Why an Insurance Underwriter Might Recommend Increasing Premiums for Polymyalgia Rheumatica
Polymyalgia Rheumatica (PMR) is a condition characterized by muscle pain and stiffness, particularly in the shoulders, neck, lower back, and hips. Despite it not being a fatal disease, an insurance underwriter may recommend increasing the quoted premium for someone with this condition. This article aims to explain the reasoning behind such recommendations and the implications for individuals with PMR.
The Role of Insurance Underwriting
Insurance underwriters evaluate the health of individuals at the time a life insurance policy is being issued. The underwriting process assesses various factors to determine the risk level and accordingly set premiums. While the Affordable Care Act (ACA) prohibits discrimination against preexisting conditions when it comes to health insurance, the rules for life insurance are different. Underwriters must consider the likelihood of future complications and the potential impact on the policyholder's lifespan.
The Connection Between Polymyalgia Rheumatica and Life Insurance
Polymyalgia Rheumatica can progress to a more severe condition called Temporal Arteritis, which can lead to serious complications including blindness and pain. Although the disease itself is not life-threatening, its progression and complications can significantly impact life expectancy. Insurance underwriters take this into account when evaluating the risk.
Other Considerations and Insurance Riders
Insurance companies sometimes offer riders that can modify the policy's terms and conditions. One such rider is the Waver of Monthly Premium (WMP), which pays the life insurance premiums until the insured individual is better or until they pass away. A more comprehensive rider, the Waiver of Premium for Disability (WPD), not only covers the premiums during disability but also ensures the policy remains in force without additional cost.
By purchasing a life insurance policy with WPD, the insured person can secure coverage that is free of worry in the event of an unexpected illness or disability. If the underwriter has imposed a rating surcharge for PMR, the WPD rider can offset this additional cost. However, individuals should carefully consider whether the surcharge is justified given the benefits of the WPD rider.
Consulting Medical Professionals
Underwriting decisions are based on medical evaluations and are not the same as medical advice. If an insurance company has rated an individual with PMR, it is advisable to consult a medical professional for a second opinion. Doctors can submit a report to the insurance company, potentially removing the rating. Alternatively, discussing the impact of WPD on the policy premium can lead to a better understanding of the financial implications.
Conclusion
While the Affordable Care Act provides protections for health insurance, life insurance underwriting operates under different guidelines. Polymyalgia Rheumatica may lead to increased premiums if it is accompanied by a high risk of progressing to Temporal Arteritis or other severe complications. Insurance riders like WPD offer valuable coverage for those with PMR, but careful consideration of the costs and benefits is essential.
It is important for individuals to consult with qualified medical and insurance professionals to make informed decisions about their coverage and to seek the best possible terms for their health and financial well-being.