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Medical Impairments

Alcohol Misuse and Alcoholism

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Alcohol consumption considered as alcohol abuse, dependence, at risk and heavy use

  • Current age
  • Amount of alcohol declared and pattern of use
  • Any diagnosis of abuse or dependence
  • How long abstinent or consuming in moderation Any relapses
  • Member of a self-help group
  • Treatment with medication
  • Any co-morbid conditions
  • Any medical complications
  • Pattern of use: daily, binge drinking, etc.
  • Any association with drug use or emotional disorder

Requirement: APS, MVR, blood and urine tests, Alcohol Usage Questionnaire

Fast Track:

  • Details of medical treatment and any psychiatric/psychological report
  • Document any residential care, including dates and length of treatment
  • Clearly outline any favourable aspects such as continued employment, attendance at self-help groups, etc.

Ratings depend primarily on applicant’s age, time since last use, pattern of use, and any co-morbid factors

Best case (over age 30 and >5 years since last consumption): standard
Typical case: 150–200%
Worst case: decline

Anemia

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

A reduction in the number of red blood cells due to blood loss, failure of the bone marrow to produce sufficient cells or premature destruction of the cells.

  • Type of anemia
  • Cause of anemia, if known
  • Details of testing done and referrals to specialists (include dates, names of tests and doctors seen)
  • Blood test results
  • Treatment
  • Medications
  • Any concurrent impairment
  • Age

Requirement: Possibly APS

Fast Track:

  • Details of investigation and testing
  • Details of ongoing surveillance of the condition (including blood tests, electrophoresis)

Ratings depend on type of anemia, age and decision can range from standard to decline

Iron deficiency anemia: usually standard when fully investigated and no underlying condition identified

Aplastic anemia: Usually decline but could reconsider once resolved

Hemolytic anemia:standard–200% but rating could be higher depending on type and severity

Sickle cell disease:standard to decline

Aneurysm

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Abnormal dilation of an artery

  • Type or location of aneurysm
  • Date of diagnosis
  • Cause
  • Size and stability of aneurysm
  • Currently present
  • Treatment or surgery
  • Smoking history
  • Blood pressure control
  • Follow ups
  • Co-morbid conditions such as high blood pressure, diabetes, CAD, alcohol misuse, COPD, smoking

Requirement: APS

Fast Track:

  • Details of all tests and details of ongoing surveillance
  • Details of any lifestyle modifications
  • Details of blood pressure and lipid control
  • Smoking history
  • Any residuals (good level of activity)

Can consider on a rated basis 6–12 months post-op depending on the type of aneurysm

Abdominal:

Cerebral:Thoracic:

Angina Pectoris

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Chest pain caused by reduced blood flow to the heart due to coronary artery disease

Refer to Coronary Artery Disease

Unable to consider until 6 months after onset or treatment

Angioplasty

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Refer to Coronary Artery Disease

Unable to consider until 6 months after surgery

Apnea/Sleep Apnea

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Breathing stops for a short period during sleep.

  • Current age
  • Type of apnea (obstructive, central or mixed)
  • Severity
  • Treatment (CPAP or surgery)
  • Compliant wtih treatment
  • Date of last sleep study
  • Current height/weight
  • Concurrent impairments such as CAD, arrhythmia, PVD, hypertension
  • Smoking history
  • Alcohol use
  • Any history of accident

Requirement: APS if moderate or severe apnea

Fast Track:

  • Details of sleep studies treatment and compliance
  • Details of risk factor control e.g. build, medications and lifestyle modification (smoking, tranquilizers, alcohol use and misuse)

Mild symptoms and no complications: Standard

Moderate symptoms and no complications: Standard to 200%

Severe symptoms and no complications: 150%–decline

Higher ratings if applicant < age 50

Arteriosclerosis

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Refer to Coronary Artery Disease, Stroke or Transient Ischemic Attack (TIA)

Unable to consider until 6 months after onset and treatment

Asthma

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Chronic inflammatory condition of the airways causing shortness of breath, which is triggered by allergens, irritants, cold air or exercise.

