathryn:     Brilliant.  If anybody would like a reminder of the next episode, please drop me a message on social media or visit the website practical-protection.co.uk and please don’t forget that if you’ve listened to this as part of your work, you can claim a CPD certificate on the website too.  Thank you so much for joining me, Matt.  Have a lovely rest of day.

Matt:           Thank you, and you.

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Neurodiversity

Hi everyone, I have Matt Rann back with me and we are focusing upon neurodiversity. We are taking a look at accessing insurance when someone has ADHD, autism, dyspraxia and/or dyslexia.

A big part of this session is focused upon adviser skills and responsibilities, to ensure that clients are supported. We also talk about potential underwriting questions and how insurers can take steps to improve their communications.

The key takeaways:

  1. Statistics over how many neurodiverse people are living within the UK, it’s millions!
  2. To never make assumptions about your client based upon their health.
  3. Ways to adapt your sales approach to support people that require different communication routes.

I will be back in a couple of weeks with Katharine Moxham and Roy McLoughlin to chat about group insurance.

Remember, if you are listening to this as part of your work, you can claim a CPD certificate on our website.

Kathryn:     Hi everyone, this is episode nine of season three and I have Matt Rann back with me.  Hi Matt!

Matt:           Good morning Kathryn, how are you?

Kathryn:     I’m very good thank you, how are you?

Matt:           Yes, yeah, the sun is shining.

Kathryn:     Absolutely, the sun is shining here now.  It wasn’t an hour ago.  I’m going to keep looking out of the window while we chat, I’m not being rude.  Today, we are focusing on neurodiversity, the conditions that often fall within this category and how to access protection insurance when you are neurodiverse.  So this is the Practical Protection podcast.  So Matt, I was contacted by somebody recently and it seemed interesting to find out that I’m not sure where this list is or sort of like whereabouts it is but apparently in the UK insurance podcasts, we’ve been listed on somebody’s blog as being number seven in the top 20 UK insurance podcasts which I think is pretty cool.

Matt:           That’s a fantastic achievement.  Well done!

Kathryn:     Oh well done to you as well, yeah, helping make this.

Matt:           Team effort, I have to say.

Kathryn:     Team effort.  Well I was going to say, the CII were number one so I get that, obviously they are very, very much insurance but then what was interesting is that number two there was a podcast about insurance with Steph McGovern which I found quite interesting.  I thought, “Ooh I’m named somewhere with Steph McGovern, that’s quite good.” [laughs]

Matt:           Oh gracious, I don’t know.  But yeah, it’s a team effort and really it’s testament to all the hard work you put in and honestly, I’m not just saying that either.

Kathryn:     Well thank you, thank you.  Well we’re going to be going on about neurodiversity today.  So there are lots and lots of conditions when it comes to neurodiversity so I’m not going to be – well we’re not going to be able to go through all of them but we thought we’d maybe go through some where maybe it’s something that it’s not just possibly an underwriting consideration but one very much for advisers as well.  So we’re going to talk about potentially how to change your approach and I’ll possibly talk through some examples as well.  So for everybody listening, I am going to go through a little bit of statistics here so just bear with me and then we’ll get on to the fun part where we start having a good natter.  So what we’re going to be chatting about today is going a little bit through the background of conditions known as ADHD, autism, dyspraxia and dyslexia.

So ADHD is a condition that a lot of us, I imagine, have heard of.  It’s known as attention deficit hyperactivity disorder and it’s something where it can be linked with another – with sort of like – say that again, with mental health conditions such as anxiety, depression, bipolar, potentially Tourette’s and also linked with epilepsy as well and it’s something that tends to make people – I’ll go through sort of the symptoms a lot more but it’s one where someone tends to have lots and lots of energy and sort of like maybe appears as if they can’t – in a sense, possibly from an outsider’s point of view, maybe as if they can’t really calm down which would be a very, very basic sort of view as to what was happening.  There is a more rare form of this as well called hyperkinetic disorder.

So something that surprised me when I was going through the research about ADHD was that it’s roughly 3-4% of adults have ADHD which, when you look at the UK – and this was specifically in the UK, that’s about two million people which for me was an incredible number of people.  I didn’t expect it to be that high and it made me really think about the fact that, you know, this is – again, from an adviser space or an insurer space, this is a lot of potential clients that we need to make sure that we’re approaching and supporting in the right way in gaining their insurances.

