Health Insurance News – Best Health UK

Households in the UK are spending almost Ł1,200 a year on private healthcare, a study has found, giving further evidence that the NHS is not “free at the point of use”.

The research by the think tank Reform found that the biggest chunk of private healthcare spending is used for the long-term care of elderly and physically disabled people. The average household spends Ł471 a year on nursing homes and home care for the elderly and disabled.

Other key areas that make up the private healthcare spend include private medical products (Ł268), the hospital sector (Ł217) and dentistry (Ł93).

Andrew Haldenby, director of Reform, said the study further demonstrated that the NHS is not free at the point of use.

“The idea is a mirage, even a charade, which is preventing proper debate about the future of healthcare in this country,” he stated.

Haldenby said it is good that UK citizens are taking responsibility for their own health by paying with their own resources. But he added that the government needs to find new ways to help people pay towards their health.

A spokesman for the DH said: “We will never change the values of the NHS - universal, tax-funded, free at the point of need. Nobody should have to pay for any available NHS service, but patients have always had the choice of paying for private healthcare if they so wish.”

AVERAGE HOUSEHOLD SPEND ON PRIVATE HEALTHCARE

Type of healthcare	Average spend
Source: Reform/Laing & Buisson
Hospital sector	Ł217
Long-term care of elderly and physically disabled people (05-06)	Ł471
Long-term care of mentally ill people (05-06, England only)	Ł24
Long-term care of people with learning disabilities (05-06, England only)	Ł67
General practice (05)	Ł18
Dentistry	Ł93
Private medical products (04)	Ł268
Sight tests (04, England only)	Ł6
Parking (05-06, England only)	Ł4
Prescriptions (05-06, England only)	Ł17
TOTAL	Ł1,184

Predicting healthcare costs is of course dependent on a number of factors, not least the thorny issue of estimating how much the actual cost of medical treatment rises each year. But while the phrase “medical inflation” remains a key weapon in the lazier intermediary’s armoury – it is an easy way to explain annual increases in premiums – it is important that the health insurance industry monitors rising healthcare costs accurately and consistently.

The standard estimate for medical inflation remains “around 10%”. BUPAsays corporate medical inflation is 9.95%, while Mercer, the consultant, says its most recent estimate is 9.5%. Competitor adviser firms come in around the same mark; Lorica Consulting says that an analysis of its bigger schemes of 5,000 lives and more reveals a “real inflation” figure – deflated for RPI at 4% – of around 6%. Similarly, IHC, the consultancy, talks of 9% inflation but, like other intermediaries, points out that it normally achieves less than that for the majority of its clients. A“well run” scheme, according to Aon Consulting, will see medical inflation of between 3%-6%, although it warns that might not be the case in the future, especially with regards to new cancer drugs and changing demographics.

An important new piece of research from Watson Wyatt, though, suggests that medical costs for UK employers are projected to rise by 8% in 2008.

The figure is part of what the actuarial and consultancy firm describes as a “significantly above-inflation global trend”. But although some 71% of insurance companies expect higher or significantly higher medical cost trends over the next five years, the UK is in fact likely to experience lower medical inflation than many other countries. The survey of 85 insurance companies that provide medical insurance to employers throughout Asia, Africa, Europe and the Americas shows that in many countries, businesses will be hit by double-digit increases this year.

MEDICAL COST TRENDS CONTINUE TO INCREASE GLOBALLY

Country	2006	2007	2008 (projected)
Source: Watson Wyatt
Italy	5.5%	11.0%	11.3%
Saudi Arabia	13.3%	13.3%	16.3%
South Africa	7.4%	10.0%	12.6%
United Kingdom	6.0%	8.0%	8.0%
Venezuela	31.3%	25.0%	25.0%

Brokers and providers in the small group PMI industry might think they have it easy. But, as Edmund Tirbutt’s market overview suggests, they might just be enjoying the calm before the storm

Lack of innovation does not have to be a hanging offence, especially if no-one is complaining about it. It can simply be a sign that a particular market is largely at ease with itself, and this seems to be the case with the small to medium sized enterprises (SME) private medical insurance (PMI) market. The prevailing attitude among providers in this neck of the woods is simply that there is little point in rocking a boat that is sailing along quite nicely.

