In Memorium of Dr Mulhearn

Article written by Dr Warwick Benson in consultation with Dr Mulhearn’s family

Many in the Life Insurance Industry will be saddened by the recent death of Dr Richard Mulhearn, on 21 January 2020 just short of his 92nd birthday. Richard had almost 50 years of association with the Life Insurance Industry in Australia, providing excellent, informed and relevant Consultant Medical advice especially in Life underwriting but also in Claims. His gentle and unassuming manner endeared to him to all who had the opportunity to work with him. He was patient and questioners were treated with the utmost respect even though others may have been dismissive or impatient. He had a long and broad experience in medicine outside his insurance work – at the bedside, in consultant practice, as advisor in the Pharmaceutical Industry, on the board of Roche Pharmaceuticals in Australia and Honorary Service to the Royal Australasian College of Physicians.

Richard graduated in Medicine in 1951 and after residency at Royal Prince Alfred Hospital in Sydney, he spent time in London at the National Hospital for Neurology and Neurosurgery Queens Square and sat and passed the examination for Membership of the Royal College of Physicians UK. Though he did not specialise in Neurology on his return to Australia, he was on the consultant staff at RPA and mentored large numbers of young trainee physicians who passed through the general medical unit on which he served.

He subsequently obtained Membership of the Royal Australasian College of Physician (MRACP) and later was made a Fellow of both the UK and Australian Colleges.

Among  his various roles, he was for many years, the Honorary Secretary of the Australasian College of Physicians, was influential in gaining support form the Pharmaceutical Industry for Research and was involved in the establishment of the Clinical Pharmacology Unit at St Vincent’s Hospital in Darlinghurst, Sydney. For his services to Medicine he received the OAM in the 1986 Australian Day Honours. Richard was a man of deep faith, never imposed on others or pretentious but lived out in kindness and compassionate care for others. We express our sympathy to his family at this time of loss

We honour as we farewell one of the most outstanding doctors who has worked in the Life Insurance Industry in Australia.

 

 

Interview with Michael Reid, RiskeBusiness Editor

Michael Reid, Regional Underwriting Manager – AIA and Editor of ALUCA’s RiskeBusiness for the last 6 years.

 

What made you want to become a volunteer with ALUCA? 

From my first ALUCA medical seminar breakfast in 2001 with Dr Paul Davis[?], I realised that there is much more to ALUCA than the information sharing and networking opportunities. ALUCA was and is, a partner in our working lives. I had a brief stint in the Vic Sub Group however I was more of a highly engaged member than a volunteer. That was until a night in 2014 when Matthew Ramjan [ex-Gen Re Chief Underwriter] approached me at a Senior Underwriters Forum and said: “Hey Michael would you consider taking over from me as Editor of RiskeBusiness?” I said yes and he said “God that was easy”.

 

What was ALUCA like when you first joined to what it is today?  

I joined ALUCA in 2001, soon after I commenced my life insurance career as a Claims Assessor at AXA. I can honestly say that ALUCA has always had good people at the helm who have had the members’ best interests at heart. ALUCA of 2001 or even 2010 cannot be compared to the ALUCA of today primarily because life insurance has become a lot more complicated. Over recent years, ALUCA has rapidly evolved to meet the growing ‘future-proofing’ needs of members in an ever changing industry.

 

What are you most proud of as your time as the Editor of ReB over the last 6 years?

Firstly, I would say getting our RiskeBusiness publication into the internet age. Our first online edition was the Autumn Edition of 2015 which was a team effort with Jamie Robinson and Jim Welsh. Membership rose exponentially over the last six years and I do believe that RiskeBusiness had some part to play in this by communicating all the great work of ALUCA and its members.

 

What ReB article over the last 6 years stands out in your mind and why?

Any decent editor should have a couple of stand outs right? I don’t. However I assure you that this is purely due to the long list of quality articles I have read over the years. I am always keen to read the fresh ideas and alternative thinking of winning papers from our annual essay competitions, I enjoy the postcard articles from Australian ex-pats who work abroad in the life industry. And I also look forward to the North American updates by Hank George from Wisconsin, USA.  He never disappoints on delivering highly researched medical updates, strong opinions and that dry sense of humour. Hank is the real deal – a genuine underwriting guru who has been so generous over the years with volunteering his time and knowledge for RiskeBusiness. We haven’t had an article from Hank for a while because is really ill. Our thoughts are with him.

 

What advice do you have for other ALUCA members who are thinking of putting their hand up to volunteer with ALUCA?

I would say absolutely give it a go. I learned so much about the Australian life industry and built relationships with many people who I would have never got to know otherwise. You will also be sharing your own knowledge and experience with like-minded peers outside of your own organisation – which is what ALUCA is all about.

