Chatswood serves the life and health insurance sector in New Zealand with market intelligence, data, and bespoke consulting services. Some of these are provided in conjunction with Quality Product Research Limited - a subsidiary that brings you Quotemonster.
We believe that good decisions are more likely to occur when we have good information about the market environment in which we operate. Intuitive leaps and creative decisions are always required, of course, but the more they are based on a firm foundation of observation, the better they tend to be.
Accessing the Quotemonster Policy Archive
Did you know we have a massive range of current and legacy policy documents available on Quotemonster?
We have a massive range of current and legacy policy documents available on Quotemonster – find out how to find them here.
FMA acts against misleading customers
The Financial Markets Authority (FMA) has been busy, with the news this week full of stories of AA Insurance New Zealand Ltd (AAI) being ordered to pay a penalty and civil proceedings lodged against ASB Bank Limited (ASB).
The Financial Markets Authority (FMA) has been busy, with the news this week full of stories of AA Insurance New Zealand Ltd (AAI) being ordered to pay a penalty and civil proceedings lodged against ASB Bank Limited (ASB).
AAI was ordered to pay a penalty of $6.175 million, for failing to apply multi-policy and membership discounts, as well as guaranteed no claims bonuses.
AAI was found to have misled customers about its multi policy discount offer in marketing material – marketing material said existing policy holders who added another policy would receive the discount immediately; however, AAI’s systems only applied the discount once the original policy came up for renewal. This issue affected 112,463 customers, who were overcharged approximately $4.89 million. In addition, AAI failed to apply discounts promised to NZAA members, affecting 90,129 customers who were overcharged approximately $2.95 million in total.
AAI were also found to have misrepresented that certain eligible customers would receive its guaranteed no claims bonus “for life”. Up until December 2011 AAI offered the bonus for each customer’s lifetime, as long as they remained insured with AAI. From 2012 the benefit only applied to the policy’s lifetime – yet AAI marketing continued to use the “for life” language without limitation. This affected 17,973 eligible customers, who were overcharged approximately $3.28 million.
Margot Gatland, FMA Head of Enforcement, said of the AAI judgement,
“AAI’s systems proved to be inadequate and its marketing was not kept in line with internal policies. This judgment sends a strong message to the industry that companies need to ensure their systems and processes are fit for purpose and customers’ interests put first.”
The FMA has filed civil proceedings against ASB for allegedly making false or misleading representations in regards to insurance products and banking services. Similar to AAI, ASB allegedly failed to apply multi policy discounts on ASB-branded insurance products, due to errors in the manual process at point of sale. Another issue arose when ASB staff misinformed customers with policies of insurance for caravans and trailers that they were eligible for the multi policy discount, despite those policies being ineligible. ASB also allegedly failed to consistently apply fee exemptions to certain customer accounts with access to ASB’s Fastnet Banking service, again due to failings in the manual processes. Between April 2014 and May 2022, a total of 23,062 customers were affected by the multi policy discount issue with the total value of overcharged premiums being approximately $2.8 million. During the same period, 2,435 customers were affected by the Fastnet Banking issue, totalling approximately $1,147,276 in overcharges. ASB has completed remediation work on both causes of action and has repaid affected customers, including use of money interest, and they self-reported the errors to the FMA.
Both of these cases demonstrate the willingness of the FMA to prosecute organisations who don’t fulfil their obligations to customers. They also highlight the importance of language in customer communications being crystal clear and that it is essential organisations have the systems-wide processes and checks in place to honour any discounts and offers made to customers. The FMA expect that if you make commitments to customers, you need to keep them, which we think is fair enough.
More news:
IFSO reminds kiwis to review their insurance policies
The Insurance & Financial Services Ombudsman Scheme is reminding New Zealanders to thoroughly review their insurance policies.
The Insurance & Financial Services Ombudsman (IFSO) Scheme is reminding New Zealanders to thoroughly review their insurance policies. Karen Stevens, the Insurance & Financial Services Ombudsman, has noted that some policyholders are unaware of specific limitations which can leave them without cover for something they thought was included. Stevens has cautioned kiwis of the need to familiarise themselves with their policy terms and conditions, paying particular attention to exclusions, as it is the consumer’s responsibility to understand the terms laid out in the policy.
More news:
Mark Banicevich believes new FAP regime creates opportunities for advisers
The FSC publish Life Insurance Industry Spotlight June 2024
Southern Cross Healthcare is looking for a Head of Enterprise Risk & Assurance
Rachel Wilson joins Fidelity Life as Business Manager Wellington region
Southern Cross release new online mindfulness practice available free to all New Zealanders
Southern Cross Healthcare sponsors Round the Bays fun runs, including Christchurch
The General Practice Owners Association has laid a complaint with the Commerce Commission over “unfair” and “illegal” contracts
Southern Cross Health Insurance unveils policy updates
From October 22, Southern Cross Health Insurance (SCHI) is ushering in a series of policy updates.
