Munich Re delve into AI’s impact on Healthcare

As part of Munich Re’s Life Science Report, they have investigated the projected impact of Artificial Intelligence (AI) on healthcare, from disease prevention to diagnosis to treatment as well as the implications for efficiency gains.

While the news is mostly good (improved mortality, better prevention, earlier diagnoses, individualised therapies), it does create some challenges for life and health insurers. With earlier diagnoses and the emergence of new disease classifications, critical illness insurance products will need continuous updating. Claims management and policy development will become more complex, as genetic and molecular diagnosis becomes more routine, requiring a higher level of medical expertise. Overdiagnosis (the detection of diseases that don’t impact on mortality and/or morbidity) and antiselection may become problematic.

AI will also create opportunities for insurers. Insights from accessing and analysing vast datasets including electronic health records, imaging and other biomedical sources will transform the understanding of the root causes of disease and in turn allow underwriting to become more accurate and sophisticated. Wellness interventions will be able to be better targeted and increase in scope and effectiveness.

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Super Early Bird tickets to the FSC 2025 Conference available now

The Financial Services Council (FSC) is holding their 2025 conference on 10 & 11 September at the Cordis Hotel in Auckland. While details of the speakers and sessions are still to be released, the FSC has said that FSC25 Conference: Transforming for Tomorrow “…aims to inspire attendees to move beyond the present and envision a future where financial services not only meet immediate needs but also anticipate and address challenges for generations to come.”

Super Early Bird tickets are on sale now, which includes the FSC Awards Dinner.

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Asteron Life paid out 97% of claims

Asteron Life paid out 97% of the Trauma, Life and Income Protection claims it received in the year ended June 30 2024. In total, Asteron Life paid out $112 million of claims, with $53.5 million being paid out for Life Insurance, $34.1 million in Trauma policy payments and $24.4 million in Monthly Income Protection cover claims.

Accident or Injury was the leading cause of claims, for both Monthly Income cover and Trauma cover. Mental Health claims duration remains high, with an average duration of 8 - 12 months, compared to other new claims where the average duration was around 6 - 8 months. Executive Manager Claims and Customer Solutions, Seema Bangera, said

“Return to work outcomes are directly related to early intervention and rehabilitation. This means the mental wellbeing of customers needs to be at the forefront for claims specialists and we need to ensure all clients have the necessary support building their personal resilience for their return-to-work journeys.”

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What does a business version of the healthy futures report mean?

We took a look at Southern Cross’s business edition of the 2024 Healthy Futures Report, which focuses on employee health and wellbeing. There are clear links between wealth and health, as the old saying has it. Whether one causes the other and in which direction the arrow of causality points is unexplored. We think it’s probably more complicated than this simple pairing of factors, although if someone becomes wealthy, they often become healthier. Likewise, if someone has the misfortune to become chronically ill, they usually get poorer. But these two are probably joined by other factors which may also have some power to affect outcomes – like education while young, health while a child, and current environment.

What employers can do to help is limited – but is appreciated by staff. At Quality Product Research Limited we offer seven of the eleven key suggestions made (soon to be expanded to eight) – we like that we can do that – but people use or do not use them pretty much as they please.

Key takeaways for us from the survey results:

• 89% of respondents said it was important to them to work for a company that supports the health and wellbeing of their staff.

• 55% of respondents’ employers were doing well in supporting their employees.

• The top ten initiatives employers could invest in were wellbeing leave (36%), lunch or break room (29%), flu vaccinations (26%), healthy food options (25%), activities promoting good mental health (23%), workplace massage (23%), Employee Assistance Programme (22%), health assessments (21%), subsidised membership to off-site facilities (21%) and stress management programmes (20%).

• 88% of employees think having a good work-life balance is important, with a third considering taking steps to improve their work-life balance.

• Making use of flexible working hours (43%) and switching off from work when finished for the day (43%) were the most common means of managing work-life balance. Conversely, having a high work load (60%), financial pressures (40%) and not having flexible working hours (40%) were cited as most commonly as reasons for poor work-life balance.

• 51% of workplaces offer flexible working arrangements, down from 54% in 2022; 60% of employees make use of flexible working hours most weeks and an additional 26% utilise it sometimes.

• Only 45% of kiwis rate themselves as happy with their financial situation; 91% cite cost of living as one of their top concerns and 58% worry about not having enough money to support themselves or their families.

• 84% of New Zealanders are concerned about not having good, affordable access to healthcare, up 8% from 2022.

• Kiwis don’t feel they are getting enough sleep (60%) or exercise (62%).

• New Zealanders without health insurance were more likely to be less happy with their health, financial situation, mental wellbeing, fitness levels, weight of themselves and their children, exercised less on average and were more likely to be stressed.

