It is likely a person who has been newly diagnosed with epilepsy would not be considered for life or...
It is likely a person who has been newly diagnosed with epilepsy would not be considered for life or critical illness (CI) protection for at least six months since diagnosis, and for income protection (IP) that period could be at least 12 months. This allows the condition to be investigated, treated and stabilised.
For symptomatic epilepsy it is likely the underlying cause of the epilepsy will be of more interest to the underwriter and GP reports may be required to assess the case.
However, in many cases of idiopathic epilepsy an underwriting decision may be possible without the need to write to the GP for details. A well-completed client questionnaire can supply details such as the date of the last seizure, how many seizures a year, the nature of the seizures and medication details. If there have been no seizures for more than two years, the underwriter may be able to offer standard terms for both life and CI benefits.
Mortality and morbidity will always be above average in continuing epilepsy, particularly when attacks are predominantly tonic-clonic (grand mal) in nature.
There is a small risk of sudden death and prognosis and premium loadings will be influenced by the nature and frequency of the seizures, and also the time elapsed since the last seizure.
For example, a person who experiences less than six seizures a year and has absence (petit-mal) seizures may be accepted at standard rates, whereas a premium loading of between 50% and 75% should be expected where the seizures are of a tonic-clonic (grand-mal) nature.
Ratings would increase where seizures are more frequent, terms may not be possible if the seizures are too frequent or where there is poor control or compliance. A rating for life cover would usually result in a slightly higher rating for CI cover, where terms are possible.
Ratings for sickness-related benefits such as IP would depend on the nature of the occupation and the length of the deferred period selected as well as how well the condition is controlled and how often seizures occur. Even seizure free epilepsy that is well controlled by medication may well require a small loading for these benefits.
The best prognosis can be expected in those who are established in their occupations, are mentally and emotionally well-adjusted, conscientiously follow medical advice, have had the condition for some years and remain seizure-free.
Occupational factors
It is essential to consider any accident risk for death and disability benefits. In addition for IP cases, and those being considered for other disability benefits, it is imperative to ensure the applicant is fully established in their occupation despite suffering from epilepsy. Occupations involving the following features may be viewed with caution:
• Stress and tension, which may precipitate attacks.
• Manual work (particularly where heights or moving machinery are involved) in view of the accident risk.
• In particular the driving license requirements of the occupation are of considerable importance as are the regulations of the relevant authority regarding driving with a history of epilepsy.
With these points in mind it may be necessary to limit the deferred period or the definition of disability available to the applicant depending on their occupation.
Advisers may wish to discuss the case with an underwriting helpline and a comprehensive point of sale questionnaire accompanying the proposal form will help speed up the underwriting process and may mean a GP's report is not necessary.
