Hi everyone, we are getting towards the end of Season 5 of the Practical Protection Podcast. In our penultimate episode we are focusing on schizophrenia and how it is often a misunderstood condition. There is a bit of a debate over the statistics, as you will hear me and Matt go through.
The condition can be linked to genetics, but it can also be the result of experiencing a traumatic event. It is mostly diagnosed within cities and in some ethnic minorities too. Experiencing schizophrenia is not having multiple personalities and you might find that some people feel very uncomfortable using the term schizophrenia, as there is quite a lot of stigma surrounding the name.
I hope that by seeing the statistic below you will see that this isn’t some condition that is far removed from us, that many of us easily speak to well over 100 clients, so the chances are that we will speak to someone at some point that has experienced this. Schizophrenia is a long term health condition but it is possible in some cases to recover from it.
The key takeaways:
- It is estimated that approximately 1 in 100 people experience schizophrenia.
- Two case studies of arranging life insurance for people living with schizophrenia.
- Why it can be difficult to arrange income protection, even with a mental health exclusion on the policy claims set.
Next time we have a very special treat for you all on the podcast, it was super fun to record with our unique guests. As the final episode of Season 5 before our summer break, I hope that you tune in and find it as useful as I did.
If you want to know more about how to arrange protection insurance, take a look at my Protection Insurance in Practice course here.
Hi everybody. We are on episode 17 of season five, and I have Matt Rann back with me. Hi Matt.
Hi Kathryn. Good morning to you.
Good morning to you too. Well today we’re going to be talking about schizophrenia and what to do if you have this condition and are wanting insurance. This is the Practical Protection Podcast. Very quickly, Matt, before we get into this, how are you doing? I believe that you’ve got a bundle of joy on the way very, very soon.
Oh, <laugh> oh, thank you for asking. Absolutely, my daughter, Rachel is 34, 35 weeks pregnant. I was lucky enough to go along with her, her partner was otherwise engaged, I would say, along to her latest scan. So I saw the little, little boy, my little grandson you know, as you know Kathryn yourself, and all mums will know out there, perfectly formed.
In his mum’s tummy and quite an emotional moment. Really. I’ve only, that’s the third live, if I can call it, scan I’ve ever seen. I’ve got two children myself, it was quite an emotional moment, but it’s yeah, it was it’s, it’s lovely. And little bit of shock to everybody concerned. But only, only six weeks-ish to go now.
Yeah. It’s great. Thank you for asking. It’s a bit of a distraction, but it’s, it’s, it’s lovely. Probably the best distraction one can have.
Oh, absolutely. I was gonna say, obviously I’ve, I’ve got three children. I have to say the scans are wonderful. And, and for me I, I kept getting more scans than you’d usually be getting because with me being quite tall, I’m six foot. So the baby had quite a lot of stomach area in a sense. So in terms of the measurements, my stomach never measured at the normal kind of size that they expected. So they’d be like, oh, we need to do a scan to just double check the baby’s okay. And I’d go in and they’d be like, yeah, the scanners were there. They’re just like, it’s absolutely fine. It’s just, because you’ve got a long body and he’s literally got lots of space to move around in, which was really, really good.
And but obviously it just meant I got more scans, which was brilliant, but I always, the one that really stands out for me was with my youngest and they did the scan and there was bubbles everywhere. <Laugh> There was literally all these little bubbles and I was just like, what is that? You know, I’ve been through this twice before, you know, I’d never experienced it. And they’re like, and they’re like, literally they’re like, he’s having a party in there, he’s dancing that much, that he’s making all the fluid bubbly. And I was just like, oh, go and have a little party then obviously I was thinking, oh, what’s it gonna be like when he gets bigger and I’m feeling, you know, when there isn’t as much room when he carries on having a party, but always a wonderful, wonderful experience. So I have obviously all fingers crossed, everything goes well. And by the time the podcast goes out, it’ll be very, very close to, to the actual time of arrival.
Any day. Yeah, absolutely
Brilliant. Okay. So let’s, let’s get into this session then. So we’re gonna be talking about schizophrenia. So as usual, I’ll do like a little bit of a background and I know we’ve had a bit of a debate on some of the statistics that we’ve found, not a debate, but just a, a difference in the statistics that we’ve found. So we’ll have a quick chat about that and then we’ll go into all the different things so that maybe advisers can better understand what they’d need to ask somebody if they’re wanting some help in terms of getting insurance if they have schizophrenia, and some of the terms and options that might be available. So schizophrenia is a serious long term mental health condition. And what’s important about it is that cause I think that some people, if they knew that someone had schizophrenia, it’s not something that we often come across day to day.
