This is the fourth post in our series bringing you the great conversation from our November Protection Forum. This section is focusing on the longer-term effects Covid has had on the protection industry and the adaptions that advisers and insurers have made to their practices.

As long as everything is coordinated I haven’t found it very difficult to place business remotely.

Adam Kaplan:

If you know what everybody’s doing, [Covid changes are] kind of one of those things you can kind of work around that. I suppose the only challenge really, and I had it recently where I’ve given somebody advice, booked them in for the application a couple of days later and then they can’t come in contact with somebody. They’ve been confirmed to have it and it just got postponed for 30 days.

I did learn that the questions are slightly different now, whereas everybody else is saying four questions at the beginning. Some are not asking certain questions. I don’t know off the top of my head, I’d have to go back to the research that I did. But yeah, advisers are, I mean, insurers are definitely becoming a lot more relaxed about it, I’d say, but ultimately, it’s like everything. If you know what everybody’s doing then I personally haven’t really found it much of a challenge to place business at all.

The biggest Covid-related issue we’ve seen is the backing up of GP services and GPRs and medical reports which is causing delays in underwriting.

Scott Taylor-Barr: I agree with that and actually it’s not really caused too much of an issue other than a couple of clients who have had had COVID or long COVID in one case or come into contact with people. So it’s been something that we’ve been able to navigate through. I think the bigger issue it’s caused has been in terms of backing up of GP services and things like that because GPRs and medical reports and that sort of thing were always a delay in protection underwriting. And what this has done is made that from ridiculous to absurd, essentially. You know, I’ve had cases where the insurer won’t insure because the client’s been asked to have some tests at a hospital, but the hospital aren’t even booking them in for the tests yet. So you literally have a rock and a hard place, and that’s been the bigger issue with the pandemic than insurers directly saying, “No, we won’t insure you because of this or we’ll insure you only on these terms.” It’s more about medical evidence or other things that have been my biggest, biggest issue with it all.

The clients tend to get a better response from GPs which has been a useful route. We’ve had a number of times insurers have been great and gotten nurses sent out to do blood tests and things and mitigate some of the impacts.

Scott Taylor-Barr: Depends on the situation. Depends on the on the client, depends on the insurer. We’ve been very lucky that clients often get a better response from their GPs when they ask for things to get done than insurers or from us. So obviously that’s one route that’s been useful. We’ve had a number of situations where insurers have been brilliant and we’ve been able to say to them, “Look, this is the situation: You want this because the doctors asked for it. The hospital is saying they’re not even going to think about booking them in for that test for eight months.” And we’ve had a situation where insurers have said, “OK, then what we’ll do is we’ll just stick an exclusion on for now or we’ll maybe send out a nurse to go out and do a blood test.” They’ll find a way around it where they can, which has been brilliant, but they’re limited into what they can do. If a client’s waiting for an MRI scan, they’re waiting for an MRI scan. And I don’t think any insurer is going to wheel a portable MRI scanner around the country. By working together, we’ve managed to mitigate some of the impacts. But it’s only some.

I don’t think insurer’s philosophies have changed dramatically, but there is a requirement to be more flexible. It’s not GPRs that are delayed, it’s also cancer treatments and diagnoses and more. One of the good things we’ve seen is an increased take-up of electronic GPRs.

Peter Hamilton: Just as you asked the question expressly, in terms of insurers’ philosophies. My sense is that they probably haven’t changed dramatically. It’s just the requirement to be more flexible, to be more pragmatic, is just being heightened. So at any time, we would want to find ways of getting people on risk wherever we can. I think what we are seeing in the medical world now is clearly just a huge burden. And it’s not just GPRs that aren’t coming back on time, it’s people not getting their cancer treatments, their diagnoses and more. So we are a part of a much bigger challenge in issues. So from a question of the health of the nation, we’ve got to be collectively concerned, I think, as to how many people just aren’t getting the treatment and diagnoses because we could easily see a kind of wave of CI claims coming through because people just haven’t been able to get the early treatment they require. But that said, I think insurers will be pragmatic. I think one of the good things we’ve seen is an increase in take up of electronic GPRs. So I would say a year ago, the average for most insurers would have probably seen something like 25 percent to take up by GP’s. It’s nearer 45 percent now, and there’s ongoing work, both from the ABI, from insurers and indeed from advisers to try and drive that further, because that will bring some efficiencies and ease the process as well. But more broadly, coming back to your individual point, I think that there is just a heightened awareness of the need to be pragmatic where possible, and in some cases that won’t be possible. But we have absolutely aligned interest here, whether with the customer, with the adviser. It’s in all our interests to get cover on where we can. There will be some cases where that will be a challenge, but I don’t think it reflects a material change in philosophy.

