Episode 2 – Type 1 Diabetes and Income Protection

Hi everyone, we have Sue Kissane (Underwriting Manager) and Caroline Hume (Key Account Manager) from Cirencester Friendly are joining me to discuss income protection and type 1 diabetes. We are talking about underwriting and claims, so that you can get a good idea how type 1 diabetes can be considered by insurers.

There are approximately 350k people diagnosed with type 1 diabetes in the UK. It is a condition that results in the body not producing any insulin, leading to a build up of sugar in the blood, that can cause long-term complications in the eyes, heart, kidneys, liver and limbs.

The key takeaways:

  • You are more likely to get income protection if you are type 1 diabetic, than you are to get critical illness cover
  • Not all insurers are able to consider type 1 diabetics for income protection cover
  • A case study of arranging income protection for someone living with type 1 diabetes

I will be back next time with Alan Knowles and we will be talking about arranging income protection for social media influencers, an area that we are starting to see popping up a lot more.

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

Kathryn Knowles  00:10

Hi everybody. We are on season 10, episode two, and we have Sue kisane and Caroline Hume with me from Simon sister, friendly. Hi, hi. Good morning. Today, we’re going to be talking about type one diabetes and income protection plus the siren sister, friendly 125, fund. This is the practical protection podcast you

 

Kathryn Knowles  00:45

so how you both doing? How’s your how’s your week been?

 

Caroline Hulme  00:50

Yeah, good. Fresh into, fresh into the new year and off to off to a good start. Hit the ground running. Brilliant,

 

Kathryn Knowles  00:59

very, very good. That’s always nice to hear. How about you sue?

 

01:04

Very busy in underwriting too. Yeah, February and lighter nights. Oh, yeah,

 

Kathryn Knowles  01:10

definitely, definitely looking forward to the lighter nights. So we’re going to start getting into things then. So go to about type one diabetes and income protection, which is something we hear quite a lot about at cura. We get asked by the public. We get asked by other advisors, and I think a lot of the time, people tend to think along the lines of critical illness cover, not necessarily thinking as much about income protection, but we are changing that. Obviously, it’s been a lot of effort from insurers, a lot of effort from advisors to make people aware of just how important income protection is. And I think what’s really, really interesting when it comes to type one diabetes is that there are more options for income protection than there are critical illness cover, and people don’t seem to really realize that or recognize that. So if you are an advisor, you’ve got someone type one diabetes, you’re wondering what is going to be a good option for them? You’re going to want to be leading down the income protection route, rather than the critical illness cover. So a type one diabetes we have done, I’m sure we’ve covered this a little bit in an episode before. Is that it’s where the body doesn’t produce insulin, which does have a knock on effect to the rest of the body, which Sue will be able to take us through and give us some more insights into it, is most commonly diagnosed in children, but it can be diagnosed when people are older. And you might recognize from some older critical illness contracts that there used to be things like type one diabetes diagnosed over the age of 40, because that would have been seen, especially at that time, as a critical illness due to the long lasting effect of the body not having had that insulin there for so long, we have around 8% of people with diabetes have type one diabetes. So Diabetes UK, estimate there’s about 4.4 million people diagnosed with diabetes in the UK. And it’s really important there to say that that is diagnosed, that isn’t accounting for all the people who have undiagnosed diabetes as well. And that’s approximately means that around 352,000 people are living with type one diabetes that we know of at the moment in the UK. So to really kick things off, and it’s a good idea to chat a bit more about the type one diabetes, how it can affect a person’s health, their body. And not many insurers are offering income protection in this space, sir and sister, friendly is one of them. So can you start off Sue by giving us some background on the type one diabetes and some underwriting considerations, please. Well, thanks,

 

Sue Kissane  03:27

Kathryn. So as you’ve said, type one diabetes is caused when the body fails to make a hormone called insulin. Insulin helps your body use glucose or sugar for energy. Without insulin, the level of glucose in your body becomes really, really high. There’s currently no cure, but it can be managed well through checking your blood sugars, tracking what you eat and drink, and adjusting how much insulin you take. It’s not possible, unfortunately, to prevent type one diabetes, as it is with type two, with lifestyle changes, as it’s caused by your immune system. So having too much glucose in our body affects blood vessels, nerves, and therefore can affect any part of the body. Diabetic complications, we usually take a number of years of poorly controlled diabetes to develop or late diagnosis. So a lot of people will have it without being diagnosed. Complications are not certainty and can be kept at bay and prevented by maintaining a strong level of control of your diabetes, your blood pressure and your cholesterol. So for our purposes, we will classify anybody with a HPA 1c of 7.9% or less, or there is a new recording system called the IFCC so that should be 63 or less as having good control and acceptable for cover.

 

Kathryn Knowles  04:42

So that’s the that’s the one where it would be the mm Ol, isn’t it? Yeah, confusing. Sometimes an advisor, because you can get two numbers, so, like, one of them. So somebody says 7.9 like, you say anything, oh, that’s a good reason. But then somebody says, So 63 you know, you can get a bit confusing. Be like, hang on. Minute, 63 things should be in

 

Sue Kissane  05:04

a percentage, so that normally comes as a percentage. So that’s what the difference is. And we do see both quoted. So either or so we would expect most applicants to have some degree of what we call background retinopathy. So this is where it affects the back of the eyes, because that’s always there in diagnosis. So that’s the only complication we can accept. There’s lots and lots of other complications as well. It then goes to more stages of retinopathy, neuropathy or nephropathy. So it affects your kidneys, or it can affect your extremities, where the blood flow doesn’t go down into your fingers and toes. So you can hear people getting gangrene and their toes and fingers chopped off and things like that.

 

Kathryn Knowles  05:50

I was going to say that’s in terms of sauce. So for me, I think from like an advice point of view. So now you said, like the background retinopathy. So if you know what I tend to say to people, have you had any type of retinopathy, and they might say background, but I think, is it prolific? Is the other version? Yeah, and that’s the one where it’s, it’s, it’s stronger in a sense, and that would be the one where it would be more advanced. Yeah, more advanced. And then with the neuropathy, I tend to say to people, because I always think sometimes, with the wording, it can be quite even if you’ve got the conditions. Sometimes medical professionals don’t necessarily use the same wording, or with the big, fancy words, you can get a little bit lost when you get into all these things. So I can, sorry, say anything you know, like, you say, like with the limbs, you know, anything with your fingers, your toes, any kind of consistent pins and needles, or you haven’t have any investigations, numbness, stuff like that. Would that is that kind of like a good idea to sort of like try and encapsulate it in those kind of

 

Sue Kissane  06:44

wordings, like you said, Some individuals aren’t clued up on medical technology, whereas, if you say the problems with your fingers and your toes, is quite a good thing to ask your clients,

 

Kathryn Knowles  06:54

yeah, yeah, absolutely. And in terms of the kidneys, I wonder if some people are wondering, you know, how would you ask about that, like you said, the nephropathy, and I think probably along that line of, you know, sort of again, when you’ve had your recent blood test, because there will have been, or there should have been blood tests in terms of the HBA 1c which is the standardized monitoring of the diabetes and the diabetic control, it would be checking things like that kidney function as well. And so your EGFR that we’ll be seeing in those results, the liver function as well, and anything like that. So maybe if we just say to people, when you had your test done, was everything in normal ranges, kind of thing, that’s probably a good starting point, I would imagine. And you’ve got

 

Sue Kissane  07:36

the NHS app now as well, which a lot of people have access to, so you’ve got your results at your fingertips, which is fabulous compared to what we used to. Oh, absolutely,

 

Kathryn Knowles  07:44

I was gonna say that’s we sometimes get it with people, especially on the phone, where they start like going, you maybe say something, they’ll just go hang on a minute, and you suddenly, you can hear them. The phone goes away from them, and they’re suddenly thinking and tapping away and trying to find the information. And it is incredibly helpful to to have that to hand. So, in terms of, and I was saying there about the the complication that can be considered is the background retinopathy, potentially, we’re not saying an absolute, but, you know, it is a potential, but the other types of complications could be, could make it harder. Are there any? Because I think one of the things that probably finds people find confusing is sort of like as to why it’s hard, especially people who, in the public, who don’t have underwriting knowledge, actuarial knowledge, or maybe, like myself, an advisor, kind of work quite alongside underwriting. And know a bit more about these things. You know, as somebody gets older, obviously the body reacts more and is affected more by different things and different aspects. But if somebody has type one diabetes, and I appreciate that lots of people living with type one diabetes have no problem at all being able to work, it’s just managed completely well in terms of their medications, their lifestyle, everything like that. But is there anything specifically that is sort of like within type? I don’t know if I’m going to say this now. I’m trying to get the right contextual words for it, and it’s I’m sorry, thinking, why is it that we don’t have it? It’s kind of like an industry standard that type one diabetes is okay with income protection. What’s that kind of concern from such, like, an underwriting perspective.