Southern Cross highlight a series of initiatives workplaces could take to improve employee wellbeing, including:

• offering education on stress management and financial management;

• offering free fruit or healthy food in breakrooms;

• encouraging employees to make use of flexible working if it’s offered;

• offering health assessments;

• educating employees on the importance of flu vaccinations;

• offer opportunities for physical exercise, through work place team sports, sports day or subsidies for gyms or exercise equipment;

• encouraging employees to take their annual leave;

• training leaders to identify those at risk of burn-out;

• offering wellbeing leave;

• providing employee assistance programmes and educating employees on what it is and hot to use it;

• offering subsidised health insurance.

1,463 employees were surveyed for this report in March 2024.

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Southern Cross Health Society Group annual results released

Southern Medical Care Society Group has shared their annual results for the year ended 30 June 2024. By the numbers:

• Group deficit of $88.2 million after tax. $43.1 million of the deficit is attributable to a change in international financial reporting standards introduced this financial year. The balance of the deficit is driven by higher claims costs from a high inflationary environment combined with high member demand for private health services, particularly in the second half of the financial year.

• Group reserves of $470.7 million.

• Claims paid at a rate of $6 million per business day (up from $5.2 million in FY23).

• 15,196 net new members, with total membership now at 955,301.

• This represents 60% of the New Zealand health insurance market by customer numbers but 71% per cent of the value of all health insurance claims paid.

• 99% of claims were submitted electronically.

Southern Cross Health Insurance

• Reported a deficit of $99.1 million.

• Paid $1.498 billion in claims from $1.605 billion received in premiums.

• Claims costs increased 15% on FY23 (up 13.9% when adjusted for member growth).

• Premiums increased 9% on FY23 (up 6.6% when adjusted for member growth).

• 93.4 cents paid in claims from every dollar received in premiums (compared to an industry average excluding Southern Cross) of 73 cents.

• Operating costs grew by 4%, less than inflation.

• 3.2 million claims in FY24

• 50% of members claimed over the financial year.

• 39,326 virtual GP consultations with Care HQ.

• 4,635 annual health check-ups with MedPro.

• 4,016 online mental health sessions with Raise.

• Net promoter score of 53.7%.

 Nick Astwick, Chief Executive for Southern Cross Health Society said

“We have never been in more demand by our members as they prioritise their health needs, largely in the private system. In 2019 33% of our membership claimed, last year it was 50%.”

“The cost of claims in 2024 was steep and rapid, driven by a combination of price, volume, and the mix of claims. The growth in the volume of claims results from an increase in the number of members claiming, the frequency, and claims being made for more expensive procedures.”

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IFSO reminds kiwis to 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.

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If you have an adviser – you tend to get better claim outcomes

Regulatory reviews in Australia have found the claims acceptance rates for the life insurance industry between distribution channels. The difference is marked – claims acceptance rates for advised retail policies was 92.1% compared to 87.8% for direct policies. For a good review check out Jack Howitt’s article here. 

Jon-Paul Hale emphasises the importance of advisers at claim time, which perhaps provides an explanation for part of the gap: Hale has questioned the use of automated portals when it comes to claims time. From his experience, there are plenty of claims where, had the clients claimed through the portals without his involvement, the clients wouldn’t have had such good outcomes. He gives a range of examples and cautions that clients can forget what cover they have and how it works – all at a time when they may be feeling overwhelmed from the medical situation they are facing. 

On the other hand, the difference between group and retail policies in Australia leans back the other way – more towards how the policy was underwritten as a potential cause for the difference in outcomes. Group insurance policies have some of the highest claims acceptance rates at just over 95%. Howitt’s explanation is compelling:

“This is likely due to the fact that group life insurance policies are typically underwritten on a group basis, which means that insurers have less risk associated with each individual policy. Retail advised policies may have lower claims acceptance rates due to the fact that they are typically more complex and may involve higher risk individuals. Direct policies may have lower claims acceptance rates due to the fact that insurers have less information about policyholders.”

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Southern Cross release their Healthy Futures Report

Southern Cross have released the Healthy Futures Report 2024, which surveyed 2,000 New Zealanders about their health and wellbeing behaviours. Some of the key findings include:

• The biggest concerns for New Zealanders were the cost of living (91%); violence in society (86%); not having access to good, affordable healthcare (84%); and affordable housing, mental health and not having access to cancer treatment services all at 82%.

• Health professionals remain the main source of health information (64%), followed by online articles/websites (52%), but social media is increasing in popularity with young people and Pasifika people (up 6% to 27%).

• A majority of people seek treatment immediately (12%) or within a day or two (47%), though 10% usually don’t seek professional advice or treatment.

• The main barriers to accessing healthcare include cost (35%) and wait times being too long (34%). There has been a jump in people not being able to access healthcare at the time they want (up 4% to 20%).

• When it comes to dental treatment, the main barriers are cost (60%) and not being covered by medical treatment (13%).

