Underwriters always require a general practitioner's (GP) report, and usually ask to see any hospita...
Underwriters always require a general practitioner's (GP) report, and usually ask to see any hospital letters the GP may have relating to the aneurysm and its treatment.
In order to make an informed decision, an underwriter would typically need details of precise diagnosis and results of investigations, location, size, cause, treatment, whether symptomatic or asymptomatic and any complications.
Rupture of an aortic aneurysm is a major complication, sudden death may result and operative mortality is high - more than 50%. This is compared with elective surgery mortality of approximately 2%. Where no surgery has taken place, all benefits are likely to be declined, including life protection.
However, someone applying for life protection post-operatively will be treated more favourably, as the condition has been treated rather than just monitored. Total and permanent disability benefit and waiver of premium are almost always declined, apart from several years post-operatively.
Critical illness (CI) and income protection (IP) benefits are always declined. If the aneurysm has led to aortic dissection, all types of cover will be declined due to the high risk of further vascular complications.
An untreated aneurysm will usually result in all types of cover being declined due to the risk of rupture resulting in a subarachnoid haemorrhage. Re-bleeding occurs in up to 30% of cases within four weeks of presentation.
Complications for subarachnoid haemorrhage include acute hydrocephalus (water on the brain), which may cause deteriorating consciousness and coma; and chronic 'normal pressure' hydrocephalus may present months or years later as memory impairment, gait disturbance and incontinence. Cerebral vasospasm occurs within the first two weeks after subarachnoid haemorrhage, and is responsible for a poor outcome and deteriorating neurological state.
Early microsurgical clipping to prevent future haemorrhage is the best treatment for ruptured aneurysms in conscious patients. Where clipping has taken place, standard terms may be offered for most benefits after a couple of years. This assumes that there are no other complicating factors, such as raised blood pressure or epilepsy to consider.
Other types of surgical treatment may need to be discussed with the chief medical officer to determine if terms may be offered. The exception is CI benefit, as it will always be declined, regardless of the type of treatment received.
Terms may be available for someone with carotid aneurysm, except for CI benefits. Peripheral aneurysm may be considered for terms, except for IP.
In both instances, the chief medical officer may need to be consulted before terms are offered.
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