YOUR GUIDE TO PROTECT UNDERWRITING. We ll help you get there

Transcription

1 YOUR GUIDE TO PROTECT UNDERWRITING investments pensions PROTECTION We ll help you get there

2 contents introduction 4 What is underwriting? 5 An underwriter s objectives 5 Medical underwriting 5 Underwriting decisions 7 Financial underwriting 7 Our service 8 Contacting us by phone 8 Online support 8 Our underwriting limits 8 Financial underwriting limits 9 How do we classify risks? 10 Life cover 10 Critical illness cover 10 Occupation 10 Family history 11 Health 11 Common medical conditions and their effect on critical illness cover 12 Alzheimer s disease 13 Arthritis 13 Asthma 13 Back problems 13 Blindness 13 Bronchitis 13 Cancer 13 Cholesterol (raised) 13 Coeliac disease 13 Crohn s disease 14 Deafness 14 Depression 14 Diabetes 14 2

3 Common medical conditions and their effect on critical illness cover CONTINUED Ductal carcinoma in situ (DCIS) 14 Epilepsy 14 Gallstones 14 Genito-urinary disorders 14 Glaucoma 14 Heart attack 14 Heart murmur 14 Hepatitis 14 Hypertension 15 Hyperthyroidism 15 Jaundice 15 Kidney failure and replacement 15 Kidney stones 15 Loss of limbs 15 Low grade prostate cancer 15 Lupus 15 Menière s disease 15 Motor neurone disease 16 Multiple sclerosis 16 Myositis 16 Obesity 16 Pancreatitis 16 Parkinson s disease 16 Poliomyelitis 16 Polymyositis 16 Progressive supranuclear palsy 16 Pulmonary embolism 16 Sarcoidosis 17 Scleroderma 17 Smoking 17 Stroke 17 Transient ischaemic attack (TIA) 17 Ulcers 17 Ulcerative colitis 17 Further information 18 3

4 introduction At Old Mutual Wealth, our continuing commitment to high-quality customer service naturally includes our underwriting services. Whether you consider it an art, a science or a combination of both, underwriting plays an important role in assessing insurance applications. We have produced this guide to support you in four ways: to help you understand why and how we underwrite to offer you some guidance on the factors that apply when underwriting the different types of cover to provide you with details of our underwriting service and to show how we would underwrite your clients health, occupations and pastimes for the different types of cover and optional benefits. If you have an underwriting question that we have not answered in this guide, please contact us. We will be happy to help you. You can telephone our Underwriting Helpline on between 8.30am and 5.30pm Monday to Friday. 4

5 What is underwriting? Underwriting allows us to balance the premium that we charge with the risk of a claim. Without it, we would charge everyone with the same age, gender and choice of insurance, an identical premium irrespective of their state of health. When we underwrite, we consider someone s health (morbidity) or how long they may live (mortality), or both. It depends on the cover wanted. We treat all the information we receive as confidential. An underwriter s objectives We aim to offer standard (normal) premium rates to as many applicants as possible and with the minimum of fuss. Where we cannot offer standard rates, we will always try to offer the best terms we can. Medical underwriting The application form This is the first, and often the only, item that an underwriter will use. Frequently, if this is fully completed, we will not need any further information to make a decision. So the more detail you can give us on the application form, the more likely it is that we can accept your client without delay. We understand that, occasionally, a client may not want to explain his or her medical details to you. In this case, your client can complete the questions on a separate piece of paper, sign it and put it in a sealed envelope. You can then send this in with the application form. If we need further information before we can underwrite the application, we will get this at our expense. Questionnaires Sometimes, the answers your client gives on the application form will mean that we need to get further information. To help get this, we have produced a variety of questionnaires, covering medical, occupational, lifestyle and financial information. For example, we have specific medical questionnaires for the more common conditions or illnesses, such as a bad back or diabetes. If you know we will need further information about your client, you can ask him or her to complete a questionnaire with the application form. You can find the questionnaires on the literature library on our website. Alternatively, you can ask Sales Support for copies. If we need a questionnaire and receive the application without one, we will send you one for your client to complete. We would need medical questionnaires for: back disorders diabetes musculo-skeletal disorders respiratory disorders 5