Most insurers that focus on SMEs already now have modular products and seem reasonably pleased with them and also with prevailing market conditions. SME business is stressed to be far less volatile than large corporate business, with some intermediaries and providers revelling in retention rates of over 90%. Unlike their larger counterparts, SME schemes do not tend to be routinely hiked around the market at renewal to see if the current terms can be bettered anywhere else. So those who look after them properly are far less likely to lose them.

Although the SME market is highly competitive and any easy pickings that used to be available have pretty much already been gobbled up, it is definitely still growing. “Steady as she goes” and “still reasonably buoyant” are the sorts of phrases currently rolling off the tongues of provider spokespeople, and 10% to 15% are the sorts of annual growth rates they are reporting for 2007.

Claire Ginnelly, head of business development at Groupama Healthcare, says: “We are not looking to launch any further new products as the feedback is that our Santé product works and that people like its modular format and the fact that it is fairly straightforward as well as flexible. I feel the market has reached a point at which there is no great need for further innovation, although we are still always talking to our brokers to check that the product continues to meet their needs.

“We are focused almost entirely on the SME market, which we see as the growth area because small companies still remain the main growth sector of the economy. The interesting thing that has started to happen in the last few months is that we are getting a lot more brokers introducing virgin business and reporting enquiries for potential virgin business.”

CIGNA HealthCare is noticeably less openly content than the other players, but can hardly be condemned as a pocket of outright negativity. Having started trying to edge its way back into the SME market in late 2005, it is not too gushing about its recent experiences but seems confident enough going forward.

Kirsty Jagielko, group product manager health benefits at CIGNA HealthCare, says: “The last couple of years have been a baptism of fire because the servicing of the administration side has proved more difficult than expected. With big companies and big brokers you don’t have the same high volume of quotes and you are installing small numbers of large schemes rather than large numbers of small schemes. It has been a steep learning curve but we are making steady progress and feel we will accelerate now we have adapted our proposition to the market’s requirements.”

At the other extreme, PruHealth reports achieving a growth in SME business of more than 50% during 2007, and continues to scoff at competitors who suggest that its business model is not going to prove sustainable over the long haul.

Tal Gilbert, head of research and development at PruHealth, says: “Everything is on target and running well, and we are generally positive about the SME market and feel there is a lot of opportunity there. SMEs are primarily concerned with economic survival and with recruiting and retaining good people, when they are often competing with big corporates. So we feel that PruHealth’s very broad range of benefits has been a key to success.

There are, however, some intermediaries who envisage PruHealth starting to receive serious rivalry in terms of new business production from Standard Life Healthcare which, by unveiling Business Healthcare last July, has been responsible for the SME sector’s one significant recent new launch. The product, which caters for businesses with between one and 249 employees, can in some respects be seen as Standard Life Healthcare playing catch-up by finally offering a modular product. But it also goes a step further than the others in the way it has been constructed.

Each category of employee can have a different benefits package built around one or more of four main modules – core healthcare (which includes an online health assessment and information service), dental cover, health cash plan and travel cover.

It also has a range of additional modules that can be added, such as the “core enhancement” module – which includes parental accommodation, pregnancy complications, investigations into infertility, oral surgery, home nursing and help at home benefit – an outpatient module with three possible levels and further modules for both psychiatric treatment and for additional therapies (including alternative therapies).

Other preventative benefits that can be tagged on as optional extras include a GP consultation line or nurse helpline, health screening and an employee assistance programme (EAP). There are also new excess levels and the company’s innovative Guided Option is available, offering a 15% discount to those willing to forsake their choice of consultant and hospital.

