Welcome to 2019 !

As we move into 2019 I wanted to drop you all a note and apologise for my dismal lack of marketing and social media work in 2018 - one of the issues around building a busy practice and supporting a number of introducers and their clients on medical insurance is that you get really busy ! This means of course that the first thing that slips are blog posts and the like. However in 2019 one of my resolutions is to try and communicate a bit more with my introducer clients both via the occasional marketing e-mail like this one but also on my blog (www.localventure.blogspot.com) and also via Twitter (@localventure1) and the like. 

If you do have any medical insurance queries you would like answered I am always here to support you, as I note below :

This year have a think about the following potential classes of medical insurance client you might refer, this might include :

Your existing SME clients who don't have cover in place - new medical insurance plans for small corporate clients are an awful lot cheaper than most clients think, there are therefore very few barriers to purchase.

SME's with a current PMI plan that hasn't been reviewed in a while - any company plan which hasn't been properly reviewed in the last year or two needs urgent assistance in my opinion. Many of the larger national PMI brokers (and some big regional specialists) often don't bother to even contact clients at renewal and when they do it is a largely perfunctory and inflexible service. Lots of 'low hanging fruit' to acquire out there.

Individual and high net worth clients with : BUPA, AXA PPP, Aviva or Vitality Health - legacy personal business is relatively easy to acquire and move to a lower cost proposition. Client with these large insurers are likely paying too much.

Older clients whose prices have rocketed upwards - there comes a point where pricing is simply too high for older clients. This is not insurmountable and in many occasions we can help clients up to the age of 79 plan a move of insurer to 're-set' their pricing at a lower level.

If you would like to discuss any prospective cases with me or need general advice on medical insurance - just call or e-mail me.

Regards

Phil

Phil Knight
Independent Healthcare Consultant
(Part of Premier Choice Group, FCA No. 312878)
T. 07792 075748
E. philknight@pch.uk.com
W. www.pch.uk.com/consultants/phil-d-knight/

Spark Email for Mac

If like me you've been a user of the Mac OS Email client for years you'll probably be as frustrated as I have been with it's idiosyncrasies and slow-downs. After 12 months of working like a snail and then more recently three days where it took 20 minutes or longer to load an e-mail, type and send it I have finally given up and moved over to Spark.

Two minutes to download from the App Store and then about five to configure the two accounts (business and personal) I need to use on a regular basis and I'm good to go.

Will no doubt come across issues - wondering whether my automator emails which I use multiple times a day in my standard workflow will operate but even if they don't it's taking so long to process one email out that I'd be quicker typing the things all from scratch anyway.

Here's to, hopefully working at normal speed again !

Working with small corporate clients on quotations

If you're an IFA or accountant who is interested in passing medical insurance clients over to a specialist healthcare broker like myself what are the key pieces of information you need to collate from your client to pass on to enable me to begin the review and organise some figures and an initial report ?

For brand new company  clients who currently have no medical insurance plan in place I just the following :

Name and address of the company, ideally this must match their appearance on the DTI Companies House website as many insurers now check that companies are legitimate corporate entities.

We will also need a list of staff including their ages/date of birth along with the same for dependents (although it is easy enough to price without family members and amend later which happens quite often). All staff to be covered will be paid in full by the company which results in a P11D 'benefit in kind' charge for the premium - this is part of the eligibility criteria implemented by HMRC for businesses to obtain the generally lower price and tax advantages of company paid medical insurance.

As with new personal client reports I tend not to take an in-depth overview of benefit requirements from the client at quotation stage preferring to offer a range of options in my report for us to drill down with the client at a later meeting/call.

In the next post  I'll cover off the same informational breakdown for company clients with an existing plan already in place.

If you are a business professional who think their clients might need advice on any aspect of medical insurance or other related plans please feel free to contact me on :

philknight@pch.uk.com or 07792 075748

Phil Knight
Independent Healthcare Consultant
November 2018

Data for an continued medical exclusions transfer

If you're an IFA or accountant who is interested in passing medical insurance clients over to a specialist healthcare broker like myself what are the key pieces of information you need to collate from your client to pass on to enable me to begin the review and organise some figures and an initial report ?

For brand personal clients who currently have a medical insurance plan in place I just need to know who is to be covered, how old they are and where they live. So names, dates of birth and home address for everyone to be covered.

