Expanding use of eGPRs: January Protection Forum Part 5

Peter Hamilton: I would echo some of the points I think that David was making just there. I think it’s good to hear David Mead’s original presentation and speaking on behalf of the ABI, because I chair one of the ABI committees that gets heavily involved in this as well. This is absolutely a very high priority for the group. Both this year just gone and the coming year. Just by way of observation, a couple of things that are being done and have been done because I think there’s an opportunity to do almost a bottom up and top-down approach here, which is working, albeit not as quickly as we might want. So it’s great to see David and colleagues approaching individual GPs almost that customer perspective from the individual perspective where the advisers make that initial contact. But also, are there some top-down opportunities? I mean, it’s worth being aware the BMA only represents about half of the GPs, so the GPs are pretty unwieldy bunch of about 30,000 odd individuals who aren’t easily herded into a particular action. But it is good, I think, to see that the take up has gone from about 25 percent to 40 percent over 18 months. That’s been a kind of perverse but positive outcome from the pandemic that we’ve seen. We’ve got to hope it hasn’t plateaued and we need to continue that. I think some of the objections from GPs will be if they don’t do it, often it’s extra systems they’ve got to get their head around so they won’t bother. You know, we do have to be alert to the huge amount of extra pressure being put on. It was only back in December where they were being told pretty much you cannot do anything but vaccinations? So as part of the booster programme and the vaccination programme, they are being mandated by the government to do that. But I think now one of the other things the ABI did was talk to all of the providers involved and look to get the both the barriers, but also the opportunities to put it across. Interestingly, one of my ex-colleagues, Dale Woodward, has just joined iGPR, one of the main firms in this market. So he’s got a kind of strong underwriting understanding from the company he’s worked for, and he’s taking that into just driving up with an iGPR, the take up of these reports. The last thing I would say is we run the danger of shooting ourselves in the foot a bit because I think we are seeing a few other initiatives and a few other suppliers around that. I think the more choice we give to GPs or the system that they use, the less likely they are to use any of them. So while that’s commercially difficult to say we will go down one rather than another, I think that the more opportunity the GP has to look at it and say, “not sure which one is right for me,” the less likely they are to do any of them. But I think overall we ought to be positive about the change that we’ve seen over the last 18 months and be reassured, I would hope the advisers on call here. And it’s a really big opportunity. And my very last point would be at one level, we might be solving yesterday’s problem because I think the other thing the ABI are working closely on is ultimately access to patient’s data through their own informed consent. So we don’t have to rely on the GPs coming back to us. But in time they are able themselves to say, “yes, I want this claim to be paid. I want this policy to go on risk. I give my informed consent to you, the insurer, to access my records.” That’s a little way off, I would say, but that’s got to be the outcome that we’re looking for, rather than necessarily just focus on eGPRs themselves, which still rely a degree of intervention from them.

Ian McKenna:

 I mean, on the question of informed consent, that sounds really good to me. I guess the BMA won’t like that because based on David’s numbers of volumes, I think if I get my sums right, insurers are spending about £200 million a year, which is ending up in GPs pockets. I don’t imagine for one moment they’re going to enjoy that revenue disappearing from them. I do think, Peter, we need to be a bit careful also in the context of competition. We’ve got to be careful about advocating that we go one route.

Peter Hamilton: I did try to make that point that that is difficult, but I think it is potentially a barrier. I don’t think we’ll ever get to one route. But I think the more we have, the more challenging.

Ian McKenna:

I mean, one of the other issues in this, just to try and put this all into context is not dissimilar from certainly the wealth side of the advice market, though there not so many players in the protection market. A very relevant link in this chain is the GPs’ practise management systems of which I think there are three main ones. There was one that I think went out of business last year, but one of them has got taken over by another one.

Coming onto points I was going to make and I think we need, as you just identified, Peter, iGPR is actually a name of one particular service. We probably need to be quite careful in our definition. There are there are at least three or four others.

