Multiple sclerosis and life insurance

Why this has its own page

Multiple sclerosis is sometimes grouped with other autoimmune conditions in general insurance writing. It is assessed on quite different criteria, and Canada has among the highest rates of MS in the world, so a general treatment does Canadian readers a disservice.

Offers are made regularly. The range of outcomes is wider than for most conditions, because the range of what MS actually does to people is wider than for most conditions.

The course of the disease

This is the first thing an underwriter establishes, and it does more work than anything else.

Relapsing-remitting, where episodes of new or worsening symptoms are followed by periods of partial or complete recovery. This is the most common form at diagnosis and generally the most favourably assessed, particularly where relapses are infrequent and recovery has been good.

Secondary progressive, where a relapsing course has transitioned to steady progression. Assessed more cautiously.

Primary progressive, where symptoms accumulate steadily from the outset without distinct relapses. Assessed most cautiously of the three.

Your neurologist’s records will state which applies. Knowing it before applying tells you a great deal about what to expect.

Function matters more than imaging

Underwriters are not reading your MRI for lesion counts. They want to know what you can do.

The practical questions are whether you are working and in what capacity, whether you walk unaided, whether you use a cane, walker or wheelchair, whether you manage daily activities independently, and whether cognitive symptoms affect function.

Neurologists often record a disability score, and where one exists an underwriter will use it. Where one does not, a physician’s description of your function serves the same purpose.

Someone diagnosed twelve years ago, working full time, walking unaided, with two mild relapses in that period, presents a strong file. The diagnosis is on it, and so is more than a decade of evidence about what it has actually done.

Time since diagnosis

MS is one of the conditions where insurers frequently want time to pass before assessing, and the reason is specific.

The course of the disease is often not clear in the first years. Someone diagnosed six months ago may follow a mild course for decades or may not, and nothing in the file yet indicates which. Underwriters generally prefer to see how it behaves.

A postponement early after diagnosis is common and is not a judgement about prognosis. It is an acknowledgement that there is not yet enough to assess.

Once several years of history exist, the file becomes assessable, and a mild course over that period is one of the strongest things it can show.

Relapses

Frequency, severity and recovery all matter, and recovery matters most.

Infrequent relapses with full recovery between them read very differently from frequent relapses leaving residual deficits each time. What underwriters are watching for is accumulation: whether each episode leaves something behind.

Hospital admissions for relapses, and courses of intravenous steroids, appear in records and mark the more significant episodes.

Disease modifying therapy

Being on it is generally read as a positive. It indicates the condition is being actively managed, and these therapies are associated with reduced relapse rates.

Underwriters note which therapy and how long you have been on it, and stability on the same treatment over years reads well. Frequent switching suggests the condition has been harder to control.

Some therapies carry their own monitoring requirements, which appear in records and demonstrate engagement with follow-up.

Age at diagnosis

MS is typically diagnosed in early to middle adulthood, which means most applicants are relatively young and the coverage period being assessed is long.

Diagnosis at a younger age means more years of potential accumulation ahead, and underwriters factor that in. It also means that when a long mild course is documented, it covers a meaningful stretch of the years that matter.

If full underwriting does not produce an offer

Simplified issue products ask a short set of questions, and some include questions about neurological conditions or about requiring assistance with daily activities. Whether they are available depends on the specific questions and your situation.

Guaranteed issue asks nothing about health, at a smaller amount and with a waiting period at the start.

Apply fully underwritten first. MS is an area where insurer approaches differ considerably, particularly for well-controlled relapsing-remitting disease. See declined or postponed.

Applying

Have the specifics: which course, when diagnosed, how many relapses and when, what therapy you are on and for how long, your current mobility and work status, and your neurologist’s name.

A neurologist’s report describing stable disease and good function is frequently the most persuasive document in the file, so it is worth making sure your follow-up is current before you apply.

The boundary

This page is about insurance underwriting. It is not information about MS, its treatment or its course, and nothing here is guidance about therapy or management. Your neurologist owns all of that.