Snapshot from Singapore – A Report on the International Underwriting Conference

 

This report, compiled by Robyn Lindsay and Tony O’Leary, appears courtesy of RiskeBusiness, the newsletter of the Australian Life Underwriters and Claims Association Inc.

 

 

29 countries, 292 companies, 381 delegates and no beer (actually there was beer but it was quite expensive!) The Third International Underwriting Congress (IUC) took place in Singapore, from 9 to 12 November 2003. With previous IUC's being held in Mexico City (1997) and London (1999) this was the first time in the Asia Pacific region.

 

Under the LOMA umbrella the IUC provided delegates with the opportunity to hear and meet colleagues and key decisions-makers in the global financial industry to share their views and insights.  Whilst most of the focus was on underwriting, the claims issues were not ignored nor left untreated. Several of the breakout sessions related to claims issues. There was something for everyone, whether you worked in underwriting, claims, product development, pricing, actuarial, forensic accounting, medical research, risk management, and so on.

 

With people from so many countries and even more financial services companies from around the world being represented it was possible to gain an appreciation of just how wide and diverse the financial services sector is.

 

Being the first IUC to be held in the Asian region there was a great deal of attention on the emerging and new markets, and the challenges that they are facing. Issues of tied agency, agent/advisors domination and shortages of skilled staff were raised along with hepatitis B. Whilst Hep B is not of major concern in some Western markets it is of major concern in Asia, where in some countries a large majority of the community are infected, often at birth.

 

Opening Address

The opening keynote address was given by Victor Apps, (Executive Vice President, Manulife Financial, Hong Kong) on "The Evolution of the Asian Insurance Industry".

 

Manulife are very active across the region and Mr. Apps presented a broad vision of the Asian life insurance industry, as it is today and as will evolve in the years ahead. He described the areas such as Japan where the insurers had, and some still have, major financial problems. He looked to the future including some of the traditional insurance bastions such as Singapore and Hong Kong as well as the new growth markets of China and India. He stressed the important part the regulator has to play in the emerging markets, particularly in Asia, where solvency has been an issue in some countries. He also mentioned the concern in some countries in the region that low quality sales people could lead to more problems for the underwriters. He also felt that the right to underwrite may well be challenged by overzealous regulators.

    

An Educational Recognition Ceremony was held to honor people who had achieved the designation of Fellow of the Academy of Life Underwriting within the Asian, Australian and New Zealand region. Among the 14 recipients of the award 6 were from Australia. They are:

 

Maeve Buultjens, AMP, Sydney

Mike Culhana, Manulife, Hong Kong

Debra Jeon, ACL, Sydney

Miriam Krajewski, BT Financial Group, Sydney

Ann Law, Swiss Re, Hong Kong
Robyn Lindsay, UniSuper, Melbourne

 

Congratulations to all our new FALUs!

 

The Panel Discussion “Inside Asia” followed, where the panelists spoke about wide range of issues related to the insurance markets, product distribution and risk management throughout Asia.

The panelists were:

Joe Dahl, Vice President of Underwriting, Sun Life Assurance Co of Canada

Geoff Baars, Managing Director, NMG Financial Services Consulting, Singapore

Geoff Coley, Director, Risk Profile Internationa,l Australia

John McKeand, Managing Director, INSINC Limited, Hong Kong

 

Issues discussed included the traditional low productivity from the advisors; difficulty in getting skilled underwriters; the opportunities available due to the underselling of protection products; in particular Income Protection; focus on Critical Illness and Juvenile insurance; different mortality issues facing the Asian market, in particular Hepatitis B; the diverse markets and mortality experience from one country to the next; and the challenges of getting reliable evidence (if in fact you can get any health evidence); a general reluctance of clients to disclose their true financial status to insurers; and the widely used tax minimization schemes.

 

It all sounded like a huge challenge and an endless supply of opportunities for growth, whilst grappling with the pricing, product development, underwriting and claims management issues, across many countries with different languages, cultures and religions.