 

If you had your time over again is there anything you would have changed during your time in the ALUCA Editor’s role? 

Perhaps we could have moved to more frequent/bite sized communication earlier in hindsight?  On a personal level, I would have liked to write some of my own articles as my predecessor Matthew Ramjan used to do.

 

4 words to describe ALUCA?

Evolving – Focused – Inclusive – Strategic

 

4 words to describe Michael Reid? 

People-orientated / career-driven / caffeine-overdosed / gym-junkie 🤬[locked out for now ]

 

4 words to describe the life insurance industry?

Purpose-driven / turbulent / evolving / wellbeing-partner

 

What’s next for Michael Reid? 

As we batten down the hatches in the war against COVID-19, there’ll be no surprise in saying that my immediate concern is protecting the physical/mental wellbeing of my family and I. For those of us who are not significantly impacted by the virus, I see this as a major opportunity to step up and assist someone less fortunate. A great example of this occurred yesterday in Sydney. A man purchased 30 take-away coffees from a local café and handed them out to newly unemployed people who had been standing in a Centrelink line for hours, in the rain. WOW. He just made 30 people feel a whole lot better. Of course such random acts of kindness can be carried out on a smaller scale too.

From a career perspective, I have some involvement in the AIA/CommInsure integration that is currently being worked through, and my underwriting leadership role was recently expanded so it’s an exciting time with much to plan, shape and deliver over the coming months.

ALUCA & COVID-19

ALUCA’s Board sent the below communications to all members and partners on March 17th and 18th. Please note that ALUCA’s Award night nominations has now been pushed out to July 31st and the night itself postponed to October 22nd. In addition we have since sent communications that the biennial conference has also been moved to March, 2021.

We apologise for any inconvenience this may have caused but feel this was in the best interest for all involved.

For those who may have missed the member email, you can read this below:

Dear ALUCA,

Due to the rapid, unfolding escalation of the current outbreak and spread of COVID-19, ALUCA’s Board has made the decision to cancel all face to face events until the end of June 2020. Please note that this is a provisional date that may need to be extended pending the situation at that time. We will be monitoring and constantly reviewing this.

Our members, volunteers, sponsors, staff and communities we work in are our top priority and we feel this is the right and most responsible decision given the evolving public health risks and the need to mitigate the spread of COVID-19.

This means that for now:

    • All ALUCA events until June 30, 2020 will be held virtually/online or postponed
    • All ALUCA volunteer meetings to be online/virtual
    • No ALUCA travel
    • We will plan for events beyond June 2020 with due caution including the ALUCA 2020 conference
    • A program of national digital events is currently being designed

Please be assured that ALUCA remains fully operational during this time. We have a robust IT infrastructure in place to ensure that we can work remotely, support members and provide a national program of events online.  

Minimising disruption to our members and partners is a high priority for us, including the health and well-being of all. We know this is a disruptive time, and we are here to help and support you. If you have any concerns or questions, please don’t hesitate to call or email us.

Sub Group Updates – Summer 2020

ALUCA VICTORIA

2019 has just disappeared and here we are towards the end of Q1 of 2020.

Last year ended with a bang.  After a sold out miniLUCA in October 2019 we quickly followed this up 6 weeks later with our end of year event at the fabulous Metropolis Events at Southgate.  The venue was beautiful and we were very lucky to host the MLC Monash ALUCA student award winner, Charles Chu, who set the pace for our keynote speaker Dr Jack Cygler.  Dr Cygler didn’t come empty handed and had some props for his talk – I think this is likely a first.  Always the trend setter!

There will be a couple of changes to the ALUCA VIC Committee for 2020.  I will be stepping off as Chair after 4 years on the Committee, two of which as Chair.  The Group will now be in the very capable hands of Stephanie Catalucci from REST who joined the sub-group early this year as Events Co-Ordinator.  Stephanie has done a tremendous job sourcing and arranging venues and with her strong insurance background that has spanned over various leadership roles she will be perfect for leading the ALUCA VIC sub group into 2020 and beyond.

As I reflect on what ALUCA has achieved in the past year, I am very proud to have had the privilege to be involved with and work with such passionate and driven people.  It has been a tough year for the industry and I am sure there are more challenges to come but what a credit to everyone for taking the time out their busy schedules to support our industry events and catch up with friends and colleagues.  With the change in the Committee will come opportunity so please look out for any upcoming vacancies and don’t be afraid to put your hand up.  It is a very rewarding experience and you will get to meet so many people while giving back to this industry we are all working so hard to transform for the better.

I would like to take this opportunity to thank everyone for your support during the year and attending the quarterly events that have been arranged by the sub-group.  It has meant a lot to us all.  We look forward to inviting you to our events – although I will no longer be on the Committee, I will be sitting up the back enjoying the session!