In addition, as I will be undertaking a comparative market review I'll need full information on the current plan. The insurer, product name, excess and other plan options taken, the renewal date and current/renewal premium. This is to ensure that when pricing we look at offering like for like comparisons to establish that the clients needs can continue to be met by the product and hospital listing of a prospective new insurer.

Lastly and in some cases most importantly I will also ask the client for an overview of claims going back a minimum of five years and any pending medical medical issues they are aware of. Switching existing clients between insurers without negatively impacting on their medical underwriting is a complex and technical element of the review and thorough fact-finding is vital. Claims in the past, depending on when they happened and their nature do not necessarily preclude moving a client to a new insurer but they might limit the options we can consider and almost certainly affect the pricing we offer.

In the next post  I'll cover off the same breakdowns for company clients with no plan already place.

Good to be back blogging again

If you're an IFA or accountant who is interested in passing medical insurance clients over to a specialist broker like myself what are the key pieces of information you need to collate to pass on to enable me to begin the review and organise some figures and an initial report ?

For brand new personal clients who currently do not have cover in place it is a relatively easy set of data that is required. Basically I just need to know who is to be covered, how old they are and where they live. So names, dates of birth and home address for everyone to be covered. That's basically it.

Some intermediaries might also ask a client what level of cover they require and which hospital they would prefer to use. My standard quotation and report process is a little more open ended. For new clients, unless they have a specific initial expectation, is to offer a range of benefits, excess levels and prices form a number of insurers (usually between four and seven providers) to give us a number of options to discuss. I find this methodology, whilst sometimes involving a little more work for me gives context and a good reason to explain how PMI plans work and the benefits of various plan options and the ideas and practicalities that sit behind them. It also means the initial telephone fact find with the client or the introducer is simpler and the initial report gets to the client more quickly.

Tomorrow I'll cover off the same breakdown for personal clients with a plan already in existence, sometimes called 'switch' or 'continued personal exclusions' (CME) transfers. Then in follow up posts I'll talk about similar information for company paid clients.

The importance of reviewing your medical insurance at least every other year

I'm just beginning looking at the mid December 2018 renewal terms for one of my clients.

The premium last year went from £ 489 per annum to £ 559 p.a. for a mid range policy with Aviva.

Last year I thought this increase was not unreasonable (equating to £ 5.83 per month) but I did a market review anyway as I often do for clients. There were lower costs with other insurers but not low enough to make it worthwhile moving insurer so the client and I elected to renew as is with Aviva. The insurer offered a small discount and everyone was happy.

This year the renewal terms have arrived in at £ 783 per annum - we will have to renew the market again and this time assuming no pending claims then I will almost certainly recommend a move as I can think of at least two insurers who on a clean switch case like this one will offer considerably lower terms than the holding insurer.

The morale to this story is two fold - firstly never ever leave your insurance to auto-renew, contact an expert intermediary and review things. Even if leaving things as they are is the right advice at least you can have some context on how your plan compares with market. Secondly, pricing and insurers approaches to taking on new clients changes in my market quite quickly - there are options available now that were not available only 12 months ago so it is always worth checking in a renewal time.

For help, contact me on 07792 075748 or philknight@pch.uk.com

I look after personal medical insurance (primarily high net worth clients but I will NEVER turn anyone away even if you just want a natter about your options), company cover 2 - 20,000 employees and various associated covers : optical, dental, cash plan, EAP, Sickness Absence - your one stop shop for professional healthcare consultancy

Phil Knight

November 2018  

The Problem with GDPR - 1) Inconsistency

Hands up anyone who understands how GDPR is supposed to work ? Not even the lawyers can do that because they know that GDPR exists, amongst other reasons, to keep them in work with it's ambiguities and inconsistency.

For anyone, business or customer those four letters have become some of the most annoying in recent history. Let me give you an example of the inconsistency of GDPR in operation.

Two weeks ago I needed to book in a medical scan for a family member - the hospital had my number and called me to arrange it on their behalf. This was agreed at the hospital with their radiology team. The call to diary in the test came to my mobile and they asked to speak to the patient - my family member. I explained as above, we'd agreed I would organise it as I'm taking the person to the appointment and have a note from their diary of when they are available - all agreed with me in one call, appointment booked. No problem.

One week later exactly. The results meant another follow up scan was needed in two months time. The procedure was agreed with the same people in the same hospital to do the same thing as noted above to book in the new visit.

