Kathryn Knowles  00:04

Hi everybody. We are on season nine, episode eight, and today I have Killian tiernu, global, head of medical underwriting propositions and products at partneree with me. I met Killian at the lucid conference last year, and we spoke about the right to forget cancer rules and insurance, something that I’m sure many people would like to know a bit more about and Killian has kindly agreed to come and share his knowledge with us, having seen this applied in the Irish insurance industry, this is the practical protection podcast.

 

Kathryn Knowles  00:39

So Killian, how are you doing? All

 

Cillian Tierney  00:41

good. Kathryn, nice to see you again. And it seems like lucid was an age ago. So good catching up then, and definitely worthwhile catching up on this topic.

 

Kathryn Knowles  00:51

Absolutely, it does feel like it was quite a while ago now, but I’m really gutted I can’t go to the one next year. Unfortunately, it would have been really, really lovely to get there, but it is every two years or so, isn’t it? The Lucid one, I think that happens, isn’t it? Yeah,

 

Speaker 1  01:05

correct, exactly, that it’s been so long they’re actually advertising the next one, so I haven’t seen you in some time. Will your husband make it to the next one?

 

Kathryn Knowles  01:12

I’m hoping he’ll be able to get there. We shall see. But it’s something I have to say. I think we were possibly the only advisors there last year, and especially if you work in the specialist side of protection insurance, really doing a lot of the underwriting side of things. I thought it was absolutely fascinating. There was so much in terms of the obviously, there was a specialist there in terms of the Parkinson’s. We had people there in terms of specialism, in terms of the cardiac side of things, and all the heart conditions and quite a lot with cholesterol. It was just really fascinating to hear from the doctors about how that was all working and stuff like that, and how that could potentially play into future things. It was genetics as well, I think, at one point, which was, again, really, really fascinating. So, um, definitely suggest it’s an important one to try and get to, if you can do so. Today we’re going to be talking about the right to forget cancer and it’s something that I think says is important, and it does kind of what it says it does. So it’s basically saying that if someone’s had cancer, there are some countries where they do not need to tell an insurer that they have had cancer once a certain amount of time has passed, post treatment. The UK protection insurance market does not work this way at the moment. And when you apply for a fully underwritten life insurance, critical illness or income protection policy, you will be asked if you have ever had cancer. So I think that’s really important to state from the beginning. If you’re in the UK, you will be asked that question. It will be under the Have you ever questioned? Set there aren’t any exceptions on the fully underwritten type of policies, you can find insurances where they won’t be medically underwritten, but we won’t necessarily have time to go through those today, but if you’re wanting the full protection by UK insurer, those questions will be there. The exceptions are things like, I say, non medically underwritten insurance policy, but also some business based policies as well. And if we’re looking at things like some types of death in service cover, and you will find with those non medical underwritten options as well, if they are not the business based ones, but the well, not most of the business based ones, I should caveat that, but in terms of the non medically underwritten ones, there would usually be exclusions regarding claims for pre existing conditions for at least the three years since treatments and follow up appointments. So it is important that that exclusion period you’re aware it isn’t just from date of diagnosis. It can be the treatment, it can be follow up, and some of those medically non medically underwritten option ones now can even put a specific 10 year time frame in that, in terms specifically for cancers, this episode could be quite emotional for some people. We’re going to be talking about things in a very obviously I’m we’re going to be talking in a very not not blunt way, but we’re going to be talking from very technical point of view, so very different to how we would be speaking to somebody if we were sat together and actually advising somebody who has experienced cancer and supporting them. There’s lots of opinions around whether or not the right to forget cancer is something that should be there or shouldn’t be there, or why it’s treated differently to say people who’ve had heart attacks or strokes and why they don’t have that right to forget. We’re not going to be providing any form of opinion as to whether or not we think that right forget, right to forget cancer, should or shouldn’t be in place. And this is purely going to be a factual account of how the right to forget cancer works in practice. And obviously Killian has a great deal of knowledge there. So to start off with Killian, if we can maybe just start with you telling us a little bit about yourself and your career in the insurance world.

