Diana Clement 's Opinion

Your Money and careers writer for the NZ Herald

Diana Clement: Insurance - it's a tough game for women

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Some of the rules are harsh ... but we can do more to protect ourselves

Wives must take charge of their own insurance instead of leaving it to their spouses. Photo / Thinkstock
Wives must take charge of their own insurance instead of leaving it to their spouses. Photo / Thinkstock

Women sometimes get a raw deal when it comes to insurance. The reasons are varied and aren't all the fault of insurers. For one, we're our own worst enemies. We leave sorting out the insurance to our husbands.

We also have more financial barriers than men. We earn less, for one. And if we work part-time, we're less likely to be offered subsidised or free health insurance through work.

Then, because we have more complex health problems than men we are charged more for health, income protection and trauma insurance — and consequently fewer of us have cover.

Income protection insurance is a must for some people. It pays a portion of your income for a set period of time if you can't work — or, with a few policies, become unemployed. The alternative is being paid a pittance by Winz.

Trauma insurance cover pays a lump sum if you're diagnosed with one of a list of illnesses.

Although women earn less than men on average, they pay more for their income-protection insurance. I used the LifeDirect search to compare premiums and found that a 35-year-old non-smoking man insuring a $65,000 salary will pay $50.70 a month at insurer Sovereign, compared with a woman with the same profile who would pay $59.55.

The reason is that women make more claims for mental health and stress-related conditions.

Sovereign's head of brand and innovation, Chris Lamers, says that although women claim more than men, there was a mix of underlying claim causes.

"For example, women relative to men have a higher proportion of claims for mental health issues and genito-urinary claims but a lower proportion that are related to accidents.

"Overall though, women have more disability income protection claims than men, driven by higher incidence rates and lower recovery rates."

Statistics supplied by Sovereign from reinsurer GenRe showed that 24 per cent of new claims from women were related to mental health, compared with 14 per cent for men.

As well as paying more, women are far less likely to have income protection insurance than men.

Sovereign says the split between men and women is 68 to 32 in favour of men. For life insurance, however, it is 50-50 and trauma cover 49-51.

There is evidence that women are more likely to have their claims declined because of pre-existing conditions.

Women make more GP visits and take more prescription medicines than men. As a result insurance companies are more likely to find evidence that a condition occurred before a policy was taken out.

As well as the insurances mentioned above, this also affects medical claims under travel insurance.

When it comes to health insurance, women have breasts, uteruses, ovaries and other parts that men don't (although men have prostates). We are also more likely to suffer from osteoporosis, autoimmune diseases such as lupus, multiple sclerosis and rheumatoid arthritis. Men do have more heart attacks than women.


One of the main reasons men have
more insurance cover in general
than women is that they are the
breadwinners. It's often assumed
only the breadwinner needs cover.
But if a non-earning spouse becomes
ill or incapacitated, it can cost the
family a lot in childcare and other costs.

One issue that comes up fairly frequently in complaints to the Insurance & Savings Ombudsman relates to breast reconstruction surgery. Or more to the point, insurers turning down claims for it. It could be argued that breast reconstruction is cosmetic surgery.

But is it any different from providing someone who has lost a leg with a prosthetic leg?

In one case, an insurer declined to pay for all but the first stage of a breast reconstruction. The woman was covered for reconstruction performed at the same time as the mastectomy. But the Ombudsman said that the surgery should include the subsequent stages of the reconstruction that occurred "during the same period".

Only reconstructions in which the initial operation didn't occur at the time of the mastectomy should be excluded.

Policies covering health issues often have exclusions or wordings related to breast cancer. For example, Cigna's trauma insurance policy, which covers "cancer", pays out the full lump-sum insured only if breast cancer results in a mastectomy. It pays only 10 per cent of the sum insured for cancer in situ of the breast or cervical cancer. This is also the case for prostate cancer in men.

There are insurers that do cover mastectomy and "women's problems". Accuro, for example, covers all the steps of breast reconstruction. The company started life insuring nurses and its client base is still 60 per cent women, which bucks the trend in an industry where more men than women have cover.

It's not just breast reconstruction that is specific to women. There are other operations.

In one case heard by the Insurance & Savings Ombudsman, a woman's breast implants ruptured after 30 years.

The claim was declined because the insurer deemed it was "directly or indirectly" related to cosmetic surgery. The woman said the rupture was not associated with the original operation.

But the Ombudsman said she would not have needed the surgery to remove the implants if she hadn't had the implants in the first place.

"Therefore, even though it was required for medical reasons, the surgery 'directly or indirectly' arose from elective cosmetic surgery and was excluded under the policy," the Ombudsman concluded.

Accuro chief executive Jeff Annals says underwriters prefer to cover men, yet women need health insurance more than men.

That is because, like it or not, women are less likely to be prioritised in the public health system and get on to or through waiting lists for surgery.

One of the main reasons men have more insurance cover in general than women is that they are the breadwinners. It's often assumed that only the breadwinner needs cover. But if a non-earning spouse becomes ill or incapacitated it can cost the family a lot in childcare and other costs. Likewise with life insurance, if the non-earning or lower-earning spouse dies, someone has to pay to have the children looked after if the breadwinner doesn't want to give up work.

Another area in which women claim more than men is for lost and stolen jewellery. That's because women tend to own more expensive jewellery than men — although men may have costly watches.

Claims do get declined. If you have expensive jewellery, do you know how often you have to have it valued? One travel policy the Ombudsman came across required that the jewellery be valued within 12 months before a claim.

Insurance for jewellery is full of fish-hooks, says the owner of GemLab Diamond Graders and Jewellery Valuers, Peter Nilsson.

If you're travelling overseas, be careful. A New Zealand traveller lost jewellery that was in a bag on the floor of a bus in Argentina. Because it was "not carried on their person while using transport providers" the traveller wasn't covered.

That's a common exclusion. So is an exclusion for jewellery stored in a suitcase in the hold of a plane or other transport carrier.

Even if the insurance company doesn't require a valuation, Nilsson suggests clients have their jewellery valued every three to five years. Values can change significantly in that time. He cites, for example, the price of gold, which a few years ago rocketed up. Although diamonds may not have increased in price at all during that period — in part thanks to the high Kiwi dollar — some gold jewellery almost doubled in value.

Nilsson also recommends documenting jewellery. An insurer can't see from a photograph if a ring is gold-plated or 22-carat gold.

Another reason women get a raw deal from insurance is we don't take responsibility for our own insurance. We usually leave it to our husbands.

Although women often do the annual admin when it comes to insurance, their husbands may have chosen the policy, says Stevens.

This can be dangerous. It's very easy to make a mistake with an insurance policy and two brains are better than one.

"You can't abdicate responsibility to your husband."

- NZ Herald

Diana Clement

Your Money and careers writer for the NZ Herald

Diana Clement is a freelance journalist who writes about personal finance and careers. She has worked as a journalist for more than 25 years in both New Zealand and the UK. Diana has contributed to a large number of local and international publications. Her pet topic is the secrets of saving money.

Read more by Diana Clement

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