Breast cancer is a consistent news story we all see, in more recent times we've seen the challenges people face with their insurance company's getting breast reconstructions done.

This 2016 article in the New Zealand Herald, 11th Hour Shock, for Anna Jobsz who is having a preventative mastectomy and breast reconstruction is pretty typical of what we see.

This follows on from the high profile treatment Angelina Jolie had when she found out she was exposed to a high chance of developing breast cancer.

Medical insurance is a changing landscape, not only with policy terms and conditions but with the providers now. 

10 years ago, we had 10 different medical providers; we now have 6 and likely that there will be more mergers in the market.

Medical insurance is a product that typically is not reinsured, so the money for claims, operating the insurer, marketing & sales all come out of the same pot.

A question that is often asked, ‘So will the insurance company actually pay?’ Yes they do, they pay valid claims.

This is the issue, defining valid claims. Valid claims are claims that are both covered by the policy and the policyholders have been complete in their disclosure.

For example a cardiac event, similar to a heart attack, but isn’t severe enough to qualify as a heart attack under the definition of a heart attack on the trauma policy wording. This isn’t a valid claim, as it didn’t meet the definition of the policy document.

I have mentioned this before; banks are good at looking after your money and giving you ways to spend it. They are not so good about helping you out of debt or giving you insurance advice. This is especially so at the teller level, which is where a lot of bank cover is sold rather than advised.

For example, 'Thanks, Mr. Smith. We've got your banking sorted. Would you like insurance with that?'

You have heard it before, possibly not the best thing for you.

I call it the fries approach

I often hear from my colleagues and providers about using electronic applications. Often phrased with the comment, “With what you do with technology, it is surprising you do so much with paper?”

Interestingly clients are also often surprised with the paper too. Maybe there is too much and more digital could be included. We will see.

Frankly of everything I do, the application form is the most difficult part of the whole process for clients. When we are in an environment where things are being simplified, insurance applications have got more difficult.

A bit of a chunky subject this post.

Lately, there has been more noise around the gay community, particularly around transgender rights. Especially so with the recent shooting, with some horrifying treatment being dealt out to those 'who are not like the rest of us’.

I wrote the bulk of this post in April 2016, well before the mass shooting in the US and off the back of media comments and articles in newspapers, TV news and social media chatter. The tension for the shooting in June was brewing, for no other reason than people are different. Something similar is brewing in the US on the subject of abortions and the rulings of the state and supreme courts there.

You do not have a need for insurance now, or you have sufficient cover for now, but you expect to need more cover in the future.

You do not want to find you have your future medical conditions affecting your cover when you do apply?

Part of this is why insurance companies want you to buy cover before you develop medical conditions, the insurance companies feel selected against if you only take cover because you have a condition. This is why they apply underwriting at application time.

 If you hear this, your adviser may not have explained things as clearly as they could have. 

'Terms' is industry slang or jargon for special terms, which means a client's policy has been modified, by the insurer, from the original standard policy contract your cover was proposed on. 

The offer of terms or special terms offer generally happens at application time, but can be applied during the policy or at claim time. If the insurer becomes aware of a material fact, that will change the terms of the contract the insurer would have offered at application time. Avoid the later two examples as they can have unintended and surprising outcomes. 

You've got a fairly steep learning curve going on and ACC has just thrown a spanner in the works. It's a spanner in the works because ACC isn't intuitive and you're short on time and don't have time to figure this crap out right now.

If this resonates with you, you need to read this, it will short cut this for you.

Let's start with the simple things you need to understand first.

I wrote recently about a new approach Asteron was taking to income protection.

In the right client situation quite appropriate, in others it would potentially be a disaster. As the options in insurance advice expand and hybrid or niche products develop, the need to have an adviser involved is even more apparent. One that really understands the application of insurance benefits to your risks.

As an insurance adviser it is interesting watching people's behaviour. Most people are put off talking to an insurance adviser because they might sell them something. I'll talk about that 'something' later.

As an insurance adviser I look at the big picture and sit across a number of disciplines. Insurance is the ambulance at the bottom of the cliff, providing financial support in time of need and loss. Those times of need and loss can be wide ranging. From your possessions, to something happening to you or your family, to something happening to your business or your employees.

A really good question. Let's tackle over insurance first

With over insurance, in its simplest form, if the risk is not realised, you've paid more for the transfer of risk than you had too. What I'm meaning is if you don't die, don't have a trauma, don't have a loss of income or property, then the risk being covered hasn't been realised.

For example, if you have a $500,000 mortgage and have a $1,000,000 life policy and you make it to retirement having paid off the mortgage. Then you have likely paid double what you needed to, to transfer the risk. Assuming your need was limited to just the mortgage over that time.

The New Zealand Herald kicked off their five-part series on cancer today. Martin Johnson investigates the controversies in cancer testing and treatment and the moving stories of people diagnosed with cancer.

I've mentioned many times, here in my blog and many times to clients and frankly anyone who will listen, that our public health system, while good in many areas, often falls short in many others.

Managing medical expenses is a large area of risk management. It is also an area where people often don't spend a lot of time. Public health is an area where the government spends the most ($15 billion for 2015), which should be an indicator that you need to consider your options here as well. 

The health system is a bit like public transport. Something you take if you have to, but something you'd rather avoid. And just like the bus, it can be a pain to catch, sometimes it's right on time, most of the time it's full or you just plain old miss it.

Today's health system is markedly different from what it was even 5 years ago. It's starting to look like it's being rationed rather than provided as a free public service.

These articles highlight the plight of those subject to waiting for the public health system:

It oft be said, ’All my insurance adviser does is turn up and sell me more insurance’. While this may be true, I hope it's for the right reasons, you have more risk. This is the point, your risks change.

What is surprising is how people set and forget their insurance, be it life or property insurance. A great example is a past colleague who had not reviewed his contents cover since university, $40,000 then might have been a great deal, now a successful business owner with teenage kids it barely covers what's in his lounge.