 

Cillian Tierney  04:47

Certainly. Kathryn, thanks for the intro. Well, you know, like any risk expert or medical expert working in in the field of insurance, it all started off at the kitchen table as a kid, my brothers and sisters sitting around.

 

Speaker 1  05:00

Drawing pictures of astronauts and solicitors, and I was busy drawing images of a dimly lit insurance office, reading medical files and working with a team of Actuaries. But now, in all seriousness, I got involved in the medical underwriting field. Back in 99 I joined a large Life Insurance Company in Dublin called Irish Life, quite a large company. Some of you may have heard of it. And there, I started off in admin. I then progressed into medical underwriting under the guidance of a very good diagnostic physician, chief medical officer, Dr Jago. So he acted as my mentor for about 10 years. I worked in a number of roles there, covering individual business and group business, and within that I was involved in auditing the team product development, educating brokers, as we call them here, or ifas, along with the tide agents of the company. In and around 2010 I joined the Dark Side of reinsurance. I joined partner E. They were ramping up their their company to service the UK and Irish market, and I joined to service the UK as a senior underwriter. That role kind of has evolved over the last 14 years. Would you believe the from working in UK, Ireland to working on some innovation in the US for HIV positive lives, from the LGBTQ only community, community, very interesting product. We then I stepped over to the other side of the world and started working on group business for Australia and New Zealand, then some group business and individual business in Asia. I came back to UK Ireland as chief underwriter. And more recently, in the last few years, I’ve been in more of a global role as head of medical underwriting products and propositions as you, as you’ve mentioned so interesting times, very enjoyable, very challenging. And, yeah, I have a particular interest in small vessel brain disease, neurodegenerative disorders, yeah, so that’s, that’s it?

 

Kathryn Knowles  07:18

Yeah, absolutely. So, I mean, you’ve got, from what I can gather, quite a lot of experience, so that’s really good, really helpful to have that there and that knowledge, and from you to share this with us. I know you’ve been sort of like playing one of the key points in this in terms of the right to forget cancer, and how it is being integrated in solid places in Ireland. So I think what be really useful for listeners is to understand, you know, when we’re focusing upon the right to forget cancer, when it comes to insurance, can you tell us, kind of how this started and what it means,

 

Speaker 1  07:52

certainly, but the European Parliament are actually using the term the right to be forgotten, okay? And the right to be forgotten kind of came about after some innovation in the French market around offering cover to individuals who suffered various conditions, which I might just touch on in a moment, but specifically for our our discussion today, we’re referring to cancer, because That’s the that’s the most common condition under the term the right to be forgotten. So the number of cancer survivors have been increasing for the last 30 years, and in many countries in Europe, that figure is actually reaching approximately 5% of the total population of some countries. And with that, I think in 2020 there was approximately 20 million cancer survivors in Europe, and about a third of these survivors were within working age and are therefore potential for, or have potential for, purchasing insurance cover. The European Commission in 21 established a plan known as the Europe’s beating cancer plan, and it covered a number of things such as, you know, raiding countries of tobacco, improving diets, etc, but specifically for the topic today, it covered accessing financial products, and specifically insurance products. So this is a section six under the Europe speeding cancer plan, which specifically delves into what insurance companies should do in order to meet the criteria the European Commission drafted up or wrote up to protect those who have survived and completed their cancer treatment protocol. Yeah, so therefore the European Commission introduced the right to be forgotten. It’s intended to ensure former cancer survivors who have overcome their illness don’t experience any adversities when applying for necessary insurance policies and. Uh. Ultimately, what that means is, when insurers are calculating the insurance premiums that they charge a cancer survivor, they cannot consider the cancers that have occurred more than, I will say, five or 10 years out. Five years is typically used for cancers that have been diagnosed and treated as a child, which they consider up to age 18 or 21 depending on the jurisdiction in Europe, and 10 years, usually for cancers that occurred after the 18 or 21 years of age. And to be honest, you can kind of insert any period of time, because we’ve seen throughout Europe that many countries have taken a different approach to this, and they’ve tweaked it slightly so the European Commission gave guidelines, and each of the countries within Europe have taken kind of a different approach to the Yeah, the small print of the plan,

