7th June 2023

John Fotheringham, senior underwriter at National Friendly, reviews how granting underwriters more autonomy can help ease broker frustrations with claims decisions and bring about better customer outcomes.


Underwriting teams in large insurers drive impressively consistent results. But with this need for consistency comes a need for seemingly endless audits to ensure everyone is adhering to the letter of the law; namely, the organisation's underwriting philosophy.

I know all this because I've been there. The trouble is what you gain in consistency, you lose in autonomy; the ability of the underwriter to make common sense decisions.

And it's this lack of autonomy that leads to broker frustrations (not to mention underwriter frustrations).

Only recently I read a comment from a broker in a trade publication, saying he would like to see claims teams being more understanding of mental health considerations around bereavement and work-related stress.

He said this is where brokers have to challenge claims decisions, adding that more of a "will pay" attitude is needed.

When underwriters are given autonomy and are not shackled by audits - as is more commonly the case with much smaller providers - you have the ability to look at underwriting on a case-by-case basis.

On the face of it, that might not seem like such a big deal, but scratch the surface and you find that being given such freedom and flexibility can help better meet many customers' needs; those with pre-existing health conditions as well as those without.

So, suddenly, all this can be viewed in a Consumer Duty light, catapulting it into a hugely timely and relevant position.

Frustrations and nuances

Let's go back to those broker frustrations around the way in which bereavement and work-related stress tend to be handled. I'll use these as examples, to demonstrate how autonomy plays out in practice.

As mentioned, autonomy gives us the ability to look at underwriting on a case-by-case basis. For instance, reviewing mental health exclusions over time and according to individual cases, potentially removing those exclusions, where it makes sense to do so.

This is about not just declining cover to people with a recent history of bereavement or work-related stress, without looking into the nuances of their individual situation.

In the case of bereavement, those nuances might typically include time lapsed. While we're not suggesting that anyone ever fully ‘gets over' the death of a loved one, we also know that time is a great healer.

So, although there needs to be a period before a mental health exclusion can be removed following a bereavement, there's potentially no reason why that situation shouldn't change after, say, six months.

On work-related stress, those nuances might include consideration of the interventions put in place by, or for, the individual to help identify and deal with the root cause.

An exclusion is unlikely to be removed if the individual simply goes back to the same job and nothing has changed. But it could potentially be removed if they move job or they have insights into the triggers, and the employer is helping remove those triggers, allowing them to stay in the same job.

This kind of freedom and flexibility on the part of underwriters might even lead to the ability to integrate additional lifestyle assessments into the process.

For long-term - chronic - conditions, for example, it should in theory be possible give a decrease in premiums to the individual if we can see that they're managing their condition well.

Underwriting autonomy also translates into the ability, at point of sale, to put more faith in the client's disclosure and offer terms immediately. This means only asking for medical evidence when it's really needed, as opposed to "evidence for evidence's sake"; also known as "comfort evidence" to use large insurer parlance.

Ask any broker and I think it's safe to say that comfort evidence represents a huge frustration.

Consistency certainly has its place. If only humans - and human experiences - were all consistent…

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