The next one that I wanted to chat through was autism.  So with autism, it’s known as autism spectrum disorder and also it can be linked with – well it’s also known as autism spectrum condition and linked as well – or potentially known as Asperger’s syndrome and Asperger’s syndrome is known as high functioning autism but that is no longer – apparently Asperger’s syndrome in itself is no longer diagnosed as a specific condition in its own right.  So when you’re looking at that again, so like when I was looking at the British Medical Association, there’s roughly 700,000 people in the UK living with autism and again it can be linked to conditions such as ADHD, dyslexia and other mental health conditions and epilepsy and I think what’s interesting about the autism is that they very specifically say as well when you’re trying to understand it that it is not an illness.  It is just the brain is interpreting things in a different way to what other people are interpreting it as.

But again, 700,000 people – we’re talking, you know, a large, large portion of people and then going on to dyspraxia.  So this is also known as DCD or developmental coordination disorder and it’s expected, when they’re sort of estimating out, that about 5% of the population is affected by dyspraxia which again is roughly 3.3 million people in the UK and of that there will be 1.3 million people that would be significantly affected with symptoms of dyspraxia.  That is more to do with motor skills and physical movement rather than anything to do with mental health or any kind of cognitive development.

But again, looking from that, we’ve had two million for ADHD, we’ve had 700,000 for autism, we’ve now got 3.3 million people with dyspraxia – we’re up to six million people now already that have a condition that really should be – we make sure that people within obviously, well any aspect of society should know, but obviously people within insurance, whether or not that’s underwriters, claims handlers or people on the front line, you know, anybody who’s speaking, because there can be different ways that we need to communicate sometimes.  The other thing I would say is there maybe needs to communicate slightly differently but it’s also really important not to make assumptions.  Just because somebody has a health condition, it doesn’t necessarily mean that they are vulnerable.  It doesn’t necessarily mean that you have to put in really, really sort of like massive adaptations to what you are doing.  The important thing is to listen to that person and to listen to their needs of what they’re telling you that they require.

The last one for me to just mention is dyslexia which is known as a learning difficulty that often involves difficulty in terms of reading and/or writing and when you look at that, that is 6.5 million people in the UK are having this.  So whilst I know – obviously while I was adding up the numbers before, I’ve just been adding it on rather than – that’s sort of like my crude attempt to sort of like add up the numbers without taking into account that some of these conditions would have people who are experiencing all of them and the numbers may be slightly lower but still, that’s – we’re talking millions of people within the UK that are having these conditions.

So a key part of what we’re going to be chatting about today is about these health conditions.  We can understand potentially how a person may need to have things adapted to them when they’re applying for insurance and what potentially might be the considerations for an underwriter and then also to maybe understand what we would maybe expect in terms of symptoms and again, not an assumption that people would have these symptoms but just to be aware so that when we experience and come across them as an adviser, as anybody else, that we’re not necessarily shocked, that we very quickly understand and can see that there is possibly some symptoms there that would maybe suggest a health condition and for us to then react in the right ways to really support that person.

So Matt, first of all, let’s have a bit of a chat about ADHD then please.  So from an underwriter’s kind of mindset and your knowledge and everything, can you in a sense tell us a bit more about ADHD and then we can sort of like chat going forwards if that’s okay?

Matt:           Yeah, absolutely.  I think one of the interesting things to start off with from my perspective is, as an underwriter now of 40-something years, I’m not going to put it exactly, it seems incredible to me with the numbers that you’ve mentioned that I have very, very rarely seen cases either at a new business underwriting stage or indeed at a claims stage that would fit into the categories that we’re talking about this morning and I do have to ask myself why.  It could well be that the insurance-buying population is a select group in its own right with people who have money, want to insure things for a particular reason – mortgage being the obvious one, family protection for children etcetera, etcetera but as I say, it’s possibly a little bit worrying for me really why I haven’t seen people in these groups hit my desk over the years.

Anyway, going back, ADHD – I can’t quite remember the number that you mentioned but certainly I’ve seen studies showing that 8% of the population have a form of attention deficit hyperactivity disorder, of course is its long name.

Kathryn:     I had 3-4% and that was about two million so 8% obviously is increasing it obviously quite a lot higher.

Matt:           Yeah.  I believe I got that from the website, one of the websites that’s available – one of the health websites.  So it is quite remarkable really.  The causes – really not clear.  People haven’t – the scientists etcetera – unusually for them these days, haven’t really come up with a definitive cause and as you’ve already said, we often see this associated with children – always manifests itself usually at a young age but behavioural therapy and medication can help a lot in these areas and it certainly can – it does progress into adulthood but the symptoms can be very subtle in adults and again that might be one of the reasons why I haven’t seen too many cases – that in fact they haven’t necessarily had to seek medication or see a GP or medical professional.