6 What is underwriting? (continued) We can supply occupational and pastime questionnaires for: Aviation Caving and potholing Diving Fishing industry workers Hang-gliding Members of Her Majesty s Forces Motor sport Motorcycle sport Mountaineering and rock-climbing Offshore oil and gas workers in the North Sea Parachuting Paragliding Powerboat and sports boat use We have specific questionnaires to cover: Financial information Residency abroad Lifestyle The General Practitioner s Report (GPR) To give us all the information we need, the application form must be fully completed. Sometimes it includes incomplete answers or we need further information, say, because of an answer to one of the health questions. In these cases, we will ask (and pay) for a report from the client s GP. You may also find this report referred to as a MAR or PMA report. We will also ask for a GPR for sums assured above the underwriting limits shown on pages 9 and 10. The Access to Medical Reports Act and the Data Protection Act state that your client needs to give permission for an insurance company to ask any treating doctor(s) for a copy of his or her medical records. He or she gives us this permission by signing a declaration on the application. When signing this, your client can choose to see any medical report either before or after the doctor sends it to us. You can find full details about these choices on the application form. Sometimes the report that we ask for is specific, relating say, to one particular condition or illness. In this case, we usually ask the doctor to complete a questionnaire. For example, for a client with diabetes, we would send a diabetes questionnaire to the doctor. The questionnaire asks for details about the medication, frequency and severity of incidences. The Medical Examiner s Report (MER) When your client applies for a high sum assured for life cover or critical illness cover, we ask (and pay) for a medical examiner s report. For example, we would need a MER for an applicant age 35, wanting critical illness cover over 300,000. Sometimes we may also ask for an examiner s report if we need to know more about a client s particular medical condition. The examiner is usually an independent doctor. Sometimes we may use the client s own GP, where his or her knowledge of the patient would add valuable additional information. For higher sums assured, we may also need a blood test and an electrocardiogram (ECG) taken at rest (and possibly during exercise). For life cover, we may also need a microscopic urine analysis. Depending on the answers your client gives when applying, we may need to know more about their occupation, pastimes, country of residence and financial affairs. 6

7 Underwriting decisions We aim to offer standard premium rates to as many people as possible. If we are unable to do this, then we will give you as many alternatives as we can. When underwriting, we consider the applicant s health and life expectancy against the norm. If we offer non-standard terms, it s because the applicant has a higher than normal likelihood of falling ill or dying within the period of insurance. However, if the terms we offer are, say, 50% more than normal, this does not mean the applicant is necessarily 50% less healthy than the average person. What it does mean though, is for a large group of people all with similar health to the applicant, we would expect the group to be 50% more likely to claim than a group who were given normal terms. We understand that if we accept the application on non-standard terms, an applicant may be concerned, especially if he or she considers him or herself to be in good health. As all insurers, including us, are bound by the Code of Practice drawn up by the Association of British Insurers (ABI) and the British Medical Association (BMA), we cannot discuss the reasons why we make a particular underwriting decision. That means we cannot talk about it with either the applicant or his or her financial adviser. However, we are more than happy to send a letter about our decision to the applicant s GP, including an explanation as to how the applicant s health affected the insurance risk. Our offer of non-standard terms may include any of the following: Paying a higher premium We call this a rating and use it to cover the extra risk. As part of the acceptance terms, we will let you know what the rating is. When we rate one benefit, it will not necessarily affect any other types of insurance or options selected. For example, if we rated total permanent disability benefit, this would not necessarily mean we would rate any critical illness cover too. Restricting the cover Sometimes we cannot offer full insurance to an applicant. Here are some examples of how we can still offer Protect to a client, although on a restricted basis. For specialist occupations, we may offer a generic own occupation definition of disability. For example, we would be able to offer total permanent disability benefit to a heart surgeon if he or she was totally and permanently prevented from being able to work as a medical practitioner. In this case, the insured occupation shown on the Policy Schedule would be medical practitioner. You can find our definition of a medical practitioner in our Guide to Underwriting Occupations. Because a client already suffers from a particular illness or condition, we may exclude it from the insurance. Sometimes, we can offer full insurance but exclude the opportunity for taking medicalfree increases. Limiting the period of insurance Some risks are expected to increase over time. If this is the case, we may be able to offer cover for a short term. For example, a client suffering from diabetes may apply for a 25-year fixed term. Instead of declining the application, we may be able to offer cover for a 10-year fixed term. We will offer your client the choice of accepting these non-standard terms or not. If he or she agrees to accept the terms, they will be shown on the Policy Schedule. Financial underwriting The life cover or critical illness cover sum assured your client applies for can also affect an underwriter s decision. For example, we would ask for more financial information for a client wanting 1 million life cover than for a client wanting 500,000. You can find details of our financial underwriting limits on page 10. If you have a client who needs a very high level of cover, please contact your dedicated Old Mutual Wealth underwriter or phone us on to discuss how much we could offer. At the same time, we can let you know what our underwriting requirements would be. 7

