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Medical History

People who have an existing medical condition or 'medical history' are considered a greater life insurance risk and are often subject to some exclusions and higher premiums. What’s more, the definitions can differ from one life insurance provider to another.

The most common areas of concern are: Health issues, Family history, Weight, Bowel conditions, Depression/Stress/Anxiety, Diabetes, Cancer, High blood pressure, Male homosexuality, Smoking.

Health Issues

If there are health issues, most life insurance providers will write to the applicant's GP for further details of a person's situation in order to properly assess the risk posed by any condition disclosed on an application form. This assessment of risk will allow the life insurance company to calculate the premiums that will be charged.

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Family History

Underwriters will take family history into account when assessing a life insurance application, either in isolation or more particularly to qualify information about an applicant’s personal health.
The main issue is that the appearance of certain conditions in one’s immediate family (parents and siblings) can indicate a higher likelihood of suffering from the same condition.

Life insurance underwriters are most concerned about the appearance of inherited conditions, such as heart disease, diabetes, breast cancer or any other cancers at an early age.

As ever, the type of benefits being applied for will affect the decision.

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Weight

The increasing prevalence of obesity and its direct effects on other medical conditions means life insurance providers are now more likely to consider overweight people a greater life insurance risk and prone to higher premiums. Underwriting calculations are made using a number of factors including gender, height, weight and type of life insurance requested.

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Bowel conditions

Crohn's Disease - A chronic inflammatory condition affecting either the small intestine (the ileum), or the large intestine (the colon). The cause is unknown, and there is no known cure. Symptoms can be alleviated through treatment and can go into remission. The crucial factor for underwriting is how recently the client last experienced symptoms. A GP's report will be requested automatically.

  • For life insurance - Major insurers take the view that if the client has had any symptoms in the last 12 months then a life insurance premium loading is likely. If more than 3 years have elapsed since any symptoms then ordinary rates are likely.
  • For critical illness – Most cases will be declined, but check with a LifeSearch adviser as to whether cover can be arranged.
  • For income protection - Most cases will be declined, but check with a LifeSearch adviser as to whether cover can be arranged.

Colitis/Ulcerative Colitis - A disease of the large intestine, in which the lining of the colon becomes inflamed, swollen and extremely ulcerated. The condition predisposes to cancer. Surgical removal of the effected areas (a colectomy) is sometimes necessary. A GP's report will be requested automatically.

  • For life insurance - Premiums will vary depending on the severity of the condition, how much of the bowel is affected and how recently the symptoms have been experienced. A successful colectomy and no symptoms for a few years may mean ordinary life insurance rates, or a small premium loading.
  • For critical illness - If it has not been treated successfully, a heavy rating at best, but a likely decline. A successful colectomy and no symptoms for a few years may attract only a small premium loading of around 50-100%. Check with a LifeSearch adviser as to whether cover can be arranged.
  • For income protection - Moderate rating and exclusion if the symptoms are mild. Large ratings or a likely decline for more severe cases. Check with a LifeSearch adviser as to whether cover can be arranged.

Irritable Bowel Syndrome (IBS) - This can cover a multitude of different conditions, and there is no agreement on a single cause or treatment. It frequently affects young women. Basic details of diagnosis date, duration, treatment and current situation will be needed.

  • For life insurance - IBS should not require a GP’s report, but may require a bowel conditions questionnaire. It should not affect life insurance premiums.
  • For critical illness - A GP’s report is more likely when applying for critical illness, but a higher premium is unlikely if the diagnosis is confirmed as IBS.
  • For income protection - A GP’s report is likely. However, assuming this does not indicate a more severe bowel condition, the result should not lead to higher income protection rates.

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Depression/ Stress/ Anxiety

There are a number of mental health issues that are encompassed by the term 'depression'. In essence, it's a general feeling of 'sadness' or a 'negative frame of mind'. This can manifest itself through behaviour, disrupted sleep patterns, excessive tearfulness, lack of concentration, loss of libido and many other symptoms.