But nevertheless, I think, looking at the symptoms again, you’ve already mentioned some of them – frequent mood swings, hot temper, low frustration tolerance, impulsiveness, history of suddenly quitting your job, you know, it’s interesting where somebody would ultimately actually fit into a diagnosis of ADHD.  Some of those things I think I could recognise in myself, let me put it – that’s what I was trying to say there.

Kathryn:     So it’s really hard actually, isn’t it, you know, some of this – especially I imagine it’s especially difficult with children ‘cos some of the main symptoms are short attention span, excessive talking, interrupting, losing interest in tasks and obviously I’ve got three boys – they’ve all obviously had that at different stages of their life so it’s something more than just those things.  It’s sort of like – it’s quite a marked and probably very, very consistent sort of situation where it’s happened I imagine.

Matt:           I think you’re absolutely right.  I think the point I suppose I was trying to make was, you know, a marked behavioural issue but 8% of the population have it?  Or even 3-4% of the population have it?  I wonder quite where those – the parameters for defining actually come in.  Now, I’ll put that down for a minute.  That, I think, also creates a challenge for underwriting.

Kathryn:     Yes.

Matt:           Because unless somebody has actually been diagnosed formally with this, then a lot of the symptoms would not even be – come up on a proposal form.

Kathryn:     Yeah.

Matt:           They wouldn’t be asked and there is nothing wrong with that, the proposal form – if you – what everybody needs to do is to answer the questions on the prop.  If they’re not answerable, then you don’t answer them.

Kathryn:     Exactly, yes.

Matt:           The challenges with ADHD in terms of underwriting again is really how it impacts that person’s lifestyle. Can they look after themselves?  Do they feed themselves properly?  Are they able to socially interact in a reasonable way?  All of those things kind of – well do play a part in mortality.

Kathryn:     Yes.

Matt:           Okay?  The lifespan of an individual.  What you will get, and I know you spoke about – you’ve mentioned it already of course, is depression is a very common associated disorder with ADHD.  You also get anxiety and sleep disorders as well and an underwriter will obviously be very interested in the depression and how that impacts them.  Just because somebody suffers from depression obviously doesn’t mean that they’d even get rated terms but we need to know the severity of that depression, how long it’s gone on for, how it’s been treated etcetera, etcetera.  So ADHD, as I say, just to summarise really, I’m amazed that I’ve not seen many cases over the years or they’ve been brought to my attention from other members of the teams that I’ve worked with.

The symptoms – you hit the nail on the head really, the symptoms are mood swings, temper – I’m assuming must be very marked in order to get this diagnosis ‘cos to try and differentiate I think between some of those – particularly and as you say, in children, and I recognise all those years ago those issues in mine as well, those challenges, how you draw a line in the sand to say somebody has ADHD and someone hasn’t is pretty damn difficult.  And underwriters of course will work on diagnoses.

Kathryn:     Absolutely.  Well I don’t think they can do anything else can they really?  You’ve got to go by what’s been told by a GP.

Matt:           Absolutely.  That is certainly the way of looking at it, yeah, or a way of looking at it.

Kathryn:     So we do speak with a number of people at Cura who have ADHD and usually when they say it to us, it’s usually more like an aside.  Like they’re telling us about something else and then they’ll just go, “Oh, by the way, I have ADHD as well,” which, you know, obviously we then take it on board.  I think something to be very aware of is the fact that there are certain things like making mistakes on forms, you know, it’s important not to – it’s really important not to talk down to anybody obviously with any kind of health condition.  You should never talk down to them as if they don’t understand something but it’s also important to make sure that you are in a sense empowering them to understand the forms and everything as best as possible.  So just like with anybody, you know, make sure that the forms that you’re giving them are clear, you know, if need be, something that we do all the time and it’s not just for people with ADHD, it’s generally for everybody because insurance documents as we all know are not the simplest things to look at.  We put little sticky notes on it, you know, saying, “Fill in this question here, ignore this question.”

You know, depending upon the situation, you know, it could be that they interrupt you which can be – if somebody is interrupting you quite consistently when you’re chatting to them, that can be very, very agitating for yourself and obviously you can start to get your own emotions sort of riled up a little bit.  So I think what could be interesting is if you are getting that kind of a situation, if someone is talking a lot, they’re interrupting you a lot, maybe their thoughts – what you would maybe think of as like jumping from place to place a little bit, maybe at that point just try and have like a little thing in the back of your mind to think, “Hang on a minute, is there maybe something here in terms of communication?”  And it could be that you maybe, you know, sort of take a slightly different approach, whether or not you’re in person or if you’re doing it over the telephone.

