I met her in a club down in old Soho

Panacea Comment for Financial Advisers and Paraplanners

6 Oct 2016

I met her in a club down in old Soho.

With the summer now well and truly over, some startling news emerged that women having NHS funded sex changes are also being given NHS fertility treatment so they can have babies after they become men.

The next step in this odyessy seems to be that the transgendered woman (now to be legally recognised as a ‘man’) whose frozen eggs have been used to create a baby should be ‘legally recognised’ as the child’s father, rather than their mother.

Still with me?

I reminded of the Kinks prophetic song ‘Lola’ and the line that goes Girls will be boys and boys will be girls. It’s a mixed up muddled up shook up world”.

We have schools setting policies for ‘transgender equality’ by way of gender-neutral uniforms and toilet provisions. Southampton University’s Student union is demanding that sanitary bins be installed in male toilets for transgender men who menstruate and staff at a Swedish kindergarten were told not to refer to children as ‘him’ or ‘her’ to avoid stereotyping.

Before anyone gets ‘offended on someone else’s behalf’, how common is the non-binary gender in the UK? This being defined as a person whose “self-identity does not conform unambiguously to conventional notions of male or female gender”.

The Gender Identity Research & Education Society (GIRES) estimates that barely 1% of the British population could be gender nonconforming to ‘some degree’. The numbers of trans boys and trans girls are about equal. That is some 640,000.

At the end of 2014, reliable figures indicated that at least 0.4% of the UK population defined itself as non-binary when given a 3-way choice in terms of female, male or another description.

That’s about 256,000.

To accommodate the needs and rights of this very small societal group, there are three UK Gender Recognition Registers, not by gender choice but by region (England and Wales together, Scotland and Northern Ireland) and anyone with a UK birth certificate who is issued with a ‘Gender Recognition Certificate’ is entitled to a new birth or adoption certificate, which is recorded in one of those Gender Recognition Registers.

As of the end of June 2015, since the Gender Recognition Act 2004 came into force in April 2005:

  • 4,631 new birth certificate applications have been received
  • 3,999 full Gender Recognition Certificates have been issued by the GRP
  • 183 interim Gender Recognition Certificates have been issued by the GRP (67% converted to full GRCs)
  • 193 applications have been declined
  • 110 applications are still pending

A 2014 survey found that 48% of ‘trans people’ under 26 had tried to commit suicide, 30% done so in the past year and 59% said they had at least considered doing so.

An interesting life insurance underwriting factor?

So irrespective of any readers personal views on the matter, which will be a spectrum ranging from incredulity as to how such a very small percentage of the population has developed such a powerful, possibly disproportionate influence, to the deep concerns felt by many that those affected can live in a very dark and confused place needing help.

The issues for the financial services industry that arise from this could be considerable.

The gender directive had serious cost implications for all insurance products, seeing the costs of protection for women increase to the same level that men pay, despite life expectancy being so different.

How will a ‘transgender’ or ‘non-binary’ be underwritten?

The Nursing Times highlighted 5 key points regarding ‘gender’ in 2015. They were:

  • Women have lower mortality rates than men, longer life expectancy, greater morbidity and are over-represented in health statistics
  • Some health problems are more commonly associated with one gender than the other
  • Sociological factors are as important as biology for determining gender-related health inequalities
  • Women’s natural reproductive function has increasingly been medicalised, leading to the increased need for healthcare

Germaine Greer got in a lot of trouble recently when giving a lecture at Cardiff University. She said“Just because you lop off your penis and then wear a dress doesn’t make you a ******* woman,”.

She has a point- genetically and chemically.

DNA (deoxyribonucleic acid) is found in just about all-living things and is the main component contained within chromosomes. It is the carrier of the genetic code that identifies the unique, distinctive and very importantly, unchangeable human male and female characteristics meaning that if you are ‘Arthur’, ‘Martha’ or travelling in-between, the transgender DNA remains as the definitive marker that just cannot be changed.

What about transgender underwriting for Annuities, Healthcare, Critical Illness, clearly a potential problem, particularly if ‘parts’ have been added or taken away.

LV= explained that “our underwriters take into account someone’s current gender. So if someone is transgender that will not be an issue at all, there is no additional loading or special treatment.

The only issue would be if they’re still having treatment (which is the same as anyone undergoing medical or psychological treatment), so if they’re in counselling then mental illness might be excluded but this is a general thing not specific to transgender people”.

Royal London said that “We are happy to consider all applications for cover for people who are transgender. 

Males and females will pay the same premium for insurance cover with Royal London, meaning that a customer can apply for cover as male or female depending upon their gender identity and not their biological sex.

If a customer has already had gender reassignment surgery and has made a full recovery with no complications, all covers including critical illness will be accepted at standard rates.

If the customer is due to undergo surgery, we will usually postpone cover until after the operation due to the potential medical and surgical complications, the same way we would for any customer awaiting any major surgery. But again, once a full recovery has been made with no adverse reactions to treatment received such as hormonal therapy, all covers including critical illness will be accepted at standard rate.. 

