5 - Agreement between the ABI and BMA
2002 (Revised July 2006)
Fees
General practitioners reports for insurance applicants
The fee for completion of a GP report will be as follows:
1 September 2006 – Increases from £70.50 to £74.70
1 April 2007 – Increases from £74.70 to £79.20
1 April 2008 – Increases from £79.20 to £84.00
1 April 2009 – Increases from £84.00 to £89.00
1 April 2010 – Increases from £89.00 to £94.30
These figures were arrived at taking into account the Technical Steering Committee of the Doctors and Dentists Pay Review Body’s (DDRB’s) predictions for the catch-up from previous years (including 2003/2004, 2004/2005 and 2005/2006) due to the difference between the interim and estimated figures and the actual figures for those years. The ABI and BMA have agreed that this catch-up and future remuneration changes can be fairly reflected in an increase in fees of 6 per cent per year for five years as above (rounded normally and to the nearest 10p).
In 2010, the ABI and BMA will review the funding arrangements for the agreement to take effect from 1 April 2011.
The fees for supplementary reports and medical examinations are calculated on the same basis as set out below.
General practitioner supplementary reports
When insurers issue a supplementary report to a GP, at the time of the original request or later, for additional information, the fee for completion will be as follows:
1 September 2006 – Increases from £18.00 to £19.10
1 April 2007 – Increases from £19.10 to £20.20
1 April 2008 – Increases from £20.20 to £21.40
1 April 2009 – Increases from £21.40 to £22.70
1 April 2010 – Increases from £22.70 to £24.10
When an insurer seeks clarification or further information regarding a disclosure made on the GP report form, this should not normally attract a fee.
Medical examinations
The agreed fee for a medical examination undertaken by an applicant’s own GP will be as follows:
1 September 2006 – Increases from £77.50 to £82.20
1 April 2007 – Increases from £82.20 to £87.10
1 April 2008 – Increases from £87.10 to £92.30
1 April 2009 – Increases from £92.30 to £97.80
1 April 2010 – Increases from £97.80 to £103.70
Where an applicant fails to keep a pre-arranged appointment, 50% of the fee should be paid by the life assurance company.
Targeted reports
Insurers are piloting targeted reports which seek information on only one medical condition (that has been disclosed by the applicant) as opposed to seeking a full GPR. There is currently no agreement between the ABI and the BMA on the content of or fees for these forms. GPs and insurers should negotiate their own fees for these forms until an agreement is reached.
Quality of work by GPs
As part of this agreement the BMA has issued guidance to GPs on the completion of reports for life assurance purposes. The guidance includes:
- recognition that life assurance is a ‘social good’ that is of benefit to patients, especially at significant points in their lives.
- advice that, as with other fee paid work, it should be done to appropriate professional standards in order to justify the agreed fees, namely that:
- the information should be provided in the manner requested and should be as complete as possible providing a synthesis of essential details from the mass of undifferentiated information held on the medical record.
- the provision of copies (paper or electronic) of the medical record is not appropriate and is not covered by the patient’s consent to the report.
- reports should be returned within 20 working days of the receipt of the request to ensure that the report is of most use to the company and the applicant and thereby justifying the agreed fee. In return insurance companies will not send reminders until 15 days have elapsed.
- the BMA accepts that insurance companies occasionally may ask for a more speedy response in exceptional circumstances eg for completion of a loan.
- GPs are responsible for the content of their reports and must sign them whether or not practice nurses or administrators have a role in their completion.
Insurance declinations
When an insurance applicant is declined or a decision postponed as a result of a medical disclosure that they have made on the application form, the insurance company will give the reason for declination to the applicant. If a new or poorly controlled medical condition is revealed on the GPR or following a medical examination, and not disclosed on the application form, the insurance company will inform the GP.
Review of the agreement
This agreement is not time limited but it may be reviewed at any time by the ABI or the BMA. When either party requests a review, the agreement will remain in force for up to six months following the request for a review unless the new agreement comes into force before then.
ABI and BMA 19 June 2002 (Revised July 2006)