There are different things that you can do so, you know, it could be sometimes that you maybe need to repeat yourself a little bit.  It could be that you need to just take slightly different approaches in the sense of writing something down via email and taking that approach, giving the person time to complete the forms, you know, just giving them the chance to go through things.  It’s the kind of things where I would be saying – I would have thought and I hope that everybody would do that for somebody regardless of a health condition or not or their age or anything like that, that if somebody was having difficulty, that you would really try – and I know we all work in really sort of like fast-paced lives now but it really can make a difference to somebody if you pause and wait and I think from the numbers that we’ve been talking about as well, you’ve probably come across a lot more people than you expect with this condition and it might be that there’s been absolutely nothing for you to notice or it might be that there has been something and you’ve walked away thinking, “Do you know what, they just weren’t getting it were they?”  But actually, that’s not their fault.  As an adviser, it’s your fault because you need to adapt.

Matt:           Yeah.

Kathryn:     So I think that’s really important.  Now, autism – going onto that one, now this is something that for me, I have found personally – I’ll be honest, in the insurance world, so many years ago, it doesn’t happen now but many, many years ago it was something that absolutely I was ready to go to an insurer and tell them exactly what for as I’m sure most people can imagine me doing.  And we were speaking to somebody – this was years ago and they had autism and we spoke to the insurer and the insurer said to us, “You need to find out their IQ.”  I found that – I’ll just say, I found it disgusting.  I found it incredibly insulting to ask somebody with autism what their IQ was because quite frankly I really wanted to turn around to that person and say, “Well, can I have your IQ because theirs is probably higher.”

There’s different levels of autism and there’s different levels of symptoms and understanding and I appreciate from an underwriting point of view that there are some people living with autism that the insurers will possibly wonder what’s known as the insurable interest.  Now for any charities that are listening, the insurable interest is something where – that’s kind of what advisers and insurers work on in the sense of what’s going to be the financial impact of somebody – of that person no longer being there.  Say that we’re looking at life insurance, so say like for parents, there would be the financial impact of the child that they’re no longer there if they were to die, they’d be no longer there to bring in the income to the household, to raise the child, they would need somebody to look after them.  So that’s kind of like one of the things that’s looked at.

So for somebody who has very significant autism who isn’t able to work, who maybe requires full-time care, that’s not to say that insurances aren’t available, it’s just to say that sometimes there would be a question as to what the insurances are there for and that’s for a number of reasons in the sense of not only establishing why that money is needed, possibly for funeral expenses would be a potential that would be looked at but it’s also to safeguard the person that is living with autism, to make sure as well that insurance is being taken out upon their life when it shouldn’t be in a sense for somebody’s benefit when they really shouldn’t have that insurance in place.  I’ve gone off on a bit of a side tangent there.

Matt:           It’s absolutely valuable.  You’ve highlighted those challenges, you’re absolutely bob-on with everything you say.  As regard – sorry to cut you off for a second –

Kathryn:     No, of course.

Matt:           But the comments that you made about the IQ I’m afraid I find disgusting.

Kathryn:     Yes.

Matt:           I’m ashamed of the industry for asking that type of question and I can only hope that it was somebody who just didn’t think about what they were doing which sadly, we’re all human and we do make mistakes but I’m very glad to say I’ve never asked that question but I wonder if a member of my team in the old days would have asked that question of anybody.

Kathryn:     Yeah, and I’m really glad to hear that and it was such a shock when we came across this and we just said at the time as well, it was just thing of, “Wow, Access to Insurance were trying so hard and then there’s this question,” and you just thought, you know, obviously you kind of think, “As advisers, we can kind of be here to buffer those questions and go back to the insurer and just go, ‘You’re wanting me to ask what now?  I’m not doing that.’”  But then you think of people who’ve gone direct and I’m not saying that – obviously this is something that’s going to happen with insurance, insurers are – to be very clear, they are – the wording that’s being used in questions now is absolutely amazing compared to where it used to be and there’s so many things that have changed through learning and, you know, insurers are in a much, much better place but there is still that thing sometimes of thinking, “Actually, put yourself in that person’s – you’re that person’s Mum maybe and you’ve just – the Mum’s just rung you –”  Me, as a Mama Bear, I’ve just rung up an insurer about one of my children who has – obviously, I was going to say my children has autism as an example but they don’t, I just want to be very clear about that and someone turns around to me and says, “What’s the IQ of your child?”  I would not be happy at all and I would have choice words with somebody who asked that because an IQ is not someone’s worth.

Matt:           No.  If that question had been asked, they don’t actually understand how intelligence quotients are worked out anyway.

