In my last column I referenced the lack of transparency in the group risk market over claim statistics. New evidence demonstrates dramatically how poorly the UK group income protection sector compares to equivalent services elsewhere in the world.
Data released last month by the Australian Prudential Regulatory Authority, paints a shameful picture. UK group income protection policy holders are over four times more likely to have their claims declined than members of a similar scheme in Australia.
To be precise in their most recent data APRA (covering 12 months to end June 2020) found that 96 per cent of claims submitted under group disability contracts in Australia were paid, the equivalent number in the UK, according to Grid, the industry’s own trade body, is 82.5 per cent, for the calendar year 2019.
The individual protection market has long disclosed claims statistics at an individual insurer level. For reasons I have never been able to understand the group risk industry, however, insist this is not necessary. Notably claims paid in the individual protection market are consistently significantly higher than the equivalent industry average numbers for the group sector.
Before claims statistics were disclosed on a company by company basis in the individual market, the percentage of claims paid was very similar to the current results from the group sector. It is very clear that since each company published their own data the percentage of claims paid has significantly increased.
Many companies in the group risk market, for example AIG, Aviva and Zürich regularly disclose their claims numbers for individual contracts, but not group products. Each of the above has a great payment record on individual contracts and processes which go over and above normal practice, going out of their way to be supportive when people need to claim.
I don’t imagine for one moment that these processes are any different for group risk, indeed in the case of Zürich I know that many of the innovations they introduced to the claim payment processes originated in their group protection division.
The Australian data is easily accessible because the Australian regulator compels insurers to disclose this. They also then make the data available to consumers in a very user-friendly fashion via a website moneysmart.gov.au. If the FCA would follow the Australian model consumers would have access not only to data, on a company by company basis, on claim payments per type of contract but also by distribution channel as well as data on the average time taken to pay claims and the persistency rate for each insurer. This appears to me to be powerful data that the regulator could use to measure the extent to which insurers are meeting customer needs and providing acceptable levels of service.
Historically group risk insurers insisted it was far more difficult to underwrite members who had exceeded no medical limits or indeed identified to those with pre- existing conditions that they would not be covered. With more and more insurers providing member apps as part of group risk contracts this no longer needs to be the case.
There is no shortage of automated underwriting engines that could be linked to such apps and processes that could be used to make clear to people if restrictions apply to the cover. I’ve heard it suggested that employers don’t want their staff to know when they’re not covered under a group risk plan, I simply don’t accept this argument. As an employer myself I cannot imagine a worse scenario than having an employee suffer a long- term illness only for them to be told when they claim that they are not covered. The impact on staff morale within the business would be devastating and undoubtedly the employer would get the blame for buying a cheap policy.
The group risk industry does lots of good work but its lack of transparency on claims is an avoidable stain on its reputation. The industry should fix this before the FCA steps in to do so. It cannot continue to be acceptable that nearly one in five people claiming on group income protection policies are told they are not covered when they need it most.