 

On Monday afternoon the various concurrent or breakout sessions commenced. Through the next 2 and a half days numerous concurrent sessions or workshops were conducted and in some cases repeated to allow as many people as possible to attend the sessions that interested them most.

 

Unfortunately your RiskeBusiness reporters could only cover a small selection of the interesting concurrent sessions. Where we were unable to attend a session we have attempted to provide a background from the IUC session material as to the content of the session. However, it is possible to see the slides for most of the presentations on LOMA’s website at www.loma.org/iuc.asp <http://www.loma.org> 

 

Disability Insurance

John Ryan, Regional Manager, Munich Re, Australia

Tassin Barnard, Managing Director, Financial Protection, AXA Australia, Australia

 

John walked us through the evolution of the Disability product since the late 1960's and the move from the traditional products that we sold via professional association to professionals, i.e. doctors, lawyers etc through the development of the guaranteed renewable products available through life agents to much wider occupation groups, followed by the deteriorating results and claim reserves forcing companies to take remedial action by revised pricing, definitions and the move back to indemnity from agreed value.

 

Tassin presented a case study about the rivalry of ACL and NMLA/AXA in the Disability business over the years, despite both being owned by the same parent company. After hearing about the major “inhouse” competition and challenges facing both companies and the restructuring undertaken in respect of pricing, product design, underwriting and claims we heard about the significant improvements made over the last 2-3 years.

 

Tassin stressed the need to manage the numbers and being careful about what you don't see and the need to look at your own companies business and know the problems.

 

21st Century Underwriting

The two sessions on 21st Century Underwriting covered the emergence of "preferred risk" underwriting: what, why and how? and were presented by:

 

Rick Bergstrom, Consulting Actuary, Milliman USA, USA

Anna Hart USA

Guizhou Hu Vice President, BioSignia, Inc, USA

Michael Benton, CEO, MedicalsDirect, UK

Mary Fernald, Sr Vice President, Underwriting & Administration, Scottish Re, USA

 

Much of the discussion in this session was around the issues in Preferred Risk underwriting and involved the presentation of various actuarial modeling techniques which would enable more accurate calculation of the discounts that should be given to preferred lives. There was also some discussion on the use of technology in underwriting and the outsourcing of the underwriting assessment process. The question of identity theft, which is potentially a major problem in North America and other parts of the world, was also discussed in some depth.

 

Critical Illness Insurance

Critical Illness was also addressed in two sessions covering:

 

Product Trends presented by Tony O’Leary, Risk & Strategy Management Consultant, Australia and

Peter Temple, Deputy Managing Director, GeneralCologne Re, Sth Africa.

 

 The focus in this session was wide-ranging and included information on the latest product development in Crisis Cover such as female plans, buyback cover, second event cover, guaranteed acceptance and ancillary services. The speakers also discussed the implications of the race to cover more conditions, with the latest count being around 55. There was also focus on the effect of recent medical developments on experience and the question of providing rate guarantees.

 

Underwriting and Claims Experience  presented by Susie Cour-Palais, International Risk Consultant, SCP International Risk Consultants, UK and Wolfgang Droste, Chief Executive, GeneralCologne Re, Hong Kong.

 

The speakers addressed the issues of the changing experience in critical illness, non-disclosure (particularly of smoking habits), the affect of medical developments on experience and presented some ideas on how the approach to underwriting should change to deal with some of these issues.  

 

Genetics and Insurance

J. Alexander (Sandy) Lowden, (Medical Director, LabOne, USA and Achim Regenauer, Chief Medical Officer, Munich Re, Germany

 

Sandy examined whether Genetic Testing has a future in underwriting and looked back over the last decade where despite the hype we are no closer to having simple screening tests that help identify risk for reasons including:

there are too many genes

there are many mutations

not cost effective

no actuarial verification.

