Risk Clinic: impaired health protection cover

clock • 4 min read

My client, a company director of a medium-sized firm, has recently been diagnosed with heart problems due to a virus. He has no cover and providers have now refused to insure him. What other options can he explore?

John Kerr, Kerr Henderson Group

The old adage about there being strength in numbers is relevant here. As a medium-sized company, group arrangements which include categories of staff on a non-discretionary basis could be used to ensure that some cover can be provided.

In the case of life assurance, should cover be required which is beyond the insurer's free cover limit, consideration could be given to establishing a non-underwritten top-up scheme. Provided this is established on a non-discretionary basis this can be a very useful solution to the problem.

In addition, a group personal accident policy should not be overlooked as it can be used to purchase more restricted life cover, and can also be configured to include benefits for permanent and temporary total disablement.

Cover for business, and in some cases personal travel cover on a non-underwritten basis can also be provided.

If a group arrangement is not a possibility for the firm it is worth exploring some specialist insurers who may be prepared to offer some form of cover, usually only life assurance, albeit at a price. Individual personal accident policies should also be considered.

Finally, although not designed as protection, the benefit of maximising employer contributions to a registered pension scheme could also be considered as there would typically be a return of fund in the event of death before taking benefits. 
If the condition is sufficiently serious, the director may qualify for preferential capital to income conversion terms on taking benefits.

Ronjit Bose, Jelf

Firstly, the client should seek treatment through the NHS immediately and should not delay this while exploring other private alternatives for care and funding options.
The option of a company scheme should be explored as there may be one as part of his employee benefits in his workplace.

If there is one, the client should look to be included on it, especially if the scheme is large enough to qualify for Medical Health Disregarded (MHD).

This could be a wake-up call as well for him, to the benefits of cover for other conditions and he should explore cover even if his heart condition is excluded. In this way, cover for future conditions will be better than nothing at least.

It is also very important the client's intermediary should explore and establish different options with insurers for medical loadings. And the question must also be asked - has the full nature of the heart condition been disclosed and provided to the insurers? This needs to be done as they may in fact provide cover for acute flare-ups of the client's condition, but not any chronic problems.

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