Or be aware that we come across in a day to day situation. So as with anything, if we’re not familiar with something, it could be that maybe an adviser feels a bit unsure as what to ask or how to approach, how to, you know, the best way for them to communicate with the person. And I think it’s important to say that the condition itself can be quite misunderstood, so it doesn’t cause violence. And it doesn’t mean that the person has multiple personalities. So the condition name itself is actually now being considered that that maybe it needs to change because it’s seen as being quite stigmatising and it’s maybe not a, a good use of the term anymore. It can be caused by a genetic sort of like tendency towards it or potentially caused by a traumatic experience. And also potentially as a follow on from drug use, it is something that a person can recover from.
So it might be that someone says that they had schizophrenia and that they no longer have it anymore. And we can always discuss what we’d need to, to ask in those kinds of situations. And it’s most often diagnosed between the ages of 15 and 35. And also mainly for people, in people who would be in like cities and also in some ethnic minorities, but when it comes to statistics. So when I was doing some research for this, so we have the world health organization or the WHO, and on that it says that one in 300 people worldwide have schizophrenia. And I know that you found slightly different statistics, didn’t you?
Yeah, that’s right. When I, when I was brushing up on the subject all I have to say all of the websites that I was looking at and, and they were both from interest groups as well as NICE, as well as other medical organisations actually quoted one in 100 people. So potentially, a more, well, certainly more common in comparison with one in 300. And I think we were just debating a minute ago, why that would be, and I just wondered whether the world’s health organization statistic would be the data hinges on the word on the word world. Yeah. As opposed to maybe the statistics that I was looking at, and I maybe should have been a little bit more attentive to see whether those statistics related to a particular geographical region. And it could well be that thinking about it could well be that this, the one in 100 relates to Europe, north America and so on and so forth where, because of the medical care generally available, then more diagnosis as would be would be made either which way.
I think it it’s, it is an interesting one, but it also to me tells, tells me that this is quite relatively common.
Yeah. That’s one of the things that stood out for me as well. I didn’t expect the statistics to show it as being so common. And I think, you know, what you were saying there about north American Europe as well, probably quite naturally, really big cities, you know, there’s and you know, it is said that, you know, it is generally, it’s, it’s more so in like a city space as well. And, and whether or not it’s one in 300, one in a hundred, what that stands out for me as an advisor is that, I mean, obviously some advisors, you know, especially if they may be working at the investments and pension space, they’ll maybe be more in a situation of saying, right. Well, I look after 80 families and that’s who I look after and, you know, so they don’t necessarily have over a hundred people that they would maybe be looking after at any one time. But for people who are maybe more possibly like the mortgage space, the, the protection space, whether or not that’s advice or non-ad advice we are speaking to hundreds of people, you know, a a yeah. If not thousands of people. Yeah. So the likelihood of a speaking to somebody is, is quite high actually at some stage.
Yeah. Yeah. I think the one, one in 100, if I go back to my career, which is, you know, I’ve been around a long time even as a reinsurer, I can’t remember, but that was a long time ago. It has to be said, even as a reinsurer, I can’t remember seeing many cases of schizophrenia hit my desk. Mm. So no, it maybe goes, goes back to the general population and the insurance population, which you’ve just touched on as a factor, as the mortgage, people who buy mortgages. Maybe people with schizophrenia established schizophrenia, which will go into a little bit later, don’t tend to severe if I can call severe schizophrenia don’t tend to, to buy houses or, or other products that would, that could require protection insurance. I don’t know, but there’s always, I think that was statistics. It’s the general population versus the insured population and people who actually have money to buy. They will, they will be a, a, a generally a healthy, well, they are that shadow about a healthier group. I would emphasize the term group there.
Yeah, of course. So I think if we go into, into it then, so what are the symptoms
Of schizophrenia? Okay. Can, can I take a little bit of a step back, go complete tangent, which is usually what I do do well, first of all, I would like to do just say that Nia is <affirmative> schizophrenia is a, is, is the most common psychotic disorder. And therefore one could argue that schizophrenia is a subgroup of psychotic conditions. And that really is schizophrenia itself is a, it’s a serious mental disorder in which people interpret reality abnormally. And what it is schizophrenia itself is characterized by continuous and relapsing episodes of psychosis and psychosis really is, is, is used describe it’s medical term, which is used to describe where people lose contact with reality and looking down at some of the questions we have or maybe a little bit here, but and the condition can result in a combination hallucinations rights and extremely disordered thinking in, in, in where behavior impairs daily functioning.
And, and it can’t be comp you know, very disabling. I’ll probably just work back a little bit in terms of hallucinations, just to clarify what I mean by that. And that’s where people see or hear things that are not there. Yeah. Delusions where people or the, the, the person’s suffering believes thing believe things that are not actually true. And cognitive impairment P term, and really just disorganized behavior, speech and or thoughts, you know, I suppose in modern parlance, very, very random behaviors. Okay. So those are the characteristics of psychosis of which schizophrenia is a, an actual subset schizophrenia itself needs to be diagnosed by the psychiatrist. And there are specific psychiatric manuals which are used. And I, I won’t go into them particularly, but basically it’s it, they, they will say, or, or make the diagnosis on the basis of some of the following system symptoms, which I’ve just talked about, to be honest with you that are present most of the time for one month or more.