Editor Note – you have done a fantastic job over the 4 years Suzanne!

Suzanne Whyte
Chair – VIC ALUCA


 

CMG ALUCA

The ALUCA CMG co-hosted two events to finish off 2019.

The CMG committee teamed up with the ALUCA QLD committee to deliver the Triple Treat event at the Hilton in Brisbane on 12th September 2019. This event had close to 100 members spend the afternoon listening to 3 fantastic speakers. Following the presentations we had an opportunity to spend some time networking with our colleagues. This event was particularly exciting as it was the first time the CMG had taken part in an event in Brisbane having previously only held events in Sydney and Melbourne. Going forward we hope to continue co-hosting events with our friends in QLD especially now that there is a greater claims professional presence in QLD.

The final event for 2019 was the Professional Development day co-hosted with ALUCA NSW on 16th October 2019. This event is traditionally held in the non-conference year and tries to feature some of the speakers from the previous ALUCA conference. The day featured 2 keynote speakers, panel discussions and breakout sessions covering underwriting, product and claims topics. This event wouldn’t have been possible without the hard working committee that coordinated 18 speakers for this day. I would also like to thank Mark Smith who was the MC for the day.

Looking back on 2019 the ALUCA CMG committee delivered 7 events across 3 states teaming up with 3 committees throughout the year.

  • Victoria: Legal Session, Financial Session and ALUCA Excellence Awards Night
  • NSW: Legal Session, Financial Session and NSW Professional Development day
  • QLD: Triple Treat

Overall we had over 600 people attend these events throughout the year.

We look forward to seeing you at some of our events in 2020.

Myles Kennedy
Chair – ALUCA CMG


On behalf of the ALUCA Rehabilitation Subgroup we would like to thank you all for your support and participation throughout the events of 2019.  Looking forward to seeing a much stronger and growing presence of rehabilitation professionals in 2020.

Our new committee came into effect 1 January 2020. Congratulations to the ALUCA Rehab Subgroup of 2020 which will be represented by our

  • Chair Josh Agar (MLC),
  • Vice Chair Hussein El-Khansa (Asteron),
  • Treasurer Amlan Sharma (AMP Life),
  • Communications Lead Swetha Purba (TAL),
  • NSW Committee Members Ben Crawley (BT), Karen Robertson (AIA), Dr Newman Harris (RGA)
  • Lucy Hartley (Swiss Re) will join alongside our VIC Committee members Stephen Cooney (MLC), Rachael Wiseman (AIA) & Tom Notley (Superfriend).

I would like to acknowledge and extend my thanks to those members who are stepping away in 2020, our Chair Kim Phan (Gen Re) Treasurer Trent McCormick (AMP Life) & Joanna Else (MLC). Kim, Trent & Joanna have made invaluable contributions to the ALUCA Rehabilitation Subgroup over the last few years and their expertise will be greatly missed.

The TPD working group has collated a survey which was sent to all ALUCA members and key stakeholders regarding employability assessments. The TPD working group will share results, insights and feedback received from the survey in the new year.

Amlan Sharma
Communications Lead – ALUCA REHAB


ALUCA NEW SOUTH WALES

Greetings from the NSW Committee.

Since the last edition, we have held 2 events. Firstly, the MiniALUCA /PDD on 16th October where we had a record breaking attendance of 200 members across the industry.  The theme of the day was “Innovation” and the highlights from the day were:

An awesome presentation on “Disruption by design” by Gihan Perera. Gihan kindly gave every attendee a copy of his e-book of the same name.

Alph Edwards and Darryl Pereira, both of TurksLegal  facilitated a though provoking discussion on three  key areas facing the industry a year on from the Royal commission followed by the winner of the TurksLegal scholarship.

The day continued with 4 breakout sessions with great speakers from the industry continuing on the theme of Innovation. The day concluded with Shelley Laslett talking on Neuroscience of change.

The final event for the year was the End of year Masquerade party on 10th Dec at L’Aqua Darling Harbour.  The event was attended by 85 members. Stephen Connolly -NSW committee Treasurer- opened the event recapping on the year and setting the scene for the speaker – Brian Hay. Tonja Nachman- NSW Committee- Event Coordinator introduced Brian. Within minutes, Brian took over the audience with his impressive presentation and sense of humour. Brian spoke on cyber security and shared some scary stats on how this is impacting everyone.  He also shared some great tips on how we need to work together to make it harder for cybercriminals to gather our data and increase protection. There were lucky door prizes and best dressed prize which were well received by the lucky attendees.

Attached are few snaps from the PDD and End of year event

We thank all the members , sponsors and industry speakers for their ongoing support.

Welcome 2020

After a successful and busy 2019, our committee has already started preparing for 2020 events.