Treatments will vary and can include medication (anti-depressants such as Prozac), counselling or psychotherapy.

GP’s report is likely to be required to ascertain, whether or not there are any suicidal tendencies, current and past treatments and the causes (if any).

Likely life insurance underwriting decisions.

  • For Life Cover - There are many potential outcomes, but stress and anxiety cases will often be accepted at ordinary life insurance rates. Depression will often also be accepted without a loading, but be wary of loadings from certain insurers, especially if the client has a long history of severe depression, or has ever been suicidal. Check with a LifeSearch adviser as to whether cover can be arranged.
  • For Critical Illness Cover - Mental health related claims may well be excluded from critical illness cover. Check with a LifeSearch adviser as to whether cover can be arranged.
  • For Income Protection – Mental health related claims may well be excluded from income protection insurance. Check with a LifeSearch adviser as to whether cover can be arranged.

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Diabetes

Diabetes Mellitus - The most common form of diabetes in which the supply of insulin is insufficient for the body's needs.

  • Type I diabetes (always treated with insulin) results from the destruction of the pancreas, usually triggered by a viral infection.
  • Type II diabetes (known as age onset, treated usually by diet or tablets) is due to a lack of the required level of insulin combined with sensitivity to the actions of insulin.

Obesity is of great importance when defining the severity of the condition. The absence of insulin deprives the muscles of energy and as a result sugar builds up in the blood stream, which is then found in the urine.

GP’s report is likely to be required to ascertain age at diagnosis, treatment, whether blood sugar levels are stable, height and weight, and any other associated medical conditions.

Likely life insurance underwriting decisions.

  • For Life Cover
    • Type I – Any decision is dependent upon age at diagnosis. It is usually diagnosed between childhood and early 20s. The younger the age diagnosed, the higher the likely premium, typically +200-300% more than normal life insurance premiums.
    • Type 2 – The age the condition is diagnosed is largely irrelevant. It is usually diagnosed from age 30 onwards. Typically, premiums are +50-100% more than normal life insurance premiums.
  • For Critical Illness Cover - Almost always declined. Check with a LifeSearch adviser as to whether cover can be arranged.

Diabetes Insipidus - A very rare disease caused by inadequate production of a hormone of the pituitary leading to excessive quantities of urine being produced accompanied by great thirst. The condition can also occur where the kidneys are abnormally insensitive to the hormone.

Diabetic Acidosis - Acid in the blood caused by untreated diabetes mellitus.

Diabetic Gangrene - Gangrene can often form following an operation or accident for sufferers of diabetes mellitus.

Diabetic Retinopathy - Fragile blood vessels in the eye that leak as a result of diabetes mellitus.

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Cancer

The term Cancer covers a multitude of conditions from relatively minor skin growths to aggressive terminal cancers. Each individual will have specific circumstances and life insurance providers will want to gather as much information as possible before making a decision. In all cases, this will most probably including questionnaires, GP’s and consultant’s reports to ascertain; a) when the cancer occurred, b) the type of tumour it is, c) how far advanced the cancer is, d) what treatment is/was received, and e) what the current situation is.

Lung Cancer - Cancers of the lungs are some of the most aggressive of all cancers. 5-year survival rates are as low as 6% and this makes it extremely difficult to arrange life insurance for anyone who has ever been diagnosed.

Likely life insurance underwriting decisions - A client would usually have to be given the all clear from the cancer for at least 5 years before any insurance company will consider it, and even then, premiums are likely to be high. Check with a LifeSearch adviser as to whether cover can be arranged.

Breast Cancer - This is the most common cancer affecting women in the UK, with over 40,000 new cases being diagnosed each year. There have been tremendous diagnostic and treatment advances over the last few years. 5 years survival rates compare favourably with other cancers, at over 70%, and rising. Check with a LifeSearch adviser as to whether cover can be arranged.

Better treatment, the varied types of breast cancers, the ‘staging system’ (0 –4, 4 being the most serious) and the individual life insurance provider attitudes all add to complicate the underwriting process.

