abcd The 2003 Healthcare Conference 5 -7 October 2003 Scarman House, The University of Warwick
IMPORTANT NOTES n What is the most important Underwriting Decision? n What is the biggest concern to applicant & Policy Holder? n Public perception of Insurance Industry n Non Disclosure n The Role of the Actuary n Linking Underwriting & Claims (complete the loop) n Legislation / Regulation – European Community n Up to date & useable data n Quality of Risk Assessment (Underwriting & Claims) Otter Risk Solutions
Where have we come from? (I) • No, or little restrictions on Underwriters. - Evidence Requested - Costs involved - Service Standards - No Transparency - Arbitery Decisions - Heavy Loading - Little concern about “Lifestyle” - High Level of Occupation & Avocational loading - Little supporting evidence - No confidentiality Philosophy - No Industry or Company Philosophy Otter Risk Solutions
Where have we come from? (ii) - Directing writing offices holding risk - Ineffective Industry Representation - Unaware of implications of fraud - No Proactivity with Media - Good all round support from reassurers - “Churning” I could go on !! Otter Risk Solutions
Where are we today? (I) • Underwriters work in a restrictive environment - Medical Inflation - Rejection of request for Medical Evidence - Process led environment - Challenging service standards - Companies run by Accountants - Possible less influence from actuaries (personal observation) - Regulation / Legislation e. g. D. D. A D. P. A A. M. R. A European Legislation (more later) Otter Risk Solutions
Where are we today? (ii) - Client base with better understanding of their medical situation - Genetics - Confidentiality - Low Level of Occupational and Avocational loading - Churning still going on to even greater degrees - Complex products - Still no transparency Otter Risk Solutions
Where are we today? (iii) - Varying levels of non-disclosure - More effective Industry representation - Only a little pro-activity with media - Greatly reduced support from reassurers - Concern of quality of Underwriting & Claims - Quota Share – 90/10 arrangements - Pressure on Health Services - Ombudsmen - Money Laundering - Increased Churning Otter Risk Solutions
Where are we going? (I) - Less reliance on Medical Evidence - Greater emphasis on applicant disclosure - Improved working relationship and understanding between Industry and F. S. A including the Ombudsmen - Greater integration between Underwriting and Claims - Process led environment - Role of Chief Underwriter & Claims Manager - Post Acceptance Validation - Implication of E. U. Directives Otter Risk Solutions
Where are we going? (ii) - Non-disclosure – Decline - Greater Transparency - Quota share continuing? - Improved Data – C. M. I - Genetics - Lifestyle Issues - Reversion to simple products - Link with Sales & Distribution - Health Service (Ownership of Health Records) Otter Risk Solutions
Future Implementations, I. T Solutions & Outsourcing • Expert Underwriting 1. 2. 3. 4. Point of Sale (Quotations) Telesales Internet Head Office • Outsourcing 1. 2. 3. Underwriting Claims Consultancy • Medical Data (N. H. S) Otter Risk Solutions
SUMMARY • • Changes must happen (Underwriting & Claims) Increases understanding of clients requirements An increased presence from Actuaries Expert systems for Initial Underwriting will be the norm • T. P. A’s will (hopefully) increase their market promise Whatever happens Actuaries have an essential role to play within the future Underwriting And Claims arena. Otter Risk Solutions
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