We bid farewell to our very own Erin Touzell as she decided to step into the motherhood journey and welcome her little bundle of joy. The rest of the members continue to remain on the committee and are looking forward to a great year.

Our First event is a Masterclass session on 19th March 2020. Dr Paul Davis- Chief medical officer , RGA. will be presenting on a very popular topic “Underwriting cardiovascular disease”. The talk will explore areas which are critical for modern underwriters, including the role of calcium scoring which can be a challenge for underwriters.

We look forward to see you all there.

Best Wishes

Ami Barua
Marketing/Comms – ALUCA NSW


 

ALUCA QUEENSLAND

ALUCA QLD wrapped up a bumper 2019 with its end of year function at the iconic Normanby Hotel.

The festivities included a particularly robust trivia competition which pitted colleague against colleague in the quest for trivial domination.

The most memorable part of the evening however was centred around our two guest speakers from The Board Meeting Surf Charity which was started in 2005 by a group of surfers looking to help Sunshine Coast kids with disabilities, through a variety of surf-related events. Run completely by a dedicated group of volunteers and supported by the local business and surfing communities, the charity raises much-needed funds for families who have fallen through the cracks of Government support, are doing it extremely tough financially and have children with needs those of us with healthy kids could hardly fathom.

To date, The Board Meeting has raised in excess of $1,000,000 and every single dollar has gone to the local families on the Sunshine Coast. ALUCA QLD was proud to donate to a charity that provides such direct assistance to the local community.

Jody O’Sullivan
Secretary – ALUCA QLD

12 Months On, Hayne Royal Commission Draft Legislation Set To Change Life Insurance Policies

Draft legislation has recently been released to implement the recommendations of the Royal Commission relating to changing – for most new life insurance contracts – the duty of disclosure and the avoidance regime provided by s29(3) Insurance Contracts Act 1984 (Cth) (the Act).

Background

On 1 February 2019, the Honourable Kenneth Hayne AC QC submitted the final report on the Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry (the RC). The report was tabled in the Australian Parliament on 4 February 2019, with the Government agreeing to take action on all
76 recommendations contained in the report.

On 31 January 2020, the Government released draft legislation to implement some of the RC’s recommendations, which will be introduced into Parliament by mid-2020. Included was the exposure draft legislation in respect of recommendations 4.5 and 4.6 – that is, the ‘Duty to take reasonable care not to make a misrepresentation to an insurer’ and ‘Limiting avoidance of life insurance contracts’, respectively.

Although the draft legislation in respect of recommendation 4.5 applies to both general and life insurance, this article only deals with the amendments as they apply to life insurance.

Recommendation 4.5 – Duty to take reasonable care not to make a misrepresentation to an insurer

The RC concluded that the current duty of disclosure does not recognise the gap between what a consumer knows and what an insurer knows is relevant to the decision of the insurer whether to accept the risk and, if so, on what terms. Instead, the RC considered that a duty to take reasonable care not to make a misrepresentation to an insurer is more appropriate for consumer contracts of insurance, as it places the burden on an insurer to elicit the information it needs and does not require the consumer to surmise or guess what information might be important to an insurer.

The new duty

In accordance with the RC’s recommendation, the draft legislation proposes to insert a new section 20B into the Act which places on an insured (including a life insured) a duty to take reasonable care not to make a misrepresentation to the insurer before the relevant contract of insurance is entered into. The duty also applies to a life insured under a group life contract (which is likely to include a life insured under a policy owned by an SMSF) that is a consumer insurance contract, but does not apply to a superannuation fund trustee who will continue to be subject to the existing duty of disclosure.

The new duty replaces the existing duty of disclosure but only in respect of ‘consumer insurance contracts’ (CICs) and proposed contracts of insurance that, if entered into, would be a CIC. The existing duty of disclosure will continue to apply to any other contract of insurance or proposed contract of insurance.

What is a CIC?

A contract of insurance is a CIC if the insurance is obtained wholly or predominantly for the personal, domestic or household purposes of the insured (as set out in the proposed new section 11AB). Interestingly, if it is alleged in a proceeding that a contract of insurance is a CIC, it is presumed to be true unless the contrary is established.