 

Kathryn Knowles  11:00

yeah, yeah, I was gonna say that’s, that’s really interesting. I think it’s, you know, we’re going to talk about some case studies later, as to, you know, how, how it works. Because I remember when we had a chat, when we were at Lucid, it was really interesting. Because, you know, I remember people asking me those stuff like, Well, do you think that options are bad for people with cancer, forgetting the insurance, and it was really tricky. Now, I’ll go through some case studies later to show that actually there’s quite a lot of situations, you know. There are situations where, you know, obviously having that right to forget after that certain period of time, five years or so, could really help people to get insurance. But there are also many situations where you can still get really good options for insurance, and potentially standard terms for insurance in the UK, you know, I can’t comment on other industries, but in the UK, where you get standard terms well within the five years. So it’s really interesting. But then it’s just popped into my mind another person that I’d helped a while ago and had wanted critical illness cover, and they had had a cancer as a as a child, when there were three, and it had recurred when there were five, and there were mid 30s now, but it meant for them, for the critical illness cover, it was just at the time, it was just flat out now everywhere, because there’d be no occurrence. So for something in that situation, obviously it would have been really, really useful, but very interesting. I think when we come to look at some of the little, not huge case studies I’ve got, I started doing them for too long. So important to just understand how this works, but in terms of the right to forget cancer. So we’ve got it. Is it across all of the protection side of things, life insurance, criticalness, cover and income protection?

 

Speaker 1  12:37

Yes and no. And it’s not to be vague, Kathryn at all, I guess you know so it kicked off while the papers were written in the 20s. The it kicked off in in France in 2016 in 2020 it came into play in Belgium, Luxembourg, and the Netherlands, more recently, in Portugal. And I think it was 22 and in Ireland, it came into effect, really, in 23 and was as a code of conduct, and then it was implemented. Excuse me, it became legislation in at the beginning of this year. What it meant in Ireland, who used a period of seven years, I mentioned a moment ago, five or 10 years Ireland implemented the code of conduct, and then the legislation at the beginning of this year using a period of seven years meant that On completion of cancer treatment, once seven years has passed after completion and the person has been informed that they are cancer free, the insurance company no longer needed a disclosure of that cancer so the person could answer that question about cancer? No, yeah. And it was, it was true tooth word you ask about the different products. I suppose it’s worth covering. I’ll use Ireland as an example. The products here in Ireland where I’m based, I’m in the Dublin office for partner re but I cover global the partner, the products in Ireland are, in fact, only life cover, and that life cover needs to be decreasing term assurance. It needs to be specifically assigned to a mortgage, and that mortgage needs to be for the principal private residence of the applicant. Okay? And to be clear, applications for any other insurance benefits are specifically excluded. So you asked Kathryn about critical illness, for example, or we call it specified illness in Ireland that is specifically excluded. Disability is excluded in some countries such as Germany, and we saw in Portugal and Belgium, they have looked to allow some disability products and income protection fall under the umbrella of the right to be forgotten when it comes to cancer. So there are variations of it. Okay,

 

Kathryn Knowles  14:56

then, yeah. So, So, typically, so in a sense, in Ireland. Very specifically, it’s the a certain type of life insurance, certain circumstances, but say, like for the critical undercover, the income protection in obviously, the wording that Ireland uses for those products, they would you would still need to notify if, if there was cancer in the medical history. Yes, absolutely. So interesting to see, obviously, how each country can still adapt it in its different ways. And I’m assuming, though, for things like chronic myeloid leukemia, things like that. So anything where it was ongoing that would still be disclosable, and everything

 

Speaker 1  15:32

precisely. Kathryn, yeah, CML is a good example, I guess. And you know, there’s, there’s hundreds of different variations of cancer where the treatment is ongoing. The those individuals because of the risks that they may bring to the table of cooled lives, which is how we operate in insurance to keep things fair, they unfortunately don’t achieve a period where they have been treatment free of that cancer for a period of five, 710, years, correct? Absolutely.

