Kathryn (00:05):

Hi everybody. We are on episode eight of season seven and I have Matt ran back with me. Hi Matt.

Matt (00:12):

Good morning. How are you keeping?

Kathryn (00:14):

I’m very well, thank you. How are you?

Matt (00:16):

Yeah, not too bad, not too bad. Survived a couple of holidays, which in fact of course you’d be very lucky to go on in the first place down to Cornwall with the whole family and it was rather soggy and wet, but it was lovely. And then the following week I went fishing in Gloucestershire and yeah, it looks, it rained and it rained and the wind was blowing and the wind was blowing. But I met up with the best man at my wedding.

Kathryn (00:42):

Oh lovely.

Matt (00:43):

So that was 33 years ago and we chewed the fat for a long time as we always do. So that was a nice ending. And of course as it was inside we weren’t fishing together. It was a lot warmer. That is

Kathryn (00:56):

Very

Matt (00:57):

Good. I’ve had a good couple of weeks. Thank you.

Kathryn (00:59):

That’s very, very good. Well I’ve just survived. Obviously people will be able to tell from the recording dates and everything and when this comes out. So I’m just surviving the end of the Easter holidays with the children. We’ve been away for a few days in Leeds. We had lots of fun which was very, very nice. And we’ve come back and obviously as with everybody, as you know when you’re going on holiday you come back and there’s so much work that you’re like why did I even go on holiday in the first place? And then I’ve come back and my youngest has come out with chicken pox so it’s going to be an extra bit of time at home with him and doing some manic bon arms typing on a laptop whilst cuddling him in the background as well. So lots and lots of lovely cuddles for me. Obviously I’d much prefer cuddles on a different reason but lots of lovely cuddles for me for the next week or so. But today everybody, we are going to be talking about arranging protection insurance when you have sickle cell. This is the Practical Protection Podcast.

(02:03):

So everybody, today we’re going to be talking about sickle cell and it’s something where we are seeing more and more questions come up in terms of access to insurance. Sickle cell is a term used for a group of inherited conditions that affect the blood. And I’ll leave Matt to tell us all about the technical side of things. On that side, it is most common in people that have an African OC Caribbean heritage and there’s also something as well known as important for advisors to be very aware of. It’s something known as sickle cell trait. Now that is where somebody has inherited the sickle cell gene but they don’t actually have the sickle cell condition. And I’m going to talk about a case study at the end of this where this became a little bit of a tricky situation when we were arranging an insurance for somebody just because there can be some confusion sometimes as to whether or not there is sickle cell trait or full sickle cell anemia. There are approximately 15,000 people living with sickle cell in the UK at this time. So Matt, can you start us off then please with giving us some background about what sickle cell is?

Matt (03:04):

Absolutely. Sickle cell actually contains a number of diseases, medical disorders within the framework of sickle cell, so it’s not just one particular disorder, medical disorder. So effectively with the group and the umbrella sickle cell, it’s a group of people who have an inherited, as you said already, blood cell disorder which affects the hemoglobin and as we know, everybody will know who listen to the podcast regularly. That’s a protein that carries oxygen through the body. It’s inherited so you cannot acquire sickle cell disease later on in life. You either have it or you don’t have it from birth. What it actually sickle cell is an app’s name for the disorder. If we’re looking at hemoglobin cells in particular of course here, but they are unusually shaped blood cells actually and they look under the microscope, they look sickle shaped. Okay, so it’d be like a crescent moon I suppose you’d call it maybe.

(04:19):

And hence why you get the term sickle. Now as I’ve said, these are hemoglobin cells and they are vitally important to carry oxygen around the body and unfortunately with the genetic fault these cells, the hemoglobin cells don’t live as long as healthy blood cells and if you’re not getting enough oxygen carried around the body then that’s going to cause issues but also because they are sickle shaped and they tend to be hard as opposed to soft and round like normal hemoglobin cells of proteins, they can block blood vessels. So you’ve got two issues there really under sickle cell blood cells, sorry the impacted red blood cells will die early and you’re not going to have enough red blood cells in the body to do the job of carrying that oxygen. But also they can get stuck, they break down die and they can get stuck in blood vessels and when you have a block in your blood vessels then that can cause all types of problems.