Factors to be taken into account when considering whether the duty has been discharged

For CICs, whether an insured has taken reasonable care not to make a misrepresentation is to be determined with regard to all the relevant circumstances, including, but not limited to, the following:

  • The type of CIC in question, and its target market – for example, an insured entering into a CIC for which they were not part of the target market may have a lower standard of care, as would an insured entering into a CIC after speaking to the insurer in person before applying online, as the insured may have told the insurer about certain matters in person and not repeated them in their application
  • Explanatory material or publicity produced or authorised by the insurer – the Explanatory Materials suggest that the provision of easily comprehensible, accessible material by the insurer that explains the specific CIC in question would generally result in the insured’s duty being lowered, but we suspect this is an error as the example provided in the Explanatory Materials suggests otherwise
  • How clear, and how specific, any questions asked by the insurer were – for example, it would generally be more difficult for an insured to answer compound questions that are open-ended, general or long, or questions that are difficult to understand or interpret
  • How clearly the insurer communicated the importance of answering those questions and the possible consequences of failing to do so – the current notice requirement in s22 of the Act will not apply to CICs, but if the communication of the new duty is clear and effective (be it verbal or non-verbal), this will generally result in a higher standard of care, and
  • Whether an agent was acting for the insured – the Explanatory Materials say that the appointment of an agent by the insured does not, of itself, change the insured’s duty but, depending on the nature of the agent’s involvement, may be evidence that the insured has taken reasonable steps to fulfil their duty. Presumably, if the agent has been involved, an insured may have disclosed information to the agent that they therefore did not include in their application form and the insured would therefore have a lower standard of care.

The Explanatory Materials provide that in considering these and any other relevant factors, it should generally be assumed that the insured is an ‘average person’ with no special skills or knowledge.

Section 20(B)(4) of the draft legislation states that any particular characteristics or circumstances of the insured of which the insurer was aware, or ought reasonably to have been aware, are to be taken into account in determining whether an insured has taken reasonable care not to make a misrepresentation. For example, where it is apparent on a telephone call that a prospective insured has Alzheimer’s Disease, this would lower the standard of care to discharge that insured’s duty. On the other hand, if a prospective insured is dyslexic but there is no reason the insurer ought to have been aware of this, this would not lower the standard of care required to discharge the duty.

The current s21(3) is repeated in part in the new s20B to the effect that the insured will not be taken to have made a misrepresentation merely because they failed to answer a question or gave an obviously incomplete or irrelevant answer to a question.

Timing of the amendments

The amendments will apply to contracts of life insurance that are:

  • Entered into on or after 5 April 2021, and
  • Entered into before 5 April 2021, but varied after that day to increase a sum insured or provide additional kinds of insurance cover, to the extent of the variation (provided the variation isn’t an automatic variation).

The date of 5 April 2021 will align with the date of application of the Design and Distribution Obligations and the proposed date of application of the unfair contact terms regime for insurance contracts.

Recommendation 4.6 – Limiting avoidance of life insurance contracts

The RC concluded that the current regime for avoiding contracts of life insurance is unfairly weighted in favour of insurers and recommended that the Act be amended to limit the circumstances in which an insurer can avoid a life insurance contract on the basis of non-fraudulent misrepresentation or non-disclosure by an insured.

The current avoidance regime

Currently, s29(3) of the Act allows a life insurer to avoid a contract of life insurance within three years of entering into the contract, if the insured failed to comply with their duty of disclosure and the insurer would not have entered into the contract had proper disclosure occurred. Accordingly, an insurer can currently avoid a contract of life insurance where, had it known of the non-disclosed information, it would still have entered into a contract of life insurance with the insured, just on different terms.

The amendment

The draft legislation seeks to restore the pre-2013 wording of sub-s29(3) of the Act such that an insurer cannot avoid a contract unless it can demonstrate that it would not have entered into a contract of life insurance on any terms with the insured had proper disclosure occurred.

The Explanatory Materials do not squarely address the issue of whether the phrase ‘a contract of life insurance on any terms’ means any contract of life insurance, or, alternately, a contract of the type under consideration.

Timing of the amendments

The amendments will apply to:

  • Contracts of life insurance entered into after the Act is amended, and
  • Contracts of life insurance entered into before the commencement which are varied after that day to increase a sum insured or provide additional kinds of insurance cover, to the extent of the variation (provided the variation isn’t an automatic variation).
Implications

We consider that the proposed amendments to the Act will have the following significant ramifications:

  • Insurers should review application forms to ensure that the questions asked are specific, clear and unambiguous – and ‘cover the field’ in respect of matters that are relevant to their decision whether to accept the risk and, if so, on what terms.
  • Insurers should also ensure that their communications with insureds and prospective insureds (verbal and non-verbal) regarding the new duty are clear and specific. Again, this will serve to maintain the standard of the new duty.
  • Before considering whether or not an insured has complied with their duty to take reasonable care not to make a misrepresentation, all factors surrounding the entering into of the contract will need to be considered.
  • It appears that a trustee of a superannuation fund will have a more extensive duty than its members, with a trustee being bound by the existing duty of disclosure and the members being bound by the new duty to take reasonable care not to make a misrepresentation to an insurer.
  • Avoidance for a non-fraudulent omission or misrepresentation within three years of the contract being entered into will only be available where the insurer would not have entered into ‘a contract of life insurance on any terms’ had it known of the information omitted or misrepresented. In circumstances where the insurer would have entered into a contract on different terms, it will remain open to the insurer to vary the contract under ss29(6) and (7) of the Act.