 

Kathryn Knowles  16:05

And just one thing, if it’s okay to check on this one, is that. So I know in the UK mark, and this is something that’s really important for UK advisors to know. So if you’ve got somebody, especially if they’re have had breast cancer, um, obviously the usual rule is, when you’re doing your research, you know they have to have stopped treatment. We need to know when the treatment has stopped. Now, in the UK, we would have it where, if somebody was having and taking tamoxifen, it’s often, quite common, to take that for about five years after the other treatments have stopped. But the it’s not seen as like ongoing treatments. In underwriting here, it’s just seen as like, a bit of like a maintenance dose and and you could still apply for insurance while people are taking that in that kind of situation, in a sense, because it’s kind of ignored in the UK. The tamoxifen, in some ways, for the underwriting is that, again, would that be something that would be notifiable, I’m assuming, under the under the current like, right to forget system,

 

Speaker 1  16:57

you know, that example, anti hormonal treatment. So it took some time, in fact, to agree certain definitions used. And it might be worth flagging that, I think, for example, in Ireland, the Society of Actuaries had the opportunity to engage with the various lobby groups, to engage with the various organizations, including European or insured and the European Commission. So we actually had an opportunity to sit down and define definitions of what cancer is. Do you want to include carcinoma in situ, or what’s known as a pre malignant condition and other conditions, and in fact, what treatment means and to the letter of the law, it was finally agreed that anti hormonal treatment, which you mentioned, is specifically excluded. Therefore, what we commonly see in medical underwriting, and your example, Kathryn of of a breast cancer treatment who’s successfully treated with chemo radio and they’re put on a dose of anti hormonal treatment for 510, years, sometimes lifelong, that will in Ireland be excluded. We felt it would be unfair in that, in your example, to include that as a treatment, in terms of, it’s not the same as chemotherapy, it’s not the same as radiotherapy. Therefore, it was agreed within Ireland, which I guess highlights the importance of having these round table discussions with insurance Europe and the ABI on your side of the water here, when defining what is the end of treatment, what is treatment and what is cancer? So yeah, in your example, we would, I letter of the law, the question on cancer can be left, can be answered, No, however, they will have a separate question on an application form, asking, Are you taking any medication or treatments, and the applicant taking toxin or anti hormonal treatment should disclose that. But the onus would be on the insurance underwriter, and the underwriting rules to ignore such a history once the actual treatment of chemo radio has elapsed more than using Ireland’s example, seven years ago. Absolutely,

 

Kathryn Knowles  19:16

I think this kind of, like, it’s really screaming up to me as well, that whole thing of the reason why, you know, advisors are so important as well. Because I think the majority of people just they wouldn’t know. You know, obviously we, we’re in the insurance world, and I always find it really interesting as well, when I speak to people from completely different, different areas of insurance, and they have absolutely no idea at times, what we can do in our side of things and protection insurance. And then you speak to other people, and I don’t know I was, I did some something once, and I was speaking to somebody who was in the means of ensuring people against pirates and stuff. And that was just that, you know, it’s just, it’s so bizarre to me, just how different it all is. And I know that I wouldn’t be able to know how to do the question sets for them. They wouldn’t know how to do the question sets for me. So so people who aren’t even. In our industry, who consumers are going to find it so so confusing, which is why, obviously, advisors who really know this stuff inside and out as well are so, so important, but, but in terms of if we go, in a sense, backwards a little bit before we had the right to forget cancer, how did insurers choose how to price life insurance policies for people who have had cancer? I know from it, from the UK side of things, but really good, interesting to hear your insight as to how it all works. Yeah,

