Hi, everybody, we have Alan back for the first time in a while and he is chatting to us about fatty liver disease. The options for life insurance, critical illness cover and income protection can vary quite a bit, depending upon the cause of the fatty liver and the stage that it is at. The good news is that the liver has a brilliant capacity to heal itself, so there can often be options for insurance.
Alcohol consumption will be a key factor in the options for your clients. Where the fatty liver disease is caused by alcohol consumption, it’s very likely that mainstream providers in the UK will not offer insurance if the person is still drinking. You can develop a fatty liver for different reasons and in these cases you don’t necessarily have to be teetotal, but underwriters will be cautious if alcohol is still had regularly or at a higher level.
The key takeaways:
- It is estimated that at least 1 in 5 people have fatty liver disease and that 31 people pass each day in the UK, due to liver disease
- The questions you need to ask clients to be able to do underwriting research
- Two case studies of arranging life insurance for people with fatty liver disease
Thank you for listening, it’s nice to be getting back to normal with the podcast and other areas. I am not completely sure what I am going to cover in the next episode, I shall see what takes my fancy in the next two weeks!
Remember, if you are listening to this as part of your work, you can claim a CPD certificate on our website, thanks to our sponsors PlannerX.
Kathryn Knowles 00:11
Hi everybody. We are back, and it is season 11, and it is episode 11, and Alan is back with me. We’ve not had him on for a little while, we’ve had lots of different things going on, so he’s here to have an underwriting chat, and we are going to be giving you insights into protecting your client with fatty liver disease. This is the practical protection podcast you Hi Alan, it’s been a while. How are you doing?
Alan 00:48
I’m very well. Thank you. How are you Have you missed me? Me. I
Kathryn Knowles 00:51
could ask
Alan 00:54
that if you didn’t spend every single day with me,
Kathryn Knowles 00:57
that is true. That is true. But no, I think it’s I think we’re everything seems to be going okay at the moment. Obviously, listeners are aware that we’ve had a bit of a an unusual start to the year and a bit of an intense one, but I think we’re, I think we’re on the right track. What do you think?
Alan 01:13
Yeah, 100% Yeah. As you said, it’s been a very difficult couple of months, especially for you, but, but we’re onwards and upwards and doing what we need to do, aren’t we, sir,
Kathryn Knowles 01:22
we are we’re getting there, aren’t we? So Right? Fatty liver disease, it is something that can absolutely influence an insurance application, and there’s a few different versions of it. So you do have alcoholic fatty liver disease, and you do have what’s known as non alcoholic fatty liver disease, that has kind of changed the way that they people like to refer to it now. So it’s now called, tends to be called metabolic dysfunction associated steotic. I’m going to say steotic, that word liver disease, or M, A, S, l, D, for short. So it basically affects how the liver functions. Your liver is there to do lots of the detoxification, to help the metabolism and to do your energy storage. And when you do get something like the non alcoholic, fatty live disease, I’m going to refer to it as that for now, on the basis that I’m not sure I can keep pronouncing that other word, or at least attempting to it does tend to be more likely if you are older, say over 50, if you have other conditions as well, such as polycystic ovary syndrome or type two diabetes. But it’s not a definite that you will have it if you have those conditions. But there are just things that can make it more likely, obviously, if you’ve got the alcohol related liver disease that is different for each person as well. What I would say is, obviously everybody’s body, like we’ve said, the liver is all to do with metabolizing and detoxifying.
So you might get somebody with fatty liver disease who drinks far less than someone else who doesn’t have it. It’s each body is individual, a really positive thing that we would see in terms of underwriting is that, you know, fatty liver disease in itself, if it is just referred to, it in that terms, usually refers to an early form of liver disease, and the liver is incredibly good at repairing itself. So if it’s caught early on, people can take steps to try and do things to, sorry, repair the liver, and so it doesn’t have those fatty deposits there. Now, the British liver trust does estimate that one in five people in the UK have some form of fatty liver disease and and sometimes I find it harder it’s one in five people, or things like that, because it’s kind of, how do you quantify it? And they do give some other stats, which I will share as well, which for me, sort of like hit home a bit more about it, which is that they say that there’s roughly 11,000 deaths each year in relation to liver disease. And to make that a bit more understandable, that’s 31 deaths a day in relation to it. So it is something that you know. It the early form of fatty liver disease is probably not going to result in that, but it is something that, if it’s not sort of really looked at, can lead, obviously, to quite an intense situation. But what I found really interesting when I was doing the research, and it’s on the British liver Trust website, and there’s a graph in there, and they’re saying that, basically, the instances of fatty live disease have increased or quadrupled by sorry, so increased by four fold in the last 50 years. And there was a chart, and it was really interesting.