8 Our service Contacting us by phone Our dedicated underwriting helpline is available from Monday to Friday. Please call us between 8.30am and 5.30pm. We can answer any underwriting questions you may have on prospective applications. For example, you may want to know: the definition of disability we would apply for a particular occupation how much cover we would offer for a business protection enquiry. Once you send us the application, if you want to track its progress, please contact your customer services team at our Head Office. Underwriting Helpline on call us with your pre-sale enquiries. Online support You can access our website, at any hour of the day or night. The Protect part of the website offers several online services, allowing you to: generate quotations apply for Protect. When you apply for Protect online, the electronic application form is streamlined. It will ask only those questions relevant to the insurance your client wants. We believe that with our Adviser Extranet offers you significant benefits. Please log on and register for the service. If you have any questions about applying online or would like to know more about the full range of Old Mutual Wealth s online services, you can contact us on Alternatively, please visit our website or contact your Old Mutual Wealth consultant. Our underwriting limits Non-medical limits As you would expect, the higher the sum assured, the more information we need. The tables opposite show you the levels above which we will need this information. These limits apply to the total amount of the same type of cover that your client has with us. For example, let s say a client aged 30 already has one Protect policy for 200,000 life cover, and five years later, at age 35, wanted to apply for a second one for 250,000. In this example we would need a GPR, as the combined sums assured exceed 400,000. 8

9 Life cover WE NEED MEDICAL INFORMATION FOR SUMS ASSURED ABOVE THE AMOUNTS SHOWN AGE NEXT BIRTHDAY Up to and over General Practitioner s Report (GPR) 400, , , ,000 50,000 Medical Examiner s Report (MER) 500, , , , ,000 Blood test (not HIV) 1 million 1 million 1 million 500, ,000 Urine test 3 million 2 million 2 million 500, ,000 ECG (resting) 3 million 2 million 2 million 500, ,000 ECG (exercise) 3 million 3 million 2 million 1 million 750,000 Critical illness cover WE NEED MEDICAL INFORMATION FOR SUMS ASSURED ABOVE THE AMOUNTS SHOWN AGE NEXT BIRTHDAY Up to and over General Practitioner s Report (GPR) 200, ,000 50,000 Medical Examiner s Report (MER) 300, ,000 75,000 Blood test (not HIV) 500, , ,000 ECG (resting) 1 million 1 million 1 million ECG (exercise) 1 million 1 million 1 million HIV testing limits LIFE ASSURED FOR SUMS ASSURED ABOVE Single male 500,000 Married male 1 million Female 2 million We will need a test from everyone below age 60, whom we identify from the application form as a member of a high-risk group. Financial underwriting limits This table shows the limits above which we will always need financial evidence. Sometimes, we may ask for evidence below these levels. For example, with key employee cover, we may need information to show how the sum assured requested matches the key employee s worth to the business. FOR SUMS ASSURED ABOVE Financial questionnaire (completed by you and the client) 600,000 Independent financial evidence 1.25 million Occasionally, for very large sums assured, we may restrict the opportunity to use the increase options. 9

