With the front page of this month's Cover magazine and numerous additional thought pieces throughout, Kevin Carr says the non-payment of CI claims has again become the industry's big talking point.
My last piece on the subject drew much feedback, in particular from the manufacturing side of the industry and those involved in the underwriting process, who perhaps took things a little too literally?
Consumer opinion carries more weight these days than arguably ever before and while nobody is advocating a removal of all claim T&Cs the industry does need to consider its long term future.
The distribution sector though, and typically those in the media, were far more supportive.
Peter Chadborn of IFA firm Plan Money agrees with the bigger picture that public perception beats reality and makes a crucial point: "Of course we can't just pay all claims, but being seen to win an argument on a technicality is part of the problem."
The point Peter makes about ‘winning' on a technicality rings true and feels a bit like winning the battle while losing the war. We need to look at the options because being technically right won't matter a great deal if there's not much of a market left to be technically right about.
I sit in many meetings with different insurers and reinsurers and pretty much everyone is talking about the latest minutiae element to tweak.
Such improvements are often made because it is what is best and fair for the consumer, as well as trying to increase new business of course.
To an extent we've moved on from the so-called ‘conditions race' and many definition changes these days are positive for customers.
I get that some of these tweaks and changes have cost impacts too, sometimes significant ones - such as the rising cost of children's cover, but isn't this all missing the bigger picture?
All protection claims are emotive and children's CI especially so, but this area of cover has developed largely because we don't want to decline claims.
Mr Chadborn added: ‘Those of us who advise, manufacture, underwrite and pay claims are expected to know the detail. The public are not. Laypeople are never going to read the voluminous guide of CI definitions.
"They enter into a contract with the motivation generally along the lines of: if I get really, really ill, you know, cancer and all that, then I've got a financial cushion to help me out so I guess that's worth paying for."
Looking back, critical illness cover was acceptable in the 80s. Founded by Dr Marius Barnard, the first product was launched in 1983 in South Africa, under the name dread disease insurance.
Cover was originally sold with the intention of providing financial protection following the diagnosis or treatment of a small number of illnesses deemed to be critical.
Things got a bit blurred in the 90s as more and more conditions were added while the product became less about life saving operations and more about protecting mortgages.
Marketing expert and ex-insurer MD Roger Edwards says the complexity caused by adding and changing conditions hasn't always helped.
He said: "Sales figures suggest that competing on complexity is not working for providers nor is it engaging consumers. All it achieves is holding onto your share of a declining market with your fingernails. Plus, we create more opportunities to "win on a technicality"
"Every time we stick a pin the medical dictionary and add a new condition. No one is going to win the illness race. Someone needs to be bold and drop out of it whilst they're still fit enough to try something new and relevant to the client."
In the 00s it was a case of Diff'rent Strokes as PruProtect (VitalityLife) sought to revolutionise the product with a new approach.
The severity concept, where the amount paid reflects the seriousness of the illness, dates back to the original design of the product in the 80s, but the more Vitality continues to succeed the more questions arise about the longer term future of traditional cover based upon a list of named conditions.
VitalityLife Deputy CEO Deepak Jobanputra is adamant that the industry needs to keep moving forward: "The traditional ‘all or nothing' CI model is broken and for the industry to grow we must keep innovating to best meet the changing needs of consumers.
"Across the industry there are sometimes large pay outs that aren't always warranted and at the same time there are some genuinely harrowing situations where no money is paid out at all.
"So it's good see to see the ongoing trend across the market towards severity based cover, but that is just one example of positive innovation.
"We need to see more because it is irresponsible if the industry provides poor benefit solutions because it does not keep pace with medical advances."
The industry has taken many forward steps over the last decade or so as the number of claims being paid continues to rise.
However, there are calls to replace the traditional idea of a list of illnesses with cover that pays out based on the impact, rather than the name of an illness. In theory this sounds like a good way forward - and is perhaps not a million miles away from Income Protection, but overall it is easier said than done for a product that pays a one-off lump sum.
So where are we now? Sales continue to fall, albeit by a little, and consumer confidence isn't great. As an industry we've been saying for years that we must do more to promote the positive side of our industry. A press release once a year about claim stats is good, but it's nowhere near good enough.
UnderwriteMe's Phil Jeynes agrees: "Most insurers have a "grey claims" team, tasked with looking at claims which, while not spurious, could be declined based on not exactly meeting the required definition within their contract.
"The aim of these teams, particularly in recent years, has been to look for ways to honour the claim, not reject it. I wonder whether more can be done by insurers to publicise the work they're doing in these areas; presenting a human face to a sometimes suspicious public?"
We know the good work we have all done over the years and most people reading this will have been involved in far more paid claims than we have declined ones.
But as somebody once said, those who look only to the past or present are certain to miss what's coming in the future.
Kevin Carr is chief executive of The Protection Review