So halluc voices delusions of control, influence, or positivity, persistent delusions, other kind that are inappropriate or completely impossible. And that you, you can go on in terms of these criteria, which actually need to be fulfilled before schizophrenia is diagnosed and then treatment can continue from there. But there, there is, there are criteria and it’s potentially is a takeaway. Just think that those symptoms have to be present for most of the time for one month or more when I, and Kathryn, you and I have spoken about this before, but when I look through all these symptoms, I must admit, I think I get some of them sometimes.
To be honest about it. Talk about self diagnosis for the, for the end rider. Yeah. But the key, the key is I’ll just go back to following the symptom, the following the symptoms to be present most of the time for one month or more.
Thankfully in my case, I can absolutely assure you that they didn’t go on for most of the time for one month or more yes. By any stretch of the imagination. Yeah. So that, that really is diagnosis to, to the keys. It’s the most common psychotic disorder and psychotic disorder is a medical term, which is you to describe when people that lose some contact with reality, such as hallucinations, delusions, and cognitive impairment. I hope that’s OK. Just to, yeah. I always like, I always like to go back and think, well, actually, what is the subject that we are talking about? You know, how is it classified? Where does it, where does it fit and so on and so forth. So I hope that’s some use.
No, I think it’s really interesting. Cause like something that’s just popped into my mind as we’ve been speak as well. Cause obviously the whole thing about it saying it can be triggered by traumatic events. And like you were saying that needing to have a psychiatrist. Well obviously after traumatic events, I think probably a lot of people would more assume that something like post traumatic stress disorder or complex post traumatic stress disorder would be diagnosed, but, you know, potentially there can also be schizophrenia. And I’m, I’m not saying that, you know, for anybody who’s in either of those situations, that there’s any kind of misdiagnosis, but it’s just probably, I’m trying to sort of like lead to his more, the complexity of, you know, there are certain situations that might lead to certain things, but as you say, you know, it’s this consistent time period. It’s, it’s all those kind of different symptoms altogether.
And that would need to be really analyzed by a psychiatrist for it to be an official diagnosis. So from, from an, from an advisor point of view, so somebody were to say to me that they were diagnosis schizophrenia. What I will be saying is you know, when were you diagnosed with schizophrenia? I’ll be double checking to just say, so it was a psychiatrist that they’d seen and I’d ask how long they’d seen the psychiatrist for and see if there’s ever any confusion then about whether or not a psychiatrist had diagnosed it or not. Then that would lead me to think action is maybe a bit more with this that I need to maybe explore, maybe ask a bit more about, because you, it would be a psychiatrist that would be diagnosing it, it shouldn’t be just a, I don’t wanna say just a regular GP. I don’t mean that to sound like that, but no,
No, exactly what
You mean, you know, it’s it’s, it’s going to be somebody who’s specifically trained in that area because they are looking for those nuances between all the different types of mental health conditions that it could be. Because I find I’m right. Obviously there’s obviously there’s usually certain treatments and medications. I do think some of the treatments can, and medications can be quite strong. So I think that’s why as well, there wouldn’t necessarily be this automatic assumption and going down that route, but can you go through sort of the, the types of things that you would expect to be told as an underwriter if someone has has schizophrenia?
Well, I think that the, you, you just touched on a couple of key areas there is, is, is when did your symptoms, where, when were you first diagnosed would be, would be absolutely very important diagnosis for schizophrenia. I would add not, not general psychotic disorders, not into play general psychotic disorders. I would add would always, nearly, always requiring patient assessment I believe. So really it is one when we diagnosed, who, who diagnosed you? Three inpatient timing. So were in hospital for a few weeks, a month. When did you leave who are you currently seeing? Who are you following up with that generally won’t be the psychiatrist after a diagnosis has been made, unless there has been a relapse of symptoms. Treatment is, is certainly useful. We’ll go to treatment a little bit later on.
But the key, sadly, the, the, and very sadly the, the key cause or of excess mortality. And what does that mean in English? It means death is from suicide. There, there’s no two ways about it and I’ll come on to some very side statistics later on, but they, they generally suicide is the, is the most common cause of sudden death poisoning, strangely crops up in the, in the studies. But really, and I know you talked about critical illness as well. Studies do show that there is twice the incidence of ischemic heart disease, so problems with your heart basically. Okay. From, from a blood flow issue in people with schizophrenia. So if you go back to what is covered in the critical illness, then you can see that is a challenge for underwriters to assess CI with people, with schizophrenia or histories of schizophrenia. If that matter, can I, can I just go back? I think this, this was certainly something which I found very, very interesting. I, I, these are statistics as always, I suppose, being under better, but right. Again, these, these are, these are psychotic disorders. We talked about schizophrenia being a subset. Okay. You, you talked about a few reasons. Why do take the fact that they are generally unknown, that statistics have shown that stressful life events, such as bereavement job loss, eviction relationship breakdowns
Are associated with a 3.2 fold risk at psychotic disorder, childhood, such as abuse, bullying, parental loss of separation, 2.8% increased risk of, of of disorders. And it goes through family heritage. You talked about that with the south, south Asian and, and our, our black populations migration from a developing comp country three times increased risk of schizophrenia,
Urban living cannabis use associated with a 40% increased risk of psychotic illness.