(05:36):

I’ve talked about the CLO in the blood flow. Now in terms of the symptoms that you will get with that, if you can think of thrombosis, if anybody who’s had a thrombosis is listening, you will know how painful that is but it can cause significant pain and it can cause generalized pain but also significant outbreaks of severe pain known as crises. The sickle cell disease in its own right is not, well sorry, I was going to say it’s not curable. That’s not actually technically correct. There is only one cure for sickle cell disease and that is a blood and bone marrow transplant but you need to get a genetic match for those and therefore being able to move towards a blood and bone marrow transplant is in fact pretty rare. Now there are other types of sickle cell disease which our listeners may come across and we’ve talked about sickle cell trait and I’ll go into that in a second but just to flag, you do also have things like sickle cell or sorry, sickle beta thalassemia which again is a genetic inherited disorder.

(06:59):

Again, predominantly seen in at least in terms of people in the USA in terms of people who have Western Indian origins and Western African origins African and that one, I won’t keep too long on this one because it gets a bit too technical, but the severity of that particular disease, bear in mind it’s a type of sickle cell disease, therefore we’re looking at blockages in the vessels and lack of the hemoglobin traveling through the body causing issues. Then it rather much depends on the type of sickle beta thalassemia. I can spit it out that you have and there are two types really that are seen a sickle cell zero and sickle cell beta plus, so beta zero and beta plus and effectively for life insurance, sickle cell beta often can be accepted at standard rates for life insurance where the sickle cell beta plus is one that would take ratings much more towards the full sickle cell disease.

(08:17):

So just be aware there are different types of sickle cell disease and talk to established very knowledgeable broker if it gets confusing. In terms of sickle cell trait, Kathryn you already mentioned this and this is effectively when I’ll go back to how sickle cell disease actually comes about. If you want to talk about that, it’s inherited, we’ve talked about that with this particular genetic disease then both parents have to carry the sickle cell gene, if I can call it that sickle cell trait is where only one of the parents has got the sickle cell gene and the sickle cell trait. There can be some complications of somebody who has sickle cell trait but they are pretty rare. So I think in most circumstances somebody with sickle cell trait with no complications at all again can be put through its generally standard rates for life insurance. Sickle cell disease, as I said it’s where both parents have it sickle cell trait and they pass it on to the child. Sickle cell trait is only where one of them, one of the parents has it. Does that help in terms of providing a background?

Kathryn (09:43):

Yeah, I think that’s really helpful just to understand it. So as you say, I think for me one of the big things is that I remember the fact that it’s sickle shaped. That’s what kind of stands out for me. It helps me to remember that that’s what’s happening with the blood cells and as you say in terms of blockages, it’s not that sort of round ellipsy kind of thing that we would expect from the blood cells, which means that everything’s flowing through as we would expect it to the more like a boomerang shape maybe

Matt (10:10):

And they’re harder, apparently they’re hard so they’re not flexible and fluid enough to get through those type vessels.

Kathryn (10:17):

Yeah, absolutely. So I know you’ve mentioned obviously the life insurance side of things, so I’ll talk a bit some point about what I may be seeing terms of the underwriting outcomes as well, but as an underwriter just to help everybody, the advisors, what is it that you would be wanting to know? So if I were to come to you and say, right Matt, I have somebody they have sickle cell, this is information I have, what ideally would you like to see to be able to underwrite that?

Matt (10:45):

Okay,

Kathryn (10:46):

Only the GP report as well probably, so I’m just reading the questions since that initial bit of information.

Matt (10:50):

No, absolutely. I mean one of the things that by the way just on that particular point and I know that you use this as well is if the client has any medical records themselves, at least in terms of the initial inquiry, you’re absolutely right. I would say that A GPR would be required at some stage but least in the initial inquiry it’s a bit like cancer as well, sorry civil cell tend to do with cancer but as a similar underwriting approach then the devil is in the detail and therefore if the client has any medical records or a report from their consultant or their last blood clinic that they went to, if they can send those to you confidentially obviously then those can be we’ll take you a long way forward in determining your next steps and possible. Sorry, I’ll go on my high heels there because I’ll get off my high heels. No,

Kathryn (11:47):

Absolutely. This is really useful.