 

Sue Kissane  09:24

Okay, so any of the conditions that we’ve mentioned, the complications where these, like sort of kick in later in life, could lead to extended times off work or even early retirement. Diabetic Retinopathy causes poor eyesight and even blindness. So you’re only losing your eyesight. Damage to the kidneys can cause liver failure and ultimately the need for dialysis. Yeah, neuropathy is damage to the nerves which causes numbness and tingling, as you’ve already mentioned, and potentially gangrene. Neuropathy can affect day to day activities, even such as walking, exercising or working with your hands. Yeah. And so there’s a lot of conditions there that, especially with some of the trades that we see, your carpenters, your ground workers, that could cause quite an early diagnosis. So time off work and retirement? No, absolutely.

 

Kathryn Knowles  10:13

That makes a lot of sense in terms of, like you say, you know? And I think when I try and do training on income protection as well, it’s I sense, try to say to people, sorry, to try and think of it in a slightly different way. So because, you know, we have, like, occupation classes. So for people who aren’t necessarily familiar, there are certain occupations that are seen as a higher risk for claiming on income protection, and some of them are quite obvious. You kind of think, well, if you’re doing that job, it’s, you know, potentially quite high risk. But I was trying to say to people, it’s not necessarily the job. It is what needs to happen to the body to stop that person being able to do that job. In a sense, you know, it’s a slightly different way of thinking about it. And I think sometimes that can help you think, Oh, actually, yeah, if I think of it more about the body rather than the job itself, then yeah, if I do lose my eyesight, that would make that trickier. Or if I wasn’t able to walk, that would make it trickier as as well. And, and I was just thinking back to a podcast that I did must have been over a year ago now, that’s that’s quite scary, that was such a long time ago, and it was talking about income protection claims and say, like links with BMI as well, and just how many long term income protection claims that there’s sort of, like a bit of an underlying theme, that there’s possibly a bit of a higher BMI aspect to it as well. And like you’re saying that if you start to lose the ability to walk or do certain things be as active, then that’s probably naturally then going to also affect that, and it’s, there’s just so many knock on effects. Isn’t there? As something starts to affect the body, it can, it can really start to then kind of become like a bit of a rolling thing, of there’s just more and more can start to develop.

 

11:53

Yeah, interesting occupations.

 

Caroline Hulme  11:55

Yeah, because we don’t know for occupation. So for us, it’s, it’s not the occupation. We don’t have the classes. We don’t have classes one to four. So we’re really unique in that sense that we don’t load from the client’s occupation. But we are still obviously going to look at everything that Sue’s just spoken about, when it comes to, you know, potential client behind you know, might be diabetic, or even have sort of the sort of pre, pre diabetic. But the actual occupation for us doesn’t come into sort of play, yeah? So, you know, we are obviously really good for a lot of certain occupations that might struggle elsewhere will be loaded elsewhere. Yeah, we still obviously have all the criteria around

 

Kathryn Knowles  12:38

diabetes. It’s a really, really great ability as well. When you look at comparisons to have somebody like yourselves on there to go actually, and it can be phenomenally different. Yes, well, over 100 pounds a month,

 

Caroline Hulme  12:53

huge difference. You know, there’s very few providers that actually will cover the piece, and it’s this demographic clients that can really struggle to get cover. Um, apologies, I’ve gone slightly off tangent here talking about sort of different demographic clients. Need to highlight that, you know, we don’t, we don’t know the occupation, and it’s, you know, something that we’re known for in the in the marketplace. I think it just opens up the door for so many other clients that might struggle elsewhere. Absolutely, the occupation, absolutely

 

Sue Kissane  13:24

you’d say about BMI as well, because obviously that comes into play if you’ve got about type one or type two diabetes. So the bigger you are, the less likely we are to cover you, because obviously that plays hand in hand with the diabetes and control. So we would only look to offer a 50% loading or less for BMI. Any body bigger than that, we would not look to offer to

 

Kathryn Knowles  13:45

Yes, absolutely so. And I have to say that that is consistent. That isn’t just sort of yourselves, that isn’t just people who are type one diabetics. You know, there is a certain point with all protection insurances. So if we look in the life insurance criticalness and income protection, where BMI will have an influence. And with a higher BMI, just for people who aren’t familiar with this, you would see kind of like a staged increase to the premium at certain levels as BMI get higher. But you can also see it’s on the other side slightly, where, if the BMI is too low, that we can start to see that there is obviously complications, and you actually tend to find that there’s much more, there’s much more sort of availability of cover. If there’s a slightly higher BMI, and sorry, there’s quite a, quite a good range of BMI that can be covered versus, say, like a lower BMI, lower BMI, sort of very quickly goes to the point where insurer says, actually, this is maybe this is too low for us to be able to ensure but that is obviously a completely different, different episode, and we could obviously go into that at some point as well. That’s an interesting one. Yeah, it is really, really interesting. BMI is absolutely fascinating. And when we’re saying things like plus 50% so as an example, and I am absolutely going to make up numbers here to make it. Easier for me. But let’s say, if we’re saying there’s a plus 50% on a premium, let’s say the premium is 10 pound a month, as an example, which says, I can do the maths really quickly with you had a plus 50% and that would mean you’d have an extra half of the premium on top. So the original 10 pound is seen as, in a sense, the first 100% you would then have 50% on top. So 10 pound would become 15 pounds per month. So that’s just a really straightforward example of what a plus 50 would look like. So Sue. Are there any specific situations where income protection with somebody who’s living with type one diabetes where it is going to be a case of that is that’s not going to be possible. It’s either going to be postponed or is going to be declined, because there’s either something happening in terms of diabetic control or maybe a bit of a an event that’s happening in terms of the medical side of things at the moment, yeah,

 

Sue Kissane  15:58

there are a few considerations. So they need to be diagnosed for more than 12 months. So basically, that’s there to ensure that the control is there, because it can spike when you’re first diagnosed. So we just like to see them get their control really good for 12 months. And also, anybody that smokes fakes or uses e cigarettes, we can’t offer to it’s just not a good combination with diabetes, somebody that smokes, obviously the complications we’ve already mentioned, so that would lead to be a decline. So that includes any recent diabetic comas, if that was at the start of their diagnosis, we’re okay with that, because obviously they’re still getting it under control. But then, in the last five years, if you’ve had any comas, any time off work, it’s more leading to it not being very controlled. Yeah, so that would be a decline as well. And applicants, blood pressure and cholesterol needs to be controlled as well, because it all interplays with each other. So if their blood pressure or cholesterol is not controlled, interplays with their diabetes and is more potentially, their diabetes is then more poorly controlled, so all their cardiovascular sort of risk needs to be really, really spot on.

 

Kathryn Knowles  17:06

Yeah, and that’s the reason that as well, I believe correct me, if I’m wrong, that there’s the issue in terms of, like, if somebody is a smoker, because with the very nature of not producing the insulin. So like we said, it’s an autoimmune condition. So the body’s, in a sense, attacking the pancreas and not producing the insulin, which means that there’s more sugar in the blood. Naturally, more sugar in the blood means that there’s more sugar going into the organs and towards the heart. Smoking and heart side of things is is immediately a very tricky situation. Obviously, we see that quite a lot of people have had heart attacks and continue to be smokers. The options for insurance significantly reduce, and so

 

Sue Kissane  17:43

the neuropathy. So smoking can cause neuropathy as well, and diabetes can, so it all sort of clogs your arteries up, and can cause like, like blocking of the arteries, yeah.

 

Kathryn Knowles  17:53

Okay, absolutely that. That makes, that makes a lot of sense. Thank you for that. When it comes to these insurances as well that we always say, and the really key thing is, is that it all comes down to what happens at point of claim. So getting the insurance is the first thing, and that’s brilliant, but ultimately, we’re buying a product. We’re buying a service, and we want to see that claim happening now with current income protection options for people who are living with type one diabetes, the policies do exclude claims relating to diabetes. Now, for anybody who’s listening who’s not sure of that, that is very, very standard with income protection, if you have a condition already, it’s very likely that it will be excluded from the claim set because it’s already there. It’s already present. So for people with diabetes, they can get the insurance as obviously, as long as they meet all the criteria in terms of the underwriting, but we wouldn’t be able to claim due to anything related to the diabetes, and that can be really hard to understand. So how would that claims process work? In terms of, how would we see, sort of like, is it diabetes related? Is it not diabetes related Caroline? I think you’ve got bit of insight into that for us.

