Epilepsy and seizure disorders

Control decides it

Epilepsy underwriting is unusually clear about what matters. It is the time since your last seizure. Everything else modifies that.

Take someone who has been seizure-free for several years on stable medication. They are often assessed at or close to standard rates. The condition is present, it is controlled, and the record shows it.

Someone having seizures regularly is assessed on that basis, and the terms reflect it. Between those two points, the assessment moves broadly with the length of the seizure-free stretch.

So with epilepsy, your own records tell you most of what you need to know before you apply.

One seizure is not epilepsy

This deserves its own section, because people often get it wrong on applications.

A single unprovoked seizure that never came back is not the same thing as epilepsy. Underwriters do not treat it as such. Say a person had one seizure years ago. It was investigated. They took no medication, or came off it. They have had nothing since. That file is a small matter.

The same goes for a provoked seizure with a clear cause that has since been removed. One example is a seizure during an acute (sudden) illness. Another is an extreme metabolic disturbance, meaning a serious upset in the body’s chemistry. A third is a head injury with no events afterwards. These are assessed on those facts rather than as a chronic condition.

If this describes you, describe it that way on the application. Do not answer as though you have epilepsy. Both answers are honest; only one is accurate.

Type of seizures

Underwriters ask, because the types differ in what they involve.

Generalised tonic-clonic seizures involve loss of consciousness and convulsions. They carry the most weight. They bring the greatest risk of injury, and of complications during the event.

Focal seizures vary a great deal. Those without loss of awareness are usually assessed more gently.

Absence seizures are assessed on their own terms.

Frequency matters within each type. Occasional focal seizures with awareness kept are a different assessment from monthly generalised seizures.

Whether a cause was found

This separates two quite different situations.

Idiopathic epilepsy is epilepsy where no structural cause has been found. It is assessed on the seizure pattern and control alone.

Symptomatic epilepsy arises from a known underlying condition. That might be a previous head injury, a stroke, a brain tumour, or a developmental abnormality. It is assessed on the underlying cause as well as on the seizures. In some of those cases the underlying condition becomes the main factor in the file.

If your epilepsy has a known cause, expect the underwriter to want the details of that as much as the seizure history.

Medication and stability

Underwriters read the treatment picture the same way they do for other chronic conditions.

Control on a single anticonvulsant (a seizure medication) at a stable dose over years reads well. Control that needs several medications points to a condition that has been harder to manage. Recent changes to a regimen, meaning the set of drugs and doses, mean the picture has not settled. An underwriter may prefer to wait.

Some people come off medication under a doctor’s supervision after a long seizure-free period. They then stay seizure-free. They are in a good position. The length of time off medication is what matters.

If missed doses are on record as a seizure trigger, that is noted. It speaks to how the condition is being managed in practice.

Injuries and emergency care

Seizures that have caused injury are counted. So are seizures that needed emergency attendance or a hospital admission. Status epilepticus is a prolonged seizure that needs emergency treatment. It is a significant marker.

A long history of seizures with no injury or emergency involvement reads better than a shorter history with them.

Practical matters that come up

Driving. Provincial licensing rules require seizure-free periods before driving is allowed. Underwriters know this. If your driving record and your seizure history do not line up, that mismatch generates questions.

Occupation and activities. Some work and some activities carry more risk for someone with an active seizure disorder. This may feed into the assessment. See travel, work and hobbies.

Alcohol. Where alcohol has been a documented seizure trigger, it appears in the file. It is assessed alongside the epilepsy, in the way set out in alcohol and life insurance.

Applying

Have the details ready:

• When the seizures started, and when the most recent one was.
• What type they are, and how often they occur.
• What medication you take, and for how long.
• Whether a cause was identified.
• Any injuries or hospital visits.
• Your neurologist’s name.

If your history is a single seizure rather than epilepsy, say so precisely.

Apply fully underwritten. Insurers differ on how long a seizure-free period they want to see for standard rates. So a single application gives an incomplete picture.

The boundary

This page is about how an insurance file is assessed. It is not information about epilepsy, medication or seizure management. Nothing here should influence any decision about your treatment. That belongs with your neurologist or family doctor.