  • Current age
  • Date of diagnosis
  • Severity of symptoms
  • Frequency of attacks
  • Timing of attacks (day or night)
  • Type of medication and frequency of use
  • Compliant with medications
  • Medication side effects
  • Hospitalizations or ER visits
  • Limitations to activities
  • Smoking history
  • Concurrent impairments such as COPD, psychiatric disorder, alcohol abuse, CAD, underweight

We are more concerned with children or with older adult smokers with a recent diagnosis of asthma

Requirement: APS selectively

Fast Track:

  • Details of recent pulmonary function tests, hospitalizations
  • Details of lifestyle modification (such as smoking cessation)
  • Level of activity and any limitations of daily activities
  • Asthma questionnaire
  • Asthma control

Minimal and mild: standard to 150%

Moderate: 150% to 200%

Severe: 250% to decline

Children

Minimal to mild: standard to 150% if diagnosis was more than 12 months ago

Moderate or severe: 200% to decline

Atherosclerosis

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Refer to Coronary Artery Disease

Unable to consider until 6 months after treatment

Atrial Fibrillation/Atrial Flutter

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Arrhythmia of the atria where it contracts chaotically.

  • Date of diagnosis and age at onset
  • Age of applicant
  • Frequency of attacks
  • Fully investigated
  • Paroxysmal vs Chronic
  • Treatment
  • Complications from treatment (e.g. drug toxicity or hemorrhage from anticoagulant)
  • Any underlying heart disease
  • Complications (e.g. stroke or congestive heart failure)
  • Any concurrent impairment (e.g. history of alcohol abuse, CAD, valvular disease, TIA, high blood pressure, diabetes, obesity, or stroke)

Requirement: APS

Fast Track:

  • Details of all cardiac investigations
  • Details of any prophylactic medication (e.g. blood thinners)
  • Outline any lifestyle modification
  • Current level of activity
  • Symptoms
  • Frequency of attacks

New diagnosis or new finding on insurance exam must be declined

If there are underlying heart disorders it will be rated according to the cause

Well controlled. Paroxysmal Atrial Fibrillation (PAF) with minimal attacks: fully investigated.
≤ 4 attacks per year: standard
> 4 attacks: 150%

If there is no CAD or other underlying heart disease: Rating ranges from 150% to 200% depending on age. If treated with ablation, could be standard.

The older the client, the lower the possible rating

Bariatric Surgery

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Surgery for morbid obesity, most commonly known as “stomach stapling.”

  • Pre-operative weight
  • Any co-morbid conditions (such as diabetes, hypertension, coronary disease, depression)
  • Date of surgery
  • Type of surgery
  • Any surgical complications
  • Outcome of surgery (weight loss, improvement of risk factors)

Requirement: APS

Fast Track:

  • Details of surgery and follow up
  • Illustrate positive improvements in lifestyle

Unable to consider until 6 months after surgery

Assuming no complications:
6–12 months:
rating based on pre-operative weight minus half of any weight loss

>1 year: rating based on current weight and any complications and residual co-morbid conditions

Barrett’s Esophagus

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Disorder in which the cells normally lining the lower esophagus are replaced by cells normally found lining the stomach. May occur due to esophageal injury caused by reflux. Barrett's esophagus may be a pre-malignant condition for esophageal cancer.

  • Current age
  • Ongoing risk factors
  • Type of testing done and results (endoscopy, biopsy)
  • Stable course
  • Medication/treatment
  • Response to medication treatment
  • Compliant with medical treatment and follow up
  • Complications (such as hemorrhage, perforation)
  • Any surgery

Requirement: APS

Fast Track:

  • Details of ongoing follow up (e.g. endoscopy)
  • Details of lifestyle modification (smoking cessation and alcohol use)
  • Medication to control reflux

Best case: standard if no dysplasia and good follow up done on a regular basis

Average rating: standard

Worst case: decline (if history of high-grade dysplasia and treated with medication only)

Blood Pressure

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Refer to Hypertension

Bypass Surgery

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Refer to Coronary Artery Disease

Unable to consider until 6 months after surgery.

Cancer

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Refer to specific organ or type of cancer

Treatment must be completed

Cancer: Basal Cell Carcinoma (skin)

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

A type of skin cancer that rarely spreads; more common in people with a history of sun exposure.

  • Date of diagnosis
  • Pathology (confirmation of basal cell carcinoma)
  • Type of treatment
  • Date treatment completed
  • Confirmation that tumour has been removed completely
  • Any recurrence or spread
  • Ongoing risk factors like multiple dysplastic nevi and a propensity to develop other skin cancers
  • Any serious complications from treatment

Requirement: APS

Fast Track:

  • Details of the doctor who has the pathology report including postoperative
  • Details of ongoing follow up
  • Details of lifestyle modification (sun screen, smoking cessation)

Incompletely removed: postpone

Complete excision: standard immediately on removal

Cancer: Breast

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Breast cancer is the most frequently diagnosed cancer in women and the second most frequent cause of cancer death. The lifetime risk of developing breast cancer is 1 out of 9 women (11.7%).