 

Caroline Hulme  19:06

I think it’s very case by case basis. I would say I probably don’t have enough medical on this. That’s probably more Sue I know the exclusion is obviously quite a big exclusion. So we’d have to look at the individual. We’re always looking at the individual member anyway. We’re neutral. We always have time first, always on a case by case basis, and clients best interest at heart. But when it comes to claim, obviously, if you’re trying to claim for something that has been excluded, we’re not going to be able to pay out. But if it’s something that isn’t excluded, and it isn’t diabetes related. And I think even if we had a concern or we thought that it might be related, we’ll have, we’ll investigate that. We will look into what actually is the whole story here for the client. Why are they signed off? What are the complications? It could be something completely separate, obviously. And this is what I always say to Advan. Is, you know, you can still have income protection in place of things like cancer or your client has a bad accident and they need to take some time off work, for example. That’s what the income protection is there for. And then it’s much more straightforward, and you put your claim through, and you’re actually claiming for something different, but when it’s actually potentially related to an exclusion suit we would investigate. When we would see if it was actually

 

Sue Kissane  20:23

we would investigate, we’d get full medical records, and then we’d access to the company doctor as well. So if anything that we’re not 100% sure on, we can ask our company doctor,

 

Kathryn Knowles  20:33

yeah,

 

Caroline Hulme  20:34

which is, I think it’s wonderful. We’ve got, obviously, a CMO where we can refer to for cases that are perhaps difficult, yeah, we would always look to get the full picture. This is why it’s so important that we get all that information at application stage as well. Don’t withhold any information. Give us as much as you have and as much as you know, to help your client have a smooth and successful claim. Don’t let there be that gray area of all. You know, the client thinks they might be able to claim for this, but actually they’re not for and I think that comes down to education and having, you know, very open and honest conversation with your client about what they’re covered for and what they’re not potentially covered for. If there is an exclusion. I mean, it might be diabetes, it could be something else that’s been excluded. It’s just that the client understands, firstly, what it is they have covered for and how it works, yeah, and then what is required at claim stage, because that’s something we see a lot of as well. It’s, you know, what happens at claim stage, and what can we do to speed that process up and just the client understand everything they need to evidence in order to have a payment

 

Kathryn Knowles  21:39

absolutely okay. So I think, you know, if somebody was in this situation and they were trying to do a claim, you know, I think from the starting point, we’d probably want to be saying, you know, have they been following medical advice? Have they been, you know, keeping upstate with their medications? Have they, you know, they’re having their the sort of like the regular reviews, stuff like that. You know, I think that’s always a good starting point to make sure that the person’s obviously complying with the medical side of things, I think. And this might be one for for Sue, sorry, this query, I’m going off on a bit of a tangent, so I appreciate that it might not be the simplest of things to answer, maybe. But I suppose for me is, you know, if I, if I was somebody who was type one diabetic, and I was wanting to accept this policy, and I was trying to figure out, right, an exclusion, you know, through diabetes, I think in my mind, I’d be thinking, right, okay, well, the type, you know, the diabetes naturally means that I’ve had higher blood sugar, possibly at some points, um, but obviously, I’d be thinking, Well, No, it’s really controlled. Now. It’s been controlled for ages, but the very nature of it, and like we said, like the cardiovascular is the same thing. Well, if I have a heart attack and I’m not able to work, is that something that can potentially be covered by a policy? And I know there’d be lots and lots of aspects to that, but does it just, like, immediately rule out things like heart attack because I’ve got a condition that’s potentially got a cardiovascular element to it.

 

Sue Kissane  23:05

I think, as Caroline said, it’s all very much individual consideration. So I wouldn’t say it’s a no, but I also couldn’t say would definitely pay out it would be investigated with, you know, what caused the heart attack, and potentially a referral to the CMO, yeah, no.

 

Kathryn Knowles  23:20

That’s really, really helpful. Thank you. So that’s the kind of thing that I would want to know. I just know from my personality type. I’d be like, right? So what does it mean, you know, kind of so to know that it’s you can never say yes, obviously, because we can never guarantee or anything like that in the insurance world, but to go to be able to say, well, it’s not a no, is. It’s, you know, it’s, well, naturally, it’s a maybe, isn’t it? But I think that would be the same with almost every same with almost every claim. It’s always a maybe, until we have the

 

Sue Kissane  23:45

circumstances, individual, isn’t it? So you’ve got one client on one side that hasn’t taken their medication, like you said, their blood sugars have remained high, and it’s all contributed to having the set of heart attack, whereas it could be completely irrelevant and totally different for client B, absolutely.

 

Kathryn Knowles  24:02

I think that’s really important to make that distinction. So thank you for that.

 

Caroline Hulme  24:06

I think client individuality, and it is, it’s case by case basis. Obviously, you know, we’re not going to be able to pay for something that is completely excluded, but yeah, we also, we’re an assurance provider that we pay our claims. You know, our stats speak for themselves, so we don’t we? I think there is, unfortunately, still with the general public. There is that distrust, unfortunately, of our industry, and they think that they’re not going to get this is where the education piece is so important, and as advisors, play such a huge part in this, to help clients understand, one understand particularly, obviously, we’re very passionate about income protection, but understand what income protection is, what it does for them, and how powerful it is, but also what is needed at claim stage. And if you have an exclusion, what does that actually mean? What can you claim for? What can’t you claim for? And just to help them sort of smooth over any questions that they have, so. That they really understand what it does?

 

Kathryn Knowles  25:02

Yeah, absolutely. And I was going to say as well, the when you’re just saying there about the stats and everything, speaking for themselves. I did a blog at the weekend, and part of it, I’d had a look at the API stats and everything. And it’s, you know, it’s billions, absolutely billions, paid out from the protection insurance industry each year. And like you say, it’s, it’s so hard because, you know, the people just, you know, there is still that thing about, oh, they’ll do anything to get out of a claim. And you just think, well, no, you know, it’s sort of like that isn’t the case. You know, as long as the rules are met, as long as your terms are met, you know, and they actually want to

 

Caroline Hulme  25:37

play claims. We want to look after our members. We want to help them when they absolutely need us the most and when they’re very vulnerable. You know, just to sort of put it into perspective about the sort of length of claim we have been paying our longest claim for over 30 years. Oh, wow. Which is I’d like to claim is pretty much my lifetime, but I’ve been alive a little bit longer than that, but I still like to use that one, because it’s so incredibly powerful when you start to talk to clients about the need for income protection, yeah.

 

Kathryn Knowles  26:06

Oh, absolutely. And I think, I think it’s that whole thing, isn’t it, of people just, you know, life gets ahead of us sometimes, and we don’t think to to sort of do things, or we think of doing this kind of thing, and then something pops up, and it gets busy and, you know, and it’s, it’s so hard, and unfortunately, I’m sure you guys have come across it as well. I certainly have where you stop, like you do these things, somebody again gets distracted with life, and then something happens, and that triggers them to come back. And then that means all the options have changed. Yes, and it’s it’s so hard when you run across. Your heart just goes out for people so much in that situation. Absolutely.

 

Caroline Hulme  26:48

My plea for the advisor community always, and I say to all my friends, please just review your clients. And if you don’t have a review, can’t get my words out today. If you don’t have that review process, put it in place. Oh, yeah, absolutely. Get that in place. Make sure you’re reviewing clients, maybe not every year. You know, it could be that you do it every two years, but don’t leave them to come to you because life gets so busy and so hectic that they’re not going to remember to ring you or to message you and or must tell my advisor, no, that’s going to be somewhere not even on their priority list, probably because they’re doing 50,000 other things.

