Life insurance is the largest product in the protection insurance market – but many people have a hard time trying to access it due to having pre-existing conditions such as diabetes and cancer.
With the growing prevalence of such diseases, and the growing awareness that the NHS might not be able to offer as much support as previously due to long waiting lists, it means that demand is continuing to grow from that underserved market.
That has helped bring about the advent of companies that are dedicated to addressing the protection gap and serving people with pre-existing conditions, accessing a market which has been largely ignored.
But as the demand for life insurance grows, the market appears to be slowly changing towards allowing greater access.
Still – there is far to go.
Health & Protection investigated new product developments in the product suite, and looked at whether insurers are getting better at supporting those with pre-existing conditions, and to determine which areas are most likely to see improvements the soonest – and where is there the most need.
Extending cover
First up to discuss the matter was Blueberry Life – the rebrand of Bluezone, which is led by founder and CEO Karan Mehta.
Blueberry started off by offering life insurance to the underserved marked of people with diabetes, and is now in the process of extending its offering to cover people with other pre-existing conditions as well.
Mehta says that there are several areas that are likely to see an improved offering.
“The areas most likely to see improvement are life insurance products for people with pre-existing cardiometabolic conditions such as Type 1 diabetes, Type 2 diabetes, high blood pressure, high cholesterol, and obesity.”
Improving lifestyles
Blueberry goes beyond just selling life insurance and works with the customer to help them improve their lifestyles.
“Improvements to these products include offering more than just insurance—providing customers with behaviour change programmes and interventions that empower them to lead healthier lives, improve their health and lifespan, and, as a result, pay lower insurance premiums.”
Positive shift
A similar organisation to Blueberry Life is More Than Diabetes which is a diabetes-specific life insurance broker. It too has seen a positive shift towards accepting people with diabetes.
Sam Stevens, director and diabetes protection advisor at More Than Diabetes, says: “In recent years we have seen the insurance markets attuite towards people living with diabetes shift in a positive way.
“More insurance companies are insuring people with diabetes without the need to speak with their GP, saving time, and are happy to consider cover for people with more complex diabetes related issues which previously could have meant a declined application.”
Lots of room for improvement
But he notes that there is lots of room for improvement, one area being making allowances for better health.
“There should be more insurance companies giving customers the option to lower their price with improved HbA1c readings without the need to cancel a policy and start again.”
He says: “Though this is a positive step, more insurance companies need to step up and offer critical illness cover or IP for people with Type 1 and 2 diabetes,
“I really hope in the future we start to see the market as a whole open up this vital cover to more people living with diabetes, giving them choice, not restricting them to one or two choices. “
Still more work to be done
And it’s not just people with diabetes who experience difficulties. Cancer too can be a barrier for people who want to protect themselves and their families by acquiring life insurance.
But there are signs that the situation is improving for these people as well, as according to Emma Thomson, consultant for Reframe Cancer.
“Insurers have been improving how they support those with pre-existing conditions,” Thomson says.
But she notes that “there is still more work to be done to further improve access to insurance – especially other forms of protection such as critical illness cover and income protection.
“While a cancer survivor may pose no additional risk for health issues such as heart attacks, strokes, back pain, deafness or having a life changing injury or accident, they will still typically be prevented from taking out critical illness cover and income protection for several years post recovery because plans aren’t being adapted to exclude the specific risk posed.”
NHS waiting list
And she points out that the situation at the NHS with a waiting list of more than 7 million people, is a contributing factor.
“Increased NHS waiting times are creating a new ‘uninsurable’ group of consumers; those who are experiencing significant delays getting diagnosed and/or completing treatments.
“Insurers will typically not insure an applicant if there are outstanding tests or investigations so more consumers are left exposed whilst they wait for their NHS appointments. “
“This NHS issue is a challenge for insurers to hopefully find some solutions for, as the situation is not going to improve significantly anytime soon.
“Reviewing underwriting philosophy, adapting free cover provision and even signposting applicants to services that could provide alternatives to NHS waiting lists could help more consumers access valuable cover.”
Significant gap in the market
Outside of cancer and diabetes, there is at least one other big pre-existing condition that often gets left out of the conversation.
Sheun Oke, managing partner and CEO at Emergenzz Financial Services, is a big advocate for people with pre-existing conditions to have easier access to life insurance.