 

Speaker 1  20:24

certainly. And it’s a good point to kind of clarify how that’s done in the first place. And you know what we’ll discuss next isn’t peculiar to reinsurers or my reinsurance company compared with another in the market, or the how the direct writers write business you know, our actuaries insurance premiums and the benefits these are determined on the risk that the applicant brings to the pool of insured lives. All the lives are combined together, and if an applicant is bringing an additional risk, we need to be aware of that and that information so relevant information to about an individual is required, and we base our decisions on whether to insure them at all, or how to insure them on data that’s pertinent to the individual for the products that they seek to have cover. And that’s, I guess, simply known as risk based underwriting, yep and direct writers and reinsurers, we invest, you know, a significant amount of time and resource in analyzing credible medical studies and converting them into risk appropriate outcomes, ie, the premiums. And this is a commercial requirement by all companies. You cannot overcharge and then refusing customers results in lost revenue which isn’t isn’t good for anyone, where we can quote and we charge an extra loading or morbidity for sorry for living benefits business where we might wish to apply an exclusion when that occurs, the underwriter needs to Be able to base their decision on evidence based research, which they do, and that’s commonplace. So the questions that came about are, when, when working on this approach within Ireland was, do cancer survivors pose and significant extra mortality? And some do, some don’t. Do they pose an extra mortality 10 years after completing treatment again, some do and don’t, and then what about for five years? Or in Ireland, we used seven. So it wasn’t straightforward, but we grouped cancer survivors into kind of three categories where we looked at what we call as a time to cure period. So that is the amount of time that it takes for the person who survived cancer to achieve the same life expectancy or mortality as the general population of a person of that age, gender, smoking status, etc. So the the life expectancy of that survivor is based on their cancer type, the age at which they were diagnosed, the staging at which the cancer was diagnosed at, and the type of treatment that they underwent. So there’s a huge variability in the survival rates of cancer. It’s survivors. And as I said, we kind of broke this down into having a short time to cure. So time to cure basically meaning the number of years after diagnosis to eliminate or make the excess mortality that a cancer survivor brings to make that negligible. And we believe those with a short time to cure have basically the same death rates or mortality as a general population. And there’s a handful of cancers that we can kind of say have a very short time to cure. They would include many testicular cancers and some thyroid cancers. Here the time to cure for these examples would typically last, you know, be at around a year or two years. So in the context of the right to be forgotten, it’s very fair to forget these histories. We’re not interested in these histories because they don’t bring extra mortality to the risk that we’re taking in the pool of lives that we take risk for. So the second group was cancers with a negligible long term risk. So this is where the cancer related excess mortality. This became negligible within 10 years for patients of a certain age. And the age bracket we were kind of looking at was approximately 45 years. And examples of cancers with a negligible long. Term impact were Hodgkin’s lymphoma, skin cancer, some skin cancers and cervical cancers before the age of 45 these cancers didn’t seem to have a significantly increased mortality after 10 years when compared with the general population. And again, it should therefore be legitimate to forget these cancers 10 years after concluding treatment. The third group which we looked at, and I guess this was the the most important group in in reality. So these are cancers that come back many years after diagnosis. So there are, unfortunately, a lot of cancers that have a risk of late recurrence or death even after 10 years of diagnosis. You know, there’s certain lung cancers with the time to cure greater than 10 years, some of the nasty your breast cancers time to cure of 10 to 17 years. And some bladder cancers with the time to cure of, you know, even longer than that, 18 to 20 years. So this group of cancers is particularly relevant for insurers and insurance industry in the scope of the right to be forgotten, because the the excess mortality that the cancer brings exceeds long after the 10 years after the diagnosis.