 

He also explored various issues around the currently topical BRCA genes and Heamochromatosis.

 

Sandy raised the issues that Genetic screening won't work as most diseases are multifactorial, and complex gene/environmental issues make actuarial predictions difficult. He suggested that one approach to mitigating risk could be where we  encourage clients to know their own genetic risks. Clients would then be able to benefit from prevention and insurers would benefit from better mortality.

 

However, care should be taken to ensure that we are not seen to be insisting on genetic testing in the risk assessment process.

 

In summary Sandy felt that Genetic screening will not meet actuarial rules for general testing for the decade; people who know their risks can mitigate outcomes; and there may in the future be good genetic-derived tests to classify risk in post-disease underwriting.

 

Achim focus on the effects of Genetic Testing on life and health insurance and commenced by saying that there are no permanent and systematic documentation and there are concerns about the quality of genetic testing for monogenic disorders.

 

When discussing Genetic testing for complex disorders it was felt that at present genetic testing is not feasible; and whilst monogenic diseases may help elucidate complex disease, the future is currently not predictable and the expectation is that within the next 5 years there will be no impact on the insurance industry.

 

Laboratory Testing

J. Alexander (Sandy) Lowden, (Medical Director, LabOne, USA presented Blood testing, while Hank George, President Hank George, Inc USA presented Oral Fluid testing.

 

We heard about the expanding role of laboratory testing in insurance underwriting, with special focus on the emergence of oral fluid screening.

 

Sandy walked us through why we do lab testing; quality controls around the testing; importance of sensitivity and specificity of the test; what is normal ; and looking at the test results.

 

He stressed lab tests are designed to help us make decisions, they are not the decision.

 

In summary Lab tests as only as good as the applicant, the collection, the lab and the use of the information and they will only tell you what you asked; and should only be used as and underwriting guide.

 

Hank gave a brief history of Insurance Laboratory testing in North America from the mid 1980's where it was dominated by urine and blood samples for large sums insured only; through the advent of the HIV testing where testing became the norm at lower levels; the 1990 to 2003 which saw the proven protective value triggering widespread use; and from the late 1990's to today the approval and increase of oral fluid test to screen for and confirm HIV-1.

 

Hank explained the Oral Fluid collected for insurance testing in NOT saliva (saliva comes from salivary glands). Oral fluid is "mucosal transudate" which derives directly from blood, and contains Proteins, Antibodies and drug metabolites.

 

Oral fluid can be used for the following insurance-relevant tests:

HIV-1 (screening and confirmation)

Cotinine (nicotine's primary metabolite)

Hepatitis C antibodies (outside USA)

 

Oral fluid is essentially as reliable as contemporary blood testing.

 

Cotinine testing is widely used in North America because:

smoker/non-smoker pricing makes it essential to distinguish from those who smoke and those who don't;

higher prevalence of non disclosure in this areas compared with other aspects of risk assessment; and

cotinine has very high sensitivity and exceptional specificity for tobacco products and nicotine products used to aid in giving up tobacco consumption.

 

Cocaine testing is performed by most North American insures as cocaine is a marker for Risk taking behaviours.

 

The advantages of oral testing in Hep C antibodies include:

HCV infection is a leading cause of mortality and morbidity worldwide

HCV antibody testing is highly reliable

over 80% of individuals with HCV antibodies are found to be currently infected with this virus.

 

In summary Oral fluid is highly reliable; it plays a major role in preventing significant aspects of non-disclosure; and the potential to expand its use, in lieu of blood testing, is now on the "radar screen" on risk managers.

 

Hepatitis B and C

Kevin Somerville, Divisional Medical Consultant, Swiss Re, UK presented Hep B, while Wolfgang Munda, Medical Director, Generali, Austria presented Hep C.

 

Information was provided on the latest mortality and morbidity issues in chronic Hep B and Hep C infection.

