Will it be difficult for me to get life cover following PTSD diagnosis? – Independent.ie

Will it be difficult for me to get life cover following PTSD diagnosis? - Independent.ie

Q I was in a serious car accident over Christmas and diagnosed with Post-Traumatic Stress Disorder (PTSD) since. I’m undergoing therapy to help with the PTSD. I would like to take out life insurance as I have a young family and I’ve a heightened awareness now of how quickly and easily life can be lost. Will my recent PTSD diagnosis make it more difficult for me to get life insurance? John, Co Dublin

A Firstly, sorry to hear about your accident and hopefully you are on the road to full recovery. You may still be able to get cover, but your premium may be loaded.

As with any mental health condition, underwriters look for the risks as well as the positives, considering any inpatient treatment, duration of symptoms, frequency of relapse, treatment, medication, ability to work and so on. Furthermore, different insurers have different thresholds for loadings.

Typically, however, for those with milder PTSD, where the episode is short lived, or where there has been very few mild relapses, standard insurance rates usually apply, whether you are getting treatment for the condition or not.

Where the episodes last longer, say six months or more, or where the relapses take longer to resolve, a loading will likely apply – usually when the last symptoms or relapse was within the last two or three years. If your last symptoms or relapse was more than three years ago, you may well be accepted at standard insurance rates. If an extra premium is charged, it will likely be between 50pc to 100pc of your standard premium, though some insurers may charge towards the higher end if you’re still on treatment.

For severe PTSD, cover may not be possible until there has been a period of 12 months from the date of last symptoms or relapse, after which point a loading will inevitably apply. The extra premium charged could be as much as 100pc of your standard premium.

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If there has been any inpatient treatment (that is, treatment which required hospital stays), or suicide attempts or thoughts, these loadings may increase.

Will Covid stop me getting mortgage protection?

Q I tested positive for Covid a few days ago – just as I was about to apply for mortgage protection insurance. Will I still be able to get this cover given my Covid diagnosis – or will I face a wait for it?  It’s a condition of my mortgage that I get mortgage protection insurance before it is drawn down and we’re almost at the point of closing the sale so I need to get the insurance sorted urgently. Joanna, Co Wicklow

A  As society begins to learn to live with Covid, it’s only a matter of time before insurers do too. Insurers’ position on Covid, and how they assess it, has changed frequently over the last two years, and it will continue to evolve.

Some insurers have already moved to only asking about, or being concerned with, hospitalisation due to Covid. This means that you won’t be asked on the application form whether you’ve been diagnosed with Covid, or if you are, your application will be accepted assuming there has been no hospitalisation. A Covid diagnosis will soon no longer be a temporary barrier to taking out cover, even if you have a significant medical history – as it was earlier on in the pandemic – meaning that you should be able to obtain cover for your mortgage.

Will I get income payouts with long Covid?

Q I contracted Covid two months ago and am still suffering from long Covid. I have been unable to work since I fell sick and my doctor has advised I continue off work until I am fully recovered. I have income protection insurance with a deferred period of eight weeks. So given I’ve been sick and out of work for two months now, can I get payouts under this policy and does my policy cover long Covid? Sam, Co Cork

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A Unlike specified illness cover, income protection pays out when someone is unable to work due to illness or injury rather than the diagnosis of a specific illness. So, whether it’s long Covid or a back injury that is causing the prolonged absence from work, the claim will be considered.

With all income protection claims, the insurer needs to be sure that the customer is unable to work and therefore may obtain reports from your GP and/or specialist. This can take some time to complete, so if you are out of work, especially on an eight-week deferred period, it’s imperative that you notify the insurance company weeks before the end of your deferred period. This will allow the insurance company to complete its assessment before your pay stops – meaning that if your claim is approved, there will be a seamless transition to claim income. Often, customers submit their claim once their deferred period expires which can leave them without pay (other than statutory sick pay, should they qualify), until their claim is approved, which can take some weeks.

Once you are in receipt of claim income, and whether that’s due to long Covid or otherwise, your insurer will work with you in assisting you back to work when you are medically fit to do so.

Does serious illness cover apply to Covid?

Q My father had been paying into a serious illness insurance policy for many years. Unfortunately he recently died from Covid. His life insurer is refusing to pay out, insisting that Covid-19 is not an illness covered by his policy. Surely that can’t be right? Ann, Co Mayo

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A Firstly, my condolences on the passing of your father. Serious illness cover is insurance that offers protection should you be diagnosed with a specific illness of a specific severity or duration. It is not a product that pays out on death (as is the case with life cover) or absence from work (as is the case with income protection).

In your policy document, it will list all the conditions – and the thresholds for severity – that the insurer covers and will pay out for. As of today, no insurer offers protection under their serious illness product for the diagnosis of Covid, even if it results in death.

However, there are specified illnesses, such as “intensive care – requiring mechanical ventilation” – where the individual is in ICU requiring ventilation for a period as specified in the terms and conditions of the policy. It is worth noting that most insurers have a survival period, usually 14 days, meaning that to qualify for a claim, before the individual died, the individual must have survived the survival period after diagnosis, or in this case, after admission to ICU for ventilation. Check the terms and conditions and see if any listed condition could be claimed for and what the survival period is.

If your father has “intensive care” as a listed condition and he required ventilation or was in ICU beyond the threshold listed in the policy, and he survived the survival period, there may be a valid claim here. Also, there may be some conditions that pay out a limited, partial payment of benefit that may apply here.