Crohn's Impact: Life Insurance Underwriting

Crohn's disease is a type of inflammatory bowel disease that affects an estimated 700,000–780,000 Americans. While it is possible to obtain life insurance if you have Crohn's disease, it can be challenging and will depend on several factors. The condition can often be unpredictable and relapsing, which makes it difficult to qualify for preferred risk classes. The cost of life insurance for individuals with Crohn's disease is typically higher than average, and the availability and cost of coverage will depend on the severity of the disease, treatment history, and any associated complications.

Severity of Crohn's Disease

The severity of Crohn's disease is a key factor in determining life insurance underwriting and premiums. Crohn's disease can be classified as mild, moderate, or severe, with advanced cases making it challenging to find affordable life insurance options.

Underwriters assess the severity of Crohn's disease by reviewing medical records, prescription history, age at onset, and time since the last symptoms. They also consider the frequency and duration of flare-ups, with longer symptom-free periods being favourable.

Severe Crohn's disease is generally characterised by hospitalisations, multiple surgeries, and frequent steroid use. Individuals with severe Crohn's may experience bowel obstructions, abscesses, ulcers, fistulas, anal fissures, and malnutrition. They may also develop complications in other parts of the body, such as arthritis, skin problems, eye issues, kidney problems, and liver disorders.

The impact of severe Crohn's disease on life insurance underwriting is significant. Individuals with severe Crohn's are likely to be rated as sub-standard risk and face higher premiums. Their policies may be "table-rated," which means they will pay higher rates than average. The specific medications prescribed for severe Crohn's, such as Humira, Prednisone, Imuran, and Methotrexate, also influence underwriting and result in higher rates.

Additionally, severe Crohn's disease may lead to a graded death benefit policy, where benefits are disbursed gradually over time. The waiting period for policy approval can be longer for individuals with severe Crohn's, and they may need to wait at least six months after surgery before their application is considered.

Treatment History

When applying for life insurance, underwriters will want to know about your treatment history for Crohn's disease. They will review your medical records and run a prescription history check through the MIB (Medical Information Bureau). The medication(s) you’re taking and how well they are treating your symptoms will help determine the severity of your Crohn's disease.

Underwriters will also want to know about the treatments you have undergone, including surgeries and physician follow-ups. They will look at the date of your last major attack, your age at diagnosis, and the duration and specific medication prescribed for your treatment. If you have had surgery, they will want to know how long ago it was performed and the success rate.

The time since your last flare-up or symptom is also crucial. The longer it has been since your last flare-up, the better your chances of getting approved for life insurance. If you have gone 5 years without a flare-up, you may be able to secure a policy at a higher rate. However, if you have had a flare-up within the past 12 months, it is recommended to wait before applying, as most companies will have a 12-month waiting period.

The type of medication you are taking will also impact your life insurance eligibility and potential costs. Medications like Humira, Prednisone, Imuran, and Methotrexate indicate more severe symptoms and complications and will result in a sub-standard rate. Taking stronger medications for a prolonged period can lead to ongoing blood tests and other issues.

Additionally, life insurance companies may require you to have had a recent colonoscopy, usually within the last few years. This allows them to ensure that your colon is not inflamed or bleeding, which can lead to other serious health issues.

It is important to note that each insurance company has different guidelines, and working with an experienced agent can help you find the right company and present your risk in the most favourable light. They can also draft a cover letter highlighting your positive lifestyle habits, which can help you secure a more affordable rate.

Flare-ups/Episodes

Crohn's disease is a type of inflammatory bowel disease (IBD) that affects an estimated 700,000-780,000 Americans. The disease is commonly mistaken for ulcerative colitis, but they are distinct conditions that affect different areas of the digestive tract.

The impact of Crohn's disease on life insurance underwriting depends on the severity of the condition, how well it is controlled, and other factors. Life insurance underwriters will consider the frequency and severity of flare-ups/episodes when evaluating an application.

Crohn's disease flare-ups are periods of active symptoms after a period of remission. These flare-ups can be unpredictable and vary in severity, duration, and symptoms. They can last anywhere from a few days to several months and can occur after months or years of remission.