 

Kevin told us that there are 2 billion people worldwide with current or past infection of HBV, and there are 4 million new acute infections per annum. Different forms of Hepatitis can be predicated by where you live. HBV is mostly likely South East Asia, while HDV is predicted in India.

 

HBV modes of infection are in the West due to multiple sexual partners; health care workers, while in other areas it is primarily due to perinatal infection.

 

Patterns of infection can be influenced by vaccination of newborns. A study in Taiwan after the introduction of vaccination of newborns was introduced in 1985 has shown a dramatic change in experience.

 

The mode of transmission either in adults or perinatally appears to be more important to the risk that the Genotype.

 

When assessing the risk it is necessary to consider if there is:

viral replication

chronic inflammation of the liver

any fibrosis or cirrhosis

 

Kevin explained that males do worse than females with HBV and strongly recommends getting hold of the liver biopsy report (if there is one).

 

Wolfgang provided an overview of the facts and figures, including a broad global prevalence of HCV, and explained that 75% of infections become chronic and the chronicity increases with age. The individual course of the disease is variable and unpredictable and 50% of cirrhoses are referred for transplantation.

 

HCV can usually has unspecific symptoms of nausea, abdominal pain and fatigue, and ALT can be normal to elevated. Specific findings include antibodies, and PCR (viral load)

 

Known risks factors for HCV are drug abuse, blood transfusion before 1990, living in areas without universal precautions, nosocomial transmission and low socioeconomic status.

 

When underwriting applications from people with HCV the underwriter needs details of latest liver biopsy, to know out come of treatment and if not treated why not, serial liver enzyme testing, an co-morbidity factors and current alcohol use.

 

HCV patients can be categorized into those with good prospects, through to very bad depending on their treatment; liver enzyme levels, tissue damage, extent of disease, no co-infection, abstaining from alcohol etc.

 

Looking into the future for insurance medicine Wolfgang felt there was a better prognosis with lower mortality and morbidity, better prognostic indicators; more reliable data, possibility of a "tailored approach" to decision making.

 

Liver and Breast Cancer

Presented by Bob Pokorski, Vice President of Worldwide Medical Research & Development, GeneralCologne Re, USA and Robert Rubens, Chief Medical Officer, Swiss Re, UK

 

We learnt the latest on mortality and morbidity aspects of liver and breast malignancies.

 

Bob focused on Underwriting Hepatocellular Carcinoma in Asia where there is a high incidence of HCC. The types of primary liver cancer are:

HCC (which makes up 85 to 90% of primary liver cancer)

Cholangiocarcinoma

Hepatoblastoma

Angiosarcoma

 

HCC is the number 5 cause of death worldwide with 33% of the deaths coming from China and another 33% coming from the rest of Asia.

HCC is the number 4 cause of cancer death worldwide and the second cause of death in China over 300000 deaths in year.

Needless to say HCC has the highest incidence on South East Asia and sub-Saharan Africa, while the lowest incidence in South America/Australia/New Zealand.

The male rate of HCC incidence is 2-4 times higher than females. With males suffering more cirrhosis and continuing to use alcohol and tobacco.

 

In northern Thailand there is a liver fluke that is responsible for a significant amount infection.

 

From 1978 to 1992 there has been significant changes in primary liver cancer incidence due to a decrease in HBV/aflatoxin, and a higher incidence due to increase in HCV.

 

The incidence of primary liver cancer can vary by ethnic group in a single country, i.e. New Zealand in the non Maori and Maori; Singapore the Indian, Malay and Chinese groups and in the USA, the white, black, Japanese, Hispanic, Filipino, Chinese and Korean.

 

Bob told us about the factors associated with poor survival including severe co-existing cirrhosis (being the most important) through to the site of the tumor, if multiple tumors, symptoms etc. And despite many types of treatment being available 50% of HCC patients die within the first year of diagnosis. This is thought to be due to the fact that most HCC's are well advanced before they are detected.