Legal Directions
February 5, 2020

Further information / assistance regarding the issues raised in this article is available from the authors, Catherine McAdam, Partner and Jessica Thurtell, Senior Associate, or your usual contact at Moray & Agnew.

 

 

 

Life Insurance and Genetic Discrimination in the World of Perfect Data /Colin Biggers & Paisley Lawyers

In brief – A look at the implications of genetic testing for Australia’s life insurance industry 

With advances in the accuracy and availability of genetic testing, it is clear that genetic testing can be used by insurers to reduce their risk profile, in both predictive and diagnostic ways:

  • to obtain a better profile of a population at large
  • working out general loss patterns
  • in overall pricing
  • by requiring genetic testing of proposed life assureds, to enable insurers to price risk and, also, to write bespoke exclusions
  • in respect of non-disclosure, and
  • determining whether a condition is caused by an insured or excluded risk

Conversely, they will also reduce the uncertainty for individual life insureds, who may question the utility of life insurance (other than accidental death cover), leading to a pool of adverse selected lives and profit deterioration.

There has been some debate about the use of genetic information in respect of human rights and discrimination.

The current law of the Commonwealth and in each state and territory exempts insurers from discrimination laws with respect to the terms on which an annuity, a life assurance policy, an accident or insurance policy or other policy of insurance is provided:

  • is based on reasonable actuarial or statistical data from a source on which it is reasonable for the person to rely; and is reasonable having regard to the data and any other relevant factors, or
  • where no such actuarial or statistical data is available and cannot reasonably be obtained, an exemption exists where the discrimination is reasonable having regard to any other relevant factors

This exemption operates even if the genetic information gives rise to a disability or impairment within the meaning of the legislation.

In summary, genetic discrimination is not unlawful so long as it is justifiable in the circumstances.

Joint Parliamentary Committee reports on genetic testing and the life insurance industry

The Joint Parliamentary Committee issued a report in March 2018 on, among other things, proposed reforms to the law of insurance. Chapter 9 dealt with approaches to the use of genetic information by life insurance companies.

By way of comparison, Chapter 9.18 of the report compares the position in respect of the use of genetic information by life insurance companies in EU countries and the US and Canada as follows:

The US federal Genetic Information Nondiscrimination Act prevents health insurers from using genetic information in relation to decisions about eligibility, coverage, underwriting or premium setting.

The Canadian federal Genetic Non-Discrimination Act prohibits insurers from requesting that a person undergo a genetic test or from requiring the disclosure of previous or future genetic test results. The Act does not prohibit an insurer’s access to family medical history but not their genetic test results (the Act also does not indicate whether someone would have to inform an insurer that they have had a genetic test). Under the Act, genetic discrimination may be a criminal offence.

In Australia, the life insurance code of practice is mandatory for all members of the Financial Services Council (FSC).

Moratorium limits life insurers’ use of genetic test results but consumers not prevented from providing insurers with favourable results

The FSC is responsible for a self-regulatory regime and its life insurance code of practice (LifeCOP) contains a series of standards, the most relevant of which is standard 11, which as the Committee noted:

…specifies that insurers must not ask a consumer to undergo a genetic test. However, where an applicant has already undertaken a genetic test prior to the application process, insurance companies do have access to the results of such tests. … (Report at 9.40)

The committee considered as a first step that the FSC should update the code and standard 11 to prohibit any life insurers from using the outcomes of predictive genetic tests at least in the medium term and should take a form similar to the United Kingdom’s moratorium. This was incorporated in the June 2019 revision to the Standard by clause 3.2.

The Committee considers that the moratorium should be reviewed five years after being imposed.

However, similarly to the UK position, the Committee considered that the prohibition should not prevent a consumer from being able to provide genetic information to a life insurer in order to demonstrate that they are not at risk of developing an inherited condition (see Revised Standard 11 clause 3.5).

A life insurer may ask for results of a genetic test (but not that the applicant take a genetic test) where sums insured are high (clause 3.3) without breaching the standard. If the request is denied and the insurer declines cover then the insurer may have a defence under the discrimination legislation and will not have breached LifeCOP. Insurers must properly document their steps and evidence before rather than after any decision: Ingram v QBE Insurance (Australia) Ltd (Human Rights) [2015] VCAT 1936.

The report also makes other recommendations that speak to the interaction between discrimination law and insurance. The Committee recommended that an insurer must provide a person with written reasons when an application for insurance has been rejected or an insurance claim denied. Those reasons should be targeted to the part of a person’s medical history relied on by the insurer in doing so.

