LIFE-INSURANCE AND INFLAMMATORY BOWEL-DISEASE - IS THERE DISCRIMINATION AGAINST PATIENTS

The aims of this study were to compare and contrast the attitude of ma jor insurance companies to patients with inflammatory bowel disease (I BD) and to a Consultant Gastroenterologist (JFM) requesting guidelines for patients with IBD. The experience of patients in Leicester with i nsurance companies was also investigated. A standard letter requesting information regarding the likelihood of loading on Life assurance in connection with a mortgage was sent to 50 major insurance companies fr om a typical patient. A similar letter was constructed from a consulta nt gastroenterologist (JFM) to the same 50 insurance companies request ing simple guidelines for patients with IBD when applying for various types of insurance. A questionnaire investigating the experience of pa tients with IBD when applying for insurance was also sent to 100 patie nts with IBD selected at random from the Leicestershire data base of p atients with Crohn's disease and ulcerative colitis. 39 insurance comp anies responded to the request for information by a typical patient, ( response rate = 78%). 24 were split between those who thought the pati ent would be accepted at normal rates (n = 7) and those who would requ est an increased premium (n = 17). Only 27 companies replied to the le tter by a consultant gastroenterologist requesting general guidelines, (response rate = 54%). There were only 17 overlapping replies to the two letters. Of these 17 overlapping replies, five companies (30%) inf ormed the patient to expect increased premiums whilst advising the con sultant a similar patient could expect normal rates. Six companies con ferred (35%), telling both the patient and the consultant to expect no rmal rates. Either one or both of the remaining six companies (35%) fe lt unable to comment without either specific details of the patient or a medical examination. 69% of patients responded to the questionnaire . Over half (54%) had applied for an insurance policy. More than a thi rd of patients had required either a medical examination (36%) or a re port from their GP (41%) before being accepted for a policy. 39% of pa tients had received an additional loading on their policies because of IBD including two patients who had been turned down altogether. In co nclusion patients with IBD are clearly discriminated against by insura nce companies. Life tables should be amended to take account of the lo w mortality recognised in recent years. Patients should be aware of th e difficulties that currently exist.