From October 22, Southern Cross Health Insurance (SCHI) is ushering in a series of policy updates. In addition to adopting plain language in some of it’s policy documents in an effort to improve clarity, the updates include enhanced allowances for breast reduction and breast symmetry; expanding coverage for treatments such as unilateral and bilateral TMJ, periurethral injection for incontinence, cochlear implant receiver/stimulator prosthesis and minimally invasive glaucoma surgery; lifting the excess requirement on certain benefits under plans with an excess e.g., surgical allowances, obstetrics and the GP minor surgery benefit; broadening member access to mental health care; increasing the number of healthcare services that must be accessed through Affiliated Providers.
SCHI is also changing the way it communicates changes to some documents that form part of some policies – listing them on the SCHI website and updating them regularly.
Regan Savage, Chief Sales and Marketing Officer for SCHI says,
“Healthcare is dynamic and fast-changing. Health technology, drugs and healthcare services are constantly being improved, so Southern Cross regularly reviews its policies and the way we engage with members, with an aim to remain sustainable and affordable.”
Our research team are looking at the pack of documents that will be considered together and include sub-limits and eligible procedures in this online document alongside the policy wording in our review of the rating of the product.
More news:
Southern Cross Health Insurance recognised in the 2024 Reader’s Digest Trusted Brand awards
Rob Hennin talks about nib's Toi Ora dedicated iwi programme
Life advisers reminded they need to actively review legacy policies
Compliance Refinery director Steve Burgess has reminded life insurance advisers they need to review legacy policies or risk opening themselves up to censure by the FMA.
Speaking at a Quotemonster roadshow event in Lower Hutt, Burgess said of legacy products,
“If you don't look at it, the regulator could decide that's you saying that product is suitable for your client.”
Burgess also cautioned that some legacy products have features that are difficult or impossible to replicate with new policies, so as well as listing the advantages of replacement policies, advisers need to be recording any disadvantages clients may face if they change.
Steve Wright has also written of how the FMA have flagged ‘suitability of advice’ as something they will be focusing on in future. Wright has helpfully listed some steps advisers should be following to help ensure the suitability of their advice, including having a suitable fact find process; needs analysis and quantification of client risks; avoiding limiting or transferring risks to an insurer; assessment of insurance types required and sums insured; and giving appropriate product recommendations.
More news:
Financial Advice NZ's webinar on the Code of Professional Conduct is on 28 August
ASB's net profit after tax down 10% from previous year
Travis Hamilton named the New Zealand country Chair for the Million Dollar Round Table organisation
Patients across the country concerned at GP fee increases; GP’s say capitation funding insufficient
Most KiwiSaver providers have now submitted their KiwiSaver climate reports
Jon-Paul Hale critiques insurers' use of “MedSafe indicated” wording in policies
Jon-Paul Hale critiques insurers' use of 'MedSafe indicated' wording in policies, saying if clinicians and customers were more aware of what the wording meant they may change their treatment plans.
Jon-Paul Hale critiques insurers' use of 'MedSafe indicated' wording in policies, saying if clinicians and customers were more aware of what the wording meant they may change their treatment plans to ensure that coverage extends to the use of the medicine.
In policy wordings, “MedSafe indicated” can significantly limit access to treatment; where MedSafe guidelines include "indicated first-line treatment", this means the medication is only authorised for use as the first treatment. Hale suggests that clients consider any mediations with ‘first-line’ indications may wish to be treated with these medications first, as insurers are unlikely to approve them for later use.
What may surprise you is that many, many, medicines are prescribed that are outside Medsafe indications. Some are prescribed even though the medicine is unapproved for any purpose in New Zealand. Several insurers will not cover medicines that are unapproved. Obtaining a Medsafe approval for the use of a medicine can be time consuming and expensive. We are a small market and some disorders are rare. That means that while it may be economically viable to gain approvals in the United States and Europe, sometimes the New Zealand market may be too small for these companies to consider seeking approval economically viable, especially when some medical professionals will still prescribe an unapproved medicine.
At Quality Product Research Limited we are committed to ensuring that research scores are descriptive of these differences, which are increasingly important. There is a review of the non-PHARMAC coverage item in our health / medical insurance research which is being consulted on right now. If you would like to participate in the review please contact us. Results of the review will be announced at our forthcoming national roadshow which runs from 23 July to 29 August. Register for the roadshow, at a venue near you, here.