10 How do we classify risks? When we underwrite, we look at the application as a whole. That means the client s occupation, pastimes, general health and family medical history can play a part in determining the terms we can offer. This section explains why these all have an effect on our underwriting decision. Life cover Life cover pays on death or on diagnosis of a terminal illness if the client has less than 12 months to live. Terminal illness benefit is available on our fixed and rolling term policies only. Please note it is not available in the last 18 months of fixed term policies. Therefore, a client s health, height, weight, family medical history, how much alcohol they drink, smoker status, occupation and pastimes can all affect the terms we can offer for life cover. Critical illness cover As with life cover, a client s health, height/ weight, smoker status and the family s medical history are important when underwriting critical illness cover. In fact, they play an even greater part in the underwriting decision than for life cover. This is because the client normally receives the money after diagnosis of a critical illness. He or she doesn t have to die before we will pay the claim. We will also assess the client s occupation and pastimes as these can affect specific critical illnesses or conditions and we may exclude them as a result. For example, someone who works at heights may not be able to have cover for coma, loss of limbs, third degree burns, paralysis, loss of independent existence or serious accident benefit, where the claim is a result of their occupation. Occupation Someone s occupation can affect the insurance risk. As well as life cover or critical illness cover, it affects two optional benefits under Protect, total permanent disability benefit and premium protection benefit. Each of these benefits has two definitions of disability. One is the client s inability to perform his or her own occupation. The other, the inability to perform three of eight occupational-related tasks, Activities of Daily Work (ADW). When we underwrite the application, we will notify you and your client on the particular definition that would apply. If you would like to know more about the optional benefits under Protect and the definitions we can offer your client, please refer to our occupational underwriting guide. Please ask your Old Mutual Wealth consultant, if you would like a copy. 10

11 Family history Some aspects of a person s health can be inherited. For example, heart disease and breast cancer can run in the family. Therefore, in cases like these, family history plays an important part in underwriting, especially critical illness cover. This table summarises our underwriting approach to family history: Heart disease or stroke Cancer Diabetes Multiple sclerosis IF ONE PARENT OR SIBLING AFFECTED If the relative was below age 50 when the illness occurred, we would need a GPR. For all other cases, we do not need any additional underwriting information. If bowel/colon cancer, we will need a GPR. We will also ask the client if he or she has undergone any medical screenings as a result of the family history. If breast cancer, we will need a GPR for female applicants only. In all other cases, we do not need any additional underwriting information. We do not need any additional underwriting information, unless a second relative is affected by another condition such as heart disease or stroke. If one family member had diabetes and another had heart disease or a stroke, we would need a GPR. We will need a MER, using the client s GP. IF TWO OR MORE PARENTS OR SIBLINGS AFFECTED In all cases, we will need a MER, which can be carried out by the client s GP. We will need a GPR. We will also need to know the location(s) and type(s) of cancer. We will need a MER, using the client s GP. If your client is adopted and is unable to answer questions on his or her parents medical history, we will offer cover based on his or her personal medical history only. Health A client s health plays a fundamental part in underwriting critical illness and life cover. Some conditions affect how long a client may live (mortality), some, a client s state of health (morbidity) and some affect both. We have described our approach to underwriting some of the more common illnesses for critical illness cover in the next section. 11

12 Common medical conditions and their effect on critical illness cover We take a holistic approach to underwriting. That means we look at all answers on the application and how they may affect one another. For example, if two applicants had diabetes, we may offer more favourable terms to the one with normal blood pressure than the one with high blood pressure. This section provides you with information that we hope you will find useful when recommending critical illness cover. It deals only with the most common conditions and is not an exhaustive list. Where we refer to underwriting total permanent disability benefit, this is in conjunction with critical illness cover or life cover. We may vary our underwriting decision from that shown depending on the particulars of an individual case. Please note that if your client has more than one of the conditions, we will need to consider how each condition affects the other. Sometimes, they may have no affect at all. However, often the conditions do affect each other. For example, a client suffering from high blood pressure and heart disease would be more likely to have a heart attack than someone with high blood pressure only. Therefore, any ratings we impose would take this combined effect into account. 12