On payments, actually certainly one of that I’m aware of, and I don’t know about the others, but will ask the questions. At least one of the systems is actually offering to take care of the payment and get the payment for the doctor and remit it to them. So it’s even easier for them to get paid. And there is certainly one where they’ll suck all the data out and do the reduction that does have to work through the practise management system. But I believe most are linked up to that, if not all, literally one of the players can suck all the data out will do the redaction for them of anything that shouldn’t be shared so that you don’t even need to worry about the issue where there’s only somebody that comes in half a day a week to do this because that can be taken care of for them.

The last thing I was going to say is, again, coming back to David, if you’ve got a claim that’s not being paid, let’s have a chat privately because if you’ve got a claim not being paid, I can think of a couple of personal finance journalists on national newspapers. I know well who would love to ring a GP surgery and say, “why are this family destitute because you can’t be bothered to fill in the forms?”

And I’ll make that open offer to anybody on this call. If you’ve got a claim that’s not being paid for those reasons. Call me, I can think of several journalists that would love to get their teeth into that because, people not being paid, claims not being paid is appalling. And of course, the poor person not getting paid to a certain extent is blaming the insurance company, which is obviously not fair. So David, love to speak to separately and anyone else needs some help with me on that.

David Mead: It’s one of those problems, it’s a thorny old problem. And it almost seems so big that it’s insurmountable really, the thousands and thousands of GP services and this provider has got one agenda and a distributor has got another agenda. And you know, there’s all these different. When we started having these conversations, I thought, this is a really thorny issue, and no wonder it’s never really been cracked. But I think it’s really important that we focus on the positive achievements that have happened. And as I say, there’s providers who have doubled their uptake over the last two years. There are several providers who are claiming that 40-45 percent of their reports come back in this way. And I’ve got to say that plays out in our stats. Now I share these stats and it’s up to everyone how they run their own firms, obviously. But for me, I share these stats with our advisers, you know, and as an adviser community, we probably need to encourage providers who are not doing this to get a move on, quite frankly, because this is really important. Johnny was talking very eloquently about, Consumer Duty, and this definitely falls into this category. The providers spend millions of pounds getting their online systems, so we’ve got our lovely question sets and journeys and automatic decisions. But in our case, about 60-70 percent of our cases go for further medical information. And right now, we are regularly seeing three, four, five month delays in that process because the GP surgeries. So if we’re getting 45 percent of them back digitally and we’re showing the advisers that providers who use these, they are voting with their feet in droves and the providers who aren’t using these are losing out. And let’s face it, money talks. So maybe you guys, I’m more than happy if anyone wants to come to me directly, to share with you, which provides are using them which ones aren’t so you can have your own conversations locally. I’d be more than happy to share that with you, but I think providers who aren’t there if we’ve got a critical mass built up with every provider using them and they all get to 45 percent, then surgeries are getting more and more calls and more and more requests for these and the penny will drop. And I think that will then become the tipping point. And if adviser firms who are phoning surgery saying are using them as well, and this combined pressure, as Peter was saying from the top and the bottom. And I think if that’s happening, we’ll get to a tipping point where it becomes the thing. And whilst being able to access patient data directly is the dream, we’re nowhere near there at the moment. So we’ve got to deal with where we are and be positive about that and deal with the issues we’ve got. And for me, the biggest bane of the advice process is getting GP reports. It’s the hardest bit of our job and managing clients expectations. It’s difficult and those few will a lot of them will appreciate that as well.