 

Kathryn Knowles  27:26

And you demand some needs reports. That’s really important, demands and needs report really thorough on Yeah, we have in ours, like, a specific kind of table at the front that, like lists life kick IP things, and it’s such a case of, I have advised on this. I’ve given you this option, yeah, this one, I’ve given you this option. This was the option you did not want, you know. So it’s just reminding people constantly something to go and like, yeah, this, you know. And you might

 

Caroline Hulme  27:51

not want it right now. You can’t maybe afford it right now, or it could be a different situation. But in two years time, your situation could have changed very easily, yeah, and you might need some other options in place. So yeah, please just review your comments

 

Kathryn Knowles  28:03

absolutely, completely with you. With that. Okay, as we’re coming towards the end, we’re going to have a little bit of chat about the Simon sister friendly. You have this brilliant 125 fund, and I have some personal experience of this. Um, So Caroline, can you tell us what the 125 fund is, how people can get involved or access it

 

Caroline Hulme  28:21

absolutely. Thank you. So 125 so 125 foundation is 125 for short, but it is. It’s a members fund, really. We launched it and we had our 125th anniversary. So we’ve obviously been around for a little while now. In the marketplace. We’ve been going for quite a while. Um, so we launched the 125, to support members, really, but it does include advisors as well. So it’s it’s split into two categories. You’ve got community fund and you’ve got an individual fund and as a client. And obviously we refer to clients as members, they can seek support through 125 so you could have something that you want to do for your community. It could be a cause close to your heart. It could be a charity. It could be that you want a defibrillator in your local sports community. Or there’s something else that your community could could really do with some support with and the 125 foundation is there to help with that. We’ve supported all various different charities. We’ve also done individual things for members. So we’ve supported with things like a treadmill that client, I think this is a really lovely one. There was a client or a member who, a while back, needed to go through a health, sort of health and fitness journey before they could have surgery. They didn’t feel comfortable going to the gym, because the gym isn’t for everyone, and I know some people find it really daunting, sort of exercising, you know, in public. So we arranged through the 125, foundation for a treadmill for that member, so that they could exercise in the comfort of their own home, and they could have sort of that space to do that at home and just be able. To go on their health journey before they had surgery. So it was something we did to support that individual member. But we also do a lot for the advisory community and our strategic partners. And it’s always available. It can always be applied for. So you speak to your speak to your BDM, speak to me, speak to strategic partnership team we can always support with, as we have done for yourself, secure so it’s there to be used to support. You know, if you have a cause that you want some support with them, then why not ask us what 125 can do? We have a 125 committee that they sit here at Sorry sister as well. And they will meet, and they will look at all the applications and see what’s been applied for. And they will discuss, and, you know, discuss an appropriate amount that we can support with. But I know we did for yourself and Alan, which was great.

 

Kathryn Knowles  30:53

Can you believe that as well? That was almost a year and a half ago. Crazy. It was September 2023 me and Alan did for people who don’t know. We did a charity Charleston for our local hospice. And I absolutely loved it, because I got dressed up as complete flapper girl, and it was so much fun. And obviously, you guys donated to it, which was just fantastic. You know, really, it was the local hospital, something really close to our house. We know quite a few people who’ve needed to use it. And it’s, it’s just an absolute fantastic thing. And the cost of running a place like that is exactly phenomenal, absolutely phenomenal. So, so thank you so much for for doing that.

 

Caroline Hulme  31:30

Yeah, and it is things like that problem where, you know, you might have, if a people listening, you know, you might have a community, of course, there could be a a charity. You know, we’ve supported other, other strategic partners with things like Winston’s wish that support blue children. We’ve done various different cancer charities. And I think the want to clarify Foundation, perhaps, you know, it’s the foundation people don’t really know about so advisors maybe don’t know enough about it, to be able to speak to clients about it. So we want to lift what it does. And is there for the members as a members fund, there’s, there’s lots of information, if anyone wants to sort of deep dive into it, but it is really there for the member yet to

 

Kathryn Knowles  32:15

support. Absolutely fantastic. Thank you. So now onto the stage of the case studies. So I usually give a case study, but I have obviously said, Do you guys have one? And I know Kathryn you mentioned about the brilliant claim story, remind advisors of what that is and where to access it.

 

Caroline Hulme  32:33

Absolutely. So Anne story was our first ever. We’re super proud of Anne story. It’s amazing. I still can’t watch it without crying. It’s a very powerful message about income protection. Anne is one of our members. She went through a claim process, and we have basically put together her story and her journey of what happened to her and her family and how she was affected. And it really puts into perspective what your income protection does for you. The 125, foundation actually stepped in here as well and supported her as a member. So supported her family while she was in claim. But I would just urge any advisors to watch it. If you haven’t seen it, watch it. It’s available on our website. It can be shared on your social media. If you use social media as a as a tool for clients, it’s a really, really powerful video to use, even if educational purposes, or just, you know, for your own understanding of what we can offer. And you know how powerful it is to actually have something in place

 

Kathryn Knowles  33:33

brilliant. I think that’s really, really positive do that. And I think it’s, it’s great that you’re able to get the claims story, because I know as a firm ourselves, you know, we’ve had it for four people said, Oh, you need to get your claim stories out. You need to do this. And you do that. It is so hard. First of all, it’s so hard to have that conversation and approach the conversation to go, you know, you’re going through a really tough time. Do you mind? Do you mind if we video this situation? You know, yeah. And it’s obviously, it’s usually something so personal on everything that’s going on, to actually have somebody who’s who’s been obviously so thankful and and appreciative of the situation, of the insurance, of the extras that you did, to sorry, put themselves out there publicly for that, you know, yeah, that’s a really good testament that they were, that they were prepared to do that as well. So

 

Caroline Hulme  34:19

absolutely. And I think it just, it showcases the fact that, you know, as a society, we all work together. Yeah, there’s, you know, a real ethos of everyone looking after and working together, because we had sort of everyone involved here. You had claims involved. You had marketing do a huge one at work on this. You’ve had member services involved as well. So Leanne is featured in the in the film as well, and there’s still that ongoing contact from the member services side with Alan, who is our member, and it just it gives a whole other level of service and support, yes, and I think that, again, is where we really stand out and showcase that it is about service. It’s about looking after your member. Are. And it’s, it really isn’t, yeah, we did a campaign a long time ago now, but it was names, not numbers, and it really, I

 

Kathryn Knowles  35:08

was just thinking, literally popping in my head. I was just thinking, not a number. That’s exactly key thing.

 

35:14

And I think you will, you know, being a friendly society, it comes it comes down to that it comes down to looking after our members and doing it, doing the proper thing for them.

 

Caroline Hulme  35:24

So no is I would recommend everyone, if you haven’t watched it, go and watch our story and make sure you speak to your

 

Kathryn Knowles  35:31

clients about it. Brilliant, absolutely. Okay, so I’ve got a case study of arranging insurance for for somebody that’s living with type one diabetes. So it’s something in their mid 20s, a non smoker. Make sure I say that, because we’ve had the smoker conversation and they were diagnosed with type one diabetes at age 12. So as you said, you know, quite common to be diagnosed when you are younger. The HBA C, HBA 1c even was 47 which was absolutely fine. And within the which, that’s the MMR version, I’m assuming, Sue that’s all the IFCC, yeah, absolutely. And I was just thinking we wouldn’t want that on the percentage if it was that version. So

 

36:13

there’s

 

Kathryn Knowles  36:17

some symptoms of retinopathy in the past, but these are all resolved, and it hadn’t actually been specifically diagnosed that. So basically, they had started to almost seem as if, is there some involvement with the eyes, but then there was no specific thing. So yes, absolutely, the eyes are starting to experience they’d be probably normally

 

Sue Kissane  36:34

going to see it in 99% of like one diabetics anyway, absolutely.

 

Kathryn Knowles  36:39

So for this person, we arranged 1109 pounds per month, monthly benefits, and there was a 13 week deferred period to age 70, and the premium was 27 pounds and 21 pence per month. It does have the exclusion on there for the diabetes, as expected, as I say, we would assume that that would be the case with most medical conditions, that there’d probably be some kind of an exclusion on the policy, but I think that’s seen obviously a fantastic price in terms of getting that policy and income protection for them, and obviously, as with anything really, really good to be able to do for someone type one diabetes, because a lot of insurers are not able to do a consideration for income protection For this condition,

 

Sue Kissane  37:20

we offer all deferred periods as well. So it can go as low as one week. Yes,

 

Kathryn Knowles  37:25

yes, absolutely. With this person, it was sick pay. So that’s why we did the 13 week. It was always make sure that you were matched to the sick pay. But yeah, of going down to the to the small to the smaller ones, so I’m assuming one week to 52 week. Yeah, yeah. Brilliant. Because we’re starting to see summer operating a little bit longer deferred periods, but we’ll keep you guys at the 52 week in our minds, which is what, again, the majority are doing. I think there’s only one that’s currently doing possibly a little bit longer. So thank you for listening, everybody, and thank you sue and Caroline for joining me. Next time I’m going to be doing a session on income protection for social media influencers, and I’ll have Alan back with me for that. If you’ve listened to this as part of your work, please do feel free to go onto the website practical high from protection.co.uk, to get your CPD certificate thanks to our sponsors, the Okta members. So thank you so much for your time today. Sue and Caroline, thank

 

Caroline Hulme  38:19

you so much. Thank you. Bye. You.