If the customer has any other medical history, this will be underwritten using our usual underwriting philosophy applied to all customers”.

Just Retirement’s view was that “ gender will make no difference to the price offered to the customer, as all rates are priced on a unisex basis. We offer customers the choice on how they are addressed.”

Male drivers pay more for car insurance than their female counterparts – despite strict gender equality laws – due to a loophole that lets firms charge more based on a person’s job. But what about the European equality laws, these did not seem to factor in- the ‘Lola’ driver?

Will non-binary be built into robo-advice algorhytmns and proposal forms?

With all this in mind, we hear that Oxford City Council is to add on it’s official forms the gender-neutral option of “Mx” as it considers whether all title salutations should disappear.

Even traffic lights have not escaped being politically correctly  re-engineered with the traditional green man sign replaced with LGBT symbols at 50 pedestrian crossings around the Trafalgar Square area in June.

And, what about dressing for work? The TUC is investigating gender-related problems associated with workplace dress codes and personal protective equipment (PPE). The probe follows reports of sexism related to work clothing, including stipulations to wear high heels, and the provision of ill-fitting PPE for women. A survey by the union Prospect found just 29 per cent of women said their protective clothing was designed for females. The TUC wants to hear of examples of bad practice, but is also keen to hear examples of good agreements and policies on dress code.

For my generation and that of my parents, it is a “very mixed up, muddled up, shook up” world indeed as the country appears to being subjected to minority influenced, politically correct socio re-engineering to accommodate less than 1% of the population. Goodness knows at what cost.

The world of financial services industry is already fraught with confusions, challenges and conundrums.

How will it keep pace?

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Paralysed by Gunfire, but Denied Care

Having recently returned from a holiday in the US, I thought that IFAs would be interested in reading about this very sad case written, reported on by reported on by RONI CARYN RABIN on JULY 20, 2015 10:31 AM

“There is no video of the altercation between Monroe Bird III, a 21-year-old sitting in a car with a friend, and Ricky Leroy Stone, 56, a security guard who found them one night in the parking lot of an apartment complex in Tulsa, Okla.

But the tragic culmination of their encounter is not disputed: Mr. Stone drew his gun and shot Mr. Bird, leaving him paralyzed from the neck down.

Three months later, as he lay in the hospital hooked to a ventilator, Mr. Bird’s insurance company declined to cover his medical bills. The reason? His injuries resulted from “illegal activity.”

Yet Mr. Bird was not convicted of any crime in connection with the incident. He was not even charged.

Without insurance, Mr. Bird’s family could not move him to a rehabilitation center specializing in spinal cord injuries. He was discharged from the hospital and died at home last month from a preventable complication often seen in paralyzed patients.

The incident joins a disturbing litany of cases in which black men have been shot by white men in law-enforcement capacities. Mr. Bird’s family and their supporters believe racial bias motivated the shooting, at least in part, and protected the guard from criminal prosecution.

But Mr. Bird’s story comes with a particularly bitter sequel relevant to Americans of any background: The plan’s refusal to pay has left his family owing as much as $1 million in medical bills and, experts say, shines a light on a little-known loophole buried in the fine print of many health plans.

There are no firm numbers on how often insurers deny medical coverage based on allegations of illegal activity. But cases like Mr. Bird’s “are more common than people think,” said Crystal Patterson, an attorney in Minneapolis and chairwoman of the American Bar Association’s committee on fiduciary litigation.

Insurers have long relied on allegations of illegal activity to deny coverage to patients injured in a variety of contexts, from traffic infractions to gun accidents. The judicial rationale is that “we don’t want to reward illegal activity,” she said.

In one court case, a union health plan denied the claims of a worker’s son who was injured while allegedly building a pipe bomb, Ms. Patterson noted. In another, an insurer declined to cover the medical expenses of a man who lost control of an uninsured, unregistered car while trying to pass another driver in a no-passing zone.

Courts have upheld the denials even when there were no convictions for illegal activity. The administrator of the policy can deny claims even when no criminal charges are filed, Ms. Patterson said.

“The administrator gets a lot of latitude to make that decision,” Ms. Patterson said. “It’s a much lower burden than ‘beyond a reasonable doubt.’”

Lisa Stites, a spokeswoman for Craig Hospital, a rehabilitation facility for patients with spinal cord and traumatic brain injuries in Denver, said in an email that it was common for health policies to contain so-called exclusions for injuries resulting from drug or alcohol use, felonies, self-inflicted trauma or “hazardous” behavior.

Dr. Ford Vox, a specialist who works at the Shepherd Center, a rehabilitation facility in Atlanta, said the exclusions provided insurance companies with “an excuse to get out of very expensive cases.”

“The insurance can pull the rug out at any time,” said Dr. Vox, who also writes about medical topics for various publications. “And it’s all top secret — people don’t know about it until something happens to them.”

Insurance exclusions for illegal activity have been outlawed in some states, but state laws do not apply to health plans administered under the federal Employee Retirement Income Security Act, which sets standards for most pension and health plans in private industry.