• New Zealander’s define ‘healthy’ as mental wellbeing (70%), avoiding smoking and tobacco (70%), getting enough sleep (67%), eating a balanced diet (67%) and emotional wellbeing (66%).

• Physical health concerns include level of fitness (65%), making sure kids eat healthy foods (65%), long term physical health effects (65%) and family health and wellbeing (65%).

• The average kiwi exercises for 30 minutes, three times a week – 61% don’t feel they are getting enough exercise. Being too tired (33%) and not having enough time (32%) continue to be the main barriers to exercising.

• While 92% of kiwis consider themselves knowledgeable about what healthy food is, 82% consider healthy eating to be expensive and 74% would like to lose weight.

• ·The top emotional wellbeing concerns are concentrated around family, with kiwis concerned about whether their children will cope with the pressures of life (60%), not having enough money to support myself/my family (55%) and parents/relatives getting elderly and needing care (51%).

• Only 44% of New Zealanders consider themselves as getting enough sleep, with those living with kids or living with a disability being more sleep deprived than others. Reasons given for not getting enough sleep included having too much to think about (49%), going to bed too late (41%) and being anxious or stressed (40%).

• While 88% consider work life balance to be important, only 33% consider they currently have a good balance. Factors kiwis consider as important to achieving a good work/life balance include having flexible working hours (43%), switching off from work when finished for the day (43%) and sticking to set work hours (34%). Conversely, factors contributing to a negative work/life balance include workload being too high (60%), financial pressures (46%) and not having flexible working hours (40%).

• Actions New Zealanders are taking to look after their emotional health and wellbeing include keeping your brain stimulated (60%), spending time outdoors (58%), nurturing and maintaining relationships (54%) and spending more time with family (52%).

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Survey highlights increasing concerns among kiwi workers about their mental and physical health

The 2024 Workplace Wellbeing survey, conducted by nib New Zealand and the Employers and Manufacturers Association (EMA), has found that 80% of respondents have been negatively impacted by the current cost-of-living crisis.

• 64% are concerned for the mental health and wellbeing of their family

• 56% are worried about their own mental health and wellbeing

• 52% are concerned about the risk of burnout at work

• 50% said the rising cost of living has negatively impacted their mental health (rising to 63% of 16 – 30 year olds)

In more positive news, 61% said their workplace proactively manages wellbeing, up from 53% in 2022. Fewer employees are being impacted by understaffing (47% down from 64%), poor work-life balance (36%, down from 42%), and the pressure to work long hours (34%, down from 39%).

Kiwis are putting more value on systems that prioritise employee wellbeing, with 60% rating Employee Assistance Programmes (EAP) as important, and 72% valuing wellbeing initiatives and subsidies. The value of employer-provided insurance continues to grow, with 64% considering medical and health insurance a benefit they look for when switching jobs, up from 57% in 2022, 48% valuing income protection illness cover and 43% looking for life insurance benefits.

Rob Hennin, Chief Executive at nib New Zealand, said

“There’s no better time than now for employers to stand up and proactively support their teams’ mental and physical health, empowering them to perform at their best knowing there’s someone in their corner no matter what happens. Fostering this positive workplace culture starts from the top down, so it’s just as important for business leaders to embody these values in their day-to-day.”

The survey collected responses from 1,229 NZ workers this May.

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Should more employers be looking at offering more flexible working options?

Increasingly, organisations are seeing the benefits of offering more flexible working options, in terms of productivity output, being able to attract a more diverse range of employees and employee satisfaction.

Stats NZ data shows that in 2023, 81% of organisations offered flexible working hours, up from 57% of organisations in 2018. In 2023, 77% of organisations offered part-time work roles, up from 53% in 2018.

Kiwibank economist, Sabrina Delgado, highlighted flexible work’s impact on the wider economy,

“Whether it’s working around school hours or the location of work, greater work flexibility perhaps has the biggest economic impact on improving the labour market outcomes and productivity.”

Infometrics chief executive and principal economist Brad Olsen said,

“Increasing participation even further can be supported by removing barriers to work for different groups, like parents, while still allowing them to do their parental duties without as much compromise as before.”

Dr Ellen Ford, the creator of #workschoolhours movement, said,

“There are a huge amount of parents who would absolutely love to work in an organisation that provides a school hours framework and they would add immense value to the organisation.”

“One of the economic benefits is that it actually allows organisations to tap into a massively underutilised section of the workforce.”

“If businesses are struggling to attract and retain great talent, one of the ways they can do that is actually offer roles that work within school hours.”

“People on part time contracts are typically the most productive in the workforce. They just get their stuff done in a shorter amount of time.”

It seems like flexible work options are here to stay. An international survey of more than 500 CEO’s around hybrid working, found 91% had adopted hybrid working and 74% said a full-time office return is not a business priority. 73% of CEO’s agreed that hybrid work allows them to attract the best workers and 76% saw improved staff retention since offering flexibility to employees.

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