With critical illness cover there had been evolution concerning the medical endorsement. Experience with life and disability insurance may only be of minimum use. Because when assessing the different risks, the single cause of death and disability may stem from critical illness. Health insurers cover specific diseases but if compared to critical illness insurers, their experience may differ.
Critical illness may occur due to certain risk factors. These risk factors may be related to the circulatory system, cardio and cerebrovascular systems. In this context, smoking may be considered as a risk factor as it may damage these systems and may as a matter of fact cause different types of cancer. Therefore, before underwriting is made, insurers may look at these risk factors closely. Also, the applicant's actual medical and hierarchical medical history can be questioned. If any hereditary critical illness, for example heart attack had existed in the family, the procedure of having the critical illness cover may become lengthy.
Furthermore, the total mortality of a risk may be assumed by consulting the Life Underwriting Manual. Only selected types of risks may be considered for critical illness endorsement. Risks that carry a high rate of mortality and also a high declination concerning life cover may as well not be accepted for critical illness. On the other hand, risks to be considered may be analysed according to its relative critical illness risk. Here are some risks factors.
Major risk factors :
- Diabetes mellitus
- Hypertension
- Hypercholesterolemia
- Smoking
- Metabolic syndrome
- Unfavourable features in family history
Minor risk factors :
- Overweight
- Hypertriglyceridemia with low HDL
- Elevation of lipoprotein (a)
- Hyperuricemia
- Hyperfibrinogenemia
- Alcohol abuse
- Lack of exercise
- Health-impairing occupation
Every risk factor may be given further debit percentage depending on its severity. The applicant may be refused critical illness cover if analysis shows that the maximum level of debit had been surpassed. Moreover, there may be other factors that may lead to critical illness. People who suffer from these 'impairments' may not be entitled to receive critical illness cover. These can be described as follows :
- Coronary artery disease
- Diabetes mellitus type I
- Arteriosclerosis
- Peripheral vascular disease
However there are some diseases that may lead to several critical illness conditions like heart attack, coronary artery, stroke or kidney failure. They are as follows :
- Chronic severe diseases of the hematological system
- Chronic severe diseases of the liver and the gastrointestinal tract
- Chronic severe diseases of the respiratory tract
- Chronic severe diseases of the kidneys and the urinary tract
- Chronic severe neurological and psychiatric diseases
- HIV infection
Some of these diseases may lead towards tumour or may even demand the necessity of an organ transplant afterwards.
Indeed, including the various aspects of critical illness cover lies the risk factors. These may be important especially to determine whether you could have a critical illness cover or not. Cases of antiselection might have also been avoided to some extent now. All this may show the image of an insurance product in the form of critical illness insurance, gradually but surely matured with time.
by Mike Armstrong