The committee also recommended that the statistical and actuarial evidence relied on by the insurer be made available to the person on request. Currently, only the Disability Discrimination Commissioner can compel this.

Genetic testing raises issues and challenges for life insurance industry

There is a fine line between discriminating in favour of those who present genetic information to insurers to reduce premiums and the conversely higher premiums that are charged to those who do not do so. Some might try to argue that the latter are being used as a surrogate to discriminate against customers on the basis of genetic material (on the assumption that the failure to provide beneficial testing is functionally equivalent to having unhelpful genetic data).

A real question then arises as to whether having genetic material that predisposes someone to a condition should be a prohibited ground under Australian discrimination law.

Insurance is a product for a world of imperfect information, where the insured does not know when trouble will strike and the insurer gambles against the insured armed with statistics and a large pool to absorb loss.

We are moving into a world of perfect information, where those who have good genetic material, or have a good idea of their life expectancy based on genetic testing and lifestyle data, will choose not to purchase vanilla life insurance.

What effect that would have on the business of life insurance remains to be seen.

Toby Blyth and Kerry O’Brien
Colin Biggers & Paisley

24 November 2019

This is commentary published by Colin Biggers & Paisley for general information purposes only. This should not be relied on as specific advice. You should seek your own legal and other advice for any question, or for any specific situation or proposal, before making any final decision. The content also is subject to change. A person listed may not be admitted as a lawyer in all States and Territories. © Colin Biggers & Paisley, Australia 2020.

 

Editor’s Note – Autumn 2020


Welcome to the Autumn Edition – we are sure it was worth the wait 😀

As the curtains close on the first quarter of this new decade, our resilience is being rigorously pressure-tested by yet another large-scale emergency. The COVID-19 pandemic is proving to be as unpredictable as it is surreal. These are trying times but rest assured that Amanda, Jim and the ALUCA Board are closely monitoring this rapidly evolving situation and will continue to keep you informed in regards to upcoming events.        

In this edition….

Hannover’s article on Rheumatoid Arthritis and related diseases is informative and relevant. It clearly defines RA characteristics and delves into epidemiology, treatments and risk factors complete with diagrams. Did you know that females have triple the prevalence of males?  Or that smoking is a risk factor?  [and yet another reason not to light up!]

From the legal perspective…. we have two insightful articles for you. Firstly, an update 12 months since the handing down of the Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry. The second, explores the implications of genetic testing within our industry in light of the Joint Parliamentary Committee report. Here is a vexing question: in a perfect world of information, will those who have good genetic material and/or a long life expectancy based on genetic testing and lifestyle data, choose not to purchase the life insurance products on offer today?

The 2019 ALUCA-MLC-Monash winning paper by Monash University student Charles Chu meshes perhaps our greatest industry challenge of income protection sustainability with behavioural economics. Through the Claim’s lens this paper explores new ways of approaching traditional thinking and provides viable alternatives. Congratulations Charles on an excellent paper!

And finally…. after listening to your feedback and after much consideration….. it’s time to evolve, reinvigorate, diversify and continue our digital journey by splitting ReB into two parts. Moving forward, get ready for regular, bite-sized evidence alerts, education pieces, articles and papers. Our quarterly publication will continue with a focus on ALUCA news and updates, upcoming events and quarterly highlights. We believe that this change will better serve our ALUCA members – so be sure to let us know what you think!

At this ReB milestone, I would like to sincerely thank a small group of people for their amazing support over my last six years as Editor – Amanda McKernan, Jim Welsh, Tracy Peterson, Devi Uka and of course Jamie Robinson who about five years ago helped me take ReB from a 1990’s style public service staff newsletter [harsh but true] into the digital age.

Stay safe and I hope you really enjoy our last edition of ReB – in this format.

Cheers

Michael Reid
ReB Editor

Michael.Reid@aia.com 
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2019 winner of the ALUCA – MLC – Monash Prize For Industry Collaboration For Health Students: Winning Paper by Charles Chu

Congratulations to the 2019 winner of the ALUCA – MLC – Monash prize for industry collaboration for health students, Monash University student Charles Chu with his winning submission: Beyond a binocular view: the interface between behavioural economics and income protection packages.

We are delighted to share his winning submission.

< < < CLICK HERE TO VIEW > > >

ALUCA’s Refreshed CPLI & CPD Program 2020

ALUCA’s refreshed CPD (continuous professional development) program for all ALUCA accredited members has been rolled out as a pilot program from January 1st, 2020.

The purpose of this pilot program is to gather and consolidate valuable feedback and comments from all ALUCA accredited CPLI members during 2020 so that it can be refined and hard launched in 2021 to help members be better prepared around the future anticipated regulatory changes

Devi Uka is the ALUCA Board member who drives the education strategy and has formed a cross industry education working committee to help with this important initiative.

