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The importance of critical illness cover

Hi, I'm Rob Rosa, chief medical officer here at AIG and I'd like to spend a few moments just talking about the importance of Critical Illness Cover. Now, Critical Illness Cover is that lifeline, that parachute. You don't ever want these policies really to pay out; if it pays out, it implies that you've actually had a fairly major catastrophic medical emergency that's occurred in your life. So it's one of those policies that you buy, you put on the shelf for a rainy day hoping that you never actually have it paid out. However if you are in the unfortunate position and you do have something happen in your life, then really what you need to be concentrating on as an individual is just getting better. What you don't want is to have that financial insecurity, that worry, that fear factor because it just adds layers on top of your recovery and it prevents you from getting better.
Now, medical practice has evolved immeasurably over the last ten years and will only continue to do so. So we are finding that we're making recoveries quicker, swifter, with far less long-term problems from conditions such as stroke disease, heart attack, all-cause cancer. But that doesn't take away from the enormity, from the impact of actually what these conditions represent. So in my time as a general practitioner, where I've spent 18 years as a medical doctor in the NHS, I've seen at first hand actually what these diagnoses cause; the pressure on the family unit, the stress on self, the impact actually on your ability to maintain your occupation. So at the time in your life, if one of these actual conditions do occur, then I think it's absolutely paramount and essential that you have proper financial security in place. And that comes from Critical Illness policies.

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Critical illness: Why we don't talk about it

With Critical Illness Cover most of us actually focus on what the Ts and Cs say and importantly, actually, what the condition is that you're claiming for. There's that whole hidden background aspect of the enormity of this condition, the effect that it has on yourself and the effect that it has on your family. So for instance, if you have a major diagnosis like heart disease, once you've had your heart attack that could knock you out of action for weeks. The rehabilitation courses that you go on, the impact of actually doing your daily exercises, the constant general practitioner visits of adjusting your medication, of seeing your practice nurse to get weighed, to have your blood checks; these are major factors that will impact your life for a considerable period of time and potentially for the rest of your life itself.
So whilst it's tempting just to look at the headline grabber, the condition that actually you're concentrating for and claiming for, I think that's actually missing the true enormity, the daily impact of your family. Of course when you get that payment, that slug of money that goes into your bank account, of course that doesn't just sit there. That's yours to actually fund and buy additional care, top-up care to make you get better quicker, potentially to feed and then dovetail with what the NHS can offer you. But most importantly it's there so that you've got choice, so that you can then still provide for your family whilst you're just getting better on your own.

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Medical advancements and critical illness

Good morning, I'm here with Doctor Rob Rosa, our chief medical officer at AIG Life. We're going to be talking about medical advancements and what impact they're likely to have on critical illness. So, over to you, Rob, to tell us a little bit about who you are and what you do here at AIG.

Hi Helen, I'm Rob Rosa, chief medical officer here at AIG Life. In my former occupation I was a full-time NHS general practitioner. I was a GP and senior partner in a very busy inner-city primary care facility in Salisbury for the last 18 years. Twelve months ago, I made the hop over to pure insurance-related medicine, which is where I've now been employed by AIG.

What advancements in medicine do you think will impact critical illness the most in the next five-to-ten years?

I think undoubtedly the hot topic in insurance medicine at the moment is the liquid biopsy. The liquid biopsy is not a biopsy in the traditional sense. At the moment, the gold standard is - and perhaps potentially will always remain - a solid tissue biopsy. But we have got the option for liquid biopsy, which is quite a novel approach to looking at molecular levels within all sorts of fluid, so cerebrospinal fluid, blood fluid, possibly even urine. This is looking at tiny amounts of DNA that a tumour then releases into the system. So, the potential is actually to diagnose cancer sooner. Obviously, if we could get to the screening stage, that would be a magnificent achievement. I think that the landscape is there for this to actually develop but I think that we're not quite there yet. In five-to-ten years, you may start to see liquid biopsies being used far more fluidly.

Great, so that could make a big difference in claims handling for critical illness?

The potential, the impact is actually huge. We also have to be slightly cautious because if a liquid biopsy can then actually look at a precancerous diagnosis, you've always got the run of the risk then of anti-selection but I think that we will cross that bridge later on.

In your medical practice, what medical conditions do you see having the biggest impact on patients and how do you see that critical illness can help support them with that?