  • Date of diagnosis
  • Type and stage of cancer
  • Size of tumour
  • Type of treatment
  • Date treatment completed
  • Any recurrence or spread
  • Reduced/eliminated risk factors (e.g. smoking)
  • Any serious complications from treatment
  • Follow ups including any tests

Requirement: APS

Fast Track:

  • Details and date(s) of treatment, including any adjunct therapy (e.g. Tamoxifen)
  • Details of doctor who has pathology and hospital reports
  • Details of follow up (mammograms, bone scan, etc.)

Underwriting can only be done once treatment has been completed and if the client is well followed. On higher stage/grade tumours, may only be able to consider > 10 years after last treatment. Ratings often are a combination of both table and reducing flat extras. A permanent rating might be needed.

Best case: carcinoma in-situ – can consider at standard 2-3 years after treatment

Typical case: unable to consider until 2 years after completion of treatment (chemo or radiation), then $12/mil x 4 years

Cancer: Colorectal

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

2nd most diagnosed in males, 3rd in females

  • Date of diagnosis
  • Pathology report including type, size and stage
  • Date treatment was completed
  • Any complications or spreading.
  • Reduced or eliminated risk factors
  • Complications from treatment
  • Any co-morbid conditions

Requirement: APS

Fast Track:

  • Details of the doctor who has pathology report, hospital treatments reports
  • Details of regular follow ups
  • Family history

Lowest grades might be insurable right away

Best case is $10.00/mil x 4 years

Cancer: Leukemia

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

A progressive, malignant disease of the blood cells and blood forming organs (i.e. bone marrow and spleen).

  • Current age
  • Date of diagnosis
  • Type of leukemia and stage of cancer
  • Treatment
  • Date treatment completed
  • Any recurrence or secondary cancer

Requirement: APS

Fast Track:

  • Details of the doctor who has pathology report, hospital treatment reports
  • Evidence of regular follow up

The most common type of leukemia seen in underwriting is Chronic Lymphocytic Leukemia (CLL) which is insurable, if stable, low-stage disease and after 2 years post-diagnosis

For other types of leukemia, depending on the type, coverage may not be available for 5 or more years following diagnosis. Very few cases can be offered

Best case: 150–200% 5–10 years post treatment

Cancer: Lung

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

The most common type of cancer death for both men and women. The two main types of lung cancer are small cell and non-small cell.

  • Current age
  • Date of diagnosis
  • Type of cell and stage of cancer
  • Type of treatment
  • Date treatment completed
  • Any recurrence or spread
  • Reduced/eliminated risk factors (e.g. quit smoking and quit date)
  • Any concurrent impairment (e.g. emphysema, COPD or chronic bronchitis)
  • Any serious complications from treatment

Requirement: APS

Fast Track:

  • Details of the doctor who has pathology report, hospital treatment reports
  • Evidence of regular follow up (CT scans, etc.)
  • Smoking habits

Only stage I is insurable. At best, would be postponed for 3 years from the end of treatment, and then best case scenario (stable, no recurrence, not smoking) is $15.00/mil x 5 years

Cancer: Prostate

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

This is the most common internal malignancy found in males. Lifetime risk is 12.8% and it's the 3rd leading cause of death for males.

  • Current age
  • Date of diagnosis
  • Type of treatment
  • Date treatment completed or if active surveillance
  • Stage and Gleason score
  • Any recurrence or spread
  • Current PSA reading
  • Any serious complications from treatment

Requirement: APS, Blood Profile to include PSA if current results are not available

Fast Track:

  • Details of the doctor who has pathology report, hospital treatment reports
  • Details of the type of treatment, regular follow up and PSA testing
  • Smoking habits

< age 70: availability of coverage will depend on the stage, Gleason grade of the tumour and type of treatment

Best case: (treated, PSA is undetectable) Standard

Typical case: (prostatectomy or radiation, PSA favourable)

$5.00/mil for 3 years

Active surveillance: Depending on age, an offer may be possible with regular documented follow ups

Cancer: Skin Borderline Malignancy

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Paget’s disease, Bowen’s disease (not genital), dyplastic nevus, Lentigo Maligna, Hutchinson’s melanotic freckle.