Kathryn:     Exactly and there is that kind of question then of well, where do we draw the line as to asking somebody’s IQ because –

Matt:           Does anybody actually know what their IQ is anyway?  Can you tell me how many people really know what their IQ is?

Kathryn:     I know, it’s very, very strange.

Matt:           Very few of my kind of friends and work colleagues etcetera so it’s an absolutely nonsense question –

Kathryn:     Absolutely.

Matt:           And I’m embarrassed.

Kathryn:     It is.  I was going to say though, slight tangent, I do know of one insurer that does ask for highest qualification status in their application which for me is something that, again, I don’t particularly understand.

Matt:           Again, it’s a nonsense question isn’t it?  How many people have left school – Mr Branson for instance?

Kathryn:     Yes.

Matt:           Didn’t he leave school at –

Kathryn:     Exactly.

Matt:           Very young.

Kathryn:     I don’t even think he got his GCSEs did he?  I think he – didn’t he leave beforehand?

Matt:           He left certainly before A-levels I think.

Kathryn:     Yeah.

Matt:           And look at him and yet, isn’t Mr Branson a – isn’t he autistic?

Kathryn:     Oh I can’t remember.  I remember seeing something now, I’m not sure.  I remember seeing – yeah, I’m going to have to go look at that now.

Matt:           Yeah, look it up.  There’s a very lovely letter he wrote to a nine-year-old –

Kathryn:     Oh how lovely.

Matt:           Who had autism.

Kathryn:     I shall – I will absolutely get that –

Matt:           A little bit from memory I have to say but – she was saying about how she found it a bit difficult and he was saying, “Well I’ve got – autism is what has helped me get where I am today.”

Kathryn:     That’s such a lovely sentiment to send to somebody so young as well.  I’ll have to get tissues.  I’ll have to get myself ready.  But with autism, so again, just for advisers to be aware, it could be somebody who is – they may come across as quite blunt and rude.  They may seem a bit anxious.  They’re not likely to understand sort of like turns of phrase, so they’re very literal so if you were to say something like, “Oh, break a leg,” they possibly won’t understand that.  They’re probably going to think that you actually are saying to them, “Go and break your leg,” which is obviously so far from the truth of what you’d be saying.  So it’s just being careful.  They may avoid eye contact.  They may talk over people.  They may also be very uncomfortable about being touched and I know that can sound very strange because everybody sort of doesn’t like being touched in many ways.

But – so this is kind of like a bit of a side-step as well to – I was explaining this to – someone said that it really surprised them, they’d never thought of it before.  So my Mum has fibromyalgia and when she meets people, obviously not Covid times but it’s our thing isn’t it to sort of – we shake hands or maybe give somebody a little big of a hug if we know them.  Both of those things are extremely painful for my Mum to do and someone shaking her hand will cause her significant pain for a long time so she doesn’t shake hands.  It’s not her being rude but she feels like she has to explain it each time and she’ll be like, “I’m sorry, I can’t shake hands because it actually causes me pain to do so.”  And she kind of gets a bit embarrassed about it but she does have that kind of awareness to be very open to say, you know, “This is what’s happened.  This is why.”  But obviously somebody with autism may not think to say something like that.  So again, it may be you’re getting what feels like quite a rude conversation, someone’s being quite standoffish with you physically, they’re maybe not sat in a kind of open – well we’re taught as advisers that open stances, sort of like the open question stances and different things, you know, welcoming kind of stance –

Matt:           Yeah.

Kathryn:     And obviously if they’re not making eye contact with you, that can also be considered to be very, very rude from what we’re brought up to be used to.

Matt:           Cultural issues, yeah.

Kathryn:     But again, that’s something where if you’re starting to see some of these signs as an adviser, especially if you’re face to face, obviously I imagine some of these are much easier to spot but, you know, it’s just something to try and be aware of and again, if you’re starting to see these things and you think, “Hang on a minute, is there maybe a health condition here and I maybe just need to be slightly more aware and maybe this isn’t anything about rudeness?  Maybe this is just this person and I need to just sort of like change my own mindset at the moment.”

Talking about as well, on a sort of like the telephone, because we’re telephone-based, I was speaking to somebody last year and she has autism and she is very much an auditory person so she was very clear with me from the start.  She said, “I have autism.  I’m an auditory person.  I would like to do – I would like to chat by phone and try and keep emails to a minimum,” which was absolutely fine.  We do obviously quite a lot by emails because I think, again, everybody has busy lives, emails are quite easy and quick to do but then what I made sure I did was I made sure that when it was time to do contacts and updates, I made sure it was a phone call that I did to her and then if I didn’t manage to get her on the phone, I would try and leave as much detail as possible via voicemail without any kind of identifying information because obviously we have to be very, very careful as to the information but to try and give her as kind of like a generic update about what was happening and, you know, not even talking about the fact we were talking about life insurance but just sort of like saying on the phone, “Right, I just wanted to ring up and give you an update about the insurance that we were discussing recently,” because again, you can’t necessarily sort of like say ‘life insurance’ on a voicemail and –

Matt:           Sure, sure.