It’s absolutely amazing. Isn’t it? And you know, I know the insurance industry does tend to get grief about asking for things, asking questions about cannabis. Yeah. But actually that is a pretty scary statistic.
You, you, there’s a whole range of life events early life factors such as in utero medication, maternal stress, nutritional deficiency parental age, these all linked to an increased risk of psychotic disorders. So perhaps in a, in, in a way I know we, we banded around you was schizophrenia one in 101 in 300, if you look at all the blooming causes of a psychotic event, then perhaps, you know, the the statistics aren’t, aren’t that much of a surprise, I dunno, but I thought I’d throw those in because yeah,
Know, again, psychotic event, we must, without any show of the doubt, think that a psychotic event means you’ve got schizophrenia. It doesn’t in the slightest and the underwriters look should, and will I hope look at these psychotic events in a, in a very different way. Schizophrenia is a very specific subsection and that’s really what I was trying to get across with, with my, my, my, my tangent that
Time. No, absolutely. And so, I mean, in terms of like medications, what are the types of things that we would be expecting to hear if somebody has schizophrenia? Cause it’s, it’s, it is quite likely that they’ll be on medication for, I think at least some period of time, I believe not. I’m assuming so.
No, no, no. AB absolutely. I think different. One of the, one of the key things with medication is it’s, it, it is the, once the doctors work their way through the medications, they’re often very different for different people, different things work for different people. And generally in the, with the NHS antipsychotic drugs go back to the psychosis part of this help reduce symptoms, but they don’t, they don’t actually cure them. That’s, that’s pretty important to know. So along with, with medicine or drugs, let’s call it that talking therapist are often news and we’ve all heard of, I would imagine most of us heard of C BT. Yeah. So
That be for people who have that’s cognitive behavior therapy, so that wouldn’t be a medication that would be a treatment that people would go through.
Yeah. Thank you for that. There is a particular term used by the doctors actually it says C BT P
Cognitive VA therapy for psychosis.
So it’s it’s a specific type of CBT. Yeah. But again, it, it, it, what it does, it doesn’t get rid of the symptoms, but it helps manage feelings and, and the symptoms better.
Okay. And they’re all, there are all types of of, of therapies these days. And I was very glad to see family intervention therapies. So that’s helped for the family of somebody suffering from psychosis or, or, or schizophrenia as well. Yeah. So the treatments will be a variety of things. And I think it’s important for advisors, not just to specifically think of drug therapies here. Yeah. I, I think the one, the, the, the, the medicine that I see most often, but there are quite a few, it has to be said, depending on the particular circumstances of an individual would be closer P C O Z P I N E. That’s it kind of technical name, if you want, like, with, with a, with a, a lot of drugs these days, they often have a marketing name as well. Which is, which can be a little bit of a, a challenge for, for advisors and underwriters, but often known as Alor as well.
I, I would recommend that if a, if advisors want to look up particular drugs, there’s a lot of information on the on the internet for, you know, you could put in a drug and see what it is and see what the, what the what it’s relates to. Absolutely. Just be a bit careful with that. Cause these things, a lot of the time are not black and white that’s, that’s through experience my experience as an underwriter. Yeah. So wouldn’t jump to a conclusion cause somebody is a, is on a drug that they are suffering from particularly a, that condition that could well be that the doctors is looking at a different regime.
Absolutely. And the different medications can be used for different things, you know? So say obviously there are some antidepressant medication that are actually used in some conditions for pain relief. Yeah. So concern with that, but that is what you said though, though, is really good. Cause that’s one of the things that I do with my advisors and even myself, you know, if someone says a medication name to me and I’m not familiar with it, then I type it into Google and I see what it is, you know? And obviously if it does say something on their like maybe an antipsychotic or you know, there are times as well. So, so like we get told certain ones that are maybe being used for different condition and then maybe more of like a steroid based medication there ones obviously just be really clear about when you’re doing your research to make sure that, you know, you are speaking to you underwriter and you’re saying what those medications are just so they can then have a really good picture about, as I say, what that regime is, that’s been a chosen for them because as well, I often find as well that if there is a medication we’re not familiar with and we speak to an underwriter, it could be a case in saying, oh yeah, that’s quite standard.