Standard Life Healthcare, which reduced premium rates for Business Healthcare by around 10% on average in January 2008, also ensures that most information given at the quotation stage will pre-populate the application form, therefore cuting down on paperwork. Other time-saving features include the ability of intermediaries to change policy details online and to receive policy documentation that applies only to the modules they have chosen.

Paula Aitken, managing director of Advo Group, a specialist intermediary based in Maidstone in Kent, says: “I think it is a great product as it has all the elements a client could possibly want. With prices being more in line with competitors since January 2008, I am expecting it to sell well and we thoroughly recommend it. In the past Standard Life Healthcare has been guilty of being inflexible but this modular plan proves it has listened to its distribution and come up with something that people actually want.”

Stuart Scullion, sales and marketing director at Private Health Partnership (PHP), a specialist intermediary based in Baildon in Yorkshire, says: “We are currently working with Standard Life Healthcare with its Business Healthcare product. We like the modular approach, Guided Option and excess per claim, which enable you to influence the premium for the benefit of a client. It is more flexible and transparent than anything else out there, but it needs the intermediaries to get the best out of it because to do so you must know what your client’s demands and needs are.

“I think Standard Life Healthcare has put its back office in order after acquiring FirstAssist’s PMI book and that it will have a big 2008. The key to getting it right this year is the pricing and the fact that it has dropped rates this January should make it a competitive proposition. Intermediaries have always liked Standard Life Healthcare for its exceptional service standards and now that it has come up with an SME product that people want it should be putting its train back on the track.”

But not everyone appears to have been completely seduced by the new format. Glen Smith, managing director of specialist intermediary HealthCare Partners, based in Braintree in Essex, does not seem to favour it any more than Primecare, its predecessor.

He says: “It hasn’t floated my boat. Primecare was a good product that fulfilled the needs of the market and there has never been a problem with Standard Life Healthcare except on price, which is a problem that continues with Business Healthcare. It doesn’t matter to me if a product is modular because most people want fully comprehensive cover if they are being served by an intermediary who fully explains the market.

“I am not yet familiar with the apparent recent new price reductions for Business Healthcare but if Standard Life Healthcare says it is going to get competitive, then I certainly look forward to it. It has been out of the water on pricing for several years, and we are not talking about a differential of 10% but about a big margin. The company is only a minor player as far as we are concerned.”

Even invitations to “watch this space” only throw up the possibility of one new product launch lying around the corner. BCWA Healthcare is working on a new formula for SMEs likely to be released in the second half of 2008. It is expected to include the Service+ facility currently available on its Personal Health product for the individual market – like Standard Life Healthcare’s Guided Option, this reduces cost by managing the patient journey.

The next best space to watch concerns systems issues. AXA PPP healthcare intends to make significant back office improvements during the next two years. It acknowledges that, having recently gone through a massive growth period, some of its systems have failed to keep pace.

The bulk of company specific news about developments that have actually taken place are confined to the addition of wellness modules or of specific wellness features. Norwich Union Healthcare’s launch of Get Active in November 2007 has been one of the most notable of these. The scheme, which involves a tie-up with Health Force, provides discounts of 15% to 40% on membership of a range of fitness clubs across the UK for all PMI group scheme members (as well as individual PMI policyholders and group risk and group life scheme members).

However, not surprisingly, most recent additions have come from PruHealth, which seems intent on extending its Vitality point system to encourage virtually any positive health feature imaginable.

One wonders how long it will be before it starts offering policyholders Vitality points for washing their hands before meals or for drinking decaffeinated coffee.

In July 2007 PruHealth upgraded its gym offering so that the more often policyholders go to the gym the less they pay for gym membership. Those who go twice a week or more to certain gyms can soon be paying nothing at all for membership. The company has also significantly expanded its network of gyms so that it covers almost a third of specialist health clubs – which is especially important for SMEs as most of them are only regionally represented.

In September 2007 PruHealth entered into a partnership with Sainsbury’s that enables Vitality points to be earned through buying fresh fruit and vegetables, and in November 2007 it joined forces with online auction site eBay to make Vitality points available for purchasing eligible sporting goods. It also started making a substantial investment in the service side of its operation in February 2007, building teams of nurses to ensure that all claims-related calls are now dealt with by nurses.