Kathryn:     Leave it somewhere for potentially anybody could grab the phone and then learn –

Matt:           Absolutely.

Kathryn:     There’s so many things to think about.

Matt:           Yeah, yeah.

Kathryn:     But I think from my understanding, especially when I was doing obviously all the research and everything, again it comes down to – again, anybody from the charities who are listening, it comes down to in a sense what is the insurable interest?  With the lady that I spoke to who had autism, she was working, she had a mortgage, she had children.  There was lots of what’s known as an insurable interest so that would be loss of income – so her household, for her if she was ill or seriously ill or potentially if she were to pass away, the ability to repay the mortgage if again something were to happen to her and also potentially funds to help raise her child until the child had reached an age of independence.  So there was very, very clear what we class as like the insurable interest in the insurance world.  There were very, very clear needs there and that’s the kind of thing that people would be looking for.

But as far as I’m concerned and as far as I’m aware, Matt, it’s probably quite a standard sort of approach as it would be to any health condition.  So it will be wanting to know when the diagnosis was made, the symptoms, possibly any medications or treatments but I don’t think there’s lots of things – obviously with some conditions there are lots of things that stand out that we need to know about and that can potentially have an influence on the terms but I don’t know specifically with autism if that’s necessarily the case.  It would seem – for me, it kind of feels like it could be quite straightforward?

Matt:           Yes Kathryn, you mentioned it should be relatively straightforward and I would go along with that.  From an underwriting perspective over and above the normal questions, if you want to call them that, then we really want to know the background to the individual.  The case that you mentioned earlier is obviously somebody who is holding down a decent job, has a mortgage, potentially has children and those are all very, very positive signs from an underwriting perspective, i.e. they themselves have the same as anybody else in terms of their ability to look after themselves, look after their health, eat properly, exercise, etcetera, etcetera so in that circumstance, yes it would be very simple.  If somebody’s got 24/7 care – needs care, then that’s the other end of the spectrum really and obviously we would need to look at that very, very carefully.

Kathryn:     Yes.  No, I think that’s right and I think as well, that kind of – that’s not just the insurers obviously, that’s to do with also as I say in terms of safeguarding that individual because the last thing we would want to do with somebody trying to take out insurance for somebody when they really shouldn’t do and trying to profit if something were to happen to that individual, so I think that also comes down to the advice side of things as well and that could be why if people have had some difficulties in the past in terms of being able to access things, it could have just been a bit more – sometimes maybe a little bit more clarity as to why the cover was needed or was felt to be needed.

So going on to dyspraxia then, so as far as I’m aware, dyspraxia is more to do with like the physical movements and I think this is possibly one where there probably would be more consideration in terms of the underwriting side of things because I understand that there can be sometimes difficulty in terms of driving and doing like household chores and day-to-day tasks and I know that driving sometimes – the ability to hold a driving licence can sometimes factor into sometimes with medical conditions as to understanding the strength of the symptoms.  Am I right in thinking that?

Matt:           Yes.  Excuse me, I think again what – the way that I would approach this anyway as an underwriter would be how the moving difficulty – how it impacted their day-to-day life.

Kathryn:     Yeah.

Matt:           And I wouldn’t be too worried about driving but I would be more focusing in on how – what their lifestyle is, whether they can look after themselves, whether they can get about, can feed themselves properly, etcetera, etcetera from a lifestyle perspective.  I think those are the key issues.  It was interesting, just in researching for today, I found a study, it was a very, very small study.  It actually came up with – and this was April 2019 so it wasn’t very long ago, people within – who have these conditions are probably about twice as likely to die than those in the general population.

Kathryn:     Oh right.

Matt:           Which is quite staggering from an underwriting perspective but very much depends where you got those kind of opposites right at the – different scales where severe will require drastic, different lifestyle to the general population, specific living arrangements, plenty of help from those around them.  That’s at the more difficult end.

Kathryn:     Yeah.

Matt:           And a measure of that obviously is the score of their social ability and daily living skills.  That’s how an underwriter will actually look at all of these types of case to be perfectly honest with you.

Kathryn:     Yeah.

Matt:           Where somebody is leading what in modern parlance is a normal life, everything will be pretty simple.  There’s no two ways – but straightforward to use your expression.