Or they might say, well, actually that’s quite unusual for that to be used for this medication or, or they’ve not come across that personally. So they might just say, can you just double check maybe with the clients as to, as to what if they’re being given it for a specific reason, you know, are, are they being soft, like told that they’re gonna do that as like a test to see if it’s that works well with them and, and, you know, that’s something that the doctor yeah. And then that can really help and, you know, saves soft, like a lot of toing and potentially if it is gonna be a case of going for things like GP reports. And I think it’s probably safe to say that for somebody with schizophrenia, it’s very likely that there’s gonna be a GP report for their application for life insurance or critical illness cover.
And I suppose we’ve, we’ve already kind of spoken, I imagine about the potential risks, but I, I think probably sort of like some of the, the probably like quite key areas is, as you said, Matt, you know, in terms of the hallucinations then obviously that could potentially lead someone to be in a situation where they might be at a high risk of, of doing something where they unintentionally obviously unfortunately die because they may be not understanding what’s going on around them. It’s maybe the environment that they end up in is, is quite dangerous without them realizing it. There’s obviously you say as well, the, the complication in terms of like potentially more heart disease I certainly don’t enough about that to try and soft. I understand why there’d be more of like a heart disease. I think there’s probably part of me that’s thinking because of all the like you said, the difficulty in terms of understanding reality, and maybe there’s sort of like so much stress in some ways based upon that, that maybe that has a, a knock on effect to the heart. I’m
Not sure my, my take one take would be, I think that the, that, that people who I do have schizophrenia and are suffering badly from it, and it can’t be, maybe the doctors are finding it D to control would be that they, they don’t look after themselves very well. So the diet won’t be great.
They, they they dismiss things like chest pain and, and don’t get themselves looked hard in terms of high blood pressure. Yeah. As so on and so forth, I would imagine it’s, it’s going to be something will, some of those factors will, will, will come into it. But noting it is two times more of skin, heart disease than the general population as well. Yeah. So it’s not an mature population, it’s the general population. So it is, it is Def definitely an issue which the underwriters need to to be aware of. And you go back just to go back to the question about asking maybe that’s a question that underwriters should ask as well. Are there any other factors in terms of the person’s general health, and that will probably come out on a proposal for more similar, but that’s given the nature of the disease and the more mortality that is seen the causes of the mentality. Maybe that should be a question asked as well.
Absolutely. And I think you know, when we’re looking at these applications, so for anybody with schizophrenia who is listening, it, we’re not, we’re not wanting to say that there isn’t an option and that isn’t possible. I will be giving some case studies of where we’ve been able to get things like life insurance for people that are living with schizophrenia. But I think it’s just obviously that it’s important as you say, Matt, and we’re looking at these statistics and we’re explaining why, if somebody has tried to get insurance and they’re living with schizophrenia, why they’ve maybe had difficulties in being able to arrange insurances because it’s, it’s, it’s one of those really hard things. Isn’t it, Matt, where obviously you could have somebody with schizophrenia who is doing incredibly well. The symptoms are, are very, very mild. They’re really soft, like taking care of themselves.
It’s something that they are living with, but you know, generally that they’re okay, it’s not actually impacting upon their life too much, but then there’s the other side of things where if somebody, unfortunately it is really significantly affecting their life. And as you say, their lifestyle factors might not be very conducive to being healthy. And, and unfortunately there’s in, in terms of the insurance, well, in terms of the underwriters, they sometimes have to, I imagine the kind of girl that’s a bit middle ground. And then if, if they can sort of like, let’s, you know, if they can take on board somebody’s positive lifestyle factors then brilliant. But generally the problem starting point is with anything is to go, right. Well, here are the rules in general for people who have schizophrenia and then kind of work from there in some ways,
Oh yeah, you’re a hundred percent. Right. I think that’s a really good way of, of explaining it. I mean, I the numbers of cases I have seen over the years where by where a asking the right questions, which I know is a very big thing for you and, and Kira and Kathryn asking the right questions up front. But also asking for the underwriter to ask the right questions from the GP or whatever medical profession professional that they, they are talking to. Because as I think I’ve alluded to already schizophrenia and psycho, you know, general psychotic disorders very individual they’re different for different people. And it’s important that that picture is built up as best as possible by the underwriter. They have to ask the right questions. That’s incredibly important to give the the client who wants needs some insurance, the best possible chances of getting it.
Yeah. And all too often these days. And I’m sure there’ll be some insurance companies who are out there that will say Matt, get into the real world here. But often cases are just turned, you know, they, they hit somebody’s desk. Oh, I haven’t gotten the information decline or it’s somebody’s desk. I haven’t got the information. Therefore we’re gonna rate five times the normal rate. But if those questions are asked upfront and the right questions are asked upfront, and this is where the Iffa comes in as well, I think to, to, to help the underwriter paint that picture the, the best possible terms can be offered now best possible terms might be sadly, we can’t do it, but at least you, you know, the client, I hope would understand that best, you know, that the market has been explored by the Iffa.
