Changes to critical illness wordings have come thick and fast over the last 24 months. A slight tweak to a wording here and a new condition added there no doubt leads to better coverage in most cases, however this is only offered to new cases. Today, Guardian have put live their first upgrade since launch with a very different approach honouring their “Cover Upgrade Promise”. But what does this mean for existing customers of Guardian, those that have applications or quotes in place and potential new customers?

Having come to market with a dual life offering only, where a claim on any benefit for either life assured will not reduce the sum assured for the other benefits or the other life assured, Guardian have now added a life with accelerated critical illness option called “combined life and critical illness”. This will provide slightly cheaper premiums (especially for joint life cases) and more comfort that the client is not over insured when used for mortgage protection, although as we explain in a previous insight this also results in less cover for the client (Click here to read the previous insight).

Other changes see three new full payment critical illness conditions added (Gastro-intestinal stromal tumour, Neuroendocrine tumours and Ulcerative colitis) with a further five conditions enhanced (Cardiomyopathy, Intensive care, Low grade prostate cancer, Parkinson’s disease and Cancer).

In terms of the enhanced wordings our panel of medical experts were particularly pleased with the change to the low-grade prostate cancer definition which vastly improves a client’s chances of claiming on diagnosis alone. This aligns their definition with Royal London and Vitality as market leaders for this condition:

“There are no longer restrictions on the type of treatment required, so those that are not immediately treated will now be covered. UK audit data is showing that less serious prostate cancers, often picked up through PSA screening and scoring 6 using the Gleason grading system, are increasingly being treated through active surveillance alone.”

Cardiomyopathy is a disease of the heart muscle that impacts its ability to pump blood to the rest of the body and can lead to heart failure. The improvements made by Guardian here are also welcome as our panel of medical experts explain:

“Guardian previously offered payment based on the severity of the symptoms, but now will also do so if there is evidence through an echocardiogram (less than a 40% ejection fraction) which is less severe.”

Whilst these conditions are less likely to impact the children of clients, the improvement to Guardian’s intensive care definition is very positive for children’s cover where this is more prevalent:

“There has been a change to the length of time a client/child is required to stay on an intensive care unit whilst receiving mechanical ventilation. This was previously 10 days but has been dropped to 7 days. This results in around 10% more clients/children that require mechanical ventilation within intensive care being able to claim.”

Another positive change for the children of clients is the extension of the maximum age eligibility. Previously this had been age 23 for children in full time education and 18 for those that are not. This has now been extended to age 23 regardless of education, meaning far more children will be covered if children’s critical illness is included. This also compares very favourably with the rest of the market.

Whilst there are many positive enhancements as part of Guardian’s latest announcement there are also two standardisation of wordings, which reduce coverage for Benign Brain Tumour and Dementia. For both conditions, Guardian previously had market leading definitions which have now been brought in line with the rest of the market as our panel of medical experts explain:

“Previously Guardian have covered, all forms of benign tumour or cyst of the brain cranial nerves or meninges. The new wording has put stipulations on the forms of treatment that are required, which importantly means that there is no longer any coverage for those monitored through active surveillance. This is roughly a quarter of all cases. 

“There has also been a drop in dementia coverage, which now brings Guardian in line with all other insurers. There was previously broad coverage for all forms of dementia, but now payment will only be made once symptoms have progressed to severe forms which have significant impact on a sufferer’s day-to-day life.”

Overall the changes are largely very positive for new customers, however due to the “Cover Upgrade Promise” existing clients are the big winners. Guardian have confirmed that those that have a policy in place will, at claim, have their existing policy conditions compared to the T&Cs available at that time and a claim will be paid if they meet either definition. This means that existing policy holders will benefit from the new conditions and enhanced definitions whilst their existing broader coverage for Benign Brain Tumour and Dementia will remain in place. As such those with existing policies will have the most comprehensive cover that Guardian offer.

The graphs below highlight who is most likely to pay a claim based on our independent medical panel’s assessment of insurers definitions combined with age-banded incidence data. The age-banded incidence data along with the gender, age and term of the plan enables us to weight each condition based on how likely someone is to suffer from it. Therefore, those conditions that a consumer is more likely to suffer from have a far greater impact on the overall score than conditions that are rarer.

 The following example is based on a 45-year old female taking out a 10-year policy:

The following example is based on a 45-year old male taking out a 10-year policy:

The old plan is now closed to new business and any new quotes generated will be on the new, still extremely comprehensive, conditions. There is however still hope for those that have valid quotes or applications in the pipeline. Guardian have confirmed that anyone that produced a quote before 19th October 2019 and has not yet applied, have 30 days from the date the quote was generated to complete their application in order to benefit from the previous terms. Anyone that made an application before 18th October 2019 and have been referred to underwriting will also benefit from the terms at the date of application.

For those that have not obtained a quote or submitted an application, unfortunately the opportunity to provide clients with the most comprehensive plan Guardian are ever likely to offer is unfortunately lost. This aside the new Guardian plan remains extremely comprehensive with more options than ever. The “Cover Upgrade Promise” is a big USP for Guardian as clients can be re-assured that their version of the plan will be, at the very least, as comprehensive as the versions of the plan that Guardian will offer in the future.