Evidence will generally be sought from the client's GP and an underwriter will look to establish the...
Evidence will generally be sought from the client's GP and an underwriter will look to establish the following facts before proceeding to offer to terms:
• Any underlying cause and severity thereof, coupled with any other known risk factors.
• Age.
• Any neurological impairment and severity thereof, for example, how good a recovery has been made.
• Duration since the event.
Once the above has been established, we can try and break down the severity of an event into three obvious categories: minor, moderate and major. As a general rule of thumb, terms prove difficult to offer in the following six months after a stroke and if a proposal was received in this period, a postponed decision would ensue. The implications for individual benefits are as follows:
Income protection
As one would expect, terms are difficult to grant to anyone who has previously suffered a stroke, but there are one or two exceptions. For example, if a stroke was caused by a head injury or oral contraceptives, terms may be possible for well documented cases where a full recovery has been made after discussion with an insurer's chief medical officer.
Critical illness
Stroke is one of the core critical illness events and one of the main elements in the pricing of the contract which makes it impractical to exclude and as a result, the benefit will generally be declined.
Life cover
Generally terms can be offered but they are very dependant on establishing the facts already outlined. Underwriters generally break applications down into age categories, for example under 45, 46-54 and so on. If we take a 56-year old male with no other risk factors such as smoking or hypertension, terms can generally be offered at around 100% on the normal premium, but this will greatly increase with the addition of any of the risk factors noted above.
Each case will be assessed on its own merits as no two cases are exactly the same, therefore ruling out a 'blanket rating' being applied, however, cases still have to be pooled for risk purposes.
Total and permanent disability (TPD)/waiver of premium (WOP)
As accident-related benefits, these will generally be underwritten under the same philosophy as critical illness. Advisers may wish to discuss if terms are likely to be possible with the underwriting helpline prior to submitting the case.
Stroke facts and figures
• Each year over 100,000 people in England and Wales suffer a stroke for the first time.
• About 10,000 of these are under retirement age.
• There are around 60,000 deaths due to stroke each year.
• Stroke is the third most common cause of death in England and Wales, after heart disease and cancer.
• Stroke accounts for over 8% of all deaths in men and 13% of deaths in women in England.
• Stroke is the largest single cause of severe disability in England and Wales, with over 300,000 people being affected at any one time.
• The cost of stroke to the NHS is estimated to be over £2.3bn.
• The total cost of stroke care will rise in real terms by around 30% by 2023.
• Stroke patients occupy around 20% of all acute hospital beds and 25% of long-term beds.
Source: The Stroke Association