In September 2007 BUPA gave all its scheme members access to Positive Health, which provides free online wellness advice on subjects such as fitness, diet and sleeping habits, and in January 2007 it extended its longstanding practice of offering discounts for gym membership by actually providing discounted gym membership through an exclusive deal with Fitness First. It is also currently considering extending the availability of a face-to-face fitness check that it currently provides to its own staff to SMEs that can afford to install their own in-house facilities. It expects this to appeal to many larger SMEs employing between 50 and 300 staff.

Additionally, in October 2007 BUPA set a precedent that could have huge implications for the group health insurance field as a whole by announcing a fundamental structural change in the way it runs its business. Whereas previously it had operated as three separate units – PMI, group risk and wellness (which includes occupational health) – all of these now operate as a single entity.

Chris Bromilow, head of company sales at BUPA, says: “The emphasis is now on offering discounts and on simplifying the whole process, so brokers now have their own telephone number to ring for a whole range of advice. We have gone the whole hog and are no longer cross-selling from PMI but making multi-product sales. We should now be talking about SME business as a whole and not about SME PMI.”

It would be no great surprise if other insurers also started to adopt a similar stance, and the marked degree of consolidation that we have seen among intermediaries (see box on page 26) is also likely to take the market in the same direction, because the larger intermediary groups will have more resources to ensure that they are able to help employers with their entire range of wellness and health insurance needs.

“Consolidated intermediary groups are approaching us and asking us not just for preferential prices but also for enhanced products,” continues Bromilow. “We are in the process of listening to them and we wouldn’t rule out arriving at some arrangements as long as they are linked to our new system of integrating the three product areas. All these conversations are around the SME sector because, when intermediaries are dealing in bulk, they want a quick, safe and simple process that saves them money.”

Another implication of the recent consolidation could also be a trend in the direction of intermediaries and insurers forming preferred provider arrangements or specialist schemes offering enhanced terms and commission arrangements along the lines of those so commonly available in the general insurance market.

AXA PPP healthcare has ventured the furthest down this route to date, having started offering bespoke deals and products two years ago to intermediaries able to demonstrate an ability to introduce volume business. CIGNA HealthCare started offering its first PMI preferred provider arrangement in January 2008 and national specialist intermediary Towergate Healthcare has operated a preferred provider arrangement with Norwich Union Healthcare since July 2007.

John Crisford, chief executive of Towergate Healthcare, says: “We are always interested in discussing with insurers the implementation of preferred provider arrangements. As with the Norwich Union one, these will enable us to offer clients an enhanced proposition but at the same time will not affect our ability to offer whole-of-market advice. The approach represents a key part of our strategy of reinventing the traditional PMI model by offering great value through market leading products and services.”

WPA has also set off down a broadly similar route by expanding its use of appointed representatives or “franchisees” to provide an exclusive service to independent financial advisers (IFAs) who are not currently involved in PMI. The company reports that the concept is proving highly attractive on the grounds that IFAs do not have to spend time doing whole-of-market reviews in what is a rapidly changing field and realise that the franchisees do not constitute a threat to other business – as they only sell PMI.

Exclusive arrangements can make dealing in PMI easier for SME customers and can give them access to a higher standard of product, and there is nothing to stop intermediaries from both offering schemes and providing whole-of-market advice. But there are inevitably those who warn that the trend will restrict choice.

PHP’s Scullion says: “I feel there is a danger. I don’t think insurers can afford the insurance market to shrink as it reduces choice of distribution, and I don’t think intermediaries want choice reduced either. So I think that it is only those making the acquisitions who want the consolidation.

“This could all rock the boat in the SME market as it will push up the levels of commissions in exclusive deals and therefore put up costs as prices will harden in a shrinking market.”