  • Date of diagnosis
  • Pathology
  • Type of treatment
  • Date treatment completed
  • Confirmation that tumour has been removed completely
  • Any recurrence or spread
  • Ongoing risk factors like multiple dysplastic nevi and a propensity to develop other skin cancers
  • Any serious complications from treatment
  • Family history

Requirement: APS

Fast Track:

  • Details of the doctor who has pathology report, hospital treatment reports
  • Details of ongoing follow up
  • Details of lifestyle modification (sun screen, smoking)
  • Any recurrences

Incomplete excision: postpone

Completely excised: standard immediately on removal; may qualify for preferred

Cancer: Skin Malignant

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Malignant change in the skin becomes more common with increasing age. Exposure to sunlight is an important predisposing factor in fair-skinned people.

  • Date of diagnosis
  • Type of cancer/tumour
  • Depth and thickness of tumour
  • Type of treatment
  • Date treatment completed
  • Any recurrence or spread
  • Ongoing risk factors like multiple dysplastic nevi and a propensity to develop other skin cancers
  • Any serious complications from treatment

Requirement: APS

Fast Track:

  • Details of the doctor who has pathology report, hospital treatment reports
  • Details of regular dermatology follow up
  • Family history
  • Date of diagnosis
  • Any recurrences

Malignant melanoma:
If in-situ:
standard

Best cases are postponed for 1 year and then a rating of $12.00/mil x 4 years applies

Cancer: Thyroid

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

The most common malignancy of the endocrine system, generally more common in women. 5th most diagnosed cancer in females.

  • Type of thyroid cancer (papillary, follicular, anaplastic, etc.)
  • Pathology
  • Age of applicant
  • Type of treatment and date(s) performed
  • Any remission and for how long
  • Any recurrence
  • Any complications from treatment

Requirement: APS including pathology report and copies of lab tests

Fast Track:

  • Details of the doctor who has pathology report, hospital treatment reports
  • Details of regular follow up

Best case: lowest grade papillary tumour, can consider at standard 3 years after treatment

Typical case: low to moderate grade papillary tumour, can consider standard 5–6 years following treatment

Worst case: decline if anaplastic tumour

Reconsideration may be possible for cases initially postponed for uninvestigated thyroid nodule which has subsequently been investigated and is proven benign

Congenital Heart Disease

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

A variety of malformations of the heart that vary significantly in severity.

  • Current age
  • Specific congenital abnormality
  • Treatment including date(s) of any surgery
  • Medications
  • Smoking history
  • Any concurrent serious impairment
  • Any underlying coronary artery disease
  • Active lifestyle
  • Blood pressure and cholesterol readings
  • Family history

Requirement: APS to include echocardiogram

Fast Track:

  • Details of investigations, surgery, post operative reports (e.g. serial echos, EKGs)
  • Details of lifestyle modification
  • Activity level
  • Surgery
  • Symptoms, recurrences

Depending on the type of congenital abnormality, some cannot be considered until they have been surgically corrected. For the more serious abnormalities (transposition of great vessels) coverage cannot be considered until two years after surgery

Less serious abnormalities such as small ASD, VSD, Paten Foramen Ovale: may be standard

For more serious abnormalities (such as large ASD, VSD, coarctation of aorta, tetralogy of fallot: ratings

Congenital valve disorders (two years after surgically corrected): postpone minimum 6 months from surgery and then 150% to 300% minimum

Chronic Obstructive Pulmonary Disease (COPD)

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

A variety of diseases that cause chronic progressive irreversible airway obstruction.

  • Current age
  • Smoking history and current tobacco use
  • Build, any current weight loss
  • Treatment (oxygen)
  • Response to treatment
  • Severity of symptoms
  • Speed of disease progression
  • Alpha-1 antitrypsin deficiency or other biochemical abnormality
  • Any concurrent impairment (e.g. CAD, cancer, depression, malnutrition)
  • Any hospitalization
  • Pulmonary function tests (PFT's) including FEV1

Requirement: APS

Fast Track:

  • Details of lifestyle modification, recent pulmonary function test results
  • Level of activity
  • Exacerbations frequency and severity
  • Stability

The younger the applicant, the higher the rating

Chronic bronchitis or Emphysema:
Mild (FEV1 60–69):
Standard–200%
Moderate (FEV1 50–59): 50%–decline
Severe (FEV1 40–49): 250%–decline
Very Severe (FEV1 ≤ 39): decline

Any use of oxygen is a decline

Coronary Artery Disease (CAD)

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

The coronary arteries are unable to supply sufficient blood to the heart due to progressive narrowing of the arteries, thrombosis or vascular spasm.