Kathryn:     Yeah.

Matt:           But nevertheless, that statistic which I gave, I’ll say it again – people within these groups are more than twice as likely to die than that of the general population.

Kathryn:     Yeah.

Matt:           Those people will generally have pretty severe forms of these disorders.  There’s no two ways about it.

Kathryn:     Yeah.

Matt:           And part of that reason is their general lifestyle, you know, you need to look after yourself or people have to help you to look after yourself.

Kathryn:     Yes.

Matt:           That’s the kind of key areas there.

Kathryn:     I think as well, probably going on from that as well a little bit so with the dyspraxia, obviously in terms of the movements, I imagine on the stronger end of the scale – the condition, that people could possibly be wheelchair-bound –

Matt:           Yes, absolutely.

Kathryn:     And obviously being lifelong in a wheelchair – obviously that in itself, being in a wheelchair isn’t necessarily a significant immediate risk insurance-wise but it does come with certain aspects in terms of it can lead to other potential conditions that insurers obviously like to know about and to be aware about but I think, you know, if somebody’s got dyspraxia and it’s the kind of thing where they have symptoms where essentially they’re not able to run or jump but, you know, they’re working, they’re able to drive, they’re sort of like living life, just like so many people with health conditions, they just know, sort of like, “Right, I can’t run, I can’t jump but I can do everything else and I don’t need to run and jump to live so that’s fine.”  Then really, you know, I would hope that, you know, people wouldn’t be too apprehensive about going for insurance if that was the case.

Matt:           I would completely agree with everything you’ve said there and I would encourage people to go to at least ask about insurance – protection insurance and there is a very good chance that in the vast majority of people with these conditions, insurance terms would be able to be given and insurance would be available.

Kathryn:     Yes.

Matt:           Certainly don’t be put off whatsoever.

Kathryn:     Yeah, that would be my thought too.  And the last one we’re talking about is dyslexia so that’s the one where we have is it 6.5 million people in the UK living with dyslexia.  So one of the things that we do at Cura is we’ve got the Recite Me accessibility and language software on the website where people with dyslexia or a number of different either health conditions or potentially language barriers are able to adapt the website so it’s accessible for them.  Now that could be that the – everything is set up so it’s read aloud.  It could be changing the background and font colours to match what that person is able to see most easily but some things to bear in mind is that, you know, it could be that you maybe need to do more of a telephone call.  You know, it has to be more of a conversation rather than written documentation and I’m sure that advisers and compliance managers everywhere in the UK are sort of cringing at the thought that somebody might not be able to read a suitability letter or read the key features documents and terms and conditions policies correctly but at the same point, the level of technical information that is in those documents, it isn’t particularly feasible to expect somebody who struggles to read to be able to go through that document and completely understand it.

I did a podcast a while ago with the person who founded the Recite Me software and he just said when he looked at his insurance documents at first, when he was looking at them he was just like, “Well I just can’t be bothered.  There’s no way –” it completely just turned him off straight away.  Even though he needs it, he was just like, “I just do not – there is nothing about me that wants to go through all that documentation because it’s going to make me feel ill.”  And I think that’s something we need to be very aware of so as an adviser I would say obviously be able to do things over the phone.  Maybe, if you feel comfortable, to do videos and then you can even maybe – whilst providing obviously for regulatory requirements – providing the demands and needs letter for the client in terms of your advice and recommendation, you could then also do a video that accompanies it so the person can actually – you’ve done the regulatory requirements of putting everything in writing but then you’ve also done it in the way that’s actually accessible to them.  You may need to adapt the documents and print them in a different colour style and everything for the person to be able to access.  It’s more difficult obviously when we come to insurance documents and key features documents because they usually – they’re often in a format where that can’t be necessarily done to them.

And also bear in mind as well something that I think we often think as dyslexia as reading and writing but it is also potentially that there can be a struggle in remembering things after a certain timeframe.  So for some people, they may be able to recall information for say like 20 or 30 minutes without written prompts but they may need some kind of written or, you know, a different type of prompt of some sort so they can refer back to the conversation that they’ve already had.  You know, it may also be as well providing copies of call recordings for the client so they can refer back and listen to it and make sure that they understand what’s been asked of them.  But I think from my understanding with the dyslexia side of things, I really don’t believe that’s going to be coming into any kind of play really with insurances.  Am I correct with that, Matt?

Matt:           Yes, yes you’re absolutely right, Kathryn.  It just wouldn’t – it just doesn’t come into the insurance field at all.

Kathryn:     Yeah.

Matt:           There’s another one actually when I was doing a little bit of research called number dyslexia.