So it was basically saying that in terms of like rates of death, and it was, it was, the graph was from 1970 to now, and it was showing that you pretty much from the 1970 data, it kind of had all your liver, liver disease, your heart disease, cancers, diabetes, things like that, all. It’s sort of like started around about the same level. But what it seemed to show is that in terms of the death rates, whilst obviously a lot of people do pass away from heart attacks, heart disease, cancer, things like that, it should. Showed that actually, the rate of deaths was starting to drop a bit. Obviously, there’s lots and lots that are being done, as in interventions, early catching of the conditions, things like that, and lots and lots more treatments. And the line for the liver disease was phenomenally higher, actually, in terms of the increase of how much people are passing due to something that is happening with the liver. So it was, it was quite, it was quite a shock actually, to see that difference in those stats. And so it is something that we definitely need to be mindful of. It’s obviously, certainly something then that if you, if you can see those stats, and obviously the insurers will have even more data that they’d be looking at in terms as to how many more people are starting to pass due to some kind of liver disease. It does make you understand why, if someone does have fatty liver disease, even its earliest form, they can sometimes be a little bit uncertain and want to know some more information. So let’s go into it a bit more. So, Alan, tell us about fatty liver disease. What are the things the things the underwriters are looking out for, and what are you looking out for as an advisor? Yeah,
Alan 06:04
absolutely. So as you sort of said, I mean, fatty liver disease is basically where there are this fat accumulating in the liver cells. So what that means is that it’s the liver is going to have to work harder to perform its normal functions. As you said, detoxification, everything like that, metabolism and all the things that the liver were sort of wonderfully does interesting one you said, it’s very good at regenerating. I believe, please don’t quote me on this, but I believe it is the only internal organ that transplants it. I was going to say that can completely regenerate it.
Kathryn Knowles 06:39
You can give a liver transplant. Can’t you
Alan 06:43
can regrow? Yeah, obviously
Kathryn Knowles 06:45
it’s the free car. Obviously
Alan 06:46
your skin can regenerate on the outside. But I think that’s the only, only internal one. That’s not an excuse to blow your liver to bits and and just get a new one, obviously, and think it’ll repair itself. Because obviously it’s,
Kathryn Knowles 06:56
I was thinking, some people think it is like a side income, a bit of liver. There you go.
Alan 07:01
That’s a different podcast. Yeah. So, yeah. I mean, obviously you said one in five people. I did see some stats that said, actually it’s thought to be as much as one in three people, potentially. So, you know, you’d have gone average one in four. And actually it’s probably like a lot of conditions. Actually, some of this will be estimations, because a lot of people will be walking around not knowing you know how many people have got simple versions of this condition, and unless you’ve had a blood test or something to find it out, you just will not know about it. So there are different, different causes for fatty liver disease, and I would probably flag that this is one of the first things to try and ascertain and find out from your customers, because it’s really important to me as advisor, really important to insurance companies. The Biggie, you mentioned alcohol.