Oke says: “One of my biggest passions is advocating for greater diversity in insurance products, ensuring they serve a broader range of people—including those with pre-existing conditions.
“A key area that still needs urgent attention is coverage for individuals with conditions like Sickle Cell Anaemia.
“Many people in underserved communities either struggle to get coverage or face unaffordable premiums due to outdated underwriting models that don’t reflect modern medical realities.
But she too thinks that there have been some positive steps towards addressing the issue.
“It’s encouraging to see some steps in the right direction, but there is still a significant gap in the market,” she continues.
“Insurers need to rethink how they assess risk, making better use of data, refining medical underwriting, and developing fairer pricing structures that acknowledge advances in healthcare.
Positive development
“One positive development is that medical doctors from the Black community are ready and willing to support underwriting teams in navigating how to provide adequate cover for conditions like Sickle Cell Anaemia,” Oke says.
“Their expertise could be instrumental in shaping products that better serve affected individuals without unnecessary exclusions or prohibitive costs.”
Inclusive underwriting
But though sometimes difficult, larger providers don’t necessarily prevent people with pre-existing conditions from buying life insurance.
Vitality is one such provider that says it is committed to offering more people protection.
John Downes, director of claims and underwriting at VitalityLife, tells Health & Protection: “Vitality is committed to ensuring more people have access to protection, including those with pre-existing conditions. We do this in a range of ways, including offering coverage with adjusted premiums or exclusions for certain risks.
“Each year, as technology and medicine advance, so too does people’s ability to manage and survive illness.
“By staying at the forefront of these developments, we can offer better coverage for many conditions, such as well-controlled blood pressure, without additional cost.
“Further advances in medicine and a deeper understanding of diseases continually refine how we assess and underwrite individuals.”
Improved access
Downes says the end result is broader access for some people with pre-existing conditions.
“This has meant improved access to coverage for conditions that previously resulted in significant premiums or no cover at all, such as HIV positive status, certain cancers, and heart conditions.
“To broaden access to protection, we provide advisers with easy access to accurate information about our policies, with specialist, personalised support when required.
“For applications from individuals with pre-existing conditions that can’t receive an automatic decision, they will be individually assessed by an underwriter to determine the terms of coverage.
“While some conditions may require adjustments, very few result in no coverage being offered. With ongoing advancements in medical treatment, access to coverage is expected to continue expanding, as it has in recent years.”
Impact on risk profile
Robert Morrison, chief underwriting officer for health and protection at Aviva, says: “We assess each applicant’s individual health and lifestyle circumstances, taking into account any medical conditions that they have already developed and the impact it has on their risk profile.
“Our underwriting approach is inclusive and we offer acceptance terms to the vast majority of applicants, with more than eight in 10 automatically accepted for cover.
“Our focus is on providing ease of access to insurance and ensuring that the social purpose of insurance is maintained, as well as ensuring that our underwriting approach continues to evolve in line with medical advances.
Room to go further
And while there is an effort to promote healthier lifestyles, that is not enough, as people with pre-existing conditions can feel that they are not being considered, because the industry is not doing enough to get a full picture from clients of their health.
Ricky Butler, head of new business and growth at LifeSearch, explains: “To this day, much of the protection industry is still focused on promoting healthier lives and understanding how to improve the protection experience for these individuals.
“However, this often leaves those with pre-existing health issues – those who need protection the most – feeling overlooked and underserved.
“While progress has been made in protecting these customers, more must be done to inform them of the products available to them while equipping advisers with more options and flexibility to ensure they can be protected, properly.”
Full picture
He says: “As an industry, we are still too static around the way we obtain information from clients. With this in mind, there’s a growing need to place more of a focus on client-submitted evidence – both pre- and post-application.
“While there were some positive improvements made during the Covid period, it’s important to continue to review ratings or exclusions. If a client’s risk has decreased due to treatment for example, they should have a better chance of securing protection.
“Encouragingly, some insurers are starting to make improvements to their underwriting processes, language, and communication when it comes to helping those with mental health.
“However, there is still room to go further.
“For example, taking medication can in some cases lead to an increase in premiums due to perceived risk. But we must also consider that this could also greatly reduce the risk of reoccurrence.”