And every chance has been has been explored in order to PO to, to provide the best terms that there are. And you’re absolutely right. I mean, you know, with, with, with, with schizophrenics this, this, whether it’s the end game is somebody who is got minimal symptoms or no symptoms. It’s very well controlled, fit and healthy, and, you know, working as a, as an example. But that first year of, of from an attack, I can call it that, or from diagnosis that first year, you, you probably won’t get terms. I’m not looking at your case studies. I know that you often hide things in there. I don’t mean that horribly. <Laugh> <laugh> you often a fantastic, fantastic war background to your cases, but usually it’s postpone a year from, from when that person’s has been diagnosed, but after five years you can get standard rates for life insurance. So that’s one attack, short duration, full recovery, five years, you can get cover. Yeah. Sorry. You can get cover after one year, but you can get standard terms after five years. Yes. And also if you’ve got more than one and you are on maintenance treatment, you are on treatment the rest of your life, but you’re still able to work. You’ll be able to get cover or be, it looks quite expensive from where I’m at after year one. But possibly you might get standard rates after year 10.
So, you know, if, if you’ve had a diagnosis, it’s certainly not the end of the world as regarding life insurance do talk, you know, do, do talk to an insurance professional. And you may, you may be surprised that you, you, that life insurance is available.
Absolutely. Well, I think we’ve got some stuff like quick, not quick fire questions in some ways with this one. So I know we’ve explained the risk for life insurance and for critical earn cover for people who aren’t familiar with the product, that is something that pays out a cash lump. Some if you were diagnosed with a, a serious or critical condition, such as a heart attack, cancer stroke, and a number of other things. So one of the key, they’re the three key areas that are claimed on soft we’ve mentioned before about the high risk of this if the heart disease. So I’m, I’m guessing Matt, that insurers are concerned that there would be a high risk of potentially claiming on heart attack. Are there any other areas that would be considered potentially a high risk?
I think all, all of the, the cardios I’ll speak in underwriting terms just for a second. Yeah. Cardio and cerebral vascular. So stroke. Cause because I’m thinking here of the the lifestyle, not necessarily it, it could constitute the filling up for the arteries and narrowing of the arteries, which of course the, the blood not gluten to flows as it should do. And therefore cause either hashtag or a stroke those would be the main ones. It, it would be the cardio and cerebrovascular.
Yeah. Which are the, are the really key ones that people are gonna be claiming on
Cancer. Of course, which is another key one, which you, you know about. I’ve not seen a statistic to say that that is higher. I would throw back the question as an underwriter, as I would, if somebody doesn’t look after themselves, you, you, it is likely IE, a lump or a bump and you don’t go and see your doctor or blurred passing blood or whatever. The, you know, the variety of symptoms that are with cancer. And you’ not looking after yourselves because you’re not very well, basically if you have a long term schizophrenic challenge then I would probably say there is a risk of that, that statistics somewhere might show there is a high risk of cancer as well, but really what’s, what’s, what’s shown in the statistical modeling is, is a ischemic heart disease. I would guess stroke would be, would be an educated guess would be quite close to that as well.
Okay. Thank you. I imagine, just to be clear as well on some, the contracts that are now available, there are some criticals contracts where they will potentially pay out for diagnosis of psychosis. And I think it would be probably fair to say that that would at least be an exclusion on the policy if somebody had already experienced psychosis in the past,
I would think so. I think, you know, I would never say never cause I’m not member. I says that I don’t, I don’t believe in it particularly with the the, the, the way that modern medical science is going. But I think it would be very, very unlikely that you get that, that you get full cover, put it that way.
Absolutely. So a couple last ones on income protection can be very, very tricky to get. Now, this is something I’ve we’ve spoken about. I’ve definitely spoken about a number of times because we can get income protection policies with mental health exclusions on them. Unfortunately at the moment, we cannot get that for people who have schizophrenia. And it’s, it’s always that really difficult conversation, especially when advisor really difficult conversation to have with somebody to say, well, yes, they can do these policies with a mental health exclusion. And even though you have a mental health condition that would be excluded, I still can’t get all the other aspects of the policy for you. But I’m assuming from what you’ve said, Matt, that is because of all those additional lifestyle factors that could in turn in a sense, probably the exclusion that would be related to the mental health condition would be incredibly far reaching. Because if it’s, if there is a high risk of a heart attack, then that, and a high risk of a stroke, then it’s not just gonna be a mental health condition. It’s gonna also be like you say, a cardiovascular. So a heart related condition of cerebral exclusion as well. Am I right in thinking that
It’s yes. In, but I would maybe throw the comment in general terms.
Yes, of course
We can’t. We can’t dismiss, as you just said, the, the cerebral cardio innovation in, in terms of of the risks that presented, I think you got just, if somebody had had a schizophrenic attack 10 years ago, 15 years ago, and had no, you know, return to normal life and therefore was being checked out medically C, C blood pressure was checked, you know, and various things. Then I would say that cover could be granted.
