Life insurance with diabetes

The starting position

Diabetes affects a large number of Canadian adults, and life insurers see it constantly. It is a routine part of underwriting rather than an unusual case, and applications from people with diabetes result in offers regularly.

What varies is the terms. Depending on the file, an offer might come at standard rates, at a rating that increases the premium, occasionally with a smaller amount than requested, and sometimes not at all. Which of those you get depends on the specifics below far more than on the word “diabetes”.

The most common mistake people make here is deciding the answer before applying.

What an underwriter is actually reading

Which type. Type 1 and Type 2 are different conditions with different causes, different typical ages of onset and different trajectories. Insurers assess them on largely separate criteria, which is why they have separate pages here: Type 1 and Type 2.

Age at diagnosis, and age now. These interact. Diagnosis at 62 after decades without it means fewer expected years of exposure to the condition. Diagnosis at 22 means the condition will be present for a long time, and duration is itself a factor in how complications develop.

Duration. How many years you have lived with it. Longer duration generally attracts more attention, and it is also accompanied by more evidence about how you have actually done, which cuts both ways.

Treatment. What you take, and how that has changed over time. Insurers look at the direction of travel as much as the current position. A treatment plan that has been stable for years reads differently from one adjusted three times in eighteen months.

A1C history. Glycated haemoglobin reflects average blood glucose over roughly the preceding three months. Insurers generally want several readings rather than one, because a single number cannot show whether control has been steady or erratic. Consistency across readings tends to matter as much as the values themselves.

Complications. This is usually the heaviest factor. Documented damage to the kidneys, eyes, nerves or cardiovascular system moves an assessment considerably, because it indicates the condition has already had effects. Their absence after many years is a strong point in a file.

Everything else on the application. Diabetes rarely arrives alone. Blood pressure, cholesterol, weight and nicotine use are all assessed alongside it, and the combination is read as a whole rather than as separate items.

Follow-up. Regular appointments, current screening, and an endocrinologist or family doctor who has documented the picture. A well-documented file is easier to assess favourably than a sparse one, because an underwriter can only work with what is on paper.

Why insurers disagree so much here

Different insurers can reach different decisions about the same diabetes history.

Some weight duration heavily and are cautious about long-standing diabetes even where control is good. Others weight recent readings and stability more, and will look past a long history if the recent record is steady. Some have specific programs aimed at applicants with diabetes; others have appetite that has shifted in the last few years.

The practical effect is that the same file can produce meaningfully different answers at different companies. That is the main argument for applying through someone who can place business with several insurers rather than going to one and accepting its verdict as the market’s verdict.

What tends to go wrong

Assuming the answer. A great many people with diabetes buy guaranteed issue coverage, which is the most expensive product with the lowest limits and a waiting period, without ever having applied for anything else. Some may have other options, but that requires an individual assessment rather than an assumption about eligibility.

Applying with an incomplete picture. If your records do not show recent readings or current screening, the underwriter is assessing an unclear file, and unclear files are assessed cautiously.

Not disclosing accurately. Prescription history makes diabetes medication visible whether or not it was declared. See leaving something off the application.

What to do

Apply for fully underwritten coverage first, unless there is a specific reason not to. It costs nothing, and the answer is frequently better than expected.

Have your own information ready before you start: when you were diagnosed, what you take and at what doses, who looks after your diabetes, and roughly when you last had bloodwork and screening done.

If an offer comes back rated, compare it properly. A rated fully underwritten policy is often better value and allows far more coverage than a no-medical alternative. See ratings and substandard offers.

If the answer is a decline or a postponement at one insurer, that is one company’s view. See declined or postponed for what follows.

One boundary worth stating

Everything on this page is about how insurers read a file. Nothing here is guidance about managing diabetes, and it should not be read that way. Decisions about your treatment, your targets and your monitoring belong with your doctor or your diabetes team, for reasons that have nothing to do with insurance.