 

It was suggested that when underwriting applicants with a history of HCC we postpone for 5 years after most recent treatment and recognize that the main risk factor after the 5-year survival is cirrhosis.

 

Professor Rubens explained that when looking at breast cancer it is necessary to focus on family history and risk of cancer; benign breast disorders; impact on prophylactic mastectomy in women at high risk; prognostic factors in breast cancer; and the impact of adjuvant systemic treatment on mortality.

 

He provide data on relative risks of breast cancers with particular focus on

age in BRCA1 mutation carriers;

those with a family history

women with non proliferative and proliferative breast disease

 

Poorly- defined benign breast conditions include Fibrocystic disease, Benign breast disease and Mammary dysplasia - all conditions which are characterized by pain and lumpiness in an otherwise physiological normal breast.

 

An algorithm for underwriting Critical Illness applications with a history of breast lumps has been developed with terms ranging from standard through to decline.

 

HIV/AIDS and SARS

Rene Geyer, Medical Assistant, Life Underwriting, Hannover Life Re, Sth Africa presented on HIV/AIDS, and Nick Perkins, Vice President, AIG Life, Hong Kong presented on SARS

 

We learnt about the changing face of the AIDS pandemic; with special focus on southern African and Asia and the outbreak of SARS in Asia. The data presented on AIDS and HIV infection showed how much more was understood about the degree of spread in Africa and how both public education and treatment were helping to bring things more under control. However, cost of treatment would be a major stumbling block in this respect. More worrying are the so called “new wave countries” which include Russia, India and China where the epidemic is growing rapidly and there is some concern over the accuracy of the available figures. The SARS presentation was an interesting overview both from an insurance and a personal perspective and concluded that the impact on the industry was minimal.

 

Issues in Marketing and Distribution

Peter Le Beau CEO, Lebeauvisage, UK, and Geoff Coley, Director, Risk Profile International Australia

 

Examination of risk management in the context of prevailing marketing and distribution practices in life insurance. The speakers presented an overview of some of the issues in market segmentation in the UK and how this can impact on mortality and the interaction between the marketing approach and the underwriting discipline. A separate view was given on distribution in Asia and how this may change the face of the market in the future and its influence on underwriting practices and procedures. 

 

Alternative Distribution issues and Underwriting

Brian Home, Director, Risk Profile International, and Andre Hermanns, Director & Principal Consultant, NMG, New Zealand

 

The presentations in this session focused on the concept that sole distribution through agents was a thing of the past and that successful companies will have multidistribution channels which will include some of the so called alternative distribution channels. These channels will include worksite marketing, bancassurance, affinity marketing and direct marketing. Underwriting will have to change to facilitate these channels rather than obstruct them as it can do at present. The underwriting approach will encompass traditional underwriting, teleunderwriting and the use of rule based and expert systems.  

 

The Underwriter as a Business Person

Ron Colligan, Principal, Guy Carpenter, USA and Tony O'Leary, Risk and Strategy Management Consultant, Australia

 

This was a detailed discussion on how the underwriters’ role has changed over the years and how the 21st Century underwriter has to develop his/her career to become the consummate business person. The presentations looked at the insurance company Balance Sheet and how this might be affected by the underwriter as well as what the underwriter might have to do to preserve and develop the underwriting role as we move into the future.

 

The Theory and Practice of Teleunderwriting

Tom Bienvenu, Executive Vice President, Canadian & Int'l Operations, LabOne, Inc. USA and Jonathan Crumiller, Chief Operating Officer, Princeton Consultants, USA

 

This relatively new approach to underwriting has been piloted in Australia and is becoming more common in the USA. The presentations identified that when performed correctly there are benefits in the process for the applicant, the agent, the underwriter and the reinsurer. 

 

An Inside Look at E-Commerce

Moderator-Dave Rosier, Vice President of Risk Management for Asia, Manulife Financial, Hong Kong.