Kathryn:     Yes.

Matt:           Where people find maths challenging.

Kathryn:     Yeah.

Matt:           Dyscalculia apparently is the name for it but you’re absolutely right, neither of those particularly dyslexia should cause an underwriter any concerns at all.

Kathryn:     The thing is, actually I’ve met somebody – I know somebody with dyscalculia actually and it was interesting to me because I wasn’t aware of that side of things and obviously it brought that to my attention as well.  So I think, especially with dyslexia, this is where we’re really talking – it’s kind of like a mix because it’s really on the advisers to make sure that they are providing as much access as possible and making things as accessible as possible in terms of making sure that the person understands or if you say people with dyscalculia, making sure that they understand the processes to what’s being recommended and that the amounts that are being recommended and why and chatting to them.  Chat to the person, find out what it is that they need and what helps them and then adapt yourself to make sure that you are doing it how they need it to be and I think the other thing as well – I did some research on this a little while ago in terms of, you know, what’s available for people in terms of who have – struggle to be able access insurance if they are blind or deaf and the discrepancy between insurers about what they do and don’t do really, really surprised me actually in terms of being able to provide people with support to access documents.

That was one of the biggest things, you know, just having different levels of accessibility to the documents was a massive discrepancy so for any of the insurers or insurance brokers who are listening, I would really suggest that something that would be useful would be to make sure that the documents are wholly accessible.  There are a number of organisations that can be spoken to that can help with this.  It doesn’t, you know, I always think that there’s sometimes this fear of sort of potentially – sometimes of the costs of making things more accessible and the fact that there’s so many documents to do and then also getting it right.

But I think the fact of the matter is that, you know, at the moment, there’s a lot of people – for the dyslexia alone, 6.5 million people who are not going to find accessing insurance documentation – which, from a regulatory perspective, we need them to be able to read and understand for us to have all done our job – insurers, advisers, reinsurers alike – these documents are not in a format with most places that are easy for somebody to really understand and I think that should hopefully be a really big takeaway for anybody who’s listening.

Matt:           Absolutely.  Very wise words indeed throughout the last few minutes.  Again, I do find it very sad that insurers in 2021 don’t help or don’t go as far as they should with people who have – for instance who are deaf or blind.

Kathryn:     Yeah.

Matt:           That’s a shame.

Kathryn:     It is.  As I say, some of them are absolutely – they’re kind of knocking it out of the park, they’re amazing but the majority there is absolutely – there are only a couple that I thought, “Ooh, that really needs to be changed,” but, you know, there’s some who have got some things in place but, you know, there are ways that it could be improved and I think that that’s definitely something that would be worthwhile.  And the fact of the matter is that maybe turn around and – like you say, you know, there’s people, you know, when was the last time you maybe saw a case of somebody with autism or ADHD and people may turn around and say, “Well when was the last case we saw somebody who was blind or deaf going for insurance?”  And I think the biggest question there is that’s possibly a very – there’s possibly a really big answer there and a really obvious one.

Matt:           Yes, I agree.

Kathryn:     They cannot access it.  They just don’t even have the means to come and talk about it because they can’t.  There’s no way for them to be able to do so and, you know, there’s only a certain amount that you can do in terms of explaining why certain documents aren’t available in certain ways and different things before somebody – well just like the guy who was obviously with Recite Me, he just turns around and goes, “Well, they clearly don’t want my business so why would I even bother?”  So I think hopefully that’s sparked some thoughts with different people in different places.  Thank you so much, Matt, for giving your insight into things.  I think what I’ve really enjoyed about this podcast – I know we always have this but with a lot of these conditions, so like the autism, dyspraxia especially – I think a lot of people would possibly instinctively think that there’s maybe a difficulty in getting insurance or maybe even advisers wonder whether or not their clients, you know, are they actually going to be able to do anything and I think what’s been nice is that – just hearing your point of view that there is that hope there, that there should be stuff to be able to be available.

Matt:           Very much so.

Kathryn:     Well thank you so much for joining me, Matt.  Next time I’m going to be chatting with Roy and Catherine Moxon to discuss group insurances and next time after that when Matt, you’re back with me I think we’re going to be chatting about diabetes if that’s okay with you?

Matt:           Sounds excellent, looking forward to it.

Kathryn:     Brilliant.  If anybody would like a reminder of the next episode, please drop me a message on social media or visit the website practical-protection.co.uk and please don’t forget that if you’ve listened to this as part of your work, you can claim a CPD certificate on the website too.  Thank you so much for joining me, Matt.  Have a lovely rest of day.

Matt:           Thank you, and you.

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