5 | Case Studies: Challenges for insurers
However, the insurer may be able to rely on the no
data exemption provided any such discrimination is
reasonable having regard to other relevant factors.
These factors may include:
•
practical and business considerations
•
whether less discriminatory options were
available
•
the customer’s particular circumstances
•
the objects of the ADA, especially eliminating
age discrimination
•
all other relevant factors of the case.
Option C may represent the least discriminatory
option, given everyone over 90 will be treated
equally. However, this will still need to be
implemented carefully. For example, a sharp
discontinuity at age 90 to a much higher ‘average’
rate might be argued as unfair by someone aged
91.
While insurers must be careful that any
assumptions are based on reasonable evidence,
it may be reasonable for TIPL to assume that
health risks continue to increase as people age
over 90, such that Option A is reasonable. Medical
opinions, especially from those with medical
assistance backgrounds, could be used to provide
additional evidence for such assumptions. It is also
less discriminatory than Option B, given the less
significant increase in premiums.
Option B poses the greatest risk of being
discriminatory, given that it results in significantly
higher premiums for people over 90, there is
limited evidence to support it, and other less
discriminatory options were available, such as
Option C or Option A. Moreover, as a decreasing
number of people over 90 travel, the significant
premiums may also not be considered reasonable
when weighing the impact on customers against
the financial impact for the insurer.
The circumstances of the individual are relevant
in determining whether any discrimination is
reasonable. In relation to the insurance exemption
under the DDA, the courts have said that decisionmaking processes which are formulaic or which
tend to stereotype individuals by reference to their
disability should be avoided.76 The courts may
adopt a similar approach in relation to age. Further
information about the customer seeking insurance,
such as medical opinions, may be relevant in
assessing whether they do present a significantly
higher risk that justifies the significantly increased
premium.
Embedded product
TIPL is considering a cut off, such as limiting access
to certain claim types to people over 60 (either in
the form of a lower sum insured, higher excess, or
exclusion of certain forms of claims altogether).
Whilst information about age is not collected, these
conditions would be made clear in the product
documentation.77
TIPL believes that this will create a more affordable
product which is fairer to the younger cohort than
if the same product were to be offered to all age
groups. However, there are concerns that an age
cut-off is not appropriate in all situations, given that
some elderly people will be of similar health (and
hence similar risk) to some younger people.
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