13 Alzheimer s disease Alzheimer s disease is the most common cause of dementia and we will decline all applications for critical illness cover. Arthritis We would need medical evidence to find out the severity, extent and progression of the disease. We would rate most critical illness cover applications and occasionally, also exclude some cover, such as that for loss of independent existence. Occasionally, we may not be able to offer critical illness cover at all. We may also be unable to offer premium protection and total permanent disability benefits or only with an ADW definition. Asthma Asthma can affect people to different extents. For example, some people only wheeze when close to an allergen such as dry grass, yet others suffer from permanent chronic lung disease. If the symptoms are mild or easily controlled, we can usually offer standard rates. For more severe cases or where health or lifestyle also has an impact (smoking, for example), we may rate or even decline any critical illness cover. Back problems A bad back, while a common ailment, can affect a person s ability to work. Therefore, a bad back has a significant impact on the claims experience for disability benefits. As a result, we may rate, apply exclusions or offer total permanent disability and premium protection benefits with an ADW definition. In some cases, we may not be able to offer these optional benefits at all. Blindness We will usually offer normal terms for critical illness cover if an applicant is partially sighted as a result of an accident or has been partially sighted from birth. If an applicant is already blind or has deteriorating vision, we may be able to offer critical illness cover with an exclusion for blindness, depending on the cause of the loss of vision. Bronchitis We can usually offer normal terms if the person had occasional attacks that were easily treated. If the attacks were frequent, prolonged or chronic, we would be unable to offer critical illness cover. In less severe cases, we may be able to offer cover without premium protection and total permanent disability benefits or offer them only with an ADW definition. Cancer Unfortunately, we normally cannot accept critical illness cover for applicants who have suffered from any type of cancer. This includes applicants where the condition arose many years in the past and the person has been given the all-clear. To discuss any specific cases, please contact the Underwriting Helpline. Cholesterol (raised) When underwriting people with raised cholesterol, we consider several factors, such as age, lifestyle, family history, weight and medical history. In respect of critical illness cover, we will normally apply a rating for raised cholesterol, even if the condition is controlled with drugs. In these cases, we would usually still offer normal terms for premium protection benefit and total permanent disability benefit. Coeliac disease When the small intestines cannot absorb certain foods, the result is malnutrition and bowel disturbances. We will usually offer normal rates for critical illness cover if the applicant can control the disease and has been able to do so for at least the past 12 months. In all other cases, we would offer a rating. We may decline premium protection and total permanent disability benefits for more severe conditions that have affected the person s ability to work. In some cases, we may be able to offer an ADW definition. 13

14 Common medical conditions and their effect on critical illness cover (Continued) Crohn s disease See ulcerative colitis. Deafness We can usually offer normal rates if an applicant became partially deaf due to an accident, non-serious disease or was partially deaf at birth. However, we would exclude critical illness cover for deafness. If the deafness resulted from a serious disease, such as cancer, we would decline any application for critical illness cover. Depression Depression, anxiety and stress are all complex conditions that need careful and thorough consideration. We base our underwriting decision for critical illness cover, on information such as the cause, treatment, frequency and severity of episodes, likelihood of suicide, time taken off work and prognosis. We can usually offer normal rates to short-lived, well controlled and mild to moderate conditions. However, we would either be unable to offer premium protection and total permanent disability benefits or offer them only with an exclusion or ADW definition. Diabetes We will usually decline most diabetics below age 45 for critical illness cover. If we can offer critical illness cover, we would rate them quite heavily and may restrict the term of the policy. This medical condition has long-term complications, affecting the kidneys, nervous system and circulatory systems. Therefore, the key underwriting factors will be the age at diagnosis, how well the condition is controlled and the applicant s personal medical history. Ductal carcinoma in situ (DCIS) Ductal carcinoma in situ (DCIS) is a noninvasive form of breast cancer. We would not normally be able to offer life cover to a client who has had DCIS within the past year, but we can usually apply a rating after this time. We may be able to offer critical illness cover after a number of years have passed, with certain restrictions on the cancer cover. Epilepsy We will usually accept the person on normal terms, if this condition is well controlled and not linked to any underlying disease. Where the condition affects work, is more severe or poorly controlled, we may decline premium protection and total permanent disability benefits or offer them with an ADW definition. Gallstones Gallstones are caused by an inflamed gall bladder. We can offer normal terms if the stones have been removed and there is no residual damage to the liver or pancreas. Genito-urinary disorders We will normally offer normal terms for critical illness cover if an applicant is suffering any of these wide-ranging conditions, such as cystitis and urinary tract infection. We can do this provided the response to treatment is satisfactory and will lead to a full recovery. In severe cases, which need to be followed up, we may postpone the application. Glaucoma Glaucoma is caused by high pressure in the eyes, which can lead to blindness. We would be unable to offer critical illness cover for blindness. In addition, we may be unable to offer premium protection and total permanent disability benefits or, where we can, we would do so with an exclusion clause. Heart attack We will not offer critical illness cover if an applicant has had a heart attack or other forms of heart disease. Heart murmur There are many reasons why a heart murmur may be present, some of which are significant and some of which are not. Therefore, we will look at each application for critical illness cover individually. If we are able to offer cover, we will probably exclude the heart valve replacement or repair condition from the cover. Hepatitis Hepatitis is an inflammatory disease of the liver and there are many different forms of this condition. With Hepatitis A for example, it will not affect the terms we could offer, as long as the applicant has made a full recovery. Hepatitis B and C and other more rare forms can be serious and we may rate or even decline an application for critical illness insurance. 14

