“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?” This was the case study question posed in this month’s edition of Cover Magazine. In this latest edition of the magazine, you will find ADVO Group’s Colin Boxall giving his expert advice.
“As an individual with impaired health, insurers will shy away. But as viral heart conditions can have a good longer-term prognosis and can leave no lasting tissue damage there may be options available in the future” explains Colin Boxall.
“For example, individual PMI with moratorium underwriting will exclude heart related claims. It will offer cover now for unrelated and new conditions with a possibility, after a future two-year treatment-free period, of including future heart claims.
If cover is needed immediately, insuring on a group basis offers options depending how much the employer is prepared to support the client and other employees. Depending on the employees covered, collective underwriting can allow the inclusion of past and current conditions.
It can, however, come at a price. Initial costs can be reasonable but future pricing is dependent on claims. With group risk, a freecover limit may not give all the cover required but is available. PMI can also cover past conditions depending on the number of employees included and may include a premium loading.
Although these arrangements can produce results for the individual and valuable staff benefits for other employees, the arrangements have to be viewed longer term for potential pitfalls.
PMI will not only cover past conditions for the client but also all other employees.
Although start up costs may be considered reasonable, future premiums will be driven by claims.
Allowing past and current conditions to be included for all could spiral future costs.”