Transcript Disclaimer:

Episodes of the Practical Protection Podcast include a transcript of the episode’s audio. The text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record.

We often discuss health and medical conditions in relation to protection insurance and underwriting, always consult with a healthcare professional if you are concerned about any medical conditions and symptoms we have covered in any episode.

Episode 2 - Type 1 Diabetes and Income Protection

Hi everyone, we have Sue Kissane (Underwriting Manager) and Caroline Hume (Key Account Manager) from Cirencester Friendly are joining me to discuss income protection and type 1 diabetes. We are talking about underwriting and claims, so that you can get a good idea how type 1 diabetes can be considered by insurers.

There are approximately 350k people diagnosed with type 1 diabetes in the UK. It is a condition that results in the body not producing any insulin, leading to a build up of sugar in the blood, that can cause long-term complications in the eyes, heart, kidneys, liver and limbs.

The key takeaways:

  • You are more likely to get income protection if you are type 1 diabetic, than you are to get critical illness cover
  • Not all insurers are able to consider type 1 diabetics for income protection cover
  • A case study of arranging income protection for someone living with type 1 diabetes

I will be back next time with Alan Knowles and we will be talking about arranging income protection for social media influencers, an area that we are starting to see popping up a lot more.

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

Kathryn Knowles  00:10

Hi everybody. We are on season 10, episode two, and we have Sue kisane and Caroline Hume with me from Simon sister, friendly. Hi, hi. Good morning. Today, we're going to be talking about type one diabetes and income protection plus the siren sister, friendly 125, fund. This is the practical protection podcast you

 

Kathryn Knowles  00:45

so how you both doing? How's your how's your week been?

 

Caroline Hulme  00:50

Yeah, good. Fresh into, fresh into the new year and off to off to a good start. Hit the ground running. Brilliant,

 

Kathryn Knowles  00:59

very, very good. That's always nice to hear. How about you sue?

 

01:04

Very busy in underwriting too. Yeah, February and lighter nights. Oh, yeah,

 

Kathryn Knowles  01:10

definitely, definitely looking forward to the lighter nights. So we're going to start getting into things then. So go to about type one diabetes and income protection, which is something we hear quite a lot about at cura. We get asked by the public. We get asked by other advisors, and I think a lot of the time, people tend to think along the lines of critical illness cover, not necessarily thinking as much about income protection, but we are changing that. Obviously, it's been a lot of effort from insurers, a lot of effort from advisors to make people aware of just how important income protection is. And I think what's really, really interesting when it comes to type one diabetes is that there are more options for income protection than there are critical illness cover, and people don't seem to really realize that or recognize that. So if you are an advisor, you've got someone type one diabetes, you're wondering what is going to be a good option for them? You're going to want to be leading down the income protection route, rather than the critical illness cover. So a type one diabetes we have done, I'm sure we've covered this a little bit in an episode before. Is that it's where the body doesn't produce insulin, which does have a knock on effect to the rest of the body, which Sue will be able to take us through and give us some more insights into it, is most commonly diagnosed in children, but it can be diagnosed when people are older. And you might recognize from some older critical illness contracts that there used to be things like type one diabetes diagnosed over the age of 40, because that would have been seen, especially at that time, as a critical illness due to the long lasting effect of the body not having had that insulin there for so long, we have around 8% of people with diabetes have type one diabetes. So Diabetes UK, estimate there's about 4.4 million people diagnosed with diabetes in the UK. And it's really important there to say that that is diagnosed, that isn't accounting for all the people who have undiagnosed diabetes as well. And that's approximately means that around 352,000 people are living with type one diabetes that we know of at the moment in the UK. So to really kick things off, and it's a good idea to chat a bit more about the type one diabetes, how it can affect a person's health, their body. And not many insurers are offering income protection in this space, sir and sister, friendly is one of them. So can you start off Sue by giving us some background on the type one diabetes and some underwriting considerations, please. Well, thanks,

 

Sue Kissane  03:27

Kathryn. So as you've said, type one diabetes is caused when the body fails to make a hormone called insulin. Insulin helps your body use glucose or sugar for energy. Without insulin, the level of glucose in your body becomes really, really high. There's currently no cure, but it can be managed well through checking your blood sugars, tracking what you eat and drink, and adjusting how much insulin you take. It's not possible, unfortunately, to prevent type one diabetes, as it is with type two, with lifestyle changes, as it's caused by your immune system. So having too much glucose in our body affects blood vessels, nerves, and therefore can affect any part of the body. Diabetic complications, we usually take a number of years of poorly controlled diabetes to develop or late diagnosis. So a lot of people will have it without being diagnosed. Complications are not certainty and can be kept at bay and prevented by maintaining a strong level of control of your diabetes, your blood pressure and your cholesterol. So for our purposes, we will classify anybody with a HPA 1c of 7.9% or less, or there is a new recording system called the IFCC so that should be 63 or less as having good control and acceptable for cover.

 

Kathryn Knowles  04:42

So that's the that's the one where it would be the mm Ol, isn't it? Yeah, confusing. Sometimes an advisor, because you can get two numbers, so, like, one of them. So somebody says 7.9 like, you say anything, oh, that's a good reason. But then somebody says, So 63 you know, you can get a bit confusing. Be like, hang on. Minute, 63 things should be in

 

Sue Kissane  05:04

a percentage, so that normally comes as a percentage. So that's what the difference is. And we do see both quoted. So either or so we would expect most applicants to have some degree of what we call background retinopathy. So this is where it affects the back of the eyes, because that's always there in diagnosis. So that's the only complication we can accept. There's lots and lots of other complications as well. It then goes to more stages of retinopathy, neuropathy or nephropathy. So it affects your kidneys, or it can affect your extremities, where the blood flow doesn't go down into your fingers and toes. So you can hear people getting gangrene and their toes and fingers chopped off and things like that.

 

Kathryn Knowles  05:50

I was going to say that's in terms of sauce. So for me, I think from like an advice point of view. So now you said, like the background retinopathy. So if you know what I tend to say to people, have you had any type of retinopathy, and they might say background, but I think, is it prolific? Is the other version? Yeah, and that's the one where it's, it's, it's stronger in a sense, and that would be the one where it would be more advanced. Yeah, more advanced. And then with the neuropathy, I tend to say to people, because I always think sometimes, with the wording, it can be quite even if you've got the conditions. Sometimes medical professionals don't necessarily use the same wording, or with the big, fancy words, you can get a little bit lost when you get into all these things. So I can, sorry, say anything you know, like, you say, like with the limbs, you know, anything with your fingers, your toes, any kind of consistent pins and needles, or you haven't have any investigations, numbness, stuff like that. Would that is that kind of like a good idea to sort of like try and encapsulate it in those kind of

 

Sue Kissane  06:44

wordings, like you said, Some individuals aren't clued up on medical technology, whereas, if you say the problems with your fingers and your toes, is quite a good thing to ask your clients,

 

Kathryn Knowles  06:54

yeah, yeah, absolutely. And in terms of the kidneys, I wonder if some people are wondering, you know, how would you ask about that, like you said, the nephropathy, and I think probably along that line of, you know, sort of again, when you've had your recent blood test, because there will have been, or there should have been blood tests in terms of the HBA 1c which is the standardized monitoring of the diabetes and the diabetic control, it would be checking things like that kidney function as well. And so your EGFR that we'll be seeing in those results, the liver function as well, and anything like that. So maybe if we just say to people, when you had your test done, was everything in normal ranges, kind of thing, that's probably a good starting point, I would imagine. And you've got

 

Sue Kissane  07:36

the NHS app now as well, which a lot of people have access to, so you've got your results at your fingertips, which is fabulous compared to what we used to. Oh, absolutely,

 

Kathryn Knowles  07:44

I was gonna say that's we sometimes get it with people, especially on the phone, where they start like going, you maybe say something, they'll just go hang on a minute, and you suddenly, you can hear them. The phone goes away from them, and they're suddenly thinking and tapping away and trying to find the information. And it is incredibly helpful to to have that to hand. So, in terms of, and I was saying there about the the complication that can be considered is the background retinopathy, potentially, we're not saying an absolute, but, you know, it is a potential, but the other types of complications could be, could make it harder. Are there any? Because I think one of the things that probably finds people find confusing is sort of like as to why it's hard, especially people who, in the public, who don't have underwriting knowledge, actuarial knowledge, or maybe, like myself, an advisor, kind of work quite alongside underwriting. And know a bit more about these things. You know, as somebody gets older, obviously the body reacts more and is affected more by different things and different aspects. But if somebody has type one diabetes, and I appreciate that lots of people living with type one diabetes have no problem at all being able to work, it's just managed completely well in terms of their medications, their lifestyle, everything like that. But is there anything specifically that is sort of like within type? I don't know if I'm going to say this now. I'm trying to get the right contextual words for it, and it's I'm sorry, thinking, why is it that we don't have it? It's kind of like an industry standard that type one diabetes is okay with income protection. What's that kind of concern from such, like, an underwriting perspective.