  • Current age
  • Date of diagnosis and age at onset
  • Severity of the disease (how many vessels and which ones)
  • Current symptoms
  • Treatment or surgery
  • Medications
  • Smoking history
  • Any co-morbid conditions such as diabetes, hypertension, coronary disease, depression or other concurrent serious impairment
  • Any history of congestive heart failure or arrhythmia
  • Active lifestyle
  • Blood pressure and cholesterol readings
  • Family history

Requirement: APS to include recent cardiac test results (e.g. angiogram, recent stress tests, perfusion)

Fast Track:

  • Details of the doctor who has complete records
  • Detailed list of medication
  • Details of any lifestyle change
  • Details on activity level

Unable to consider until 6 months post treatment (bypass surgery, etc)

Decline if age at onset is ≤ 35

Decline if Class 4 (heart failure, ejection fraction <40%)

Class 2 CAD (average severity. Examples are 2 vessel disease and an ejection fraction of 50–55%). Ratings may be higher or lower if the CAD is Class 1 (e.g. 1 vessel disease and ejection fraction >55%), or Class 3 (e.g. more serious CAD, e.g. 3 vessel disease and ejection fraction <40–50%))

Best possible ratings Class 2 CAD:
Age ≤ 49:
225%
50–69: 200%
70–85: 150%

Average ratings Class 2 CAD:
Age ≤ 49:
225%-300%
50–69: 200%
70–85: 150%-175%

Crohn’s Disease

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

A chronic inflammatory disease affecting any part of the GI tract. It has an unpredictable course and while complete remission can occur, the disease is generally chronic and relapsing and may require surgery.

  • Current age
  • Severity of the disease
  • Frequency of flare ups
  • Severity of symptoms
  • Medication
  • Hospitalization
  • Surgery
  • Weight stable or loss
  • Testing and follow up
  • Complications or concurrent impairments such as rheumatoid arthritis or other inflammatory disease
  • Any hospitalization
  • Any surgery
  • Extra-intestinal symptoms

Requirement: APS, colonoscopy – selectively

Fast Track:

  • Evidence of regular GI surveillance (colonoscopy)
  • Details of and frequency of flare ups or attacks
  • Stable weight
  • Active lifestyle

The younger the age at application and the more severe the course of the disease, the higher the rating. Severe symptoms currently may not be insurable until stabilized for 1 year

Mild disease: standard is possible if stable course for 3 years

Moderate disease (incl. steroid treatment): 200–225%

Severe disease: 200–300% to postpone, depending on the age of client

Diabetes

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

A group of metabolic disorders caused by inadequate production or use of insulin. It is a common disease affecting approximately 30 million people worldwide. Diabetes is usually irreversible, although controllable by diet, medication and exercise. Complications such as accelerated CAD, stroke and kidney disease result in reduced life expectancy.

  • Current age
  • Date of diagnosis and age at onset
  • Type of diabetes
  • Treatment
  • Medication
  • Degree of control – blood sugar readings
  • Complications – nephropathy, neuropathy, retinopathy, cardiovascular disease
  • Current height and weight
  • Blood pressure
  • Smoking habits

Requirement: APS, blood tests including Hgb A1c, urine tests including microalbumin/creatinine ratio. If client >=40: Obtain ECG

Fast Track:

  • Details of the doctor who has all records. Other doctors involved in treatment
  • Type of diabetes including age at onset
  • History of blood sugar control – copies of blood tests (incl. Hemoglobin A1c where possible)
  • Details of risk factor modification
  • Active lifestyle

For all diabetics: if currently smoking, then it's an individual consideration. Client could be declined.

Type 1 also known as Insulin Dependent Diabetes (IDDM)
Best case: (excellent control, no complications) 200%
Typical case: 250%
Worst case: (complications, poor or uncontrolled) decline

Type 2 also known as Non-Insulin Dependent (NIDDM) or Adult Onset Diabetes
Best case: (if ≥ age 55, excellent control, no complications, treated by diet or oral medication, normal ECG) standard
Typical case: 150%
Worst case: decline

Emphysema

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Refer to Chronic Obstructive Pulmonary Disease

Heart Attack

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Refer to Coronary Artery Disease

Hypertension

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Primary, or essential hypertension is the most common type affecting 95% of people with hypertension. The cause is unknown but is thought to be the result of a complex interplay of factors which include demographic, family history and environmental factors. Secondary hypertension results from disorders of the kidney, endocrine or nervous system.