Now, even though you have something called non alcoholic fatty liver disease, the problem is, is if somebody you can’t really tell at that early stage, if it’s just from a blood test, maybe slight differences in which liver functions are higher and which which are not. But ultimately, if, unless somebody says they’re drinking a lot, if somebody says, Well, I drink one pint a week, and they’ve got this, this condition, the doctors are going to put it down as non alcoholic fatty liver disease. If they put it down that they’re drinking 40 units a week, they’re probably going to put it down as alcohol so that there is a I guess, reliance on honesty there from the individual. But regardless of that, alcohol levels are still really important. If you have somebody with fatty liver disease, it’s important to ascertain how much they are drinking. If it’s been caused by alcohol, they must abstain to get life insurance. Insurance companies are going to expect them to be completely abstinent for a period of time, because they must have been drinking quite a lot to get that level. And that’s an obviously,
Kathryn Knowles 08:50
I think what’s important there is to bring in that. That brings in, especially if someone’s having that much alcohol, it brings in that there is alcohol does damage the body, and so there’s lots of lock on effects, not just the liver, other aspects of it, there’s obviously life they can start like question the lifestyle, that can question mental health, everything you know, sort of like an overall picture. So when it’s not just about being or how much are you drinking, in the sense is it is, if there’s so many tangents that the underwriters are needing to look at that it can get quite complicated, absolutely
Alan 09:22
it’s absolutely fine. It’s absolutely fine. So even if someone’s got non alcoholic fatty liver, still ascertaining how much they drink, you know, if they’re drinking 510, units a week, probably not a problem. If they’re drinking 30 units a week, insurers are actually going to be quite nervous about that, even if it is an early stage non alcoholic version, because it’s extra strain, extra pressure on the liver. Well, they’re probably
Kathryn Knowles 09:42
wondering, is it actually alcohol, you know, if it’s early stage, but you’re drinking that much, they’re probably going to think, Well, is it actually the alcoholic version? But it’s just such early stages that nobody really knows at this point what that progression is. Yeah.
Alan 09:56
And as you said, you know alkaline alcohol can lead to other things as well. So high blood pressure. Pressure is a very common, obviously, a very common thing that happens for many reasons, but alcohol causes your blood pressure to be to be higher. So actually, if they’ve got higher blood pressure, for example, higher sugar, Lee readings, diabetes, things like that, and they’re drinking a lot, and they’ve got non alcoholic fatty liver, you are definitely going to get that question. Well, actually, is alcohol contributing factor here? So just things to be aware of, medication. This one’s really interesting to me, because I actually have personal experience of this. So I’ve had two instances now where not necessarily been told it’s a fatty liver as such, but I’ve had elevated liver function tests, one when I was younger, and one a few years ago, and both we believe were probably down to some form of medication. So one with those Baroque tablets, you know, the orange vitamin ones. And I was popping those like anyone’s business. I guess I’m taking too many of them, thinking they were doing me some good. And obviously not stop taking those. Have them retested. It was fine. And a few years ago, I was doing quite I was taking quite a lot of supplements for gym workouts and things like that. And again, we think that that possibly affected, because I knocked some of those on the head and all of a sudden that, you know that the LFTs came down.
But again, you kind of your first instance for somebody with this, I probably skipped a little bit, is a blood test. You know, most people will get this diagnosis. They will have a blood test. It will show an increase in their LFTs, which is their liver function test, usually things like the AST level, for example, maybe the GGT, things like that. So there are certain liver function tests that will highlight this. People like me, for example, they will say, well, actually, that’s a simple thing. We’ll get it retested. Comes back as normal, not a problem. But if these readings keep being elevated, then it might indicate there is a form of fatty liver disease there. You can go further to be more certain, you can get an ultrasound done on the liver, where they actually scan and look for the fatty deposits. And in more extreme things, you could actually have a biopsy of the liver done as well, but that’s typically more for the more severe ones. So things that underwriters need to know, I’ll kind of cover this one off as the main things, because these are what’s really important for you. So first one we’ve already covered was alcohol a factor. Was medication a factor? How much does the person drink? Now? Was there another cause? You know, was there another medical condition? So I can’t remember. Have we done a podcast on primary sclerosin, cholangitis? PSC, no,
Kathryn Knowles 12:19
because I don’t remember trying to say that repeatedly. Well,
Alan 12:23
so there’s our next one. So PRC is a liver condition, and actually can quite commonly cause fatty liver disease because it’s, again, making the liver work harder. So is there another condition that’s causing it? And really important, actually, is the stage of the fatty liver disease. And I’d probably go as far to say this is one of the most important questions to ask. So you’ve got kind of stage one, which is theater sources I’ve got you now, which is probably what I had, in a sense, it’s that initial buildup of fat due to a reason, but actually easily reversible, not a problem. If you change whatever that factor is that was causing it, you’ve then got Nash or mash, which is kind of the next stage up. I’m not going to try and pronounce that one, because I made a fluff of the last one. That’s where intros are going to get maybe a little bit more nervous, because it’s showing that it’s developed to a, you know, sort of a slightly higher level. And then we’ve got the warning ones, which is fibrosis and cirrhosis. Cirrhosis you probably all heard of, which is scarring of the liver. Fibrosis is chronic inflammation which is starting to sort of cause this scar tissue to form. And once you get to cirrhosis, it really is looking even though we said about regenerating the liver, that is, there’s
Kathryn Knowles 13:38
a limit. There’s only so much of a battering.