Such a health warning is perhaps surprising, coming from a spokesman from an organisation that has been among the sector’s most acquisitive during recent years, and whether consolidation will ultimately prove a good thing or a bad thing will probably remain unclear for some time. The one thing that is certain, however, is that the market is changing and, while the insurers and intermediaries involved are clearly largely content with their lot at present, they simply cannot afford to take their finger off the pulse.

2007 was the year in which the focus shifted from insurers acquiring other insurers to intermediaries being acquired by other intermediaries and, in some cases, by insurers. But Legal & General’s decision to exit the PMI market in February 2007 and to allow AXA PPP healthcare to offer its customers renewal terms has been widely misconstrued as having constituted a takeover situation.

On the intermediary front, however, AXA and its subsidiaries can hardly be accused of losing their acquisitive appetites. Their conquests during 2007 included healthcare intermediaries Essential Healthcare and The Health Insurance Group (THIG) and employee benefits consultancy PIFC Consulting.

But, although some may find it hard to believe, it is possible to have merger and acquisition activity that does not involve AXA, and one of the highest profile deals to prove this point has been the November 2007 acquisition by national intermediary Oval Group of United Medical Services, a specialist intermediary based in Bristol and Lytham St Annes. Others have included Private Health Partnership’s August 2007 acquisition of the medical insurance portfolio of Home Counties Healthcare, a specialist intermediary based in Luton in Bedfordshire, and this January’s merger of Advo group and Colchester-based specialist intermediary Health Plan.

But of potentially even greater significance in terms of creating the type of clout that can help secure preferential terms with insurers has been a recent trend for intermediaries to acquire or launch broker networks.

In November 2007 national corporate consultancy Jelf Group, which had also acquired several regional insurance brokerages during the preceding months, announced the launch of The Purple Partnership, a new network which provides brokers with the chance to enjoy collective bargaining that benefits from Jelf’s provider relationships. The following month national insurance intermediary Towergate then announced the acquisition of the AIM-listed insurance broking network business Broker Network.

Experts have forecast that the number of cancer cases could rise by a third to 300,000 a year by 2020.

Meanwhile, our survival rates are among the worst in Europe, because we spend less on treating the disease than many other countries. Some advanced drugs that are used in Europe are not available on the NHS.

In answer to this, some insurers are offering cancer-only cover, but what does it do and is it worth taking?

Earlier this year, Western Provident Association (WPA) launched a scheme which pays for cancer drugs that are not available on the NHS but are approved by the European Medicines Agency. Called MyCancerDrugs, it pays a lifetime maximum of Ł50,000.

You still have your care from the NHS, but it pays for drugs and private treatment to administer them. With some advanced drugs costing Ł10,000 a month, critics believe the cap of Ł50,000 is too low, but premiums are cheap.

Your health authority may refuse to treat you if you mix and match their service and private treatment, though WPA's lawyer Nigel Giffin QC says this is illegal

Premiums are the same as your age, so a 40-year old pays Ł40 a year plus 5% insurance premium tax (Ł42 in total).

There are restrictions. It's only available up to the age of 65 — cancer often strikes in old age — and anyone whose parents or siblings had cancer before the age of 60 will not be eligible. It also won't pay out within 90 days of taking out the policy

Julian Stainton of WPA says: 'People without medical insurance tell us they need help to get and pay for these very expensive anti-cancer drugs when they've been refused them by the NHS, which is why we devised this policy.' Prudential has a serious illness policy sold under its PruProtect arm which reduces the cost of cover for those who lead a healthy lifestyle. Customers get subsidised gym membership, have help giving up smoking and are offered health screenings.

If they then use the gym, lose weight and generally lead a healthy life, they earn points to reduce their monthly premiums.

The policy covers more than 140 serious illnesses and medical conditions, including cancer.

It pays out in stages based on the severity of the illness, ranging from 10% of the sum assured at the outset rising to 100% if the condition becomes really serious.

A 40-year-old man who doesn't smoke would pay Ł76.73 a month for Ł100,000 of cover over 25 years, reducing by 2.25% a year if he takes part in the healthier lifestyle programme.

