Why the protection gap isn’t closing - Legal & General

Written by Vanessa Sallows, Claims & Governance Director, Group Protection, L&G

The majority of the UK’s working population faces a protection gap, in terms of protecting their home, their livelihood, their family, should illness or death strike. As an industry, we can – and do – highlight the need. But human nature dictates, and in some cases, that need doesn’t hit home unless we experience difficulties for ourselves or hear about the real-life experiences of others.

In this article, we help illustrate the power of communicating with real-life stories through three Group Protection case studies. They also illustrate how committed insurers are to securing positive outcomes for employees and their loved ones facing the worst of times.

First, a quick look at the scale of the UK protection gap.

A static market: 54% of the UK working population remain unprotected

The Financial Conduct Authority’s (FCA’s) latest Financial Lives survey highlights that too many people still don’t have protection cover in place. This is the case for life cover, critical illness and income protection alike.

Almost half (46% – 24.9m) of UK adults held at least one protection product in May 2024, unchanged from 2020. The most commonly held protection products in May 2024 were life insurance (28%); private medical insurance (14%); and critical illness cover (13%). Just 6.2% had income protection insurance, although that represents a slight increase on the 5.3% in 2020.

Closing the protection gap: personal experiences build awareness & trust

Highlighting the need for protection in a way that speaks to human emotions is crucial. But to be truly effective, this needs to be underpinned with giving people reasons to trust insurance companies to act in their best interests.

In both instances, hearing about the personal experiences of others speaks volumes.

Flexibility: Ensuring payment without requesting additional medical reports

In such cases, insurers can be more flexible than you might imagine in getting all the information needed as quickly as possible, to pay the claim.

For example, instead of just waiting for a GP report – sometimes a lengthy wait – the insurer might ask the employee or the beneficiary to provide letters that might have been sent by the treating consultant. The insurer would need to verify this information, but that can be done via a phone call to the consultant’s admin team. This can represent a much quicker process, eliminating any further worry for the employee or their dependants about finances, when they’re already going through a stressful time.

Insurer flexibility might also extend to requesting alternative medical information, such as an independent medical specialist, or their own clinical team (if they have one) as the insurer will want to do everything they can to help speed up the claims process.

The following two case studies illustrate the financial peace of mind that Group Critical Illness can often provide when cancer strikes. The time from noticing first symptoms to diagnosis and treatment can, in some cases, be very swift. And uncertainty during time off work – whilst an individual is undergoing treatment – about how they’ll pay the bills, is the last thing anyone needs.

Case study 1

It’s not always necessary to wait for a GP report if there are other ways and means to gain the full information needed. For example, a spouse claim for cancer moved from symptoms beginning in January 2025 to diagnosis and then surgery taking place five months later. The last thing this couple needed at the time of this sudden and life-changing event was to worry about their finances.

So, although we’d requested both the GP and consultant reports, the claims assessor also spoke with the individual and asked them to send any copies of the clinic letters, to help speed up the process. Then, when the consultant report was received, we spoke with the secretary over the phone to ask for outstanding information. We were able to finalise the claim without waiting for the GP report.

Feedback from the employee: “The whole journey from the start of my husband’s cancer diagnosis to the end was exceptional. Everyone I spoke to was hugely helpful and supportive. And providing the claim payment in a swift manner really helps during a financially challenging time. Amazing customer service and support.”

Case study 2

An employee needed urgent chemotherapy treatment after investigations confirmed an advanced cancer. Initially, he hadn’t signed the claim form, because he’d been in and out of hospital and very unwell. This prevented us from being able to request medical evidence.

At an appropriate time for the employee, we had a telephone conversation, explaining the claims process, but also suggesting – in the interests of time – that they forward copies of medical correspondence. When received, we called the consultant’s secretary to verify everything. This provided us with all we needed to decide. We were able to pay the claim, without requesting any additional medical reports.

Feedback from the employee: “A huge thank you for your care and sensitivity in a really tough time. Your thoughtfulness and empathy made a huge difference, and I very much appreciated how you kept us updated throughout. This benefit [provided by my employer] and the service provided has enabled me to share across my team of over 350 people the importance of protecting yourself and your family. And I have had no hesitation in recommending people to review their employee benefits as a result.’’

Overcoming obstacles: Pursuing all avenues to afford peace of mind

Case study

Ensuring peace of mind for claimants and their families is often about the insurer not giving up when faced with hurdles during the claims assessment. For example, when an employee covered under their employer’s L&G group critical illness cover passed away recently, the death certificate said one thing, but the medical evidence said another. And the latter didn’t meet policy definitions.

Although the death certificate listed dilated cardiomyopathy and ischaemic heart disease as the causes of death, the policy definition for cardiomyopathy was not initially met. In layman’s terms, the employee’s wife had stated that her husband suffered a heart attack, but no medical professional was willing to confirm this in writing. After four months of attempting to gather sufficient medical evidence to support payment of the claim, it became apparent that no further documentation would be available.

Not content with accepting defeat, we requested a review from a cardiologist medical officer. We wanted to assess all existing evidence and consider the possibility of an ex-gratia payment for cardiomyopathy, given its role in the claimant’s death.

Upon review, the cardiologist concluded that the cardiomyopathy was secondary to a heart attack that had occurred approximately six weeks prior. This allowed us to approve the claim under the heart attack definition of the policy for the employee who was a husband, father and grandfather.

Throughout the claims process, the claims assessor maintained regular contact with employee’s wife to provide updates, recognising that she was grieving and emotionally distressed. She was also financially vulnerable following her husband’s passing. Compassionate and timely communication throughout this difficult time was paramount.

Feedback we received: “Thank you so very much for all your care and support through this extremely difficult time. He was not only my husband, but my best friend. I cannot even start to explain the massive void this has left in my life, and our family will never get over the sheer emptiness this has left for myself, my daughter and my granddaughter. She talks about him all the time. She is only 4 but they were so close. They were the best of friends and used to have so much fun together. Once again, a massive thank you.”

As these case studies help demonstrate, Group Protection provides incredibly valuable support when people are at their most vulnerable. As an insurer, our priority is simple; namely, getting the right outcomes for our customers.