Kathryn Knowles 13:40
And
Alan 13:40
actually, if you get into fibrosis and cirrhosis, your mainstream insurers are going to start declining. And I know we’ll come back to this, you start getting a bit more specialist medication taken. You’re only likely to take medication if you’ve got a more advanced form. You certainly wouldn’t usually expect it in a simple form. You
Kathryn Knowles 13:56
might have the sides, things like we were saying about high blood pressure. So you might be taking some medications in regards to those. But you know, other
Alan 14:02
conditions like diabetes, high blood pressure, sleep apnea, you know, a big cause can be BMI weight. You know, people are carrying too much weight around their organs, internal, visceral fat, things like that. Again, it leaves these fatty deposits in the liver. You then start to see these secondary, Oh, that. Oh, actually, fatty delivery is probably, you know, the secondary condition as well. But you see these groups of conditions that you expect with higher BMI as well. I was gonna say, sorry, I just,
Kathryn Knowles 14:26
so, just something that’s popped into my head there is that, you know, obviously, when we’re talking about this, and, you know, thinking as to why people might, if people do, wonder why the underwriters are maybe a little bit more so, so about it Nice thinking, Well, you know, if there is fatty liver disease. So obviously, there’s been, obviously that build up of fat in the liver, but that’s the thing. It’s been identified in the liver, but those fatty extra levels are also going around everywhere else in the body. Yes, it’s been identified there. It is clear to see, probably there, and you can clearly see those readings for the LFTs. But it is that thing like, well. Well, if it’s if those levels have changed so much that it’s starting to develop fat in the liver, well, what is that doing to the heart? What’s what’s being deposited in the heart? What’s being deposited in the kidneys? You know, there’s
Alan 15:11
if your liver is working harder than your kidneys are probably having to work hard, and then other parts of the body as well. So
Kathryn Knowles 15:16
it is a real, sort of like environment, you know that it’s having to, sort of like, go through,
Alan 15:22
I think, my last one. And, you know, I know, I say this a lot. This is the most important question, next to the staging and making sure it’s not alcohol related the most recent liver function tests. So, you know. And this is hard, because people might not necessarily know this, but you can ask them and say, do you know when your last liver function tests were, and were they normal? If possible? Could you get me a copy? Could you have a look at your NHS app? Could you get your last specialist letters and send me a copy? Because my NHS app has got every single blood test I’ve ever had. I know that doesn’t necessarily work everywhere, like for Scotland, where you don’t have access to them at the moment, but if you can get a copy of them, what they have next to them is, it’ll be like five or six function tests, and next to them it’ll have a number, and then next to it’ll have a reference. And the reference is the safe range that they expect. So you can then see, are these within normal limits? Now, if the reference range is, I don’t know, 10 to 50, and it’s 51 probably not too bad if it’s 150 I mean, you can use your own logic and say that’s three times as high as it should be. We’re going to have a problem here. Yeah. So, you know, it just helps. And that information primarily, if
Kathryn Knowles 16:33
you saw that, you think, right, I need to go and chat to my doctor to be honest, you know? I mean, that’s the really key thing as well. You know, these are all really frustrating thing. You know, people find it really frustrating. Oh, why won’t the underwriters underwrite me? Or underwrite me, or things like this, or why won’t they do this, do that? But ultimately, if you do, if you did have a range that was that far out, then it’s a really good thing that it’s being looked that, you know, obviously it’s been looked at. Not, not a good thing in terms of the insurance that you’re going to have to wait for. It’s a bit, possibly, I’ll go super specialist. But it does mean, right, this has been identified, and we can, you know, you can do stuff to try and try and bring it back down.
Alan 17:06
Absolutely have I covered everything?
Kathryn Knowles 17:08
I think,
Alan 17:09
couple of tangents. Not too bad.