That will be my take. Cause if I’m looking at the risk factors, so I’m not talking about somebody here who is on continuous treatment necessarily. Okay. But somebody who’s been working, obviously that’s condition of income protection and has had no problems for many years then I, I can’t see why, why cover could not be granted maybe with a schizophrenic exclusion maybe. Yeah. But I, I would’ve said, what are, what are the chances of them after that length of time having another episode, which, which would stop them working for a significant, well, a period of time, if you put an exclusion on, then that gets rid of that. So what else we looking at here that is, remember, I I’m being very specific, I think in terms of the select group of, of schizophrenic people. Yes. Here in that we are talking a long time ago.
Yes. So somebody who’s recovered.
Yeah. You’ve torn intent and purposes recovered you.
Yeah. No, that’s good. Thank you for, for the clarification on that. And I suppose, you know, what flows on quite nicely for that is so like, what are your thoughts on things like permanent self-harm exclusions on insurances? We are starting to see this emerging in the market. And I think there’s still this kind of some people are sorry, still a bit Ming and ING as to whether or not this should be something that the market adopts more widely. Cause I think, you know, there’s, there is the, there’s so many different aspects to it. Isn’t there. So there’s like if we can do exclusions, that means we can ensure more people, which is obviously fantastic. But then we need to make sure that people really understand what that exclusion means and not just them, but also potentially people who might need to step in and help if there’s a claim.
So they, in a sense, they realize that this isn’t just something that’s been like slipped in somewhere, you know, it has been part of the contract, the person’s been aware of it. And, and, and other things as well as to whether or not other people might sort think, well, is it okay at all? Is it legitimate to be putting exclusions on people won’t want them? Which is really hard because there’s a lot of people that we speak to, especially who would be love the policies, even if it did have an exclusion, you know, but sometimes they just can’t get them. And so, especially on the standard market. So, so what are your thoughts on things like that? Do you think that it’s something that we might see more of?
Right. I think, I think the first thing I would say is that I, I know there is a fair amount of opposition in the insurance market particularly from some of the, the, the new cos on the new companies, insurers on the block to exclusions full stop. My inherent view and absolutely stuck in stone view is that if by putting on an exclusion and I would caveat the, that the exclusion in a minute. But if, if that means that we can get cover for somebody for all the other causes, then I am totally for that.
I am. I am, you know, to, to say somebody can’t have cover at all, just because we’re not, we’re not prepared to offer an exclusion is I, I, I think is wrong, fundamentally wrong. Secondly, I think the term of the, the, the, maybe the more specific part of the question is is to use the example you, I, I have is the self-harm exclusion.
You’ve, again, touched on the point that it’s all well and good underwriter putting on an exclusion, but if they can’t be used in practice
Or by the claims folk then they’re not worth the paper they’re written on really in, in terms of risk management and terms for the client as well, if that matter. Yeah. Cause if they can’t understand or, or why, you know, an exclusion is being put on and why then they they’re being excluded because it’s got something very tentative, very tentative link to the exclusion wording, then that doesn’t do the industry any good at all and, and flies in the face of my view of what protection’s all about. So my always has been our exclusions. I, I, I believe in exclusions it, it is the practicality of the wording of that exclusion that I would look at very carefully and, and how it could be used a claim a does it, is it, is it, is it a fair deal for the insurer and potentially even more importantly, is it a fair deal for the client?
And if both of those boxes are ticked, then I would go for it. I think if I look at the definition or sorry, the wording self harm, then I would wonder quite what that covers and what it doesn’t cover. <Laugh> yeah, I would, I would, I would have to look at the exclusion wording to, to, to, to have an absolute view on it, but it does seem extremely wide ranging. And when you have a, a wide ranging exclusion, it kind of defeats the purpose, exclusion look better. If they can be, be specific, let me put it that way. Absolutely wide ranging wordings allow themselves to be misinterpreted all over the place.
Not, not just underwriter, not just claims underwriter, but also the client and the Iffa who are putting their names behind that, that insurance company’s exclusion ruling. Let’s be honest here.
Exactly. I was gonna say sometimes when we do get things like a mental health exclusion on something like it, it could be on like an income protection policy. It might be on something which is known as wave for premium, which is specific technic technical and on type thing that I won’t go to in depth in here. But sometimes when you see those mental health exclusions, they’re a paragraph and they cover, they almost seem to cover anything and everything sometimes. And you know, and it’s, it is really difficult because ultimately it is a case, you know, when I speak to people, I get a mixture of responses. So a lot of the time, if it’s something that has an exclusion, a lot of the time, people who do have a mental health condition, just from my experience, I’m certainly not saying it’s everybody. But the majority of people have turned on and said, you know what, actually, that’s fine.
