ProtectionMar 21 2018

High risk need not spell uninsurable

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High risk need not spell uninsurable

I am going to tell you a story of a woman who life insurance companies consider to be "an impaired life". 

She is in her early thirties.Runs her own business. Has a husband, children and a mortgage. You can see plenty of protection needs being flagged there already. Let’s call her Margaret.

Strike 1: Doctors diagnosed Margaret with Hypermobility Syndrome at the age of 12, having suffered from years of unexplained pain, bone fractures, joint dislocations and sprains. The symptoms resulting from the condition are now less severe, but some insurers now class her illness as Ehlers Danlos Type 3. That is not good when it comes to arranging protection insurance.

Strike 2: In her early twenties Margaret became ill with anxiety. She suffered from generalised anxiety disorder with panic attacks, social withdrawal and a period of agoraphobia. Agoraphobia returned for a second time 10 years ago. Margaret has controlled her anxiety well for many years, but as anyone who has had anxiety will tell you, it never goes away for good.

Strike 3: Following the birth of her second child Margaret decided to work on her fitness. She took up running and joined Zumba classes. A positive outcome was that this helped with managing the anxiety, however on the negative side she found out her heart rate become too high when exercising. Following tests, doctors told her she has a form of tachycardia. In stressful situations her heart rate goes much higher than is “normal”. She also has elements of postural tachycardia syndrome, that on occasion can result in her becoming light-headed when standing which, in the past, has caused her to faint. 

Strike 4: Margaret now faces a further problem with her thyroid after the birth of her third child. Initially, the tests results showed a borderline overactive thyroid, but doctors have now diagnosed an underactive thyroid and she’s started medication for the condition. This has caused her to experience sensitivity to the cold, hair loss, hot flushes and exhaustion.

On paper, Margaret seems to be a difficult client to arrange insurance for. Do you think insurers would decline her cover, increase her premiums or exclude her pre-existing conditions? And why?

Key points

  • A case study looks at a woman with plenty of protection needs, being married with a mortgage and children
  • The woman in question has lots of outstanding health issues, but who will step up to the plate?
  • The insurance industry is likely to make her protection coverage more of a challenge, but need it be?

Life insurance

Margaret has undergone many tests for her heart, including an MRI scan, ultrasound, ECG and an exercise-induced monitor. The tests show she has a fast heart rate in stressful situations, but other than that her heart is perfectly fine. Her thyroid, anxiety and hyper-mobility have no bearing on her life expectancy. It is, however, possible that Margaret may face a higher premium than somebody without these conditions. Some insurers will decline her cover.

Who presents less risk though? Someone who has undergone tests to show a healthy heart, or somebody who has not seen a medical practitioner since childhood and is blissfully unaware of what lurks inside?

CI cover

As with life insurance, doctors have not diagnosed Margaret with any condition that could increase the chance of developing a critical illness (CI).  But insurers are cautious about any heart-related conditions, and again, Margaret will face terms ranging from a premium increase, exclusion of heart conditions, or being declined the cover.

Again, who presents less risk of having a heart attack? Margaret with her collection of heart checks, or the person with no disclosures who has undiagnosed high cholesterol?

Income protection

This is where Margaret’s protection application is going to be trickiest. Her hyper-mobility syndrome and history of anxiety issues could place her at a higher risk of being unable to work, if the symptoms return. 

But why can she not have a standard income protection (IP) that simply excludes pre-existing medical conditions?

Why should mental health and musculoskeletal conditions, prevent someone from protecting their income if they get cancer?  

The problem is musculoskeletal and mental health conditions account for the highest claims for IP. So insurers  – who do want to pay claims – are worried about offering cover that might exclude the two largest portions of the policy claims set. 

For Margaret, the thought of applying for insurance in today’s market is daunting. She has many questions and is unsure of the answers. Will the adviser that she speaks to understand her situation?

Will they know about her conditions and how they affect a person’s health? Will the insurer try to wrangle out of a claim later, saying she did not tell them everything about her conditions? Is she even insurable?

Here we have a woman who is in the prime of her life, has clear protection needs and wants protection insurance, yet she may struggle to obtain vital family protection due to a complicated market and lack of understanding of her medical history.

She has no life-threatening illnesses, nor does she have anything that predisposes her to develop illnesses such as cancer, a stroke or multiple sclerosis.

Just because Margaret has this medical history does not reduce her need for protection insurance. To keep premiums affordable, she may have to choose to insure herself for less, to make sure that she has at least something to leave behind for her family, should the worst happen.

To life insurance companies Margaret is an “impaired life”. A higher risk. 

Perhaps it is time for a change in philosophy for life insurance companies. Rather than looking for a reason not to insure someone, we should look for ways to insure someone.

Now, to reveal what is likely the most obvious detail to this story, Margaret is me. I am one of the main reasons my company, Cura Financial Services, focuses on insuring “impaired lives”. 

I co-own a multi-award winning insurance brokerage. I have a beautiful family. I gained my doctorate and have my own home, despite the fact the insurance industry will label me as impaired. 

I am proud of my quirks and very thankful that medical consultants say that I am a healthy individual.

Kathryn Knowles is an adviser at Cura Financial Services