The cheapest option is to move to Scotland where many of the advanced cancer drugs denied in England are freely available on the NHS. Mr Giffin, who examined the possibility for WPA, found that you need only to live in Scotland for a short time in rented accommodation to take advantage of the country's favourable system.

Cancer patients in Scotland can be prescribed one or more of 19 life-saving or life-prolonging drugs on the NHS that are denied patients south of the border.

An alternative to cancer-only cover is private medical insurance, which pays for treatment of acute conditions such as cancer and operations such as hip replacements, hernias and heart attacks.

The biggest providers are Bupa, Norwich Union, Axa PPP, PruHealth and Standard Life.

Before taking out a policy, read the exclusions carefully. You won't be covered for pre-existing conditions and other common exclusions are emergency treatment after an accident and chronic illnesses, such as asthma, Alzheimer's and arthritis, where you are unlikely to return to your previous state of health.

Check insurers' definitions of 'acute' and 6.40% 6.40% 'chronic'. Most limit how long they will fund treatment for a condition before they regard it as chronic. Some have stopped paying for cancer drugs part-way through a treatment.

Costs vary widely depending on your age, your state of health and even where you live — Londoners tend to pay more, for example. A 40-year-old non-smoker in good health is likely to pay around Ł60 a month.

With many policies, you pay the first Ł100 of any claim yourself, though you may be able to choose the amount of excess. You can choose to pay a bigger excess to bring the premiums down, but this may leave you unable to claim at all for smaller problems.

There really isn't a higher priority in life than the health of you and your family. But that doesn't mean you need to break the bank to pay for the best treatment. Our comprehensive guide to insuring your health shows you what to buy, where to buy it and what to pay.

The key benefit of private medical insurance (PMI) is that it will pay for the insured to be treated more quickly than on the NHS, by medics of their choosing and probably in greater comfort. In this way, PMI is a luxury product rather than an absolute necessity

It is not an alternative to the NHS; private hospitals do not have casualty departments, for example. Neither do you necessarily get better care - but you do get it more quickly and at a time and place to suit you.

So before you buy, ask yourself if these benefits are worth the money you will be forking out. Will the money you spend on PMI premiums be of more use inside a savings account? You could always put the money towards treatment if you need to.

If you decide that you must go private, check that you aren't already covered. Some employers provide medical insurance for their workers, and even for their families. Check if your or your partner's employer runs such as scheme. If you need to pay to be in the work scheme it may work out cheaper than buying your own insurance, so compare the costs of each.

*IMPORTANT - You must pay close attention to what is actually covered in each policy. Different polices can provide wildly different levels of cover, with some treatments and conditions covered in one policy, but not another.

If you are worried that you may end up with a policy that won't suit your needs, or if have particular requirements that you feel need to be catered for, it may be better to use an insurance broker to buy your insurance.

The Association of Medical Insurance Intermediaries (AMII) enables you to find a reputable broker in your area who can give you advice on what policy to go for. They are usually paid through a commission from the insurance company.

It might be worth your while asking if they are able to reduce the commission they receive in order make the insurance cheaper for you. Remember, if you don't say yes to the insurance, they get nothing, so you are in a strong position.Cutting the cost

The cost of insurance depends on a number of factors. Traditionally, insurers have priced their insurance according to your age, sex and whether you smoked, but increasingly they will take into account the more general state of your health.

Some will offer no-claims discounts that can be passed from one insurer to the next. Check to see if you are able to benefit from such an arrangement.

You may also be able to increase the excess – the amount that you pay towards the cost of treatment before the insurance begins to pay – as is possible with car insurance policies.

This can help to reduce the monthly cost. For example, A non-smoking couple, both 35, with and two year old son would pay Ł31.20 a month to get basic PMI cover with a Ł500 excess. If they increased the excess to Ł1,500, the couple would pay Ł23.31 for the same level of cover.

If you think you could cover a slightly higher excess payment, this might be a good option.

If you are self-employed, and you know other self-employed people, you could club together and take out a group medical insurance scheme. It can work out 50% cheaper for the individuals and can be arranged with the help of a broker. Use the AMII to find one.

