A quite common and relatively benign condition often seen on insurance applications, Paul Gyseman discusses the insurability factors and the pathophysiology of this illness
Generally, there is no treatment required to manage this illness and Gilbert’s syndrome sufferers lead normal healthy lives.
Gilbert’s is often seen in insurance applications and therefore underwriters are familiar with the pathology and the consequences that arise.
Nevertheless, there are certain medications that Gilbert’s patients need to be careful of, which include:
■ Statins that are used to treat hypercholesterolaemia
■ Some cancer drugs
■ Medications used in HIV sufferers.
It is also recommended that a healthy diet be maintained, avoiding fatty or sugary foods, as well as drinking plenty of water.
Gilbert’s patients can be ultra sensitive to alcohol and as a result, care should be taken when drinking.
UNDERWRITING IMPLICATIONS
As mentioned above, Gilbert’s syndrome is a common finding in insurance applications, either disclosed in the applicant’s medical history or as a chance finding through haematological tests.
Fortunately, it is usually a harmless condition that has little or no impact upon mortality or morbidity good news for buyers of life, critical illness and health insurance products.
There may be some misconceptions surrounding this condition, but it is unequivocal that Gilbert’s is a benign impairment that has no relationship with alcohol abuse or other forms of hepatitis.
Additionally, there is significant evidence to suggest that patients with Gilbert’s have a significantly lower incidence rate of coronary heart disease.
The Framingham Heart Study has indicated that some groups may have an incidence rate of heart disease as low as a third less compared to the standard population.
Once any other more serious underlying pathology has been excluded, such as hepatitis or other forms of anaemia, life insurance can be assessed at the standard rate of premium for this benign condition of hyperbilirubinaemia.
If the client discloses the condition on the application form, there is unlikely to be any need for further medical evidence.
Critical illness cover can also be accepted at the standard rate of premium in most cases.
A tele-interview will normally obtain sufficient information to assess the risk.
Income protection and other disability related products may need to be assessed in a little more depth to evaluate the psychological ramifications of the condition, although most cases would still be accepted on standard terms or, at worst, with a small extra premium.
A tele-interview would normally be sufficient to assess the risk and, in rare instances, a GPR would be required if there were any complications or psychological factors to be considered. In extreme cases or for large sums assured, a full set of lab tests would be required.
Paul Gyseman is director of underwriting and claims at PruProtect
