Your Guide to Multiple Sclerosis and Life Insurance

Multiple Sclerosis is a lifelong disease and may cause a varied combination of symptoms. No one can tell you at the outset what course your MS will take, it’s an unpredictable condition with no clear prognosis. As a result, living with MS means living with uncertainty. However, MS is not a fatal disease and planning for your future should still remain a priority.

your-guide-to-multiple-sclerosis-and-life-insurance

Because of MS, you will not be able to buy life insurance at standard rates, but many people with this condition have been able to qualify for policies. Whether you qualify or not largely depends on the type and severity of your MS, how long you’ve had the condition, and your overall health.

Due to the number of questions we get from people with MS , we have put together an explanation of the underwriting process for applying for life insurance when you have multiple sclerosis. We hope this information assists you during your application process. The disease might be unpredictable, but your expectations when applying for insurance doesn’t have to be.

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Life Insurance with Critical Illness | The Insurer’s view

Having multiple sclerosis does not mean an automatic rejection from all life insurance companies. That’s why you need to shop around first. However, the insurance companies will want to gather a substantial amount of information about your condition, to determine its severity, and properly rate your policy for premium purposes.

Insurance companies group people according to the type of risks they represent. Being diagnosed as having MS automatically puts you in the category of having a chronic disease that is perceived as having some impact on mortality. In most cases, you will be approved for life insurance, but you’ll be “rated” and charged a higher premium. 75% is generally the minimum loading that companies apply to applicants suffering from MS. Unfortunately in general, it’s not possible to get critical illness cover or income protection with multiple sclerosis however to be certain always best to ask as many companies as possible and potentially consider any automatic salary continuance cover that may be available in your super fund.

Despite this, you must be upfront about your condition when applying for insurance – insurers are unlikely to pay out a claim if you took out cover knowing you had the condition, but didn’t tell them.

What are the Factors companies look for when you have Multiple Sclerosis?

number-1The Type of MS you have

There are 4 Types of Multiple Sclerosis

This is the most common form of MS. People with RRMS have temporary periods called relapses, exacerbations, flare-ups or attacks. The time between relapses vary. During these relapses new symptoms appear or existing symptoms become more severe. These symptoms can last for varying periods and they fade away either partially or completely (remission). For some people their MS may be inactive for months, even years at a time.

You can only get SPMS if you’ve had relapsing-remitting MS. Once SPMS develops, relapses and remissions from inflammation slowly decrease or stop altogether. Instead, the disease and its symptoms steadily progress with accumulating disability.

This is the rarest from of MS and is progressive from the start, with slow onset and steadily worsening symptoms. There is an accumulation of deficits and disability which may level off at some point or continue over months and years.

PRMS is characterised by a steadily worsening disease state right from the beginning, with acute relapses but no remissions, with or without recovery.

number-2Date of diagnosis

Time frames of how long someone has had the condition is the second factor underwriters will look at. They will want to know your age at the onset of symptoms, and how long you have been living with the disease. Most people who are categorized with RRMS are diagnosed with SPMS between 5 and 15 years into the disease. Thus, early diagnosing of multiple sclerosis is very important.

When you treat someone early on you can push out the period of time in which they may ultimately need assistance with walking – or the time they may need to use a wheelchair, for example.

If you are considering a policy, time is a factor. It is easier to get life insurance within the first two years after diagnosis and if you have mild MS symptoms. This brings as to the third factor influencing MS and life insurance.

number-3Symptoms and course since diagnoses

Insurers will look at the severity of your MS symptoms:

Mild:
Infrequent attacks, long periods of remission, no disability.

Moderate:
Attacks with increasing frequency/duration with some residual neurological impairment but you are fully functional.

Severe:
Wheel chair bound or bed ridden and need assistance with daily activity.

The underwriters will also need to know approximately how many attacks, such as seizures, you’ve had in total. A high number may mean that your condition is worsening.

number-4Treatment and Medication

Life insurers will want to see that your condition is under control and that you are receiving the optimal combination of therapies. This means that you are seeking medical treatment as necessary, taking any medications required and participating in rehabilitation therapies as needed.

The treatments that you are receiving for your condition can be a positive in the underwriters’ eyes. By receiving treatment, it shows you are attempting to manage and control your MS. However, the type of medications you are taking can cause different loadings on your policy due to the potential side effects they may have.

The underwriters will also ask you:

  • If you have undergone treatment, how you have responded to such treatment?
  • Following such treatments, has your condition improved or has it worsened over time?
  • What, if any, medications are you currently taking for your condition?

number-5Current neurological status; what degree of disability exists?

An important factor for underwriters to consider when you are applying for life insurance with multiple sclerosis, is if you use any aides for mobility? The company will need to know your Expanded Disability Status Scale (EDSS) – this is used by neurologists to measure MS dysfunction. For example, 0 – 1.0 is no disability and minimal symptoms, where as a scale of 6.0 means ambulatory impairment i.e. you need a cane to walk 100m.

To the degree that you are functioning in a lifestyle that is reasonably close to what would commonly be defined normal, your chances of both life insurance approval and reasonable premium rates will be greater.

number-6More questions

In addition to condition-specific information, the underwriters will also review the information that you will be asked on your life insurance application coverage. These questions will include:

  • Your Age
  • Gender
  • Height and weight
  • Smoking status
  • Alcohol usage
  • Occupation and income (if applicable)
  • Foreign travel
  • Family health history
  • Past times

At any time during the application process, the company will also request a PMAR (Private Medical Attendant’s Report) in which your Doctor will perform any needed investigations required for MS and life insurance.

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How to prepare for your Life insurance application

There are measures you can take to prepare yourself before applying. Doing so will help your chances of getting approval. Use the following tips to put yourself in the best position possible:

Visit your doctor as often as recommended

Follow your doctor’s advice regarding medication and treatment

Make sure your medical records are updated regularly

Get any other complications under control. For example, if you smoke, quite

Your Duty to Disclose

If you took out insurance before you knew you had MS, there is no requirement to tell your insurer about any changes to your condition since the policy started, unless you are making a claim, or unless the policy terms requires you to do so. When in doubt, ask your insurer what they require.

However, if you are diagnosed between the time you apply for the policy and when it goes “on risk” (that’s the date the insurer starts to cover you)or at any time beforehand then you must tell the insurer.

Conclusion

Remember, no two insurance companies will view your case the same way. They’ll all view your MS differently. Don’t let previous negative life insurance experiences deter your quest for coverage. If you would like more information about getting life insurance with multiple sclerosis, please call us on 1300 135 205.

Published: November 13, 2015

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