Finally, to keep costs low you should look for PMI every year. The insurance works on a renewal basis, like car insurance, and your insurer may increase your premium if you renew with them.

If you feel you don't need, or you don't want to pay for, a PMI policy, a Healthcare Cash Plan may be a better option. Cash plans are similar to insurance but they only pay out set amounts for certain circumstances, rather than pay for treatment whatever the cost

For example, in exchange for your premium you might get Ł300 of dental treatment, Ł100 of physiotherapy etc, in one year.

The allowances go up with your premium and you can pay anything from Ł4 to Ł30 a month.

There are limits on what the plans will pay for, for instance it might pay 80% of your dental bills up to a maximum of Ł100 a year

Besides cash plans, there is a new generation of health insurance products that differ from traditional PMI.

PruHealth's Vitality Plan, rewards policyholders for staying fit. If they use the gym regularly, do not smoke and undergo regular check-ups, they can earn discounts of up to 75% on their premiums. And there are guaranteed no-claims bonuses of at least 25%.

Every parent dreads their child suffering an unexpected serious illness. It happened to Colin and Victoria Boxhall, who still wake up some mornings wondering whether it was all a bad dream.

It wasn't. Their nightmare began when their son Alex went down with what his parents thought was a routine infection two years ago. But his health soon deteriorated alarmingly and they rushed him to hospital near their home in Ewhurst, Surrey, where doctors said he had suffered a stroke.

Alex, eight at the time, was immediately transferred to Great Ormond Street Hospital for Children in central London where further tests revealed he had developed a clot on the brain.

Thankfully, as a result of the superb skills of the doctors at the country's leading children's hospital, Alex has made a good recovery, though he has had to endure prolonged speech and behavioural therapy to aid his recovery

Apart from the emotional trauma, the illness hit family finances as Colin, 44, had to take time off work as a financial adviser to attend hospital appointments with Alex and Victoria, 46, a carer, was absorbed in looking after Alex and their older son, Joe, 11.

The Boxhalls had a critical illness policy with Bupa that embraced the whole family, so when Alex was ill, the policy paid a lump sum of Ł12,500.

Colin says: 'Because of my work, I have always known how important it is to have adequate insurance in place. But the true value of such insurance doesn't really strike home until you benefit from it.'

Critical illness insurance pays out a tax-free lump sum on the diagnosis of certain serious illnesses, for example cancer, multiple sclerosis or following a heart attack or stroke. Despite its 'comfort' factor, the number of people taking out such insurance is falling. Data from reinsurer Swiss Re shows that just under 600,000 people took out critical illness cover in 2006, 50% down on five years ago.

There are a number of explanations for its declining popularity. As medical care has advanced, the probability of surviving many serious illnesses has improved, causing insurers to impose tough new restrictions on illnesses they will pay out on. And cover has become steadily more expensive. In addition, consumer confidence has been eroded by the habit some insurers have of rejecting claims.

Financial Mail has repeatedly highlighted cases where insurers have turned down claims on the basis that a minor, unrelated ailment had not been disclosed when the policy was bought.

Britons choose hygiene over privacy as the top reason for wanting private medical insurance, according to BUPA's annual health of the nation survey. The survey was conducted earlier in the year and involved 1,024 face to face interviews.

When questioned on the reasons for not taking out private medical insurance, affordability and being happy to rely on the NHS were the top reasons.

Cancer remains the top health concern for both men and women whilst heart disease and blood pressure are also a worry. However, 17 percent of women are also worried about Bird Flu while about one in ten men are concerned by the virus.

The majority of UK residents are wholly unaware of how expensive healthcare treatments and procedures are in real terms, whether performed on the NHS or by private providers, a new survey says.

Insurance and investment firm Legal and General says that people underestimate the true cost of healthcare by almost two-fifths.

Research conducted by YouGov in May 2006 found that the most commonly undervalued health treatment was cataract removal, with respondents' average estimate of £1,362 58 per cent short of the actual cost of £3,275.