Matt (11:49):

Those things are I think often missed by advisors or they don’t realize that avenue is open to ’em. Okay, so it’s a very obvious thing to say I think, but maybe it’s an underwriter and touching on what I just said, the first thing if somebody says sickle cell disease, what do they actually mean by sickle cell disease and is it sickle cell trait, is it full sickle cell disease? Is it let’s say one of the variants of sickle cell disease like thalassemia beta thalassemia, which I mentioned before because knowing that will provide you with a better idea of where the terms may go or not. So establish what type of sickle cell disease we are talking about right up front and then lead you down a path in terms of if I look at what sickle cell disease in its full glory, it’s not really, really right expression I wanted to use there, but

Kathryn (13:03):

I get what you mean.

Matt (13:04):

Okay, well thank you. I didn’t mean to belittle this disease whatsoever. No, no, no, it’s fine. What we see, we’ve talked about pain and so on and so forth, but not surprisingly when there’s a disorder of hemoglobin, we are looking at past histories of anemia, how often severe where that has led to in terms of medical treatment episodes of these pain crises, how often where they’ve led to history of swelling of hands and feet where there’s been a frequent infections, vision problems. If you can imagine the issue that we talked about with these sickle cells causing blockages in the small vessels, then if you can think of the major organs in the body now particularly for instance taking an example, use kidneys, if they start blocking off the blood flow to the kidneys, then that can lead to kidney problems.

Kathryn (14:10):

Is there a heightened risk for heart attacks and strokes

Matt (14:13):

Very much on stroke? Yeah, and I see stroke mentioned all the time in reference books and so on and so forth, but I can’t see ultimately why the heart attack wouldn’t come in as well, but certainly strokes, maybe it’s because of the size of the vessels maybe I don’t know, but stroke certainly can be a problem and can be a cause of death obviously. So what I would be looking at as an underwriter, I would first of all know what exactly I’m looking at in terms of the type of sickle cell disease that we’re looking at and then the history of any problems that have occurred. Now we’ve said, or I’ve said with the exception of a transplant, then sickle cell cannot, sickle cell cannot be cured, but there are treatments that can help, but what they tend to do is they manage some of these issues that I’ve just talked about so it helps with the anemia, it helps with the pain and so on and so forth.

(15:29):

And if on average the actual life expectancy for somebody with sickle cell disease now, and this has improved absolutely dramatically over the last 30 and 40 years but is around is between, in the UK anyway, between 40 and 60 I’ve seen averages were around 54, 55 for the life expectancy of somebody with full blown sickle cell disease. But there are milder types as I’ve already alluded to, and some of those types of sickle cell can lead to normal life expectancy, sickle cell trait, again, any complications are very rare. I understand with that particular medical condition should be standard rates for life. Does that help? I’ve talked about what I would look for, so it’s really just doubling back on the complications that somebody has,

Kathryn (16:37):

I think

Matt (16:38):

How those have been treated and therefore how severe it has been or is for that particular individual.

Kathryn (16:44):

Absolutely. I think one of the things that I would, it is really good to have all that background as to why I’ll be asking those things. So from an advisor point of view, what I would be sort having is kind of like my base template of questions and I think what’s important for all advisors when I do my training I do suggest is to people is to build a spreadsheet and on each tab have a condition and in that have your question set so that you know what to ask for and at first it can take a bit of time, you need to build up what these questions are, but for say something like sickle cell, you’d be saying to ’em right, what type of sickle cell do you have? Is it full sickle cell disease? Is it sickle cell trait? When were you diagnosed? Obviously a lots of people probably diagnosed quite young but they might have been a bit older.

(17:29):

Any medications, any treatments that are needed? Sorry, I’m just going to cough. Sorry about that. What I would then ask is I know you mentioned about the crisis, so that would be a really specific term to use as well. Have they experienced any crises due to the condition? Maybe ask a little further, just have you ever needed to be hospitalized at all due to condition? That can sometimes help to trigger some memories about things that have happened in the past and again that can really help people to understand and the underwriters to see what the severity of the symptoms are. Obviously when that happened would be really useful. So if you know that someone has been hospitalized once and it was five years ago, that would probably be quite different to say somebody who’s been hospitalized three times in the last two years. In terms of the underwriting outcomes for the different options, I’m trying to think if there’s anything else that I would generally have in my question set.