 

Kathryn Knowles  26:18

Absolutely Amy. You can see that it’s obviously a very, very tricky and complicated area. I mean, for what I see in the UK insurance market, you know, life insurance can be offered at standard terms, often quite quickly after the end of treatment. It does depend, obviously, on lots of things, like, we say, the type of cancer, the staging, the grading, if people are not on, show us to the staging and grading. It might be. You also have been told something known as the TNM score, so that’s Tango November Mike score, which can be really, really helpful in terms of some answers. There’s completely different namings that would be really useful. But it’s, you know, it does depend upon that. Sometimes it can be that we can get standard terms within the five years post treatment. You know, sometimes it can be one to two years or so. So when it comes to the right to forget cancer, and it helping people, and obviously, going back to those statistics, as you say, is to some of the the fact that there are some cancers that do have very, you know, potentially decades worth of of, you know, I think, if it’s fair to say, from an insurance point of view, a decade’s worth of risk to the insurer that, you know, there would be a payout. And so it’s probably the right to forget cancer is probably mainly helping people who’ve had quite strong cancers. Is that fair to say you’re

 

Speaker 1  27:29

absolutely correct? Kathryn, it’s it’s exactly that, as I alluded to earlier. There were some cancers that had, like, a short time to cure negligible risk, after or within 10 years. Those cancers. If a history of such a cancer was disclosed to any of the direct writers in the UK or in Ireland, there would be no excess mortality charge. It isn’t practice for the insurance companies to be charging premiums where it’s not deemed necessary or fair. So the reinsurance guidelines do not suggest rating on those so therefore it is, in fact, those that are that present the biggest risk that is most concerning for such an initiative like the right to be forgotten.

 

Kathryn Knowles  28:15

Yeah, I think that’s fair say. And I think, you know, I don’t want to just be clear for anybody who’s listening. I don’t want it to make it seem as if I’m saying that some are, some cancer strong, and some, some aren’t. It’s, you know, obviously all cancer is, is horrible forever. Who experiences but you know, we’re talking here about, you know, it is where there’s a very high staging, the high gradings, where you would usually see, you know, terms aren’t being as favorable for quite a while and but you know, ultimately, there are obviously cancers at the other end of the scale, where they are, you know, very low staging, very low grading. You know, very caught very, very early on, which is where we’re much more likely to see that the the options with insurance are available, um, available more quickly. So I think we are coming towards the end of the the podcast, and I think this has been really, really interesting. So I think one of my last questions for you, if it’s okay, if I give a couple of sort of examples, is, you know, are we currently seeing any other conditions that people are advocating for a right to forget?

 

Speaker 1  29:13

Good point. Kathryn, yes. The answer is yes, we are. And it differs throughout Europe. I was using Ireland as the main example there, where it is specifically only applicable for a history of cancer, and that’s in the context of Europe’s beating cancer plan as a result of the introduction of the right to be forgotten for a cancer history, some countries have induced, or have, in fact, extended that For a number of other medical conditions, such as hepatitis B, C and HIV. Yeah, some other countries have, in fact, allowed the approach of forgetting cancer, HIV, hepatitis, apply to more than just life cover for the likes of disability and. For some income protection policies. So, yes, it is for more than just hate, more than just cancer. Yes, correct. Okay, that’s

 

Kathryn Knowles  30:07

really interesting, I think, because we’re just coming to the end there as to sort of before I do the case studies. And I think what’s, what’s interesting, I think it’s fair to say, obviously, I’m not in a reinsurer or insurer, so I can’t say it for absolutes or anything like that. But, you know, as an advisor, and we’re looking at it and just going through all the information that we’ve said, you know, we are at a stage with some countries where there is this right to forget cancer. I think ultimately, you know, before there was a right to forget cancer, insurers were pricing, in a sense, the risk that they would see as a claim based upon that person’s medical history. And now that risk they’re not seeing and but that, in a sense, the the medical or the statistical risk is still kind of there. It hasn’t just sort of like disappeared now that that legislation is there. So I think it’s it’s important to just be mindful that obviously these can be make absolutely brilliant outcomes for for clients, for people who have had cancer. But it doesn’t mean that it’s just, it just kind of like wipes out that that risk from the insurance side of things, and what it will ultimately mean is that all the prices will go up for everybody, because there has to be some kind of absorption somewhere of you know that that pricing, because ultimately, insurers, you know, and reinsures, everybody is A business, there needs to be certain amounts of money in the background to make sure that they can, you know, promise, and pay out those claims for everybody they’ve made those contracts with. So they do need to make sure that there is still that balance happening between the amount of money that comes in from premiums versus how much is going out in claims. Because simply, if that, if that balance wasn’t there, then the companies would fold. So it’s important. It’s a magic it’s very, very technical and very, very complicated on that math side of things. And, and I certainly don’t envy the person that has to try and balance all those books and and figure it out.