In the longer term I think we will do away with GPR reports because patients will potentially have access to their own data and be able to share it by giving informed consent.

Peter Hamilton: I think a longer-term prognosis, as it were, we can do away with GPR reports because in the same way as we were talking earlier on this morning about access to data, patients in time will potentially have access to their own data and will be able to share it with whom they want, so they will be able to to give informed consent. And so you almost cut out the middleman and potentially we can go through to to that data. I have to say, I think that’s a while off because it comes with certain challenges, not least what information is provided, what is redacted, how much information comes through. But yeah, for as long as I’ve been working in the industry, the need to get GPRs has been problematic and it’s just been heightened by the current pandemic. So the long term solution isn’t to get faster GPRs. Ideally, it’s to get access to patient records with their informed consent. In the meantime, I think collectively we just need to do all we can to encourage GPRs and benefits. So various people are working with both the BMA and others to try and encourage, take up and reflect to the GP’s– but actually, it’s in their interest as well because they can avoid issues with data protection and more by using it electronically as opposed to medical records coming to us getting lost in post, etc… So again, it ought to be in everyone’s interests. So there would be a short term continued effort to increase take up and in a longer term, can we get away from them altogether and use data in an informed way, or at least a way with informed consent to speed the whole process up?

I’m also struggling with getting cover for someone because he can’t get booked in for test he needs. Some of the electronic GPRs lately are coming back within days.

There’s a huge range of time it’s taking to get the GPRs back, sometimes in days and sometimes it’s taking months and months.

Adam Kaplan: I agree with a lot of what Scott was saying. It reminded me of a case I’ve got at the moment where he’s got some outstanding investigations just due to COVID. This has been ongoing literally 18 months now and I chased him up regularly once a month and he still hasn’t gotten this follow up. It’s just to do with his eyes. But the insurer, has said that until he’s had that follow up, we can’t offer cover and now that we’re aware he’s got outstanding investigations, where else can I go with it? And it’s a bit of a challenge that one. But in regards to GPR, I’m probably going to say something a little bit controversial from an adviser’s point of view. But I do agree they are necessary on occasions and I’ve got a case at the moment where we actually got– this must be a world record– I’ve got a GPR back within two days. They sent it out and because it was an electronic one, it came back within two days and we got that back before they’d even booked the medical. Just due to it was a big case and it was an automatic decline. So I was like, “For what?” And yeah, he’d forgotten to tell me he had a heart attack. It’s not great for me because it’s a policy we can’t do. But ultimately, if we’d to go ahead with that policy, he’s got a policy in place at the moment that was taken before he had the heart attack. Imagine that went into force and then he died because he forgot to tell us about the heart attack and we never had a medical report. Then he’d have never been paid out and that would’ve been really terrible. So there is 100% a place for it. And I do agree that obviously moving forward, everybody should be signed up for the electronic version because if you can get back in a couple of days, that’s saving two, three four months of chasing. It’s just incredible. One of the worst cases I had was actually my cousin. I’ve just sorted out his income protection which took nearly a year to get his medical records back. Literally. It’s just over 11 months from the first conversation I had with him to when his policy went on risk. And that’s the difference we’re looking at now is two days to nearly a year.

I think the problem is often the GPs who don’t see the GPRs for insurers as important and so they don’t prioritise getting them done.

Scott Taylor-Barr: I’ve got nothing against GPRs. I think they’re very necessary. And I think the weak link in the chain is the GP and not always because of timing issues, which obviously we know it’s strained. But I think just also they see it as an administrative task that’s not that important to them. They see it as helping an insurance company. I don’t think many of them see it as helping their patient. Yet many of them would probably moan if they said to a client, “Right, you just had a heart attack. You cannot work for the next six months.” And then they found that their patient was back at work a month later. They’d probably go, “What did you do?” They’ve got to see this as working hand in hand to help their patients and ongoing care, and I don’t think they do. And I think they just get these report requests come in and they go and it just goes to the bottom of the pile. Not all, admittedly, but I think there are some and that’s where you get these stories like Adam’s and I’ve had them to where you like 12 months later and you’re going, “you asked for prepayment on this report in December, and I’m sitting here in August and we’ve still not had it.” And I think we’ve got to work to get the medical profession to see why these are important for them as much as us and their patients to really get a sea change in their attitude to how quickly these things get turned around. And hopefully that will mean they’ll go well, “right, if they’re that important, we need to get to turn around quickly.” Then obviously electronic GPRs become the answer.