Pulse Insurance's Livi Jenkinson discusses why obesity is a major barrier to life insurance coverage and what can be done for customers
The prevalence of obesity is similar among men and women in the UK, but it has been recorded that men are more likely to be overweight than women. The Health Survey of England results for 2013 showed that 62.1% of adults were either overweight or obese.
Birmingham University has recently stated that "obesity rates in the UK are the highest in Europe and have increased dramatically over the past few years to such an extent that in excess of 20% of the population are now obese and the costs to the UK economy exceed £3bn per year", with the BBC advising that "In the UK, 64% of adults are classed as being overweight or obese."
The word obesity is used to describe somebody who is very overweight, with a lot of body fat. BMI (Body Mass Index) is the most commonly used method to determine a person's health in relation to their weight. BMI is a measure of body fat based on height and weight that applies to adult men and women.
Generally speaking, the standard market underwriters in the UK will start loading life assurance applications when a BMI is in excess of 33. This BMI equates to height of 5' 10" and weight of 16 stone and 4 pounds as an imperial example.
Where an individual's BMI is less than 40, life insurance should be possible, providing there are no other complications with the life assured's health.
When a BMI is over 40 and where the client has associated complications with being obese, companies such as Pulse Insurance Ltd are able to assist.
A BMI of 40 is the same as someone being 5' 10" in height and weighing 20 stone and 3 pounds.
Pulse Insurance Ltd (Pulse) is a specialist company who, with their Lloyd's of London Underwriters, for whom they are a cover holder, are able to consider life insurance for people with a BMI of up to 60. This BMI, in an imperial measurement, is height 6 foot and weight of 31 stone and eight pounds.
Obesity is frequently, but not always, associated with a number of medical conditions including:
• Type 2 diabetes
• Coronary heart disease
• Respiratory disorders, such as sleep apnoea (when a person stops breathing for short episodes during sleep) and asthma
• Certain types of cancer
• High blood pressure
• Gallbladder disease and gallstones
• Osteoarthritis; and
It is important before submitting an application for life cover to establish with the applicant whether or not he or she has any of the above or other medical issues. This will affect the availability and cost of cover.
On 12 May this year, the BBC reported that the Stroke Association had warned of the alarming rise in Strokes of people aged in their 40s and 50s in the United Kingdom. Obesity and an inactive lifestyle are to blame for this increase.
Ischaemic strokes are the most common type of stroke and are caused by a blood clot blocking the flow of blood and oxygen to the brain.
These types of blood clots normally develop where arteries have been narrowed over time by fatty deposits which are also known as plaques.
Arteries can narrow with age but this process can also be brought on by certain medical conditions and lifestyle options, such as:
• High cholesterol levels
• High blood pressure; and
Life insurance is still possible when someone who is obese has had a stroke or another associated medical condition. Take for example a case study from Pulse, the client has a BMI of 42.4 and has had a stroke.
They obtained life insurance for a sum assured of £63,000 over a term of 24 years for a premium of £50.00 per month.
Obesity can also be the cause of anxiety and depression in individuals because of low self-esteem and psychological problems which being overweight can lead to.
Obesity is associated with increased mortality from all causes, but in particular cardiovascular disease, diabetes and gastro-intestinal disorders. Mortality is directly proportionate to the level of obesity.
There has been significant media and government attention to the so-called 'obesity epidemic' over recent times in view of the pressure of the long term effects of obesity particularly the cost of treating the complications of obesity.
Quoted by underwriters
One of the more recent tools that the health industry has been using is bariatric surgery. This is more commonly known as weight loss surgery.
It is considered the last resort and is only carried out on people who have a BMI of over 40 with potentially life threatening medical conditions such as Type 2 diabetes and when other treatments or lifestyle changes have failed to reduce a persons BMI.
Surgical measures can be extremely effective, resulting in rapid weight loss and, in terms of life insurance, cover could be available from mainstream insurers six months after surgery providing there have not been any complications and the individual's weight is stable.
However, according to our underwriters, "complications such as metabolic disorders, malabsorption syndromes and liver disorders can develop. Depression and psychological symptoms are common and over 40% of those treated surgically will return to previous dietary habits".
Livi Jenkinson is responsible for marketing at Pulse Insurance Limited
CASE STUDIES OF COVERAGE
Client 1: aged 30, non-smoker
The above client had been declined by all the life Insurance companies the financial adviser had approached in The Republic of Ireland. The client was in need of Life Insurance to secure a mortgage and due to the time taken already by the Irish markets, the client was in urgent need of this cover. A recent medical report was provided by the client and a simple nurse screen examination was carried out by Pulse’s underwriters and cover was offered to this client just 26 days from the initial enquiry.
Client 2: aged 63, non-smoker
This client was in need of life insurance for the re-payment of a loan. Originally, a five-year term was requested but due to the combination of medical conditions, underwriters restricted the term to one year only – to be renewed each year on fresh medical evidence. As the life assured had been declined cover everywhere else, the restricted term was accepted. This is an example of how complications associated with obesity may have a significant impact on premium and term. The good news however is that specialist underwriters, having taken into account all the complications, were prepared to offer cover and this solved the client's loan problem.
Client 3: aged 37, non-smoker
Pulse has renewed the cover for this client. A total of six years has now been offered (two sets of terms for three years each). All terms offered by Pulse and their underwriters, even if they are restricted at inception, can be re-assessed at expiry. On renewal, further consideration will be given, on receipt of up to date information, which may enable a longer term to be provided than initially.
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