(18:23):

Oh, another one that I do tend to ask people, it does come up sometimes in the question set, but I think it can just really help again for me as an advisor to really quickly understand what I might be looking at in terms of research is does the condition affect their ability to work or do day-to-day tasks at all? So as with a lot of conditions, there are some conditions that would really stop people being able to work, especially once they’re reached certain stage, especially chronic conditions, but ultimately with lots of medical conditions I wouldn’t genuinely be expecting them to stop someone from working. So if someone isn’t able to work due to that medical condition, it kind of leads me to straightaway start to think does this mean that this person’s condition is actually and their symptoms are actually quite severe and it’s not always that’s the case, it’s just that it just gives you that initial bit of an inkling as to sort of, well why is this person not able to work?

(19:23):

So as an example, let’s say for anybody with any conditions, say like someone tells you that they have sickle cell trait as an example and they say that there’s no symptoms, there’s no complications, but then they’re not able to work because of it. That for me would immediately be thinking, well something doesn’t quite link here, that’s not what I would be expecting to hear from this. So I need to maybe know a bit more because ultimately if I were to speak to an underwriter and say the exact same thing to them, well it’s just the trade, there’s no complications but they can’t work because of it. The underwriter as well will just turn back to me and say, but that doesn’t necessarily match up with what we would usually expect from that somebody with this medical condition. Yeah, appreciate. So I generally have that in my question sets.

(20:04):

Also, when I train people, train advisors, I have question sets. So I say, right, just use this, use this for pretty much everything and that is one of them that really stands out. So in terms of any potentially linked conditions, Matt, I know we’ve spoken about you said about the swelling of the hands, we’ve talked about potentially there could be some kidney conditions, some difficulties. So I think it’s quite clear that if someone were to say to us that they’ve maybe had some difficulties with their kidneys, we might be thinking, well that could be linked to this. It could be a complication of it. Obviously an under would probably be able to give us a much, an underwriter wouldn’t be expecting us as an advisor to maybe go, oh well that’s probably linked to this. I don’t want to scare who are hearing us thinking, oh I need to think about all this type of thing.

(20:50):

But if you gather that information then the underwriter will do that in the background. If you are not, it’s someone who’s confident to know that that’s kind of a link there. And like you’ve said, there’s the eyes as well, so eyes, kidney involvement, the swelling. Are there any other kind of linked conditions? I know we mentioned possibly stroke. Is there anything else that we should be thinking? If that’s said then that would maybe make us think that maybe even for a period of time that the condition wasn’t as well controlled as we would hope it would be.

Matt (21:20):

I think only of the blockage in the arteries, sorry, not the arteries in the blood vessels, sorry, and think of the challenge I’ve got to answer that one is it is pretty generic. A blockage in a blood vessel can cause a problem anywhere in the body, let’s be honest about it. So anything where hospital treatment or let’s forget hospitals you need to see your GP about which involves pain and swelling. If I want to be generic as that would be useful to know about. The one that I would throw in maybe, I’m sorry if I missed it when you were talking about it a minute ago, was problems with your vision?

Kathryn (22:14):

Oh yes. Yeah. You did say about the eyes, yes.

Matt (22:17):

Again, it’s those little vessels that feed the eye can get damaged if there’s a blockage there. So I think that that’s one that is regularly mentioned is problems with the eyes.

Kathryn (22:31):

Is there a specific term for that? I know with diabetes we talk about retinopathy. Is there sort of a specific medical term in regards to what might happen with the eyes or is it just generic? Anything happening with the eyes? Kind of?

Matt (22:46):

I think in the context of this particular disease then you’re probably just looking at something called an occlusion,

Kathryn (22:54):

One

Matt (22:54):

Of the vessels, which basic means it’s blocked, P blocked the difference really between that and retinopathy, which tends to be more easily diagnosable if I can call it that. It has specific symptoms which are very specific to diabetics. This is more around a blocking of the artery or an occlusion. The occlusion by the way is a term that you can use for strokes, coronary heart disease, a lot of other places just literally means blocking blockage.