References:
Medsafe – about and role: https://www.medsafe.govt.nz/other/about.asp
Medsafe – use of Unapproved Medicines and Unapproved Use of Medicines: https://medsafe.govt.nz/profs/riss/unapp.asp#need
More daily news:
Partners Life campaign top in the 2023 Global Effie Rankings - insurance category
AIA recognised as one of the most diverse insurance companies
AM Best withdraws ratings for Accuro
Philip Macalister discusses research on areas advisers can improve in
Retirement Commissioner proposes 15 recommendations aimed at enhancing KiwiSaver
The FSC continues to call for review into KiwiSaver settings
Health New Zealand orders hiring freeze on all non-frontline roles
AMP settles with Australian financial advisers for A$100 million
AMP has settled a legal dispute with hundreds of Australian financial advisers affected by unilateral changes to buyer-of-last-resort (BOLR) terms.
AMP has settled a legal dispute with hundreds of Australian financial advisers affected by unilateral changes to buyer-of-last-resort (BOLR) terms. After a long-running legal dispute AMP has settled, with no admission of liability, for A$100 million.
In August 2019 AMP made unilateral changes to adviser contracts that meant BOLR multiples were cut by almost 40%, from 4 times recurring revenue to 2.5 times (excluding grandfathered commissions).
In July an Australian Federal Court decision found AMP erred in altering the buyer-of-last-resort terms for two advice businesses operating under its brand. Justice Moshinsky ruled in favour of the two Australian advisory firms who bought suit, awarding Equity Financial Planners A$813,000 and Wealthstone A$115,000 and opening AMP up to 120 or more similar claims. AMP lodged an appeal in October but opted to settle following a mediation process in November.
More daily news:
Jon-Paul Hale questions whether non-smoker rates are non-smoker rates
AIA Group has announced the publication of its inaugural climate transition plan
$100 million programme for specialist mental health services is behind schedule
Southern Cross responds to accusations it dropped a $60k benefit without informing customers or advisers
Southern Cross has refuted a Good Returns article where advisers complained about not being informed about Southern Cross dropping a $60,000 a year benefit for non-surgical hospitalisations.
Southern Cross removed the non-surgical hospitalisation benefit as part of the Society’s benefit review in 2020, and Southern Cross’ head of customer strategy and experience, Nic Johnson has said that “Members were communicated with at the time of the benefit change.”
Johnson said that Southern Cross advisers were informed of the changes at the time via a virtual meeting, and that the company’s adviser gateway portal to manage their customers’ policies had information on the changes also.
Johnson said
“The original intention of the non-surgical hospitalisation benefit was as a 'catch-all' for eligible healthcare services that required in-hospital medical treatment. Based on a 2019 review of our claims data, which showed that the benefit was not widely utilised, it was assessed that this benefit was no longer fit-for-purpose.”
“The majority of medical (or hospitalisation) claims at the time were already covered under existing benefits, such as the surgical procedures, chemotherapy, radiotherapy and diagnostic tests/imaging benefits.”
We have commented on the change here.
Quality Product Research are in the process of conducting a review of the score for the feature, giving Southern Cross time to respond with more details of equivalent benefits being present in other parts of the medical insurance. We will raise the results of the review with our Southern Research Advisory Board next month – and update research subscribers immediately.
More daily news:
Katrina Shanks writes about whether cryptocurrencies are a safe investment
Rob Hennin talks about why he loves working in the insurance sector
Southern Cross funds the ‘Under One Umbrella’ report on mental health and addictions
nib publishes their top five medical claims for July
Quotemonster online roadshow confirmed!
The Quotemonster team have just spent four weeks on the road visiting 15 towns seeing hundreds of advisers. We have received so much great feedback and requests for an online one for those who couldn’t make it.
So now is your last chance to see what all the hype is about. Our online session will be held Wednesday 23 August at 9.30am.
9.30am - 10.30am - Presentation and Demonstration ✅
10.30am - 11.00am - Q&A ✅
We will be covering new tech and new tools:
- New comparisons
- New AI tools to make your life easier
- New ways to make your advice process better, safer, and quicker
Presented by Aneel Ravji, Kelly Pulham and Russell Hutchinson.
Click here to register: https://zoom.us/webinar/register/WN_OuTZihV9TY-MnmMxqkWw6w#/registration
Quotemonster in Palmerston North!
Thank you for hosting us Palmerston North, we hoped you enjoyed the session!
We have one more week of our roadshow and if you’re interested in attending, please click here to see our remaining dates and locations!
