Insurance advisers must know their products

Although this complaint related to health insurance exclusions, the need for product knowledge extends to all aspects of the products an adviser can recommend, including an understanding of ancillary matters relating to particular products, like product underwriting conditions and detail of available premium structures.

For now though, let’s concentrate on health insurance general exclusions (those exclusions written into policy wordings that apply to all policyholders) because they matter and because they differ from product to product.

Understanding what health conditions and which medical treatments may not be covered by health insurance policies is a tricky area to navigate.

Some treatments and conditions may be clearly excluded by the general exclusions, while others may not be covered because there is no benefit under which a claim can be made. Some conditions or treatments may effectively be excluded simply because the claim benefit monetary limit is way too low to give effective protection.