Kathryn (23:29):

Okay, that’s good. I was going to say it’s one of those things where it’s like if I, again I’m going to diabetes because I’m thinking of retinopathy, the one that really stands out in my mind I’ve heard it so much. But for me when I’m speaking to people as an advisor, I would say to people, I might say retinopathy, but I might also just say, have you had anything in terms of your eyes, have you needed to have specific checks at all? Any kind of outcomes because I always wonder if I say retinopathy that people might not have heard that term in a sense. Technical.

(23:58):

So technical and also I sometimes worry like that I might actually forget the word for it myself. We’re not doing it all the time. So that the occlusion that you just mentioned there, I’m worried that I would maybe not remember to say the right word and that I might just panic and say retinopathy because I’m used to retinopathy. So yeah, so just for anybody advisor that you don’t need to know all the technical, just make sure you’re asking any kind of involvements with the hands off, feet swelling, any kind of involvements with the eyes and that should be able to get you those initial indications, that initial bit of information from people to just really, really help.

Matt (24:36):

Yeah, I totally agree with that. Yeah, I don’t think you do need to know all the technicals at that stage. Absolutely the symptoms which I think people will remember.

Kathryn (24:48):

Yes. Well most people remember going to get their eyes checked, weren’t they? And saying, well, I’ve got it checked and it was fine, or I had it checked and there was something else that was going on that they need, they want to have a look at. And then that’s when you know and you can speak to the underwriters who will then be thinking, right there could be an occlusion there and they can do the technical side of it.

Matt (25:05):

I think it’s the key thing with those vision problems is to ask the question why were you checked? So just to absolutely differentiate, this isn’t a routine checkup at your optic. Yes, absolutely. Somebody, a GP or a consultant ophthalmologist would ask, we need to look at this. So it’s the why I think key visions

Kathryn (25:29):

Definitely. So I know you’ve said a bit about life insurance and outcomes, so the next bit is just say life insurance, critical illness cover income protection. What do you think people are potentially likely to see

Matt (25:42):

In terms of the living benefits? I would say that anybody with full sickle cell disease will not get any of the living benefits in terms of the critical illness. Then there are a number of the big conditions where the individual is at risk of suffering problems from, you mentioned stroke, we touched on heart attack. If push comes to shove, if the blood doesn’t get through to a part of the body, let’s say hands, feet, loss of limb, maybe I’m being a bit left field there on that one. So I believe you would not get critical illness or income protection be thalassemia and therefore this is why it’s important to get the type of sickle cell disease, then I don’t see any reason with the positive you should not be able to get terms depending on the overall case as in what symptoms and what issues have come out of having that particular disorder. In terms of sickle cell trait, again, look at the history, but in the event of absolutely no problems whatsoever, then I would say there’s no reason to get why you shouldn’t get standard rates. But if we look at, we talked about life insurance, absolutely right, but if we look at the average age of death mentality of being, let’s say I said 40 to 60, but let’s take that 54 some sadly very sadly something is going to kill these people and it’s very unlikely to be a sudden death

(27:44):

They would’ve died of one of the complications and a lot of those complications are actually covered in critical illness and also the income protection then those complications will stop somebody from working. So I do not see how any people could take those on. The key issue is to get the actual type of sickle cell sorted on day one, otherwise it can take you down a path of maybe not offering cover when in fact a solution could be found one way or the other. Does that help with full-blown sickle cell disease? We’re talking a pretty serious disabling illness.

Kathryn (28:30):

No, absolutely. I think in terms of what we’ve seen as an advising note, the majority of that, I completely agree with you Matt. In terms of Chris cover income protection, we are going to be looking at a lot of insurers wouldn’t be able to offer and cover four full sickle cell anemia if somebody is living with that. There can be some specialist options, there can be some options through employers. Oh absolutely. There can be some options in terms of the income protection where, so with income protection we ideally want it where somebody is able to get a policy where it could potentially pay right up to retirement age where we might find that somebody who’s living with sickle cell, it might be that it’s more restricted to maybe one or two years claim per claimable event. So it is not going to be being there for the long-term.