Scott Taylor-Barr: My comment was really just about, is it a case of getting the GPs themselves to see the value of the underlying insurance product in terms of outcomes for their patients in a healthcare setting as opposed to just from a financial setting? So, the fact that they can access remote GPs, remote physio services, the fact that the person who’s had the heart attack and the triple bypass, who the doctors said “you’ve got to take at least three months off work” actually can afford to take three months off work and doesn’t end up going back after a month and having another massive heart attack. We need the GPs to see that value to their patients. And if they do, then I’m sure that GPRs would be filled out at downside quicker and not just GPRs. You know, when we have to go from the back of a GPR after a specialist report or something like that. I think fundamentally at the bottom of this and a lot of the problems throughout the insurance industry as a whole falls down to, as AMI’s Viewpoint research picked up on, just a lack of trust when it comes to insurance. The public and the GPs form part of the public, do not believe insurers pay out. The public, feel that advisers talk about protection to earn more commission. So we’ve got a fundamental lack of trust sitting there. And I think, part of what we need to do is educate doctors that they’re part of this solution and that what we’re trying to do is protect the health of their patients. As much as it’s all about money. Money for the patients as well as everybody else, they’ve got to see it as a health care thing. And I think if we can crack that nut, if we can get in front of GPs and get them to see that this is good for their patients, then that might be half the battle won.

Peter Hamilton: Just to echo I think the points made just there. I do think it’s really important to kind of personalise the impact on the patient and the positive health benefits of that. I would say the other element, as far as the doctors are concerned that we will continue to look to push is the benefits to themselves, not least through the greater data protection, because every time they send a paper with a client and very, very sensitive personal information through the post, they are putting themselves at risk, whereas the electronic route through whichever route you do is inherently more secure. So I think we need to articulate what’s in it for their patient, but also what’s in it for them. And I think that data protection piece is probably often overlooked by very busy doctors.

David Banks: It was just I think we have to be careful in, saying that the GP’s are totally at fault here. I think a large number of them do appreciate the benefit of protection. And insurers do, what the adviser community does as well, but they’re under huge amounts of pressure and, I’m not condoning taking six months to return reports. But for a lot of surgeries, they hardly get any insurance reports. We talked about the total numbers, but a lot of them go to big surgeries and big cities, and smaller surgeries may only get a handful of reports a year, so the the imperative to change to them becomes very little. And on the point that Peter raised there about the security, that’s something else we’ve spoken to GPs about, trusting the medical records to the post and why not eGPRs as a solution? And one of the fears that comes through is that because it becomes an automated system, they are more at risk if something was transmitted that maybe talked about a third party and hadn’t been redacted, then that GP can be struck off for having data like that exposed. So there’s a lot of competing risks and pressures for the GP as well, so I think we should just be careful on how much we put at their door.

Emma Astley: Definitely. We hear a lot of clients coming through where they’ve had an experience with another broker and they haven’t taken any further information. It’s gone to underwriting and it’s been a GP report for months and months. And then they’ve contacted ourselves and then we’ve actually taken that information for them. We’ve asked them for consultation letters, diagnosis, treatment, discharge letters. They can get a lot of that information from the GP directly themselves or from apps that they’ve got or they’ve saved the letters and they’ve got them. If we are doing more as an adviser to actually then help the underwriter get a better overview and journey of what the client has been through and why, they’re then going to give us a better outcome quicker for the client. So I think there’s a lot more that advisers can do to help the whole journey to actually stop these GPR reports being needed. So, I’m a big advocate for working with the clients, working with the underwriters and trying to obtain as much information as we can to get a better decision quicker for the clients, really. So that’s what I was just trying to get across in there.

Emma Astley: We’ve got quite a few clients, really, a guy who had testicular cancer at the age of 30. We’ve had breast cancer clients who they’ve had all the journey and treatment, and we had a lady accepted yesterday who had been through eating disorders, suicide attempts and mental health disclosures. But because of the information that we’ve gathered together from the client and the GP, we’ve got a decision for her within two days and no GP report has been needed. So it does make a massive difference for the client, really, just by obtaining what we can with their help and people like to talk these days. So, you know, if you’ve got that good relationship with a client, they are going to open up with you and give you all that information for you then to send to the underwriter. Just because you’re going through an application and you’re answering yes, no questions and you put in a bit of text in a free box. Don’t leave that as the final stage, come away from the application, then email the underwriter directly with a lot more information, copy the clients in for full acknowledgement and authorisation, and then we’ll get that communication working between an underwriter and the client and ourselves, and it gets a better outcome.