Underwriting Multiple Sclerosis: What You Need To Know

Multiple Sclerosis: A disease of the autoimmune system, which affects the bodys own immunities resulting in an attack on its nerves.

Given that this disease affects about 500,000 people in the United States and more than 2,000,000 worldwide, it is possible that a few of your clients may have it. If so, how do you approach the case? Well consider some strategies here. But first, here is a primer on what multiple sclerosis entails.

MS, as the disease is often called, is one of the most common causes of neurological disabilities occurring in early to middle adulthood and then declining thereafter. It is twice as common in females as in males and its occurrence is higher in whites than in any other racial group.

The disease causes degeneration in the “myelin,” which is a type of sheathing that insulates the nerves. This degeneration process is termed “demyelination.” What happens is, the myelin surrounding the nerves becomes plaque bound, or “sclerotic,” in different areas of the nervous system. When this happens, the nerves are disrupted.

Depending on the degree of demyelination, the affected nerves may become unable to transmit electrical impulses to and from the spinal cord and to the brain in a normal fashion. The breakdown of these impulses or messages is what causes the symptoms of MSwhich vary by individual, but which may include numbness, visual and/or speech difficulties, reduced bowel or bladder control, and muscle weakness, among other things.

The cause is unknown. Some have suggested that viral infection, such as the measles or herpes, may be associated with the condition. Others suggest that genetic makeup or even the environment may play a role. Studies show that MS is more common in certain parts of the world. Therefore, some posit that exposure to some sort of environmental influence, possibly before puberty, may predispose a person to MS.

You need to know that diagnosis is difficult. No one test single-handedly leads to rapid detection. However, CT scans, MRIs and studies of the cerebrospinal fluid all contribute to the evaluation. For instance, the CT scan and MRI help clinicians detect the sclerotic plaque, giving rise to possible presence of the disease. Identification of symptoms, such as those noted above, help as well. But the disease pattern is highly variable and can consist of remission, exacerbations, and from slow to rapid progression, so it often takes a while for medical professionals to reach a solid diagnosis.

Although there is no effective “cure,” a number of drugs currently exist that have proven beneficial in disease management. Steroids, such as prednisone, and chemotherapy agents, such as interferon, have proved to suppress the effects of the bodys immune system and shorten the length and severity of an attack in many individuals with MS.

Now, what do you need to know about placing life insurance on an individual who has MS? The home office underwriter will look for the degree of neurological impairment. That is important because individuals with MS tend to group into mild, moderate or severe categories. Some patients move from one category to another, while others may stay in the same category all of their lives.

The underwriter will pay special attention to symptoms if a physician has indicated in the medical records that there is suspicion of probable or possible MS.

Keeping the three categories of MS in mind, the underwriter will review how the individual performs activities of daily living and whether the disease has made little to severe interference in these activities.

The degree of muscle weakness, numbness, bowel and bladder control, and respiratory functions are other manifestations the underwriter will look at when reviewing the records.

What are your chances of making a successful placement of life insurance? A mild form of the disease that has been stable and nonprogressive for over five years may be looked at quite favorably and be considered at standard. If the client is diagnosed with having moderate and/or slowly progressive form of MS, this may produce a slight table rating.

On the other hand, cases presenting with a rapidly progressing severe form of the disease may be declined. That is unfortunate, but you need to be aware of this so that you can give your client appropriate expectations.

Remember to be sure to ask your client the proper questions about his or her condition, so that you can do a thorough job of preparing your MS case for the underwriter.

Also be sure to include a good cover letter with the application, giving details that may positively influence the outcome. Outline the basic facts, including category, progression, and treatment methods used. This will build a strong basis for the best possible underwriting decision.

Elizabeth V. Cammarota is vice president at Brokerage Professionals Inc., Phoenix, Ariz. Her e-mail is beth@bpim.com.


Reproduced from National Underwriter Life & Health/Financial Services Edition, October 31, 2003. Copyright 2003 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.