  • Current age
  • Date of diagnosis
  • Type of hypertension (essential or secondary to another impairment)
  • Medication/treatment
  • Response to medication treatment
  • Current blood pressure readings and history of readings for past two years (demonstrate stable course)
  • Compliant with medical treatment and follow up
  • Any concurrent impairment (e.g. CAD, stroke, kidney disease, build)

Requirement: Vitals

Fast Track:

  • Record of blood pressure readings
  • Details of any cardiac investigation
  • Details of risk factor modification
  • Active lifestyle

Rating depends on severity of hypertension

Most cases can be offered standard if well-controlled and compliant with medication

Myocardial Infarction

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Refer to Coronary Artery Disease

Pulmonary Nodule

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

A small shadow found on chest X-ray which may be caused by a benign cyst, infection or abscess or granuloma.

  • Current age
  • Date of diagnosis
  • Any treatment
  • Date treatment completed
  • Benign pathology
  • Reduced/eliminated risk factors (e.g. smoking)
  • Any concurrent impairment (e.g. emphysema or chronic bronchitis)

Requirement: APS

Fast Track:

  • Details of follow up
  • Demonstrated stability of lesion
  • Details of risk factor modification
  • Size of nodule if known

Pulmonary Nodule: can be due to a benign cause. The underwriter must investigate thoroughly

Depending on the size of the nodule and the follow ups: standard to postpone

Stroke

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Permanent (> 24 hrs.) damage to the brain caused by a vascular event, thrombosis or hemorrhage resulting in permanent neurological deficit.

  • Current age
  • Date of diagnosis and age at onset
  • Current symptoms/extent of neurological deficit
  • Cause of stroke
  • Treatment
  • Medications
  • Number of strokes
  • Smoking history
  • Active lifestyle
  • Blood pressure and cholesterol readings
  • Any co-morbid conditions such as diabetes, hypertension, coronary disease, depression or other concurrent serious impairment

Requirement: APS

Fast Track:

  • Details of the doctor who has all records
  • Other doctors involved in treatment
  • Current function (how active)
  • Lifestyle modifications

Depending on severity, may not be able to consider until 6 to 12 months after stroke

If currently smoking and less than age 50, decline, otherwise there would be an additional rating

Multiple strokes: usually decline

Average rating: for a well worked-up stroke, with minimal residuals, 150–200%

The younger the applicant and the more recent the stroke, the higher the rating

Transient Ischemic Attack (TIA)

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

An episode of neurological dysfunction lasting less than 24 hours and no permanent neurological deficit.

  • Current age
  • Date of diagnosis and age at onset
  • Any neurological deficit
  • Number of episodes
  • Treatment
  • Medications
  • Smoking history
  • Test results
  • Active lifestyle
  • Blood pressure and cholesterol readings
  • Any co-morbid conditions such as diabetes, hypertension, coronary disease, depression or other concurrent serious impairment

Requirement: APS

Fast Track:

  • Details of the doctor who has all records
  • Other doctors involved in treatment
  • Current function (how active)
  • Lifestyle modifications

Unable to consider until 6 months after the episode, and must have been investigated

Depending on the age of the client and length of time since TIA, could be standard to 250% but average rating would be 150%

Ulcerative Colitis or Ulcerative Proctitis

Condition and description Factors affecting the decision Fast track the app Likely underwriting decision

Chronic inflammatory ulceration of the colon (relapsing-remitting type disorder).

  • Current age
  • Severity of the disease
  • Frequency of flare ups
  • Severity of symptoms
  • Medication
  • Hospitalization
  • Surgery
  • Weight stable or loss
  • Testing and follow up
  • Complications or concurrent impairments (e.g. rheumatoid arthritis or other inflammatory disease)
  • Extra-intestinal symptoms

Requirement: APS

Fast Track:

  • Details of regular GI surveillance (colonoscopy), hospitalizations
  • Stable weight
  • Active lifestyle
  • Details and frequency of flare ups or attacks

The younger the age at application and the more severe the course of the disease, the higher the ratings

Mild: depending on age and date of last attack, ranges from standard to 250%

Moderate: Average rating would be 150%–200%

Severe: Individual consideration if current attack otherwise average 175% to 300% depending on control and number of episodes