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Trauma Insurance for Multiple sclerosis in Australia

Russell Cain
Russell Cain Updated: 12 May 2020

Multiple Sclerosis (MS) is a neurological disease that is long-lasting (chronic), often leading to random attacks on your central nervous system, affecting your brain, spinal cord and the optic nerves in your eyes. Symptoms can range from tingling and numbness to paralysis and blindness.

Trauma insurance provides a lump sum benefit if you’re diagnosed with MS and meet the insurer’s definition of the disease. In 2017, the average cost for treating MS and living with the disease was over $68,0000. The lump sum amount can significantly alleviate the financial strain MS causes, making your life a bit more comfortable.

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What is the MS life expectancy in Australia?

There are over 25,000 people in Australia living with Multiple Sclerosis, three-quarters of which are women (MS Australia). 10 people are diagnosed every week, and it’s the most commonly acquired disease of the central nervous system affecting young adults. People with MS often live just as long as people without it. However, the progression, severity and specific MS symptoms differ from person to person.

Due to medical advances, Multiple Sclerosis is usually not fatal, but it can affect your quality of life. The quality of life for Australians with MS is 31% less than the overall population (MS Australia, 2017). According to a study conducted by Clinical Medicine & Research, 15 years after the onset of Multiple Sclerosis, about 20% of people are bedridden or institutionalised and another 20% may require a wheelchair or crutches.

Many Australians are looking for trauma insurance policies that list Multiple Sclerosis as one of the critical illnesses covered because of the high costs and prevalence of the disease.

What is Multiple Sclerosis age of onset?

According to Australia MS, diagnosis of the disease is generally between the ages of 20 and 40. There is no single test for a definitive diagnosis. However, an MRI scan showing evidence of lesions in at least two distinct areas of your central nervous system is generally a good indicator.

The doctor might also test your reflexes and balance, how your pupils’ respond to light, and your ability to follow moving objects with your eyes.

Does trauma Insurance cover Multiple Sclerosis?

Yes, Multiple Sclerosis is generally listed as one of the critical illnesses covered by trauma insurance policies and a lump sum benefit will usually be paid when meeting the insurer’s definition of MS and diagnosis is confirmed by a consultant neurologist. However, MS will usually not be covered if it was a pre-existing condition when you applied for your policy.

When will critical illness cover for Multiple Sclerosis pay out?

Critical illness insurance will generally pay a lump sum benefit when you’re diagnosed with MS and meet the insurer’s definition of a valid claim. Trauma insurance definitions for Multiple Sclerosis vary from policy to policy and can also differ between life insurance companies.

Apart from the definite diagnosis by a neurologist, most life insurance companies require there be evidence of:

Some insurers state that each episode must last at least 6 months, while others do not specify the duration.

A small number of life insurance companies only pay trauma insurance claims if the person insured is unable to function independently and needs assistance with daily living.

It’s best to shop around and compare critical illnesses policies from some of Australias leading life insurance companies and then carefully review their product disclosure statement (PDS) to determine how they define MS.

How much will critical illness pay out for Multiple Sclerosis?

The lump sum benefit paid depends on the amount of cover you purchase. Usually, you can buy a minimum trauma benefit of $50,000 up to a maximum of $2 million, depending on the insurer.

Take note; most trauma policies also require you to survive for at least 14 days from the date of diagnosis before a claim will be eligible.

There is also generally a 90-day waiting period from policy commencement before you are eligible to start claiming benefits. Meaning, after starting your cover, no benefit will be paid for any critical illnesses that became apparent or were diagnosed during the first 3 months of your policy starting.

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Can you purchase trauma insurance if you already have MS?

Every life insurance company has different underwriting guidelines and will assess your specific circumstances individually. However, it is generally unlikely that you’ll get trauma coverage for MS when already diagnosed. Although, you might still be able to get cover for the other critical illnesses listed in the insurer’s product disclosure statement (PDS).

Does life insurance payout for MS?

Generally, your life insurance policy will pay you a lump sum benefit should you die or be diagnosed with a terminal illness where you are not expected to live for more than 12 months. Should you die from the complications of advanced MS, your death benefit will be payable to your nominated beneficiaries. However, because MS is rarely fatal, life insurance will generally not pay out a terminal illness benefit.

Can you get life insurance with MS already diagnosed?

Generally, you might still be able to get life insurance when you have Multiple Sclerosis. However, you’re likely to receive a loading on your policy, meaning you’ll be charged a higher premium to protect the company against the risk of you possibly lodging a claim.

When applying for a life insurance policy, it is your duty to disclose that you have Multiple Sclerosis, including:

Apart from the MS specific information required, you’ll also need to answer some standard questions, like your family’s medical history, your age and gender, smoking status, BMI, occupation and past times.

Where does multiple sclerosis come from?

The overall cause of multiple sclerosis is still unknown. It is thought that genetic and environmental factors are involved. Due to medical advances, better health care and lifestyle adjustments, Multiple Sclerosis often progresses slowly. However, the course of the disease depends on your risk factors, for example, if you’re a smoker, have a Vitamin D deficiency or a family history of MS.

Symptoms result when inflammation and breakdown occur in the protective fatty layer of insulation, called myelin, surrounding the nerve fibres of your central nervous system.

Overactive immune cells damage and destroy myelin, this is called demyelination. Over time, hardened scar tissue will develop at the lesion site. This scarring then interrupts the transmission of nerve signals to the brain, which may result in things like blurred or double vision, numbness and tingling in your body or limbs, and changes in your balance or coordination.

Early signs and symptoms

Multiple sclerosis symptoms are unpredictable. Some people are minimally affected by the disease while others have rapid progression to total disability. Although every individual will experience a different combination of MS symptoms, below are some of the symptoms with the most perceived importance:

Symptoms vary greatly from person to person and from time to time in the same person. Other signs may include impaired vision, loss of balance and muscle coordination, slurred speech, stiffness, difficulty walking, short-term memory loss, mood swings and, in severe cases, partial or complete paralysis.

4 Common types of MS

Clinical-Isolated Syndrome (CIS)

A single episode of neurological inflammation or demyelination in the central nervous system that generally lasts for 24 hours or more. You may never experience another event, or this could your first attack.

Primary-Progressive MS (PPMS)

This form of MS is characterised by a gradual progression of disability present from the onset of the disease and the lack of relapses or periods of remission.

Relapsing Multiple Sclerosis (RMS)

This is the most common form of MS. The disease may be inactive for months or years, only to worsen or start again, lasting for hours, days, and even weeks, then subside with full or partial recovery. Because of the frequent relapsing, RMS may eventually transition to the 4th category.

Secondary Progressive Multiple Sclerosis (SPMS)

Starts as RMS that later evolves to become more consistently progressive.

If you or a loved one have concerns of possibly developing Multiple Sclerosis in the future and want trauma insurance coverage, please reach out to us, and our specialists will assist you in finding the right policy suited to your unique circumstances.

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