 

Sue Kissane  09:24

Okay, so any of the conditions that we've mentioned, the complications where these, like sort of kick in later in life, could lead to extended times off work or even early retirement. Diabetic Retinopathy causes poor eyesight and even blindness. So you're only losing your eyesight. Damage to the kidneys can cause liver failure and ultimately the need for dialysis. Yeah, neuropathy is damage to the nerves which causes numbness and tingling, as you've already mentioned, and potentially gangrene. Neuropathy can affect day to day activities, even such as walking, exercising or working with your hands. Yeah. And so there's a lot of conditions there that, especially with some of the trades that we see, your carpenters, your ground workers, that could cause quite an early diagnosis. So time off work and retirement? No, absolutely.

 

Kathryn Knowles  10:13

That makes a lot of sense in terms of, like you say, you know? And I think when I try and do training on income protection as well, it's I sense, try to say to people, sorry, to try and think of it in a slightly different way. So because, you know, we have, like, occupation classes. So for people who aren't necessarily familiar, there are certain occupations that are seen as a higher risk for claiming on income protection, and some of them are quite obvious. You kind of think, well, if you're doing that job, it's, you know, potentially quite high risk. But I was trying to say to people, it's not necessarily the job. It is what needs to happen to the body to stop that person being able to do that job. In a sense, you know, it's a slightly different way of thinking about it. And I think sometimes that can help you think, Oh, actually, yeah, if I think of it more about the body rather than the job itself, then yeah, if I do lose my eyesight, that would make that trickier. Or if I wasn't able to walk, that would make it trickier as as well. And, and I was just thinking back to a podcast that I did must have been over a year ago now, that's that's quite scary, that was such a long time ago, and it was talking about income protection claims and say, like links with BMI as well, and just how many long term income protection claims that there's sort of, like a bit of an underlying theme, that there's possibly a bit of a higher BMI aspect to it as well. And like you're saying that if you start to lose the ability to walk or do certain things be as active, then that's probably naturally then going to also affect that, and it's, there's just so many knock on effects. Isn't there? As something starts to affect the body, it can, it can really start to then kind of become like a bit of a rolling thing, of there's just more and more can start to develop.

 

11:53

Yeah, interesting occupations.

 

Caroline Hulme  11:55

Yeah, because we don't know for occupation. So for us, it's, it's not the occupation. We don't have the classes. We don't have classes one to four. So we're really unique in that sense that we don't load from the client's occupation. But we are still obviously going to look at everything that Sue's just spoken about, when it comes to, you know, potential client behind you know, might be diabetic, or even have sort of the sort of pre, pre diabetic. But the actual occupation for us doesn't come into sort of play, yeah? So, you know, we are obviously really good for a lot of certain occupations that might struggle elsewhere will be loaded elsewhere. Yeah, we still obviously have all the criteria around

 

Kathryn Knowles  12:38

diabetes. It's a really, really great ability as well. When you look at comparisons to have somebody like yourselves on there to go actually, and it can be phenomenally different. Yes, well, over 100 pounds a month,

 

Caroline Hulme  12:53

huge difference. You know, there's very few providers that actually will cover the piece, and it's this demographic clients that can really struggle to get cover. Um, apologies, I've gone slightly off tangent here talking about sort of different demographic clients. Need to highlight that, you know, we don't, we don't know the occupation, and it's, you know, something that we're known for in the in the marketplace. I think it just opens up the door for so many other clients that might struggle elsewhere. Absolutely, the occupation, absolutely

 

Sue Kissane  13:24

you'd say about BMI as well, because obviously that comes into play if you've got about type one or type two diabetes. So the bigger you are, the less likely we are to cover you, because obviously that plays hand in hand with the diabetes and control. So we would only look to offer a 50% loading or less for BMI. Any body bigger than that, we would not look to offer to

 

Kathryn Knowles  13:45

Yes, absolutely so. And I have to say that that is consistent. That isn't just sort of yourselves, that isn't just people who are type one diabetics. You know, there is a certain point with all protection insurances. So if we look in the life insurance criticalness and income protection, where BMI will have an influence. And with a higher BMI, just for people who aren't familiar with this, you would see kind of like a staged increase to the premium at certain levels as BMI get higher. But you can also see it's on the other side slightly, where, if the BMI is too low, that we can start to see that there is obviously complications, and you actually tend to find that there's much more, there's much more sort of availability of cover. If there's a slightly higher BMI, and sorry, there's quite a, quite a good range of BMI that can be covered versus, say, like a lower BMI, lower BMI, sort of very quickly goes to the point where insurer says, actually, this is maybe this is too low for us to be able to ensure but that is obviously a completely different, different episode, and we could obviously go into that at some point as well. That's an interesting one. Yeah, it is really, really interesting. BMI is absolutely fascinating. And when we're saying things like plus 50% so as an example, and I am absolutely going to make up numbers here to make it. Easier for me. But let's say, if we're saying there's a plus 50% on a premium, let's say the premium is 10 pound a month, as an example, which says, I can do the maths really quickly with you had a plus 50% and that would mean you'd have an extra half of the premium on top. So the original 10 pound is seen as, in a sense, the first 100% you would then have 50% on top. So 10 pound would become 15 pounds per month. So that's just a really straightforward example of what a plus 50 would look like. So Sue. Are there any specific situations where income protection with somebody who's living with type one diabetes where it is going to be a case of that is that's not going to be possible. It's either going to be postponed or is going to be declined, because there's either something happening in terms of diabetic control or maybe a bit of a an event that's happening in terms of the medical side of things at the moment, yeah,

 

Sue Kissane  15:58

there are a few considerations. So they need to be diagnosed for more than 12 months. So basically, that's there to ensure that the control is there, because it can spike when you're first diagnosed. So we just like to see them get their control really good for 12 months. And also, anybody that smokes fakes or uses e cigarettes, we can't offer to it's just not a good combination with diabetes, somebody that smokes, obviously the complications we've already mentioned, so that would lead to be a decline. So that includes any recent diabetic comas, if that was at the start of their diagnosis, we're okay with that, because obviously they're still getting it under control. But then, in the last five years, if you've had any comas, any time off work, it's more leading to it not being very controlled. Yeah, so that would be a decline as well. And applicants, blood pressure and cholesterol needs to be controlled as well, because it all interplays with each other. So if their blood pressure or cholesterol is not controlled, interplays with their diabetes and is more potentially, their diabetes is then more poorly controlled, so all their cardiovascular sort of risk needs to be really, really spot on.

 

Kathryn Knowles  17:06

Yeah, and that's the reason that as well, I believe correct me, if I'm wrong, that there's the issue in terms of, like, if somebody is a smoker, because with the very nature of not producing the insulin. So like we said, it's an autoimmune condition. So the body's, in a sense, attacking the pancreas and not producing the insulin, which means that there's more sugar in the blood. Naturally, more sugar in the blood means that there's more sugar going into the organs and towards the heart. Smoking and heart side of things is is immediately a very tricky situation. Obviously, we see that quite a lot of people have had heart attacks and continue to be smokers. The options for insurance significantly reduce, and so

 

Sue Kissane  17:43

the neuropathy. So smoking can cause neuropathy as well, and diabetes can, so it all sort of clogs your arteries up, and can cause like, like blocking of the arteries, yeah.

 

Kathryn Knowles  17:53

Okay, absolutely that. That makes, that makes a lot of sense. Thank you for that. When it comes to these insurances as well that we always say, and the really key thing is, is that it all comes down to what happens at point of claim. So getting the insurance is the first thing, and that's brilliant, but ultimately, we're buying a product. We're buying a service, and we want to see that claim happening now with current income protection options for people who are living with type one diabetes, the policies do exclude claims relating to diabetes. Now, for anybody who's listening who's not sure of that, that is very, very standard with income protection, if you have a condition already, it's very likely that it will be excluded from the claim set because it's already there. It's already present. So for people with diabetes, they can get the insurance as obviously, as long as they meet all the criteria in terms of the underwriting, but we wouldn't be able to claim due to anything related to the diabetes, and that can be really hard to understand. So how would that claims process work? In terms of, how would we see, sort of like, is it diabetes related? Is it not diabetes related Caroline? I think you've got bit of insight into that for us.

