Coronavirus (COVID-19)
FAQs for advisers

 

 

We are closely monitoring the impact of COVID-19 on our members and will continue to update our guidance as the situation evolves.

The Financial Conduct Authority (FCA), has published consultations on what it expects from insurers in these exceptional circumstances.

We’ve created some online support below in response to this guidance, including the value your clients can continue to expect from their policy with us and the steps we have taken to ensure fair treatment of our members.

Are you still accepting applications for your policies?

Yes, we are still accepting applications for our life cover and income protection products.

As our life cover products are designed to cover people with serious or multiple medical conditions, any applicants who the NHS would regard as higher risk may see a delay in their application. In some cases, the application may be postponed for a period of up to six months before any decision is made.

We are still accepting income protection applications for all waiting periods. New policies with a Day 1 or 1 week waiting period will have an exclusion applied for claims arising in the first 12 months from symptoms of respiratory illnesses. These will be subject to a 4 week waiting period.

My client has been furloughed on 80% of usual income, can they apply for a new income protection policy?

Clients who are furloughed are technically not working, and as such we would not normally consider applications. However, where there is a reasonable expectation of a return to work before any waiting period might end, we would consider applications with a waiting period of four weeks or more.

Have you changed your application questions?

Yes, we have introduced a new question:

Have you tested positive for coronavirus (COVID-19) in the last 2 years?

Are you offering virtual medical screenings?

We are currently trialling this with a number of life cover and income protection applicants and are contacting advisers whose clients may meet the criteria.

How are you complying with FCA guidance relating to COVID-19?

Product value

The FCA expects insurers to consider the value of their products in light of the exceptional circumstances arising out of coronavirus. We are still able to provide the contractual benefits that our members expect from their policies, giving valuable financial protection against the risks of death and ill health. Specific answers to questions around how members can claim on their policies at this time are covered in more detail below.

Customers in temporary financial difficulty

The FCA expects insurers to consider the support it can provide customers who are facing financial hardship as a result of coronavirus. We are committed to helping you and your client keep insurance cover in place; please call us and we will talk through the options available.

Will you pay a claim on a life cover policy if my client dies of coronavirus?

Yes, we will assess a claim in the usual way.

Will you pay a claim on an income protection policy if my client is unwell due to coronavirus?

Yes, we will consider claims. We will establish if your client’s illness is preventing them from undertaking their own occupation. If they are currently unable to work due to lockdown, we will establish whether their illness would have prevented them from undertaking their usual duties. If they are receiving a grant from the Government due to lockdown, this would be taken into account and treated as continuing income.

Will you pay a claim if my client is self-isolating?

If your client had an income protection policy in place before 12pm on 16 March 2020, we will consider making an ex-gratia payment outside the terms and conditions of the policy if they have received official medical guidance to self-isolate, from Public Health England, NHS 111 or a GP.

For policy applications submitted on or after 16 March 2020, any claims for self-isolation
(including medically advised self-isolation), will not be considered.

If my client is listed in the NHS ‘vulnerable’ group and has been advised to self-isolate, will they be able to claim?

As a minimum we will consider paying for 14 days of self-isolation. We will then consider further a supplementary ex-gratia payment depending on the individual circumstances.

Will you pay a claim if my client travels abroad and has to self-isolate on their return?

All claims will be individually considered, but it is unlikely that we will make any ex-gratia payments if your client travels overseas (to or from the UK) and is required to self-isolate as a result.

Will you pay a claim if my client’s income reduces due to coronavirus or they are made redundant?

We wouldn’t be able to pay a claim in these circumstances. Our income protection policies are designed to cover a loss of income resulting from illness or injury, not as a result of economic factors.

If my client claims for income protection in the future and their job or income has been affected by coronavirus, how will you assess it?

We will consider every situation individually. We normally assess a claim by gathering evidence of your clients’ personal taxable income in the 12 months immediately before their illness or injury, however where it is clear that coronavirus has interrupted their normal earnings we will take a common sense approach to the claim.

What other support can you offer my clients?

With the NHS currently under immense pressure, our member benefits app, HealthWise, can give your clients direct access to medical experts via their smartphone or tablet. HealthWise is free to use and includes access to four remote GP consultations each year, a second medical opinion service and six virtual consultations for both physiotherapy and mental health support.

The HealthWise app can be downloaded from the App Store or Google Play. Your client will need their policy details in order to activate their HealthWise account.

How are you complying with FCA guidance relating to COVID-19?

Product value

The FCA expects insurers to consider the value of their products in light of the exceptional circumstances arising out of coronavirus. Given the impact that COVID-19 has had on private healthcare, we have detailed in the questions below the steps we have taken to ensure our members can still get value from their policies at this time.

Customers in temporary financial difficulty

The FCA expects insurers to consider the support it can provide customers who are facing financial hardship as a result of coronavirus. We are committed to helping you and your client keep insurance cover in place; please call us and we will talk through the options available.

Can my client still use their health insurance plan?

Some private facilities in the UK are now accepting patients, although there will be regional differences. If your client has a health concern they would like to discuss with us, please ask them to contact our claims team on 0300 123 3253 between 8am – 8pm Monday to Friday and 8am – 1pm on Saturdays.

We have set out the following steps to support your clients during this period.

Clinical Support Centre
We understand that your clients may still be worried about accessing care, so we’re pleased to let you know that they can continue to access the Clinical Support Centre for eligible claims for the remainder of 2020. This provides virtual access to specialist consultations with some of UK’s leading specialists and practitioners by telephone, video or online.

Members using the Clinical Support Centre will not have to pay any policy excess and the No Claims Discount (where applicable) won’t be affected, nor will out-patient benefits for consultations and diagnostics. Normal personal and policy exclusions still apply, however, and any treatment resulting from use of the service will need to be covered within your clients’ policy limits. Members can access the Centre by calling our claims team on 0300 123 3253.

Impact on premiums
We expect that the current situation will result in The Exeter paying less in claims than expected during 2020. As a result, we have made a commitment to our members that any surplus resulting from a reduction in claims will be returned to them. Once the full impact of the COVID-19 outbreak is clear we will determine the best way to do this.

Enhanced cash benefit
In response to the requisitioning of private hospitals by the NHS, we have added a temporary ex-gratia benefit to health insurance policies. From 1 April – 31 August 2020, we will offer an enhanced cash benefit of £500 per night to members who are treated without charge in either an NHS or private setting, for any eligible claim including COVID-19.

This benefit will be capped at £10,000 and will not affect any excess, No Claims Discount, available cash benefit or overall policy benefit limits. It applies to the following new and existing policies; Health+, Health Cover for Me, Health Choices for Me, Health Essentials for Me, Exeter Care Preferred Plan, Exeter Care Low Cost Plan, RBS Plan, Overseas Plan and Interplan Worldwide. Claims for cash benefit must be submitted within 3 months of hospital discharge.

What other support can you offer my clients?

With the NHS currently under immense pressure, our member benefits app, HealthWise, can give your clients direct access to medical experts via their smartphone or tablet. HealthWise is free to use and includes access to four remote GP consultations each year, a second medical opinion service and six virtual consultations for both physiotherapy and mental health support.

The HealthWise app can be downloaded from the App Store or Google Play. Your client will need their policy details in order to activate their HealthWise account.