15 Hypertension Hypertension is high blood pressure. We may not be able to offer critical illness cover where an underlying disease such as kidney failure or a heart problem has caused it. We are unlikely to offer standard terms to clients who are diagnosed with this condition. Any additional premium we charge will take into account several individual factors. These are age, control of the condition, personal medical history, physical build and family history. We will usually apply a rating to any additional disability benefits or amend them to an ADW definition. Hyperthyroidism This condition can lead to weight loss and heart disease because of an overactive thyroid. If an applicant has had successful surgery or treatment, we could offer critical illness cover, often on normal rates. If the condition is complex, or only recently diagnosed, we may have to postpone or decline offering terms. Jaundice Jaundice signals a liver abnormality and turns the skin yellow. We would need to see evidence of a full diagnosis and recovery before we could offer any cover at all. The terms we could offer would depend on the cause of jaundice. Kidney failure and replacement We cannot offer cover to someone who has kidney failure. However, if the applicant has only one kidney then we may be able to offer terms. We would need to establish the reason why he or she has just one kidney and to see evidence that it functions normally. Kidney stones If an applicant has occasional stones and can pass them, we can offer cover at normal terms. For recurring or more severe conditions, we may rate or be unable to offer cover. If the applicant needs dialysis or a transplant, we could not offer any cover at all. Loss of limbs Our underwriting terms will depend on why the limb was lost. If it was because of an accident, we usually offer normal rates for critical illness cover, although we may not be able to offer cover for loss of limbs. However, if a limb was lost because of an underlying disease, we may not offer cover at all. Low grade prostate cancer The severity of prostate cancer can be measured using a Gleason score. A prostate cancer with a Gleason score of 6 or less or a TNM classification of T1N0M0 would be classified as low grade. There will usually be a period of deferment for life cover clients who have had low grade prostate cancer, for up to four years, depending on the actual grade of the cancer. After this, we can usually apply a rating for life cover. We may be able to offer critical illness cover after a number of years have passed, with certain restrictions on the cover. Lupus Discoid Lupus Erythematosus is a condition where the skin becomes inflamed and we can usually offer standard rates. Systemic Lupus Erythematosus, often referred to as SLE, is a much more severe and rare illness with many complications, so we will normally decline the application. Menière s disease Menière s disease is a condition affecting hearing and balance. We can usually offer standard rates, although we would exclude deafness from the critical illness cover. For total permanent disability and premium protection benefits, we would normally offer an exclusion or an ADW basis only. 15