Even after passage of the Affordable Care Act, self-insured plans regulated under Erisa maintain wide latitude to determine coverage. These plans “can do pretty much what they want to do,” said Robert Laszewski, an insurance industry consultant in Washington.

Mr. Bird’s family was insured by his stepfather’s employer, Southern Hills Country Club, and claims were processed by HealthCare Solutions Group of Muskogee, Okla. Citing privacy laws, representatives of both companies declined to comment on Mr. Bird’s case.

The events leading to Mr. Bird’s shooting may never be fully known. Like many trauma patients, Mr. Bird had no memory of the incident.

According to the police report, Mr. Bird was sitting in his car with a girl in the parking lot of the apartment complex where he lived with his sister’s family around 8:30 p.m. on Feb. 4.

Mr. Stone, the security guard, told police he approached the car because he had been instructed to look out for couples having sex in the parking lot. Mr. Stone said he shone a light into the car, told Mr. Bird that he was with security, asked for identification, and then tried to open the car doors.

Mr. Bird locked the car doors and tried to back out of the spot, according to Mr. Stone, who told police he stood behind the car to prevent Mr. Bird from leaving and was hit when the car backed up. He said that he jumped and fell against the rear window, breaking it.

When he was back on his feet, he said, he fired three shots as Mr. Bird drove away. He told police that he feared for his life.

But the car passenger, a minor whose name has not been released, told police she did not think the car struck the guard, and said the guard only started firing as they drove away.

Mr. Bird was paralyzed immediately and was treated in Tulsa hospitals for several months. In April, an official with HealthCare Solutions Group called Mr. Bird’s stepfather, Johnny Magness, to say that the company was beginning an investigation.

“I told her, ‘It sounds like to me you’re about to become the judge, prosecutor and jury,’” Mr. Magness said. “I said, ‘Please ma’am, don’t turn my son into a statistic. He needs care.’”

Two days later, the company denied coverage for Mr. Bird’s medical claims. The denial letter cited three exclusions, including one for illegal activity, which the letter said was triggered by Mr. Bird’s allegedly “striking the security guard with his motor vehicle and then leaving the scene.”

The denial meant the family could not transfer Mr. Bird to a rehab center where he could have received preventive care and adapted to life as a quadriplegic. The family appealed the denial, but it was affirmed last week.

This time, however, HealthCare Solutions cited “hazardous activity,” not illegal activity, and suggested that a third party, like the apartment complex, should pay the medical bills.

Mr. Bird’s medical claims might not have been denied had criminal charges been brought against Mr. Stone. But Oklahoma has a “stand your ground” law permitting citizens to “meet force with force” if they are attacked.

Steve Kunzweiler, the Tulsa County district attorney, concluded that Mr. Stone’s use of force was justified because he thought his life was in danger. “Mr. Bird might have made choices that might have gone a different way if he had listened to the security guard and obeyed his instructions,” Mr. Kunzweiler said.

Police discovered a vial of marijuana, illegal in Oklahoma, in Mr. Stone’s bag that night, and the results of a preliminary blood test showed that he had cannabinoids in his system.

David Riggs, a lawyer for Mr. Bird’s family, noted that the state’s stand-your-ground law did not apply when “the person who uses defensive force is engaged in an unlawful activity,” such as drug possession.

“The fact is, he was shot in the back as he was fleeing, driving away from this security guard,” Mr. Riggs said of Mr. Bird. “If there was ever a threat, there is no longer a threat.”

Repeated attempts to reach Mr. Stone for comment were unsuccessful. Mr. Bird’s family has filed a lawsuit against Mr. Stone, the security firm that employed him, the apartment complex where the shooting took place, and its property managers.

After the denial of coverage, Mr. Bird was discharged and went to his family’s home in Boley, Okla.

The young man, who required a ventilator to breathe, was cared for around the clock by his mother and grandmother, who fed him, bathed him, helped him cough, turned him in bed to prevent bedsores, and moved his limbs to maintain his range of motion, said Tezlyn Figaro, a publicist speaking on the family’s behalf.

Despite their care, Mr. Bird developed blood clots in his lungs and died on June 30”.

We do know that UK insurers have a clause in their policies regarding criminal activity such as: ‘We do not cover treatment you need as a result of your active involvement in criminal activity’.

The UK situation is slightly different as immediate A&E care would be provided by the NHS, the patient would then transfer to the NHS or private (as required) when they are stable.

We are sure most insurers would judge each case on its own merits and to our knowledge we have not seen a situation like this in the UK. 

However, we would be interested to hear of any example of declinatures such as this.

Esther Dijkstra on Scottish Widows protection and improving customer engagement

Scottish Widows must be one of the most iconic brands in UK financial services.

And after almost a ten-year absence they are about to launch back into the adviser protection space.

My guest today is heading up that relaunch. Whilst she isn’t going to tell you all the secrets of the new proposition she does drop some tantalising hints.

Esther is passionate about customer engagement and share her views on what we as an industry need to do to improve that engagement.

Hear Esther talk about the importance of using emotions rather than statistics to empathise with customers.

Listen how looking at completely different propositions, in this case Spotify, can give you a different perspective on customer engagement.

Listen now