Signs of a flare-up include:

• Diarrhea, often with mucus and sometimes with blood
• Low-grade fevers
• Abdominal pain or cramps
• Unexpected weight loss
• Frequent or urgent bowel movements
• Eye pain or red eyes
• Patches of inflamed skin
• Sores in the mouth or throat
• Joint pain and swelling (arthritis)
• Swelling in the eyes
• Mental health problems

Triggers:

While the exact triggers of flare-ups are not fully understood, certain factors may bring them on. According to the Crohn's and Colitis Foundation, these triggers can include:

• Disruptions to your treatment plan, such as missed or wrong doses, or switching medications
• Environmental pollution
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Dietary factors: certain foods can trigger flare-ups, including high-fibre foods, lactose, sugar alcohols, fat, grease, spices, added sugars, caffeinated beverages, and alcohol.
• Smoking
• Infections
• Stress: according to the PLOS ONE study, about 75% of people with IBD believed that stress and mental health issues could trigger flare-ups.

Treatment:

There is no single test to diagnose a flare-up, but monitoring your symptoms can help you recognize one. Treatment for flare-ups may include a combination of over-the-counter (OTC) medications, prescription medications, and at-home remedies. It is important to follow your prescribed treatment plan and make healthy lifestyle choices to manage flare-ups and prevent future occurrences.

Prevention:

While flare-ups cannot be completely prevented, certain steps can help manage the disease and reduce their frequency:

• Take prescribed medications consistently
• Prevent and reduce stress: mindfulness, cognitive behavioural therapy, and yoga have been found effective in alleviating gastrointestinal pain and improving quality of life.
• Exercise: even light exercises like walking for 10-20 minutes a day can help lower stress levels and reduce symptoms.
• Eat healthily: follow a nutrition plan that avoids high-fibre foods and fried foods. Stay hydrated with water, broth, or tomato juice.
• Monitor your symptoms: use mobile apps like GI Monitor and myIBD to track symptoms and predict flare-ups.

Complications

Some of the complications that can occur with Crohn's disease include bowel obstructions, fistulas, and an increased risk of colorectal cancer. These complications can impact an individual's life expectancy and, therefore, may affect their life insurance rates and eligibility.

In addition to the frequency and severity of symptoms, underwriters will also evaluate the overall management of the disease. This includes evaluating an individual's medical records, medications, and compliance with treatment plans.

The more severe and frequent the complications, the higher the risk assessment is likely to be. This can result in higher premiums or even disqualification from coverage.

It is important for individuals with Crohn's disease to be transparent about any complications during the underwriting process. Hiding or downplaying these issues can lead to problems with coverage down the line.

Additionally, underwriters will also consider the time since the last complication or flare-up. The longer the period without any issues, the more favourable the rates are likely to be.

To improve their chances of securing favourable rates, individuals with Crohn's disease should focus on proactive health management. This includes regular check-ups, adherence to treatment plans, and open communication with healthcare providers.

Overall Health

Crohn's disease is a chronic inflammatory bowel disease (IBD) that affects an estimated 700,000 to 780,000 people in the United States. It is a lifelong condition with no known cure, but treatments can help manage symptoms and allow patients to live active lives. The disease causes the digestive tract to become swollen and irritated, resulting in symptoms such as abdominal pain, diarrhea, weight loss, and rectal bleeding. It can affect any part of the digestive tract but usually impacts the small and large intestines.

The overall health of individuals with Crohn's disease can vary significantly. The disease can range from mild to severe, and some people may experience chronic symptoms, while others have periods of remission. The first few years after diagnosis are when the mortality risk is highest, and the cost of life insurance during this period may be high. However, advancements in surgical and medical treatments have improved the life expectancy for people with Crohn's disease, and the chances of getting approved for life insurance have also increased.

The severity of Crohn's disease is classified based on several factors, including the frequency and duration of flare-ups, the time elapsed since diagnosis, the patient's age at diagnosis, and the response to treatment. Medications, lifestyle habits, and underlying health conditions also play a crucial role in managing the disease and can impact overall health. For example, taking stronger medications for a prolonged period can have potential side effects and may require ongoing blood tests. Additionally, Crohn's disease can lead to other health complications, such as intestinal obstruction, fistulas, abscesses, anal fissures, malnutrition, and inflammation in other parts of the body.

It is important for individuals with Crohn's disease to work closely with their healthcare providers to find the right treatment options and manage their overall health. Treatments typically include medications that reduce inflammation and immune system activity, as well as dietary changes and, in some cases, surgery. Lifestyle changes, such as quitting smoking, avoiding trigger foods, and adopting healthy habits like regular exercise and good nutrition, can also positively impact overall health.

Frequently asked questions