Likely life insurance underwriting decisions.

  • Stage 1 – Likely to be accepted soon after treatment, but also likely to incur a higher premium.
  • Stage 1 or 2 – Decision deferred for 1 to 5 years after treatment, then only with higher temporary premiums. Premiums are likely to reduce from year 6 to 10 after treatment, to near normal.
  • Stage 3 – Decision deferred for 5 years after treatment, then only with even higher, temporary premiums.
  • Stage 4 – Likely to be declined. Check with a LifeSearch adviser as to whether cover can be arranged.

There are also some other factors to consider.

  • Critical Illness – At best approved with high premiums. At worst, usually declined if there is any history of breast cancer.
  • Family history – Usually restricted to close relatives (such as parents and siblings).

Skin Cancer - Malignant melanoma is a tumour of the cells that produce melanin, the pigment that colours the skin, the hair and the iris of the eyes. Skin melanomas occur most frequently in people who are middle-aged or older. They are becoming more common - the incidence of malignant melanoma has doubled every 10 years for the past 40 years - almost certainly because holidays in sunny climates have become more widely available and sunbathing has become more popular.

Likely life insurance underwriting decisions. Non-melanoma skin cancers can sometimes get ordinary rates for life insurance. A GP’s report may be required to ascertain the timing and frequency of occurrence, how it was treated, what the full diagnosis was and whether the client is under review with regular skin checks.

Hodgkin's Disease - A malignant disease of lymphatic tissues evidenced by the enlargement of one or more groups of lymph nodes. Hodgkin's Disease refers to malignant tumours of the lymphatic system. There are various stages and degrees of severity of this condition, and diagnosis usually includes lymph biopsies and removal of the spleen. Treatment depends on the staging and may include radiotherapy or chemotherapy or a combination of the two. The lymphatic system is the network of lymph glands and channels which occurs throughout the body. This collects lymph - fluid that bathes all the body cells. The lymph system is also a very important part of the immune system, which keeps the body free of infection.

Leukaemia - Leukaemia is a form of cancer of the white blood cells. These are the cells that fight infection in the body. There are different types of leukaemia depending on which type of blood cell is affected. There are two main groups of leukaemias - acute (more aggressive) and chronic (where sufferers may live for years). In both groups, treatments have improved dramatically and complete cures may be achieved.

Prostate Cancer - Every year around 16,000 men in the UK are diagnosed with prostate cancer. It is currently the third most common form of cancer to affect British men, striking an average of 1 in 12 during their lifetime. Experts predict that these incidences will triple in less than 20 years. Early diagnosis can improve the chances of a full recovery.

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High blood pressure

Hypertension is an increase in the arterial pressure in relation to a normal range for one's age. It can be indicative of underlying problems and can cause damage to other parts of the body.

Two figures are required when measuring blood pressure. The systolic - when the ventricles of the heart are contracting, and the diastolic - when the heart is relaxing.The measurement is expressed as two numbers - firstly the systolic, followed by diastolic. For example 120/80.

The closer the systolic number is to 90-100, the more serious the problem. The higher the diastolic number, the more serious the problem. Readings are likely to increase naturally with age.

A GP’s report is likely to be required to ascertain, whether there are any other heart conditions (high cholesterol, angina), the most recent readings and current medication.

Likely life insurance underwriting decisions - Generally speaking for males and females, any recent reading between 120-140/80 should be accepted at normal life insurance premiums. If a loading is applicable, this is likely to be around +50% for life insurance.

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Male Homosexuality

Different life insurance providers take differing views on the subject of male homosexuality.

LifeSearch advisers will always be happy to offer expert guidance and advice on the most appropriate life insurance policy and life insurance company to suit your actual circumstances.

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Smoking

All life insurance providers now ask about the amount that applicants smoke, if they have indicated that they are a smoker on the application form. In short, the more you smoke, the higher your likely premium.

LifeSearch advisers will always be happy to offer expert guidance and advice on the most appropriate life insurance policy and life insurance company to suit your actual circumstances

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