Kathryn Knowles 17:12
No, absolutely so. And I do think so there was something that you that you mentioned there about BMI and things like that. And so I think it’s really important. And we did do, I’m sure we did an episode on this, but about weight loss, medications and that. And there is quite a thing at the moment. We did some, there’s some pieces out in some of the reinsurers websites and research and articles that they do. And it’s really, really interesting. I’m pretty sure it was one, I can’t remember if it was Hanover Rios, Swiss three. It was one of them. I was reading up on it about the weight loss medications. And there’s a really big issue at the moment, actually, about non disclosure. And so I know we’re going to get a bit off on a side tangent, but it’s really, really hard, because the question sets aren’t necessarily matching what people think, and it’s all to do with it was a really interesting piece on the reinsurance thing about actually changing insurers questions to be more behavioral focused, rather than than sort of otherwise. Because, you know, if you if the thing question says, Have you been prescribed medication from your GP, and someone’s actually buying the medication, not having it prescribed, then they don’t see that as well. I don’t need to say yes
Alan 18:23
for this. It’s a really good point, because even though it might not necessarily say by your GP, but you know, in the last three months, have you taken any prescribed medication for more than you know, three months or four weeks or whatever? And some of them do say, you know, from your GP, but some are just prescribed. Well, actually, do people think that if they are buying from an online pharmacy. Yeah, that that’s prescribed. You know, it’s, it’s a nuance that actually, we might say, well, actually, no, you need to put this down. But if you don’t volunteer and tell you that,
Kathryn Knowles 18:50
yeah,
Alan 18:50
then, then does it go down? People buying online now, obviously we’ve learned from this, and we typically say, by the way, this includes things like weight loss injections,
Kathryn Knowles 19:00
absolutely.
Alan 19:01
And there are some now that people are buying as well, and I can’t remember the name of it, but there’s one that’s in clinical trials that people are buying and using that is not sort of generally approved and available on prescription, so people are buying it, but through sources that are less than ideal. Now, where does that get disclosed? Because it’s not prescribed. Yeah, it’s it’s certainly not prescribed, but it’s also not a recreational drug either, so it doesn’t fall under any questions. So because
Kathryn Knowles 19:33
the other thing as well, on the flip side is that we’re all told don’t over disclose. You know, if the insurance questions don’t match what you’re being asked. You don’t need to volunteer extra information, and that is really, really hard. And I was going to say for us as advisors in the specialist area, we would know what to do, but for advisors who aren’t working in a generally, really specialist area and doing these things quite regularly. Or for your general public who don’t understand the way that it works.
Alan 20:04
So I would say that we are encouraged to disclose as much as we possibly can, and we know, but actually in some forms that can disadvantage the customer. And under the Insurance Act, and I believe it’s Sidra, insurance companies do need to ask the questions that they want to know the answers to and cannot expect the general public to volunteer information that they are not explicitly asked about, and that’s in the retail personal space. So yeah, and obviously there is always that thing, volunteer as much as you can, but there are circumstances where you’re absolutely right if you volunteer something that, in a sense, you shouldn’t, it can be used against somebody. Yeah, exactly yeah. Interesting one for the
Kathryn Knowles 20:43
fatty liver disease, going back to that,
Alan 20:45
is going to come absolutely weight loss medication. For anyone listening, I would encourage please disclose everything. Put everything
Kathryn Knowles 20:52
Yeah.
Kathryn Knowles 20:53
You don’t want
Kathryn Knowles 20:54
to
Alan 20:54
have ring your insurance and speak to them about it as well.
Kathryn Knowles 20:58
Absolutely So in summary, when were you diagnosed with fatty liver disease? Has there been any specific cause for it? How much alcohol do you drink, either when you were initially told that you had it or now? And what are your most recent liver function tests? They are really, really key questions here, you then might go off onto the tangents into the, say, the the extra thing. So, like, if you said to somebody, what stage fatty liver disease, some people won’t possibly know, but some people might get a little bit confused by that terminology. So if you take at least that initial information, that will give you a really good starting point to know how to dive in deeper. So what outcomes are we expecting? Alan, as
Alan 21:38
always, my answer is, it depends.
