Crohns Disease Is Serious, But It's Not An Automatic Turndown

On an optimistic note, research continues to make progress in treating this disease. There are new medications such as Remicade (infliximab), which the Food and Drug Administration approved for the treatment of Crohns, starting in 1998. Infliximab works with the bodys immune system in neutralizing the activity of “TNF alpha” (a pro-inflammatory chemical that the body produces; its considered to be a main cause of inflammation).

In fact, some researchers say their studies prove that people who were dependent on steroids to control moderately active Crohns disease were able to turn their control over to infliximab and maintain clinical remission.

Another common strategy for dealing with Crohns disease is surgery. This is done to relieve blockage, bleeding or other complications. Experts predict that, in due time, a vast majority of patients will require surgery, many having two or more operations during their lifetime.

Although there is no cure for Crohns disease, the future is bright. Prognosis is variable and some individuals experience only one or two attacks and may be completely asymptomatic after that.

The disease may also go into a sort of remission or become inactive, not showing up for months or even years. And, as medical progress continues, Crohns disease patients may some day benefit from the discovery of a cure.

Unfortunately today, some individuals who have this disease experience severe diarrhea, weight loss and the need for intravenous feeding. The condition in such cases may be uninsurable.

Therefore, when packaging your case for underwriting, be sure to understand the diagnosis, its severity and its duration. If the evidence shows the disease is progressing, this may suggest the severity is on the high side, and the client may require a higher underwriting rating.

If your clients history shows several operations have been performed, this may suggest an even more severe condition.

The message for you, then, is to develop complete information about the clients medical history, including symptoms and medications currently being taken and those administered in the past. For instance, since you know that the risk of cancer increases with the duration of the disease, look for adequate follow-up care, including colonoscopies and biopsies. Look for blood tests, as well, because underwriters will want to see if there are signs of anemia and intestinal bleeding. A high white blood cell count is a sign of inflammation.

Remember, its important to understand these basic facts about your Crohns client, so be sure to ask the proper questions. Good communication between you and the client will help you effectively organize the case for evaluation.

Crohns disease is not an automatic turndown. Some cases can and will be placed, if carefully selected and developed. Your goal should be to obtain the best possible underwriting decision by presenting the pertinent information accurately and in an organized format.

Elizabeth V. Cammarota is vice president at Brokerage Professionals Inc., Phoenix, Ariz. Her e-mail is [email protected].

Reproduced from National Underwriter Life & Health/Financial Services Edition, November 18, 2002. Copyright 2002 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.