(29:24):

Like you were saying there Matt, the complication that might stop someone working due to having the sickle cell, it’s not going to be there for that long-term support in terms of the income, but it might provide at least a couple of years worth of support if possible. In terms of the life, there are some insurers who can potentially, it really just depend upon timeframes. So if somebody has say a lot of insurers, again, I think with full sickle cell and if the symptoms have been quite recent or strong, then we’re going to find probably a lot of insurers are going to be declining. There are again some really specialist insurers and in the life insurance space, especially with the specialist insurers, it’s not saying that we’re necessarily going to be looking at silly prices or silly exclusions or anything like that. There can be incredibly high prices for them at times, but I’m just saying it’s not always the case. There can be options that we can be looking at for people.

(30:25):

So another thing with that one as well is you were saying there Matt, about the age of the average age actually of death is around the age of 54 with some insurers on the standard market, what we can potentially do without having to go super specialist, we can potentially say to them, well what about doing instead of we are wanting a policy, I don’t know, to cover the mortgage of 25 years, which is exactly what we’d want to do if there was a mortgage. But if it’s either a choice of no cover or some cover, if you can’t do the full 25 years, can you at least ensure them for the next 10 and trying to do something like that, you can sometimes, and I know that that’s not ideal because we’re not doing the full mortgage term. This is just an example, a random one that’s coming to my head, but at least we’re getting 10 years worth of cover and then when we’re getting a couple years down the line, can we maybe look at changing it?

(31:13):

Can we extend it and start another 10 years in a sense and cancel the original one, start the new one. So it’s just each year we’re trying to hopefully get a couple more years out of the cover for sickle cell trait. We probably wouldn’t be expecting much difficulty in getting the insurances, but as Matt has been saying, it does depend on whether or not there has been any kind of symptoms at all and the insurer would obviously take that into account and that would be very much what the symptoms were and how recent they were as well. So just before we got into the case study, Matt, what are we thinking in terms of the family medical history of sickle cell Now when we asked these things on protection insurance applications, sickle cell in itself isn’t usually listed as a, we asked things like if you have had any family members, well just immediate family members, so that’s just your blood related parents and siblings before the age of 65 had they had any of these conditions. Now sickle cell doesn’t usually pop up, but there are some insurers that do say any hereditary condition that you know of and might have been tested for, don’t they? So for those insurers where we’d maybe have to say yes, there has been sickle cell in the family, what kind of outcomes do we think that family medical history could lead to?

Matt (32:37):

I think I’ve taken a specific question there, but maybe I’ll just beat around the bush a little bit in terms of I’m not a personally and very personally speaking, I’m not a great level of the question and any other inherited condition. Yeah,

Kathryn (32:57):

It’s a bit broad isn’t it?

Matt (32:59):

It’s extremely broad and frankly I think it shouldn’t be asked end of story. You should ask a specific question in terms of if an advisor actually knew that it was an inherited condition, then bear in mind it’s not really for the advisor to make their own mind up on this. It’s that we’re advising it’s the client then by all means put down sickle cell. I think by the time somebody is of the, how do I put it, the insurable age, the most common insurable age, so let’s go 18, that’s far too young, but let’s go 18 then If they did have full-blown sickle cell disease, they would know about it.

Kathryn (33:48):

Yes, absolutely.

Matt (33:49):

And therefore everything it would kind of come out in the generic underwriting proposal questions anyway. The one thing I would also throw in here is that I’m sure you’ll know this particularly as you’ve got relatively young children, but sickle cell is tested for very early on in a baby’s life, the newborn’s life, that

Kathryn (34:13):

Little heel prick test that they do on them at the beginning.