Kathryn Knowles 21:41
Yeah. Do you
Alan 21:41
want me going to it more detail? Go on, right? So life insurance and critical illness, I’ll group these into one, I guess. And I’m proof of this. You know, people can get standard rates for it. You know, I got standard rates when I was younger, and I had some high liver function tests. I got it a few years ago when I had some tests. Because ultimately it was simple. I had it all rechecked and tested, and it was was all fine, and I removed what we thought was causing the issues. So, you know, simple, fatty liver, odd, high liver function tests, potential to get standard rates if readings are normal now, very unlikely to start seeing exclusions on critical illness or anything like that. If people are getting more into the Nash territory, more likely to start seeing loadings involved. If somebody is getting fibrosis or cirrhosis, pretty much you’re going to see all mainstream insurers decline. You are going to end up needing to go more specialist for that. And obviously that is going to come with a price tag. We have covered people for life insurance with cirrhosis. We’ve done a few now, but the price tag is higher. I will share a quick example of somebody, and this was many years ago, actually now, and whether we would get the same outcome now, I’m not sure, but we did have one customer who had it was, you know, you’re talking 10 years ago, prior to us sort of thing in the cover, they’d had issues around alcohol and drinking and all sort of reasons around it, and they had been diagnosed with cirrhosis of the liver, but they had had repeated ultrasounds and scans, and we actually had documented evidence to show that the liver had actually completely repaired itself and that there was now no cirrhosis, which I know goes against a little bit of what I’ve said. So it probably says that the cirrhosis wasn’t too bad.
We did actually manage to get that cover client cover on the standard market at the time, but it was a real talking to senior underwriters. Yeah, whether we would see that same decision today, I sort of doubt it. I think that was probably one more so in the past when, you know, it was a lot more case by case than maybe what we see today. But, yeah, generally, cirrhosis, fibrosis, no critical illness. Cover, life, cover, more to specialists. Income Protection, probably similar to critical illness. Cover, really, you know, the simple versions of this, well controlled, no high LFTs. Now I’d expect potentially standard rates or a small loading with it again. You start looking at the other conditions, and you know, if they’re diabetic, obviously that’s going to impact it. Blood pressure, BMI, all these sorts of things do impact it. There are a couple of simplified income protection policies where they will likely take people with these conditions, as long as the BMI is okay, and they’ve not had advice to reduce alcohol consumption. That’s something we didn’t mention earlier, by the way. Is advice to reduce alcohol consumption is a relevant question as well, because we know insurers don’t like that, but that is generally always going to be the case with this condition. So yeah, you’ve kind of got a bit more context around that to get was it because you’re drinking too much, or was it general advice, just because you’ve
Kathryn Knowles 24:41
got fatty liver,
Alan 24:43
liver disease. But, yeah, you know, income protection, there are these simplified products available. But again, I’m sort of thinking, you know, you start getting into cirrhosis, fibrosis territory, yeah, potentially you might get some cover with an exclusion on a simplified or you’ve got accident and sickness cover, which is a guaranteed accept. Version of the cover, but you’ve got to really look at these pre existing health condition exclusions and think, Well, what impact could that have on potential claims? But as I said for you, for your majority of clients who have a simple version of the condition, I’d be expecting near on standard reps, as long as it’s now well controlled,
Kathryn Knowles 25:19
yeah, I’m going off on a side tangent in my head now about the alcohol and advice, because, I mean, GPS just pretty much tell everyone,
Alan 25:28
yep,
Kathryn Knowles 25:29
you know, reduce. So it’s really hard, isn’t it, because we’ve seen, like, a real I know it’s been across the industry, we’ve seen a real issue in terms of advice to reduce, because I’ve mentioned it before on the podcast, that it used to be that people were advised to drink no more than 21 units a week. They’ve now changed it to 14 units. So people who were drinking around 21 units now are just kind of like automatically in total, where you need to reproduce. But even if you were doing even eight units a week, probably some doctors would probably go, Well, do you know what? As with anything? Don’t drink as much and things like that. And it’s like, that. And it’s like, it’s almost a bit like, Well, where do you draw the line on that? And and I think it’s hard, because when, especially when we’ve had that thing of going from like the 21 to 14, there’s been some really hard line things from underwriters going, No, absolutely not. It is absolute advice to reduce rather than just looking at the situation of going, come on. It’s from government guidance and things like that, and changes from the British Medical Association and guidance and stuff. But then sometimes I do think we’ve maybe we do have, like, said, like with this, if someone does have mild fatty liver, and the doctor has said, Look, you should probably try and reduce alphabet underwrites. Seem to actually be quite understanding of that, because there is a condition that’s, it’s, it’s a really, really kind of contentious area.