 

Caroline Hulme  19:06

I think it's very case by case basis. I would say I probably don't have enough medical on this. That's probably more Sue I know the exclusion is obviously quite a big exclusion. So we'd have to look at the individual. We're always looking at the individual member anyway. We're neutral. We always have time first, always on a case by case basis, and clients best interest at heart. But when it comes to claim, obviously, if you're trying to claim for something that has been excluded, we're not going to be able to pay out. But if it's something that isn't excluded, and it isn't diabetes related. And I think even if we had a concern or we thought that it might be related, we'll have, we'll investigate that. We will look into what actually is the whole story here for the client. Why are they signed off? What are the complications? It could be something completely separate, obviously. And this is what I always say to Advan. Is, you know, you can still have income protection in place of things like cancer or your client has a bad accident and they need to take some time off work, for example. That's what the income protection is there for. And then it's much more straightforward, and you put your claim through, and you're actually claiming for something different, but when it's actually potentially related to an exclusion suit we would investigate. When we would see if it was actually

 

Sue Kissane  20:23

we would investigate, we'd get full medical records, and then we'd access to the company doctor as well. So if anything that we're not 100% sure on, we can ask our company doctor,

 

Kathryn Knowles  20:33

yeah,

 

Caroline Hulme  20:34

which is, I think it's wonderful. We've got, obviously, a CMO where we can refer to for cases that are perhaps difficult, yeah, we would always look to get the full picture. This is why it's so important that we get all that information at application stage as well. Don't withhold any information. Give us as much as you have and as much as you know, to help your client have a smooth and successful claim. Don't let there be that gray area of all. You know, the client thinks they might be able to claim for this, but actually they're not for and I think that comes down to education and having, you know, very open and honest conversation with your client about what they're covered for and what they're not potentially covered for. If there is an exclusion. I mean, it might be diabetes, it could be something else that's been excluded. It's just that the client understands, firstly, what it is they have covered for and how it works, yeah, and then what is required at claim stage, because that's something we see a lot of as well. It's, you know, what happens at claim stage, and what can we do to speed that process up and just the client understand everything they need to evidence in order to have a payment

 

Kathryn Knowles  21:39

absolutely okay. So I think, you know, if somebody was in this situation and they were trying to do a claim, you know, I think from the starting point, we'd probably want to be saying, you know, have they been following medical advice? Have they been, you know, keeping upstate with their medications? Have they, you know, they're having their the sort of like the regular reviews, stuff like that. You know, I think that's always a good starting point to make sure that the person's obviously complying with the medical side of things, I think. And this might be one for for Sue, sorry, this query, I'm going off on a bit of a tangent, so I appreciate that it might not be the simplest of things to answer, maybe. But I suppose for me is, you know, if I, if I was somebody who was type one diabetic, and I was wanting to accept this policy, and I was trying to figure out, right, an exclusion, you know, through diabetes, I think in my mind, I'd be thinking, right, okay, well, the type, you know, the diabetes naturally means that I've had higher blood sugar, possibly at some points, um, but obviously, I'd be thinking, Well, No, it's really controlled. Now. It's been controlled for ages, but the very nature of it, and like we said, like the cardiovascular is the same thing. Well, if I have a heart attack and I'm not able to work, is that something that can potentially be covered by a policy? And I know there'd be lots and lots of aspects to that, but does it just, like, immediately rule out things like heart attack because I've got a condition that's potentially got a cardiovascular element to it.

 

Sue Kissane  23:05

I think, as Caroline said, it's all very much individual consideration. So I wouldn't say it's a no, but I also couldn't say would definitely pay out it would be investigated with, you know, what caused the heart attack, and potentially a referral to the CMO, yeah, no.

 

Kathryn Knowles  23:20

That's really, really helpful. Thank you. So that's the kind of thing that I would want to know. I just know from my personality type. I'd be like, right? So what does it mean, you know, kind of so to know that it's you can never say yes, obviously, because we can never guarantee or anything like that in the insurance world, but to go to be able to say, well, it's not a no, is. It's, you know, it's, well, naturally, it's a maybe, isn't it? But I think that would be the same with almost every same with almost every claim. It's always a maybe, until we have the

 

Sue Kissane  23:45

circumstances, individual, isn't it? So you've got one client on one side that hasn't taken their medication, like you said, their blood sugars have remained high, and it's all contributed to having the set of heart attack, whereas it could be completely irrelevant and totally different for client B, absolutely.

 

Kathryn Knowles  24:02

I think that's really important to make that distinction. So thank you for that.

 

Caroline Hulme  24:06

I think client individuality, and it is, it's case by case basis. Obviously, you know, we're not going to be able to pay for something that is completely excluded, but yeah, we also, we're an assurance provider that we pay our claims. You know, our stats speak for themselves, so we don't we? I think there is, unfortunately, still with the general public. There is that distrust, unfortunately, of our industry, and they think that they're not going to get this is where the education piece is so important, and as advisors, play such a huge part in this, to help clients understand, one understand particularly, obviously, we're very passionate about income protection, but understand what income protection is, what it does for them, and how powerful it is, but also what is needed at claim stage. And if you have an exclusion, what does that actually mean? What can you claim for? What can't you claim for? And just to help them sort of smooth over any questions that they have, so. That they really understand what it does?

 

Kathryn Knowles  25:02

Yeah, absolutely. And I was going to say as well, the when you're just saying there about the stats and everything, speaking for themselves. I did a blog at the weekend, and part of it, I'd had a look at the API stats and everything. And it's, you know, it's billions, absolutely billions, paid out from the protection insurance industry each year. And like you say, it's, it's so hard because, you know, the people just, you know, there is still that thing about, oh, they'll do anything to get out of a claim. And you just think, well, no, you know, it's sort of like that isn't the case. You know, as long as the rules are met, as long as your terms are met, you know, and they actually want to

 

Caroline Hulme  25:37

play claims. We want to look after our members. We want to help them when they absolutely need us the most and when they're very vulnerable. You know, just to sort of put it into perspective about the sort of length of claim we have been paying our longest claim for over 30 years. Oh, wow. Which is I'd like to claim is pretty much my lifetime, but I've been alive a little bit longer than that, but I still like to use that one, because it's so incredibly powerful when you start to talk to clients about the need for income protection, yeah.

 

Kathryn Knowles  26:06

Oh, absolutely. And I think, I think it's that whole thing, isn't it, of people just, you know, life gets ahead of us sometimes, and we don't think to to sort of do things, or we think of doing this kind of thing, and then something pops up, and it gets busy and, you know, and it's, it's so hard, and unfortunately, I'm sure you guys have come across it as well. I certainly have where you stop, like you do these things, somebody again gets distracted with life, and then something happens, and that triggers them to come back. And then that means all the options have changed. Yes, and it's it's so hard when you run across. Your heart just goes out for people so much in that situation. Absolutely.

 

Caroline Hulme  26:48

My plea for the advisor community always, and I say to all my friends, please just review your clients. And if you don't have a review, can't get my words out today. If you don't have that review process, put it in place. Oh, yeah, absolutely. Get that in place. Make sure you're reviewing clients, maybe not every year. You know, it could be that you do it every two years, but don't leave them to come to you because life gets so busy and so hectic that they're not going to remember to ring you or to message you and or must tell my advisor, no, that's going to be somewhere not even on their priority list, probably because they're doing 50,000 other things.