You know, I, I’ve never, I’ve never not been at work for my mental health, or I’ve never had this or that, but basically is this cuffing me? And is it gonna do this? If I get cancer or if I have a heart attack, a stroke, you know, there are multiple sclerosis, the key things that people tend to worry about. And and it’ll be a case of yes. And then they’re like, well, that’s fine that, you know, that’s the things that I am worried about that, you know, you do sometimes get the people who say, well, no, I don’t want it. If it doesn’t cover my mental health. And, and unfortunately that’s a really difficult conversation because in terms of the personal insurance markets, that means that a lot of the time it’s, it’s not available or, you know, you’re having to go through potentially incredibly specialist policies that are very, very expensive.
But generally what I would say is on the personal market, if someone does have a mental health history exclude life insurance, but say like for, for things like wherever premium things for income protection, you would, you know, be seeing a mental health exclusion on there. With life insurance, you don’t typically see exclusions. So that’s really important to say as well, there’s with all, well, let’s say all, I can’t say all, but with the majority of life insurance policies, there is an initial 12 month suicide exclusion for anybody who takes out the policy regardless of their past. And that would be generally the only exclusion that you would see that there are sometimes exclusions for other reasons, but generally for health, you don’t get exclusions for, for health on on life insurance policies. So I do have some examples and these ones go slightly outside of that sorry.
Point, because they are for people who had are living with schizophrenia and actually both of the policies that I’m gonna mention, they do have, there’s a very specialist policy, but they do have a permanent self-har and suicide exclusion on the policies. And that means that if somebody in, in either of these situations, if they were to die whilst the policy’s active and it was attributed to something to do with self-harm or suicide, then the policy wouldn’t pay out. Now, some people might think, well, they don’t like the sound of that, that it’s up to each person individually as to what feels right for them or not. Other people think, well, that’s okay because that’s not the person that I feel that I am. Obviously we can never say for certain, what might happen to somebody at some stage or what might happen in their life that might trigger such things.
But generally, you know, when we speak to people in this space, if it’s a choice of maybe not being able to get the insurance versus being able to get it, then they might get it. And and what can be quite a positive from these policies as well is that, I guess they do have those exclusions on them, but they are then priced accordingly. So we’re not going into city pricing. Which obviously I’ll, I’ll demonstrate as I go through the case studies. So the first case study I had was for a female in her late thirties, and she had been diagnosed with schizophrenia about 16 years before we did the application for her life insurance. And she had had some history of hospitalization. So that goes back to what you were saying, Matt, about the about, so like the, we would probably expect some level of hospitalization at some point.
So for this person, we were able to get 60,000 pounds worth of life insurance over 17 years for a premium of 20 pounds per month. As I say, that did have the permanent self harm and suicide exclusion. The next case study that I have was actually for a couple and they were in their early to mid thirties. And it wouldn’t be in, in some ways we wouldn’t usually if, if we had a couple and somebody had schizophrenia maybe going to be, go down the route where there would be the self harm and suicide exclusion, we wouldn’t necessarily put both people down that route because the person without the schizophrenia might not have that. But it all comes down to people’s choices. And also if we were doing things like mortgage cover, which this was for, you would usually do a joint policy.
And so in this situation, we’d given them the option of the joint policy together with this exclusion set or potentially doing two individual policies, one that had the permanent self-harm and suicide exclusion for one of them. And the other one that only had that initial 12 month suicide exclusion period, which is standard in the market. So say there’s couple early to mid thirties. The person with schizophrenia had been diagnosed about three years before the application. And there had been a history of some self harm and some suicidal thoughts as well in the past. So we were able to arrange for them 112,000 pounds worth of life insurance over 33 years for a premium that was close to 13 pounds per month. So I hope that’s given people a good idea of some examples. And, you know, obviously I’ve tried to do it where it was a case of somebody who was diagnosed quite a long time ago versus somebody who was diagnosed quite recently. And and just to give that price in there, just to show that we, we’re not talking silly money when we’re talking about these insurances necessarily, obviously everyone is individual. Every application is individual everyone’s circumstances are individual. But I thought there were just some nice nice ones to obviously end this on quite a positive.
Absolutely. No, it’s it’s it just shows you what can be achieved, where where’s the will there’s often a way, not always sadly, but there is often a way, so that’s really, really good.
Absolutely. Well, thank you everybody for listening and thank you as always for your insights, Matt. Next time we have a very unique episode. I’m not gonna give anything away. You’re just gonna need to turn up and listen to it. And we’ve got some very fun guests for the last episode of season five, and we’ll be taking a little bit of a break over summer and starting back up again in September, if you’d like a reminder of the next episode, please do drop me a message on social media or visit the website, practical height and protection dot code UK. And don’t forget if you’ve listened to this as part of your work, you can claim a CPD certificate on the website too. Thanks to our sponsors, the Octo Members. Thank you again, Matt.
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.