Reader says: I have a friend who suffers from Polycystic ovary syndrome (PCOS), a medical condition, and has difficulty finding a company who wants to sell her insurance.

(Principal features of this condition are obesity, anovulation (resulting in irregular menstruation), acne, and excessive amounts or effects of androgenic (masculinizing) hormones)

She is keen on:

1) Medical expense insurance

2) Hospital cash insurance

3) Critical Illness insurance

4) Disability income insurance

5) Long-term care insurance

a) Could you advise us on where to look or what types of insurance are there for my friend who has a  pre-existing medical condition?

b) Under what circumstances insurers may not want to cover an individual?

c) What usually is the basis for declining an application for coverage?

Leong Sze Hian, President, Society of Financial Services Professionals

Leong Sze Hian says: Dear reader, I am afraid it’s unlikely that any insurer will cover your friend.
 
Generally, insurers may decline to insure, if the probability of claims will far exceed the premiums that can be charged.

For example, a person with a health condition may not be able to get medical insurance, or even life insurance if the probability of early death, statistically, is very high.

Although in theory, it may be possible to charge higher premiums, or have exclusions, sometimes this may not be feasible.

For example, statistically, excluding a particular existing condition may not be appropriate, because the likelihood of other medical conditions are often statistically linked to an existing condition.

As insurance is a sharing of risk among  all insureds, the insurer has to weigh the impact on other “healthy” insureds, as a poor risk may mean higher premiums or reduced benefits for all