 

Kathryn Knowles  27:26

And you demand some needs reports. That's really important, demands and needs report really thorough on Yeah, we have in ours, like, a specific kind of table at the front that, like lists life kick IP things, and it's such a case of, I have advised on this. I've given you this option, yeah, this one, I've given you this option. This was the option you did not want, you know. So it's just reminding people constantly something to go and like, yeah, this, you know. And you might

 

Caroline Hulme  27:51

not want it right now. You can't maybe afford it right now, or it could be a different situation. But in two years time, your situation could have changed very easily, yeah, and you might need some other options in place. So yeah, please just review your comments

 

Kathryn Knowles  28:03

absolutely, completely with you. With that. Okay, as we're coming towards the end, we're going to have a little bit of chat about the Simon sister friendly. You have this brilliant 125 fund, and I have some personal experience of this. Um, So Caroline, can you tell us what the 125 fund is, how people can get involved or access it

 

Caroline Hulme  28:21

absolutely. Thank you. So 125 so 125 foundation is 125 for short, but it is. It's a members fund, really. We launched it and we had our 125th anniversary. So we've obviously been around for a little while now. In the marketplace. We've been going for quite a while. Um, so we launched the 125, to support members, really, but it does include advisors as well. So it's it's split into two categories. You've got community fund and you've got an individual fund and as a client. And obviously we refer to clients as members, they can seek support through 125 so you could have something that you want to do for your community. It could be a cause close to your heart. It could be a charity. It could be that you want a defibrillator in your local sports community. Or there's something else that your community could could really do with some support with and the 125 foundation is there to help with that. We've supported all various different charities. We've also done individual things for members. So we've supported with things like a treadmill that client, I think this is a really lovely one. There was a client or a member who, a while back, needed to go through a health, sort of health and fitness journey before they could have surgery. They didn't feel comfortable going to the gym, because the gym isn't for everyone, and I know some people find it really daunting, sort of exercising, you know, in public. So we arranged through the 125, foundation for a treadmill for that member, so that they could exercise in the comfort of their own home, and they could have sort of that space to do that at home and just be able. To go on their health journey before they had surgery. So it was something we did to support that individual member. But we also do a lot for the advisory community and our strategic partners. And it's always available. It can always be applied for. So you speak to your speak to your BDM, speak to me, speak to strategic partnership team we can always support with, as we have done for yourself, secure so it's there to be used to support. You know, if you have a cause that you want some support with them, then why not ask us what 125 can do? We have a 125 committee that they sit here at Sorry sister as well. And they will meet, and they will look at all the applications and see what's been applied for. And they will discuss, and, you know, discuss an appropriate amount that we can support with. But I know we did for yourself and Alan, which was great.

 

Kathryn Knowles  30:53

Can you believe that as well? That was almost a year and a half ago. Crazy. It was September 2023 me and Alan did for people who don't know. We did a charity Charleston for our local hospice. And I absolutely loved it, because I got dressed up as complete flapper girl, and it was so much fun. And obviously, you guys donated to it, which was just fantastic. You know, really, it was the local hospital, something really close to our house. We know quite a few people who've needed to use it. And it's, it's just an absolute fantastic thing. And the cost of running a place like that is exactly phenomenal, absolutely phenomenal. So, so thank you so much for for doing that.

 

Caroline Hulme  31:30

Yeah, and it is things like that problem where, you know, you might have, if a people listening, you know, you might have a community, of course, there could be a a charity. You know, we've supported other, other strategic partners with things like Winston's wish that support blue children. We've done various different cancer charities. And I think the want to clarify Foundation, perhaps, you know, it's the foundation people don't really know about so advisors maybe don't know enough about it, to be able to speak to clients about it. So we want to lift what it does. And is there for the members as a members fund, there's, there's lots of information, if anyone wants to sort of deep dive into it, but it is really there for the member yet to

 

Kathryn Knowles  32:15

support. Absolutely fantastic. Thank you. So now onto the stage of the case studies. So I usually give a case study, but I have obviously said, Do you guys have one? And I know Kathryn you mentioned about the brilliant claim story, remind advisors of what that is and where to access it.

 

Caroline Hulme  32:33

Absolutely. So Anne story was our first ever. We're super proud of Anne story. It's amazing. I still can't watch it without crying. It's a very powerful message about income protection. Anne is one of our members. She went through a claim process, and we have basically put together her story and her journey of what happened to her and her family and how she was affected. And it really puts into perspective what your income protection does for you. The 125, foundation actually stepped in here as well and supported her as a member. So supported her family while she was in claim. But I would just urge any advisors to watch it. If you haven't seen it, watch it. It's available on our website. It can be shared on your social media. If you use social media as a as a tool for clients, it's a really, really powerful video to use, even if educational purposes, or just, you know, for your own understanding of what we can offer. And you know how powerful it is to actually have something in place

 

Kathryn Knowles  33:33

brilliant. I think that's really, really positive do that. And I think it's, it's great that you're able to get the claims story, because I know as a firm ourselves, you know, we've had it for four people said, Oh, you need to get your claim stories out. You need to do this. And you do that. It is so hard. First of all, it's so hard to have that conversation and approach the conversation to go, you know, you're going through a really tough time. Do you mind? Do you mind if we video this situation? You know, yeah. And it's obviously, it's usually something so personal on everything that's going on, to actually have somebody who's who's been obviously so thankful and and appreciative of the situation, of the insurance, of the extras that you did, to sorry, put themselves out there publicly for that, you know, yeah, that's a really good testament that they were, that they were prepared to do that as well. So

 

Caroline Hulme  34:19

absolutely. And I think it just, it showcases the fact that, you know, as a society, we all work together. Yeah, there's, you know, a real ethos of everyone looking after and working together, because we had sort of everyone involved here. You had claims involved. You had marketing do a huge one at work on this. You've had member services involved as well. So Leanne is featured in the in the film as well, and there's still that ongoing contact from the member services side with Alan, who is our member, and it just it gives a whole other level of service and support, yes, and I think that, again, is where we really stand out and showcase that it is about service. It's about looking after your member. Are. And it's, it really isn't, yeah, we did a campaign a long time ago now, but it was names, not numbers, and it really, I

 

Kathryn Knowles  35:08

was just thinking, literally popping in my head. I was just thinking, not a number. That's exactly key thing.

 

35:14

And I think you will, you know, being a friendly society, it comes it comes down to that it comes down to looking after our members and doing it, doing the proper thing for them.

 

Caroline Hulme  35:24

So no is I would recommend everyone, if you haven't watched it, go and watch our story and make sure you speak to your

 

Kathryn Knowles  35:31

clients about it. Brilliant, absolutely. Okay, so I've got a case study of arranging insurance for for somebody that's living with type one diabetes. So it's something in their mid 20s, a non smoker. Make sure I say that, because we've had the smoker conversation and they were diagnosed with type one diabetes at age 12. So as you said, you know, quite common to be diagnosed when you are younger. The HBA C, HBA 1c even was 47 which was absolutely fine. And within the which, that's the MMR version, I'm assuming, Sue that's all the IFCC, yeah, absolutely. And I was just thinking we wouldn't want that on the percentage if it was that version. So

 

36:13

there's

 

Kathryn Knowles  36:17

some symptoms of retinopathy in the past, but these are all resolved, and it hadn't actually been specifically diagnosed that. So basically, they had started to almost seem as if, is there some involvement with the eyes, but then there was no specific thing. So yes, absolutely, the eyes are starting to experience they'd be probably normally

 

Sue Kissane  36:34

going to see it in 99% of like one diabetics anyway, absolutely.

 

Kathryn Knowles  36:39

So for this person, we arranged 1109 pounds per month, monthly benefits, and there was a 13 week deferred period to age 70, and the premium was 27 pounds and 21 pence per month. It does have the exclusion on there for the diabetes, as expected, as I say, we would assume that that would be the case with most medical conditions, that there'd probably be some kind of an exclusion on the policy, but I think that's seen obviously a fantastic price in terms of getting that policy and income protection for them, and obviously, as with anything really, really good to be able to do for someone type one diabetes, because a lot of insurers are not able to do a consideration for income protection For this condition,

 

Sue Kissane  37:20

we offer all deferred periods as well. So it can go as low as one week. Yes,

 

Kathryn Knowles  37:25

yes, absolutely. With this person, it was sick pay. So that's why we did the 13 week. It was always make sure that you were matched to the sick pay. But yeah, of going down to the to the small to the smaller ones, so I'm assuming one week to 52 week. Yeah, yeah. Brilliant. Because we're starting to see summer operating a little bit longer deferred periods, but we'll keep you guys at the 52 week in our minds, which is what, again, the majority are doing. I think there's only one that's currently doing possibly a little bit longer. So thank you for listening, everybody, and thank you sue and Caroline for joining me. Next time I'm going to be doing a session on income protection for social media influencers, and I'll have Alan back with me for that. If you've listened to this as part of your work, please do feel free to go onto the website practical high from protection.co.uk, to get your CPD certificate thanks to our sponsors, the Okta members. So thank you so much for your time today. Sue and Caroline, thank

 

Caroline Hulme  38:19

you so much. Thank you. Bye. You.

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We often discuss health and medical conditions in relation to protection insurance and underwriting, always consult with a healthcare professional if you are concerned about any medical conditions and symptoms we have covered in any episode.