Panelists:

Robert Littell; Principal, Littell Consulting Services, USA

Jean Gora, Manager of Research, LOMA, USA

Les Cantlay, Monevate Ltd., UK

 

The panelists examined the strategic innovations in the use of technology and e-commerce in administration, marketing, underwriting and related functions. The message was that E-commerce can and will impact on all areas of the insurance value chain with the key being the customer. Once the legal issues surrounding electronic signatures have been resolved the feeling was that doing business electronically will become more and more attractive. However the whole process of the sale of a Life policy needs to be rethought. Initially E-commerce will not do away with Agents but will improve the efficiency of the whole process. Ultimately more will be able to be done direct between the insurer and the proposer. 

 

Health Insurance

Horst Weber, Deputy Member of the Executive Management, Munich Re, Germany and Andrew Scott,  Manager-Technical Sales, Discovery Health, Sth Africa

 

The presenters discussed the advantages for both the proposer and the insurer of full underwriting when compared to the traditional pre-existing exclusions approach traditionally used in Health Insurance. Some arguments were put forward for the use of rule-based and expert systems in this area compared to underwriting manuals.

 

Juvenile Insurance

Dewi Arifin, Chief Underwriter, Munich Re, Singapore and Mick Jones, Head of Risk Management, Hong Kong & Macao, Swiss Re, Hong Kong

 

Dewi focused on the demographics, practical medical aspects and underwriting considerations, some common illnesses (congenial and hereditary/genetic diseases; cancers, injury and obesity) and underwriting acceptance.

 

In 2000 the major causes of death among children under five, worldwide were:

Perinatal 23%

Acute respiratory infections 19%

Diarrhea 13%

Malaria 9%

Measles 5%

HIV 3%

Others 28%

Overriding this 54% of all deaths were associated with malnutrition

 

Drawing on a 1999 World Health Organization report Dewi explained that the pattern of disease and disability among children in developing countries was:

Children aged 0-4 years - mostly infections, perinatal and nutritional disorders (80%)

Children aged 5-14 years- infectious, perinatal & nutritional disorders; non- communicable disease and injury (33% each).

 

When underwriting Juvenile Insurance it is necessary to apply equal significance to non-medical factors and to adopt a different approach from underwriting adult lives.

 

Characteristics of medical Juvenile Insurance medical underwriting are:

recognizing that child development is the number one factor;

the limited medical evidence, including differential diagnosis;

harder to medical examine children; and

lack of statistical data

 

Congenital and hereditary/genetic diseases of high importance are:

B-thalassemia which has a high prevalence throughout South East Asia and the Indian subcontinent; and

Congenital heart disease with about 70% being diagnosed before age 1. VSD is the most common acyanotic group and Tetralogy of Fallot being the most common cyanotic group.

 

When underwriting, minor impairments maybe acceptable but the more complex impairments with high loadings are speculative. Prudent to postpone if diagnosis/prognosis is unclear.

 

In summary:

Juvenile life Insurance underwriting is difficult and Critical Illness/TPD/ Accident benefit is a challenge;

medical underwriting is very important;

immature portfolios and lack of experience and statistical data

careful underwriting approach needed.

 

Mick started his presentation by posing a questions "Should be we insuring our children" and again highlighted that there are different issues facing life insurers, underwriters, product development etc in the Asian markets compared to our Australian/New Zealand markets.

 

Juvenile Insurance is considered for reasons including:

healthcare

regular savings to provide for the future,

education; and

protection.

 

The sales pitch is relatively easy with Juvenile Insurance in that it:

is easy to qualify

assures affordable protection

cheap rates

guaranteed insurability,

funeral costs covered

 

However reasons against Juvenile Insurance include:

lack of insurable interest;

putting the child's life at risk; and

primary aim of insurance is to protect the income of the breadwinner.

 

Legally there are few legislative restrictions on Juvenile Insurance across Asia. However there is the moral risk and it is paramount to financially underwrite.