All ALUCA accredited Certified Professional Life Insurance (CPLI) members annually have to undertake ALUCA’s CPD (continuous professional development) program and log their CPD hours to maintain ALUCA CPLI accredited membership. We have a compulsory random audit of 10% of accredited members each year.

The refreshed ALUCA CPD program has been modelled on the 5 categories that FASEA have been mandated to use. These have been adapted by ALUCA’s CEO and Life member Tony O’Leary specific to Life Insurance underwriters, claims and rehabilitation professionals. During the process of the development of this refreshed program we have consulted with key industry bodies and will be consulting with life insurers, reinsurers and education providers during 2020 as well as running a series of roadshows.

We have developed an ALUCA CPD and CPLI PPT and updated ALUCA’s CPD FAQ to help explain this program further.  The key items to be aware of are as follows:

  • ALUCA CPD points have been simplified to represent hours i.e. 1 hour of eligible CPD activities = 1 ALUCA CPD point
  • ALUCA CPD points have moved from 35 to 40 each year
  • The annual ALUCA regulatory and ethics mandatory webinar will move to 5 CPD points and will include a multiple-choice assessment.
  • There are 5 key CPD categories that accredited members need to achieve the minimum hours designated across the year however during 2020 this is being piloted so we will look to feedback around these. The pilot hours are:
  • Technical & specialist = 15 hours,
  • Customer focused = 5hrs,
  • Regulatory Compliance & Consumer Protection = 5hrs
  • Professionalism & Ethics = 5hrs
  • General = 10 (depending on the minimums above)

We wrote to all ALUCA accredited CPLI members at the end of last year and provided a CPD log examples of the CPD activities that contribute towards ALUCA CPD hours which are the same activities we have had in place for the last 3 years.  The category requirements are just different.

For 2020, ALUCA’s Board have agreed that the 40 CPD hours across the categories are fluid as we want to gain real time feedback about the program during 2020. ALUCA’s Board feel that 40 CPD hours are achievable but are keen to ensure that this task in not an onerous one for accredited ALUCA members. We understand the additional stress members would be feeling with the impacts of COVID19 pandemic and as such will be lenient around hours this year but welcome all feedback.

Thank you in advance to all of ALUCA’s accredited CPLI members for helping to pilot this important program during 2020 and for their ongoing feedback.  We look forward to your input and comments.

 

ALUCA’s 3rd Annual Life Insurance Excellence Awards

ALUCA’s 3rd Annual Life Insurance Excellence Awards – NOMINATIONS EXTENDED to JULY 31, 2020

Please note that due to the current COVID19 situation the Awards night has been postponed until later in the year and nominations for the 3rd Annual ALUCA Life Insurance Excellence Awards will now stay open until JULY 31st.

ALUCA members, regardless of country of residence, are invited to either nominate themselves or another member, or their team if they have achieved great work in any, or all, of the 10 award categories. We also have an additional award category especially for ALUCA volunteers – the Hero award.

To enter, you must provide responses addressing each of the award criteria for the award category being entered on an official ALUCA awards application form.  Please note this was for work and activities completed for the full calendar year 2019.  To submit your nomination/s please go to ALUCA’s website aluca.com/membership/awards-and-scholarships/

 

Award Judges

The judging panel consists of key cross industry leaders and senior industry professionals who will judge each nomination against the category criteria.

 

Awards Night – POSTPONED from May 21st to the 22nd October

All finalists and winners will be announced at ALUCA’s Award night being held at Dockside, Darling Harbour. The original date of May 21st has been postponed until the 22nd of October at the same venue.

AWARD Categories, Criteria & Prizes

For the full entry requirements, awards criteria, prizes and categories download the awards brochure and application form at aluca.com/membership/awards-and-scholarships/

ALUCA Life Insurance Excellence Awards Night – Tickets

The venue for this year’s 3rd Annual ALUCA Life Insurance Excellence awards night is at Dockside at Cockle Bay Wharf, Sydney on October 22nd. Guests will enjoy a 3-course meal and hear from guest speaker Michael Rabbitt, Chair of Spinal Cord Injuries Australia. The last 2 Awards nights have sold out.

Book now at aluca.com/event/aluca-life-insurance-excellence-awards-2020/

Early Bird offer (ends July 31st, 2020) – prices are inclusive of GST

  • Table of ten: $1897.50
  • Half table: $951.50
  • Individual ticket: $203.50

Regular pricing (from August 1st, 2020) – prices are inclusive of GST

  • Table of ten: $2200
  • Half table: $1100
  • Individual ticket: $247.50

We very much hope you can join us for what promises to be another great night and show your support for your colleagues and peers.