I think that this won't come as a shock to anyone to know that obesity probably is the biggest risk factor to CI certainly over the next five-to-ten years and probably substantially into the long term as well. If you look at the three major Cs, so cerebrovascular disease, cardiovascular disease and cancer, and you remember those old mathematical Venn diagrams you had at school, if you put obesity in the centre of this and like a spider's web then coming off, you'll see actually that obesity has the biggest impact. I think the claims experience moving forwards, we will then see more and more cases with a direct correlation with obesity. And without using the pun, it's a big problem and I think it's a big challenge not just at a local level but I think at national level and certainly if not global. So our own personal experience of CI, I think, is very much going to be shaped with obesity moving forwards.

I was hoping you could share with me some information on what are hot topics in medicine at the moment.

Well, those two that I've just mentioned there probably are not just hot topics but I would actually say white hot topics. You've got government agenda being driven by obesity crisis and on the other side of it, you've got liquid biopsy, molecular level, ultra-niche levels of medicine which is actually coming into mainstream practice. I think that those two together are the twin elements that we're seeing. They face a challenge, not just a financial challenge, but of course the treatment challenge as well. And if we could just crack some of the core levels at the earliest possible stages then we stand the chance moving forwards actually of making really solid healthcare grounds.

So there's a real focus on prevention rather than cure?

Prevention rather than cure is always the gold standard, isn't it? If we can actually address it in the early infancy of these conditions, then actually we stand a better prospect of actually having some - well, not just a decent dialogue about these conditions - but actually having proper management strategies that effectively work.

Brilliant. Thanks, Rob, that was really insightful. Thanks for joining us here at AIG and we look forward to working with you more in the future.

You're welcome.

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Mental health and Critical Illness

Mental health is one of those silent background illnesses that unfortunately can reach catastrophic levels and so CI cover really is there designed in that awful eventuality if you experience a major life event and you end up with a major serious psychological or psychiatric disturbance. It's not intended for the lower-grade levels that stay within primary care, but really for those conditions that have the most enormous intrusive impact on your lives. And when you take out CI cover, by and large you don't expect to have one of these but life is not like that. Unfortunately as life continues, we are constantly exposed to stresses and to strains and the eventuality that you have a very unexpected serious mental health diagnosis or that you're sectioned for some reason or another, then of course a CI product may be there to provide some of that background financial security for you and for your family.

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Pregnancy

So the next topic actually is really quite a difficult one; it's one the very seldom people will want to share with friends or even with their family unit and it's about pregnancy complications. Now, this is the most unthinkable situation; where something happens that actually threatens the advancement of your pregnancy. The pregnancy is something that you've planned for, that you desperately want to succeed, and in that situation unfortunately things can happen and unfortunately they genuinely do happen. So in that scenario, you want to know that actually you do have some support so that you really can devote time not just for yourself to get better, but for your family and your friends actually to share in that involvement of getting better. In some instances, unfortunately, pregnancies end in a bereavement. In those catastrophic situations, really your life is then put on hold. So if you are going to have a policy with this kind of benefit that adds in place there, it's really for that event that you don't want to take your mind to, but unfortunately for a core group of women it does happen. And when it happens you need to know that actually you've got some support in the background.

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Pacemakers: How they work

Pacemakers have actually revolutionised our treatment of dysrhythmias and abnormal heart rates in medicine. As the years have progressed we've actually gone now to quite incredible devices. Now, these pacemakers are really novel agents; they will either correct an abnormal rhythm, slow up a very fast rhythm or speed up a very slow rhythm. So we can actually programme them manually in order to keep somebody at a nice regular distinct rhythm permanently. The way in which we actually fit them is you make a very small incision just under the skin, create a little pocket; it's usually just on the left-hand side. The pacemaker itself is a little disc. That sits inside there. This is all done as a day case unit, taking perhaps no more than 30-to-60 minutes in the operating theatre.
They have a couple of leads; they will attach inside the heart, sit inside the chambers and bury themselves into the wall. What they do is they keep that nice regular rhythm, so it's designed to kick in when your rhythm goes into an abnormal one. The follow-up checks take place every six-to-12 months. The batteries last a few years. Really once it's in place, life doesn't really change at all. In fact most people should feel slightly better. Heart rhythm disturbance tends to cause things like chest pain or even some aching and certainly some shortness of breath. So actually a well-chosen pacemaker that's fitted correctly and is working properly actually makes you feel an awful lot better. So in terms of the procedure itself, pretty slick, very quick, very simple technically. In terms of the long-term prognosis; absolutely excellent. In terms of you feeling better; once you've had it inserted, you feel brighter, you're able to walk further with less shortness of breath and your limitations on life, apart from extreme strenuous exercise, actually sees no difference whatsoever.

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