Matt (34:16):

Absolutely. So again, as far as I’m aware, I don’t think I’m wrong, but as far as I’m aware, all babies born in the UK have that test and therefore

Kathryn (34:29):

They should do yes,

Matt (34:30):

Should do, yes. Their comment should, that condition again would be well known by the time the actual proposal they are of the age and the proposal is completed. Which then begs the question, why do insurers ask? Because it’ll be a well-known fact and by the time the person gets to let’s say 18, if there had been a problem then they would know about it. Is it as a gatekeeper, as some underwriters love to term some of these questions then it may be, but what real value it adds, I wouldn’t be too sure. So family history, do you really need to ask it? I would probably say as little value you would know if the person had sickle cell full blown on via the questions on the prop. I

Kathryn (35:32):

Was going to say, yeah, because I was going to say in terms of the other hereditary conditions, logically if someone said yes and there is sickle cell anemia in the family, sickle cell disease, then logically it shouldn’t affect the terms because the person would’ve already been

Matt (35:48):

Diagnosed

Kathryn (35:49):

Themselves anyway and it would’ve come up elsewhere in the application. So if there’s a family history, it shouldn’t affect the outcomes as us to say it matters whether or not that’s going to be the outcome that people see everywhere. But as far as we’re concerned, that is the outcome that people,

Matt (36:03):

That should be the outcome. And remember of course you can get a lot of what I would call a false positive. I hope that’s not too to a technical term. No, no, that’s fine. Where yes, there is family, but it results in sickle cell trade, which is not great interest to underwriters. So it’s not a question that if I was ever a chief underwriter again, I very much doubted my age, then it would be something that I would not have on my proposal form.

Kathryn (36:36):

Okay, that’s really good to know. Thank you Matt. Right then. So we’ve just got a little case study to share with everybody. So we had somebody that had come to us at Cure and needed support. They’re in their mid thirties or non-smoker. And when we discussed everything with them, everything was absolutely fine, but they did tell us that they had sickle cell trait and that was okay, absolutely fine. The amount of cover we were going for did mean that we were going for medical reports, that we were going for medicals as well. So nurses screen, which is for anybody who’s not familiar with nurses screen as well a nurse or GP visits the application or the applicant. There we go at a time and place that suits them and they’ll do things like blood tests, urine samples, height and weight. They can check with a little swab in the cheek to check that they’re a non-smoker or not.

(37:24):

They can sometimes be things like lung capacity as well. I’ve had ’em done a few times myself, so I’m quite familiar with them. And what happened was is that we were going through everything and all of a sudden the GP report came back and it showed actually that the person had had some crises in the past, which did lead us to think, well actually maybe this person has, it’s not just sickle cell trait, maybe they actually do have sickle cell disease and there’s been a misunderstanding somewhere because they’re very clearly in the GP reports and when it’s always a good idea when you get this information on GP reports to just chat with, not assume that the GP report is correct, but also not assume that it’s wrong, but just to speak to your client and say to ’em, look, they’ve mentioned this and this happened at this time, is that correct?

(38:06):

Is that you? And sometimes they can come back and go, oh God, yeah, I completely forgot about that. And then other times they come back and go, absolutely not me. And they have to get the medical records corrected and then you can end up with really positive outcomes once all the changes have been made. But for this person, it was accurate that there have been some crises and we were at a timeframe where the insurers clearly did want to know about them and it did change the outcome a bit compared to what we thought. So instead of the original terms that we thought we would have was an increase to the premium due to the person’s medical history. So for this person, it was a million pounds worth of life cover over 38 years and the price ended up being around about 158 pounds per month.

(38:50):

So I appreciate for people listening and if anybody does have sickle cell who’s listening to this and isn’t familiar with the insurance world, that premium is going to seem probably pretty hefty. But please just bear in mind for this person, we were looking for a million pounds worth of life cover and it was over a very long time period as well. We were going into their seventies, which isn’t something that everybody is going to need. Not everybody needs somebody in pounds worth of life cover often. For a lots of people it is much less than that. So that premium isn’t necessarily, don’t take that as an assumption of where your pricing might end up being, but that’s it. So thank you everybody for listening and thank you as always, Matt for your insights.

Matt (39:29):

My pleasure. Look to speak

Kathryn (39:30):

To you lovely. Speak to you too. Next episode, we’re going to be back and we’re going to be speaking with the C charity and we’re going to be talking about financial abuse and what we can do as advice to try and be as best as possible to spot this, try and be involved in helping to prevent it and what we can do if we think that something like this is happening. So if you’d like a reminder of the next episode, please do drop me a message on social media. I’ll visit the website, practical protection.co.uk. And as always, 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 Okta members. Thank you Matt. Speak soon.

Matt (40:08):

Take care.