 

Speaker 1  31:54

Yeah, I think you summed it up perfectly. You know, if you bring an extra risk, as I mentioned at the beginning, we pull all the lives together. So if there’s a life, a group of lives, that are inserted into this pool, who aren’t priced for correctly, bring, given the risks that they bring, we we need to actually use, we need to find money to actually call to cover those risks, which can can lead to some price hikes. I think it’s worth mentioning as well. Well, the mechanism of the right to be forgotten has been introduced in a number of markets. It hasn’t entirely been evaluated fully. You know, there’s little data available right now to establish weather, ignoring the histories. Let’s say it’s been in France since 2016 but, you know, we’re approaching nine years of that, but we don’t yet have information on the exact costing of ignoring those histories of cancer. Yeah, absolutely.

 

Kathryn Knowles  32:48

And I think you know from what you were saying as well, but we sometimes have decades, you know, well into 20 years or something, with some cancers that can potentially lead still to that higher risk. And obviously in terms of insurance, just in general, you guys work off statistics, or decades worth of statistics, to be able to model things and really see how the risks are. So only having nine years worth of data isn’t actually isn’t giving you that information that you would usually be working from. So I think it’s fair to say that it’s definitely an area to be watching, and I think it’s only probably in the next 510, years, possibly more, that we’ll actually start to see the sort of like how this is going to affect the industry as a whole going forward. So I have a couple of case studies. I’m not going to go too long to them, so I appreciate quite a long podcast here. It’s been really fascinating. Thank you. Killian, so my first one is, I just wanted to give the examples of what we might be seeing in the UK, so where we don’t have the right to forget cancer. So first one is somebody in their mid 30s diagnosed with testicular cancer. It was classed as a stage one, grade one seminoma type, which was treated with removal of the textical I do have the technical name for that, but I can’t. I’ve never said it before, so I’m not going to risk trying to say it for the first time here, but we had standard rates for life insurance 12 months after treatment. So I think that’s a really interesting one just to share, to say, you know, because for anybody who is listening, who has had cancer, is to, you know, depending, it’s so dependent upon the cancer you’ve had, that that staging, that grading, and it might be that, you know, say we’re not needing to wait five years or seven years, or whatever that kind of time frame is, sometimes we can get the standard terms much, much more quickly. I have another example of breast cancer, somebody, again, in their mid 30s. Now, with this person, they had air cancer that had been seen as as one of the the stronger types of cancer. So they had, there’s different ways that premiums are changed, in terms of things like life insurance and and the way that her cancer had been, it had been, it had been one of the the higher ways that they would change the premium. So it was 380 pounds per month for three years. And after that. Three years, it was dropping to standard terms of 70 pound per month. Now what’s really interesting about that, just from an advisor point of view, I’m just going to throw this in there as well. That was the rule. However, by the time this person was speaking to me, we were already a little bit past her end of treatment. So whilst it was during June, 80 pound a month for three years, the insurer and I was speaking to the like, well actually, because we’re starting the policy right now, it’s that price for three years, but in the next, in 12 months time, should have reached that time frame where we could do the standard terms. So it was really interesting and important as an advisor to be aware of that and to go, right, yes, I’m going to put this in place, and it would for the next three years, charge that much, but if I reapply for this, for this client, in 12 months time, should be able to get standard terms and not be paying that high amount for that further two years. So that’s just a really interesting aspect to it from an advisor point of view. But again, for some of you listening, who’s maybe had breast cancer, and I say this was very much a strong cancer, breast cancer this person has had, it isn’t necessarily going to go to that kind of a premium. There’s lots of factors in terms of, sort of like, the amount of insurance you’re having for, how long you’re having it for, so it’s just really important to to obviously reach out and and just see what your individual circumstances will be. And then the last one, as a bit of an example, is bowel cancer. So bowel cancer tends to be the one where we see the really high premium changes for quite a while, usually, potentially up to about 10 years, even post treatment. And I think, Kelly, you might correct me if I if I’m getting this wrong, but I think it’s possibly because with bowel cancer, by the time it’s found, again, it’s often developed into that stronger diagnosis. Am I right in thinking that Killian? Is that correct?