16 Common medical conditions and their effect on critical illness cover (Continued) Motor neurone disease Motor neurone disease has no cure and therefore, we will decline all applications for critical illness cover. Multiple sclerosis Multiple sclerosis is a progressive disease of the nervous system and we will decline all applications for critical illness cover. Myositis Myositis or fibrosis is pain and stiffness in the muscles and joints and we can normally offer critical illness cover if there is no underlying cause. For more complex cases, including those affected by gout, lupus and arthritis, we may rate or decline critical illness cover. Obesity Obesity can affect the circulatory systems and the joints and limbs and, therefore, we may rate the cover. Occasionally, for cases of severe obesity or where other adverse risk factors are present, we may even decline critical illness cover, total permanent disability and premium protection benefits. Pancreatitis If the pancreatic inflammation was acute and the applicant has made a full recovery, we will normally offer standard rates. If the pancreatitis is chronic, we may decline all cover, depending on the cause. Parkinson s disease Parkinson s disease is a progressive and degenerative condition affecting the nervous system. If the illness is not too severe, we may be able to offer cover for a limited range of critical illnesses. Poliomyelitis Poliomyelitis is a viral illness that causes wasting and paralysis. If the applicant has recovered, we can normally offer standard rates. If the applicant needs assistive devices to move around, we would rate any critical illness cover. In severe cases or where there are frequent urinary tract infections, respiratory infections or impaired kidney function, we would be unable to provide any cover at all. Polymyositis Polymyositis is a degenerative disease of the skin and muscles. If the disease has not recurred for 12 months and there are no residual problems or symptoms, we may offer standard terms. Where the condition is more severe, we may rate or even decline any cover. Progressive supranuclear palsy This is a condition similar to Parkinson s disease and affects the nervous system. We will decline most applications for critical illness cover. Occasionally we can offer cover for a limited range of critical illnesses. Pulmonary embolism This is a blood clot blocking part of the circulatory system, between the lungs and the heart. If the embolism were a one-off with no underlying cause, we would usually offer normal terms. If more than one attack has occurred, or there are serious underlying causes such as heart disease, we would rate the cover. In some cases, we may be unable to offer cover at all. 16

17 Sarcoidosis Sarcoidosis is a disease of unknown cause and it can affect any organ, usually the lungs, lymph nodes, skin or liver. The terms we can offer will depend on which parts have been affected, the extent of recovery, or the likelihood of a full recovery. In more severe cases we may not be able to offer any cover. Scleroderma Scleroderma causes the skin to thicken and harden. For mild cases, we may be able to offer cover with a rating. For more severe cases, including those where the internal organs are affected, we may decline applications. We will normally decline total permanent disability and premium protection benefits if this condition is or has been present. Smoking Smokers have an increased risk of heart disease, cancer and respiratory problems, all of which affect the critical illness cover. For Protect, we classify those who use tobacco or any tobacco-based product (including those using nicotine patches, etc) as smokers. The terms we can offer will depend on how much the applicant smokes, together with other factors such as, respiratory function and build. We will decline heavy smokers. Stroke If the applicant has had a stroke, we are unable to offer any critical illness cover. Transient ischaemic attack (TIA) A transient ischaemic attack is a temporary interruption of the blood supply to a part of the brain. We will decline critical illness cover, but may be able to offer terms for life cover with a rating applied. Ulcers Ulcers in the digestive system (peptic, gastric and duodenal ulcers) can lead to discomfort and even bleeding and weight loss. We can offer normal terms to most applications, however, we may need to rate more severe cases. The extent of the loading would depend on other reasons, including smoking and alcohol consumption, as these can irritate the ulcer. For more severe cases, we may only offer the ADW definition for total permanent disability and premium protection benefits. Ulcerative colitis Ulcerative colitis and Crohn s disease are inflammatory diseases of the digestive system. In severe forms, they can lead to organ damage and even increase the likelihood of contracting cancer. Therefore, where we can offer critical illness cover, we would do so with a heavy rating. We may also only offer the ADW definition for total permanent disability and premium protection benefits. If the condition has recently recurred we may not be able to offer cover at all. 17

18 further information You can find full details of Protect in our financial adviser guide About Protect, available on request. Please contact Sales Support for a copy. The benefits under Protect strictly follow the relevant Policy Terms, copies of which are available on request. 18

19 Old Mutual Wealth Head Office PO Box 37 Old Mutual House Portland Terrace Southampton SO14 7AY T F Calls may be monitored and recorded for training purposes and to avoid misunderstandings. Old Mutual Wealth Life Assurance Limited is registered in England & Wales under number Registered Office at Old Mutual House, Portland Terrace, Southampton SO14 7EJ, United Kingdom. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Financial Services register number VAT number When printed by Old Mutual this item is produced on a mixed grade material, which uses a combination of recycled wood or paper fibre from controlled sources and virgin fibre sourced from well managed, sustainable forests. PDF2286/ R/March 2012