The call came in to my mobile and they asked to speak to the patient. I said, "Oh the scan people - I'll book in the appointment as I'm bringing the person and have their diary."

"No, can I speak to the patient" I said "Why" - guess what the answer was : GDPR.

I tried to make the point that GDPR hadn't applied seven days earlier in EXACTLY the same circumstances especially considering that the only personal information they divulged was the name of the patient which I had already. Totally bonkers. They wouldn't let me book the scan and therefore they had to call back again to my family member directly who of course couldn't book in the visit as they didn't have my diary - the person who was organising the transport.

Ludicrous on two levels - the inconsistency within the same department in the same hospital and the fact that despite no personal medical information being involved they've made it functionally impossible for someone who can't organise their own transport/needs to be accompanied by a family member to make an appointment. Lunacy.

Welcome to Localventure 2018

Well looking at the stats is appears that it has been over two months since I last posted on this blog (wonder what happened to 'daily content' ????).

As I've talked about before it is generally other work issues that prevent me from having the time to log my thoughts and in fact I'm pretty busy today but checked in on the blog to ensure that the new data notice a la GDPR was displaying properly - it is so, no issues with my stealing your lovely cookies for nefarious anti-privacy purposes (give me strength).

If you're reading this as one of my business introducers, Welcome - now that tax year end has finished and the summer holidays are shortly to begin this is usually the time of year I get quite a few client referrals from my IFA's, general brokers and accountants - so please feel free to ping over your enquiries as and when - I'm here and ready to serve.

Phil Knight
Independent Healthcare Consultant
07792 075748
philknight@pch.uk.com

May 2018

No claims discounts in personal medical insurance

It's a bit beyond the scope of this blog to explain the detailed in's and out's of pool risk in insurance (the idea that a group of people paying together carry the overall cumulative risk for all individuals with the pool as a whole, single unit - this being one of the basic premises of general insurance) but some insurers have chose to dilute or even divert this pure form element of their pricing model and offer clients an element of individual risk pricing for members either transparently or via a behind the schemes process of applying claims an individual makes to their renewal pricing on an on-going basis.

Insurers call this addition of risk pricing by several different names but the most common idea is one that people will be familiar with form their car insurance : No Claims Discounts or 'NCD's'.

The medical insurance NCD (offered by many insurers) is however subtly different to that offered by car insurers. At its most basic a client is placed at plan outset on an NCD pricing band and moves up and down these multiple price bands depending on their claims status for the year. In principle NCD is fairer. Creating a situation where individual clients pay more if they claim and the idea of low claimers subsidising their claiming equivalents is theoretically reduced.

There are though some significant drawbacks with this NCD model of pricing. Non claimers of course still subsidise to an extent, especially given that most insurers have a maximum NCD level - once you get to that point and do not claim you are still subsidising those who claim, although to a lesser extent. But also insurers tend to move clients down a higher number of bands when they claim than they move them up when they don't. This means that, especially in the early years of a plan, it can seem punitive in terms of increases following claims. In particular a punitive NCD regime can prevent clients from claiming for low level claims if they understand that the price can increase following the NCD being applied far more than the actual notional cost of the claim itself.

In other words you claim for a private consult and a couple of tests - total cost £ 200 but the premiums increase the following year by £ 30 a month - £ 360 total - £ 160 more than the claim itself. This example seems counter-intuitive that insurers would do this and expect to get away with it (in terms of clients not going postal following this situation). I can assure you that it does happen, regularly. Two factors prevent it causing insurers problems. Firstly people often don't check their renewal pricing very carefully (read other blog posts where I rail about regularly reviewing renewal pricing being totally essential). Secondly, if you've made a claim in the last 12 months it can be problematical to move insurers immediately following that claim. This means that insurers literally have their policy holders by the proverbials, cancelling the plan becomes an exercise in cutting off your own nose to spite your face when moving insurers is not an immediate possibility.

Some insurers have therefore either shied away from the strict NCD model (WPA, The Exeter) or offer a differentiated version of the same thing (Vitality's ABC version) in the attempt to either give clients an alternative to NCD mechanics or attempt to offer more transparent often through complexity.

My experience is that NCD are a bit like high street banks - every client has one insurers version that they hate/like and if you asked 10 clients whether they like the NCD or a different approach you'd probably get 10 subtly different answers. Certainly I speak to clients on this subject on a weekly basis and remain ambivalent about it myself as a PMI client in my own right.