 

Speaker 1  36:42

Yeah, precisely, Kathryn, I guess you’re you’re saying stronger, I would say more aggressive, or the staging. So the staging, which Kathryn you mentioned earlier, the TNM, by the time it’s finally diagnosed, unfortunately, it’s at a more advanced staging, which leads to potential, potentially a more aggressive tumor. Unfortunately,

 

Kathryn Knowles  37:03

yeah, absolutely. So yeah, aggressive is I always keep thinking, what is the word I want, and I keep not remembering either way, yeah, so the more aggressive side of things. So for this person, what’s really interesting is this, obviously, we were still, I think we were about five years post treatment, but we were still in the really high premiums. So this was hundreds and hundreds of pounds per month for this person. But what was interesting is being able to look at, and this isn’t always everybody’s favorite type of product, you know, which is, you know, to each their own, but depending based upon what this person needed as well. It was looking at over 50s cover, which was really, really fascinating, because what you can do is, you know, in certain ones, there’ll be certain questions, so quite a lot of them have a two year moratorium period, which you know does mean that, you know, if you die from from natural causes in the first two years, they would be from the premiums after the first two years, and they cover any cause of death. So the first two years is more of an accidental death type policy in the UK. And what was interesting with this situation is that we were able to access an over 50s policy that only had a six month waiting, you know, moratorium period. So because of the fact that the questions you’re asking, have you been told you’ve had cancer in this time period? Have you had treatment for cancer in this time period? And the answer was no. So all the answers were just No, no, no. So we’re able to get the cover, which was brilliant, because the other way and going on the sorry, the more usual routes for life insurance was just absolutely unaffordable. There was no way that this person could afford to have that policy. But through the over 50s, with that six month period of that accidental death side of thing, then moving to the full debt claim, we were able to get that person insured for a very, very reasonable price, which was very, very positive. So it’s important to always have those different options to hand when you are an advisor. Thank you for listening, everybody. And thank you, Kim, it’s been really, really brilliant to have you with us. It’s definitely been useful to have your insights.

 

Speaker 1  39:00

Pleasure to be here. Kathryn, good to see you again, and maybe I’ll see you before the next lucid, or I’ll meet your husband at Lucid, but thanks a lot for having me.

 

Kathryn Knowles  39:09

Fantastic. Be lovely to lovely to get there. If I can, definitely, I’ll try my best to get there, but we’ll, we’ll see what happens. I’m sure Alan possibly will be next time I’m going to be back and doing another shortish episode based on writing life insurance to support gift planning in the UK, there’s a couple of ways to do this, but a super key thing is to make sure that you set up the trust in the right way. You must check the small print the trust is absolutely essential. Here. You can access all of our episodes on all major podcast platforms or visit the website practicalhythm protection.co.uk, and don’t forget, if you’ve listened to this as part of your work, you can claim a CPD certificate on the website too. Thanks to our sponsors, the ox members. Thank you very much, everybody. And thank you. Killian, goodbye.