Kathryn Knowles 26:43
It
Alan 26:43
is no absolutely, and, you know, I guess risk going into another podcast entirely here, don’t we on this one? But you know, some insurance companies will take a very hard stance and say, if you have had any, and I mean any advice to reduce in the last five years, they will decline an application which, and I’ve seen this, per, you know, with my customers, where there’s been a note on saying, you know, reminded of safe alcohol limits, for example, that’s been interpreted as advice to reduce they were maybe drinking, you know, 20 units, for example, or 20 units in itself, If you declare that it’s standard rate 20 units with that statement potentially declines. But then some insurance companies are fine, and some insurance companies will accept up to 40 units a week. Absolutely fine. So, but I also know that it is a big area that insurers are reviewing and looking at at the moment, because ultimately, we’ve got to move with the times, and we’ve got to be able to get more than just that, that simple line, there’s got to be context as well with it
Kathryn Knowles 27:44
absolutely right? Well, I’ve got a couple of case studies as always to finish off the episode. So the first one is someone in their mid 30s. They’re a non smoker and a BMI. When we were doing the application was 37 so on the going towards the higher side of things, in terms of what insurers be able to accept in terms of life insurance. Now, what was interesting is, and it’s obviously to do with things that we’ve said so far, is that, obviously this person had the mild fatty liver disease, but their liver function test, their LFTs were in normal ranges and no concerns. They also raised blood pressure. Now their fatty liver disease had been attributed to their weight. So they had been for a couple of years taking weight loss medication, and had lost 44 kilograms before they had come to us. I believe their original BMI when they started the weight loss medication was in the 50s. So for this person, obviously they’re dramatic weight loss, which is absolutely fantastic in terms of like long term health and benefits and things like that, and the fact that the fatty liver had been there, but everything was in normal ranges, which is good. So they were able to get 500,000 pounds of life insurance over 33 years for 72 pounds per month.
Now the second case study had quite a few more things going on, and I think it’s always a good idea for me to bring in cases wherever possible, of someone who’s had a situation where things are there’s not as much going on. So you can see, sort of like, probably what the the general things that you would see with clients that you might get in this situation, and then the ones that have a lot more, there’s a lot more complication. So that you can just see the, sort of like, just how far we can go and being able to get cover for people. So the next person was someone in their mid 40s, again, a non smoker. Now, in terms of their disclosures, they had quite a few and so they had rheumatoid arthritis, fibromyalgia, type two diabetes. They had a former tachycardia that had needed some ablation, so some actual interventions in prior years that sleep apnea, they were taking weight loss medication, high blood pressure, and they had the non alcoholic fatty liver disease and the state of hepatitis stefatitis, steato fighters, they had something extra with a fatty liver disease that I can’t. Announce
Alan 30:00
theater for hepatitis that I think that was even worse than what you said. That’s where it’s going. I
Kathryn Knowles 30:05
think
Kathryn Knowles 30:05
yours was far better than mine. So they also had that as well. And this person does actually drink alcohol still every now and then. So whilst they do still have that fatty liver disease, they have that thing that Alan just managed to pronounce for me, and they’re obviously still drinking alcohol, but it isn’t something that they’re doing regularly. But obviously there’s a lot of conditions there that in their own, in their own assessment, would potentially lead to ratings with insurers. Now this one did have to go to specialist insurer, just for the pure range of just how many things were were in this person’s life and and the amount of ratings that there would have been. So we have arranged a 50,000 pound of life insurance over 10 years for 55 pounds per month. So that is it. Thank you very much for listening, everybody. Alan, thank you for being back with
Alan 30:55
- Thank you for having me. It’s been
Kathryn Knowles 30:56
a pleasure. You’re very, very welcome. We’re back with another episode in a couple of weeks, and please visit the website practical hyphen protection.co.uk, to get your CPD certificate, and we get them. Thanks to the team over at plan X, who are sponsoring us. Thank you, everybody. Bye.
Transcript Disclaimer:
Episodes of the Practical Protection Podcast include a transcript of the episode’s audio. The text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record.
We often discuss health and medical conditions in relation to protection insurance and underwriting, always consult with a healthcare professional if you are concerned about any medical conditions and symptoms we have covered in any episode.