My current view (from an advisory standpoint) is this. Like a lot of situations it's all about knowledge and applying that knowledge during and the following a claim. As NCD based plans tend to be set at a lower premium cost at outset as opposed to non NCD insurers plans there is an initial budgetary advantage in applying for this kind of product. For new and younger clients who are actuarially less likely to claim perhaps the NCD model works best initially. As clients age and therefore (in theory) claim more there is likely to be more pricing stability in a non NCD, traditionally risk pooled pricing model. This means though that those insurers who offer a traditional fully pooled risk product (Exeter as an example) tend to be more expensive - simply because they will have more older, sicker clients who are more likely to claim. This is also, in my opinion one of the flaws in the current implementation of standard risk pooling - those insurers who offer this capability will have to increase everybody's rate more often by a larger amount because their book tends to carry more claims - I've seen this happen a couple of times in recent years.

That said, neither type of product is perfect and insurers offering both can make pricing mistakes that require correction over time. Again this is simply the market in which they insurers operate - any broker claiming to offer guaranteed pricing stability to their clients is frankly making it up.

If you make a claim on your PMI plan, expect an increase is my advice - if you know the claims is going to be minor maybe consider self funding the first element of the claim and seeing where it goes (do check though that the condition, doctor and hospital are all covered just in case the claim needs to go further - any insurer will talk you through this element of coverage without formally setting up a claim on their system). If the claim is small and self limiting you haven't activated an NCD. If the condition is more serious you revert back to the private claim and will you likely be ok with an increase the following year anyway having used the plan and obtained value from it.

In the end NCD is actually a bit of a red herring. A product feature that whilst avoidable neither adds nor detracts from the efficacy of the benefits - large increases year on year are possible with any insurer regardless of the underlying pricing model they apply to their renewal and new business pricing. In the end I've worked in medical insurance since 1994 and have lost count of insurers who have needed to re-set their pricing following adverse claims experience and/or a pricing snafu. This is the market in which we operate and clients have to understand this. The best plan for a client should, in my opinion, be based not on the technical framework underpinning the price calculation but rather on the benefits package and the best (i.e. most comprehensive) version of this they can afford or are prepared to pay within their budget. If the price of a plan is initially fine but increases over time we need to review the market and consider moving insurer.

NCD is, in my opinion really only 'window dressing' the renewal pricing chosen by the insurer. It is not, or rather shouldn't be, a primary concern for policy holders.

Ask me to review your medical insurance plan if you'd like expert help or even contact me just if you want to know if you have an NCD built in to your cover - always happy to help.

Phil Knight
Independent Healthcare Consultant
07792 075748
philknight@pch.uk.com
March 2018

Dog Walking Discourtesy

I have a 22 month old CockerPoo who is still mid-training. He will come to heel when called but is excitable and when walking, for his safety (i.e. I don't want to lose him) I do not currently allow him off lead. I also have a 14 year old Cocker Spaniel who is now a very slow walker. With these two dogs looking after them on lead is a task that requires care and concentration.

On my morning walk starting at 7.00am I am not interested in my dogs playing with other dog walkers pets. It hypes up the CockerPoo and distresses the older Cocker plus frankly at that time in the morning I just need to get the walk done and ensure I can get off to work. Surely that is not an unreasonable position ???

The reason for this post is that I'm frankly sick and tired of dog walkers with all the time in the world in the morning allowing their dogs off lead to harass me and my dogs without taking any action. Last week I had to actually tell another dog owner to control his dog and take it away as he idly watched his dog drive my younger dog mad for over 200 yards as I tried to continue my walk being literally 'dogged' by his animal - as a result I was forced to cut my walk short as my Cocker was distressed - shaking and whining and my shoulder problem (a serious injury I received 10 months ago) was aggravated by the effort of keeping my younger dog from breaking off lead and being lost next to a main road.

This kind of ignorance is staggering from other dog owners and it would be great if people could respect the fact that :

1) I don't know you or your dog and have no interest in being friends with either - it's 7.00am in the morning I'm barely conscious at this stage !

2) if I wanted my dog to play with yours it wouldn't be on a lead.

3) read the body language - it's pretty clear that I do not want to interact from the fact that I turn my back and carry on walking.

Lastly my message is this - if you can't control your dog then don't let it off the lead near other dogs.