 

Unlike in Western countries Asian children are expected to contribute to the financial well being of their parents.

 

Mick explained the need to understand and know the relevant market when deciding on Juvenile Insurance. Juvenile Insurance is available across the traditional product types including Whole of Life, Term Insurance, Critical Illness, Accidental Death and TPD each with their own issues and often utilizing the adult style definitions.

 

The applications must be underwritten with thorough attention to the financial situation of the parents and it is preferred that at least one of the parents also has insurance. Suggestions that the sum insured under the Juvenile Insurance be a % of the adult cover and that all siblings are insured would help overcome some of the moral unease attached when promoting and underwriting applications.

 

In summary Mick suggested that it was too early to tell what the Juvenile Insurance experience has been, although anecdotally it appears to be excellent without many dubious or fraudulent claims.

 

Financial Underwriting

David Laskey, General Manager-Asia, Hannover Re, Hong Kong and Wayne Macedo, Vice President and Chief Underwriter, Transamerica Re, USA.

 

The speakers considered the growing role of financial underwriting analysis in the Asian market and the difficulties facing underwriters and claims departments with the reluctance to disclose the actual financial situation and the numerous tax minimizations schemes. The agents’ role in the financial underwriting process was considered and how it can be used as an aid to more quality sales as well as part of the underwriting process.

 

Fraud Risk Management

John Saunders, Manager, Linden Management, UK and Tina Paap, Claims Manager, RGA Re, Australia

 

John and Tina allowed us to discover the latest on insurance fraud and measures taken to counteract this growing problem.

 

John told us about his experiences as a private investigator based in the UK and trips into the African continent to investigate mysterious deaths, and occasionally deaths and funerals when in fact no death had occurred. Regrettably the majority of the claims investigated come from developing countries and involve corruption, violence, fake deaths, poverty, drugs and fake documents which are easily obtainable.

 

These types of frauds are often committed by people in financial difficulties; domestic, health and residence problems and criminals.

 

Tina shared with us an awareness fraud, the definition of fraud, and opportunities for fraud whilst posing the questions of where do we draw the line with fraud. Is claimant who extends their DI claim beyond the true disablement period guilty of fraud? Is the TPD claimant who pursues their claim despite knowing their is a large element of choice in the action they take guilty of fraud? Interesting questions and ones that no doubt regularly come across the desk of Claims staff.

 

In preparing material for her presentation Tina found a wide range of fraud (how to defraud) information by doing some simple searches on the web.

 

Workshops

During the IUC delegates could attend 1 of 3 discussion/interactive workshops:

 

1. The Right to Underwrite

Moderator-Petar Peric, Manager, Underwriting and Product Advisory Services, GeneralCologne Re, Australia

Panelists:

Andre Chuffart (Senior Management, Swiss Re, Switzerland

Robert Young, Consultant Physician & Senior Lecturer, University of Auckland, New Zealand

 

This forum addressed the very topical issues of the right to underwrite and how it was being attacked around the globe. We were given a very interesting overview of the situation in Europe including potential European Union legislation which would prevent the use of gender in pricing. This also included a discussion on how privacy laws are leaning less towards relevance of questions and more towards their proportionality which effectively means that we may only be allowed to underwrite the larger sum assured policies but not the smaller ones. We were also provided with an interesting and detailed view of the practical implications of The Human Rights Act in New Zealand and how its practical application was changing through a new complaints process.    

 

2. Claims Workshops

Tony Frommel, Manager, Operational Division: Life, Munich Re, Germany and Jeff King, Managing Director, Riskman GmbH, Switzerland

 

Tony and Jeff provided an overview and some examples of hard and soft/or opportunity, fraud experienced in various world markets.