While the cost of treating varicose veins (£2,680) was misjudged by 43 per cent, it is not just cheaper procedures that are miscalculated, with Britons estimating how much heart bypasses cost healthcare providers as £10,347, more than £7,000 off the realistic cost.

Other treatments that respondents had false value-impressions of in Legal and General's survey include hip replacement, hernia repair and knee replacement, with the true cost of the former underestimated by two-fifths.

Tessa Webster, director of customer services at the company, warned that few people "are aware of the actual costs of treatment should they need an operation, which only the minority could afford if they were expected to pay it themselves".

She added that "despite negative press coverage the service the NHS provides can be invaluable", with four-fifths of Britons saying they rely on the health service for healthcare.

Today's survey also found that people aged between 18 to 29-years-old are the least clued up when it comes to healthcare costs, while the over 50s are the most in the know

Hundreds of thousands of businesses face chaos thanks to the new law that officially recognizes same-sex couples in registered civil partnerships as married.

Same-sex couples can now claim parental leave, emergency time off for dependents, adoption leave, maternity and paternity leave, and can make requests for flexible working. The Civil Partnerships Act 2004 gives same-sex couples the same rights as married couples. That means businesses will need to make sure that all rights and benefits given to married employees are also offered to staff who have the status of civil partner.

Where, for example, an employer has a benefits package (such as private health care), which is available to the spouse of an employee, it should also be available to an employees civil partner. More favourable benefits can also be conferred on civil partners as they are for married people, and a surviving civil partner will be entitled to the same pension benefits as those of a surviving spouse.

20 Feb 2006 - Our Health, our care, our say: a new direction in community services

On 31 January, the Department of Health published a White Paper entitled 'Our Health, our care, our say: a new direction in community services', stating that the Government aims to build on previous work and move towards "a greater emphasis on prevention".

Some of the areas of the White Paper which we believe are of most relevance to our industry, our businesses, and the businesses of our clients are:

PruHealth are offering any new private medical insurance customers free gym membership to Canons or Holmes Place up until 28th February. The membership will be free for 6 months and there is no tie in period. PruHealth have a unique health insurance concept where they reward their customers for staying healthy. They operate a system called "vitality" and points are awarded for various activities. These points can mean that medical insurance premiums are lower at renewal. For more information, contact Best Health uk on 0800 073 0582.

For most organisations, employees are the biggest investment they make.
Like every asset, it pays to ensure they have the right environment to maximise their effectiveness and productivity. For many companies the effects of stress in the workplace is a real cost burden.

Research carried out by the Chartered Institute of Personnel Development in 2004 identified that nearly 40% of employers reported an increase in stress-related absence, compared to the previous 12 months.

The cost and consequences of employee absences have long been a serious issue for UK employers, but proactive moves to limit them are only just beginning in the UK. Plenty of research exists to demonstrate that promotion of health and wellbeing in the workplace can create improvements in productivity and reduce absenteeism.

Employers in the Bristol area attended a seminar on Thursday 8th December to find out for themselves how investing in the Health and Wellbeing of their workforce can provide tangible benefits.

Companies based in Bristol who have recognised the benefits of promoting Health and Wellness in the workforce include Mechanical Engineering Services, Lucy Bristow Appointments and Mainline Employment, all of whom are very happy to talk about their own experiences with the media.

The seminar was sponsored by Pruhealth and hosted by Cannons Health Club in Bristol. Best Health uk are keen on promoting Pruhealth as they have an innovative product that is unique in the market place. Their medical insurance recognises and rewards members for staying healthy. Cannons Health Clubs are vitality partners with Pruhealth. The Vitality Points concept is that if members reach a certain level of points, their premiums are reduced. There are many ways to achieve these points - going to the gym, checking the Pruhealth website for healthy meal recipes, having a health check etc.

Burges Salmon, well known employment law specialists locally, spoke at the seminar about the legal implications of stress in the workplace and of course preventing them.

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