They presented several case studies including:

a death claim in mainland China, with non disclosure and the difficulties in obtaining any medical evidence and the role of a middleman in between the insured and agent in completing the business and the complications that bought to unraveling information at claims stage;

a Critical Illness claim in Taiwan were it was necessary to determine if the insured had suffered a Heart Attack in accordance with the definition, a confusing non disclosed family history regarding heart problems, and demands the agent (who is related to the insured) for the claim to be paid.

an Australian court case surrounding a Critical Illness claim and the Heart Attack definition.

 

and posed various questions for each scenario to determine what the audience would have done with the available evidence.

 

3. Long Term Care

Moderator-Robert Littell, Littell Consulting Services, Altlanta, USA

Panelists:

Lucie Taleyson, Head of Research & Development Centre, SCOR Re, France

John Evans, Associate Medical Director, SCOR Re, France

 

Closing Keynote Address

The closing keynote address was given by John Tiller, Senior VP Research & Development, ERC Group, USA presented the keynote address on "Considerations for a Changing World"

 

Recognizing the dramatic change in the life insurance industry due to restructuring, complex regulations, international expansion, new products and competitors, John shared his perspectives on the future of worldwide life and health insurance.

 

John sees the business issues in our changing world to be Concentration of risk by geography, by risk and by product; Consolidation effects on the primary company and the reinsurer; and increases in IT investment; Digitization which will drive economies of scale and establish cost advantages, and enable data-driven decision, while providing 24/7 research and training capabilities; Globalization including operational efficiencies to be gained by work being performed in low cost regions (e.g. India and Mexico), and enabled by digitization and process control. Globalization of course needs to be measured against local balance and Regulation.

 

Risk Management is greater than just prudent reserving and conservative underwriting and utilizing strong processes that use timely and accurate data that is then turned into useful information.

 

John saw information being the driver and expense lever for the 21st century and recognized that the reinsurers, due to their consolidation into fewer companies and few main players, would no longer be the source of cheap capital for the life offices.

 

And an underlying theme that Knowledge and Expertise = the Keys to Success.

 

Closing Session

The 3rd IUC was bought to a close with announcement of the venue and dates of the next 2005.

The 4th International Underwriting Congress will be on the 17 to 20 April 2005 to be held in Geneva, Switzerland

 

The 4th IUC planning committee have already met and things are well underway for what promises to be another exciting IUC.

 

Delegates enjoyed a closing party complete with a buffet of Chinese and Indian foods and several local dance performances. Delegates also made the most of the last opportunity to catch up with old friends and meet new ones. 

 

Finally the IUC came to a close and delegates prepared to return home, with many taking advantage of the proximity to exotic holiday destinations to take in some needed some rest and relaxation.

 

Overall

The IUC provided excellent opportunities for delegates to learn about issues impacting our industry worldwide and with a particular focus on the emerging Asian markets.

 

The various sessions and keynote addresses highlighted the various changes which have impacted us in the past, are with us today and which will influence us in going forward.

 

The need to know one’s business and the market in which one operates remains paramount, along with the need to embrace technology to allow us to maximize our full potential and deliver shareholder return.

 

The IUC highlighted the many differences in products; medical conditions and access to readily available and affordable treatments; the availability of medical and financial evidence on which to based informed underwriting and claim decisions; the need for more and more statistical data on which to make and base decisions to allow us to effectively and efficiently manage our business and risks.

 

The dominance of the advisors force, whether tied agencies or not; and the lack of skilled underwriting (and claims) resources remain problematic for all markets; coupled with rationalizations and reduced resources amongst the reinsurers.

 

A copy of the slides of the various presentations has been posted on the LOMA website and we encourage you to visit the website and view/download the areas that are of particular interest to yourself. This report, whilst lengthy, is really only a snap shot of what was a very full program.

 

 

Robyn Lindsay is Claims Manager, UniSuper, Melbourne, Australia (robyn.lindsay@unisuper.com.au) and Tony O'Leary is a Risk and Strategy Management Consultant, Sydney, Australia (toleary1@bigpond.net.au)