About Colitis & Crohn's Disease
Colitis or ulcerative colitis (UC) is the most common type of inflammatory bowel disease. It is a condition of episodic inflammation of the lining of the colon, typically resulting in bloody diarrhea, abdominal pain, fever, anemia and/or weakness. Most often occurring and diagnosed between the ages of 20 and 40, this condition carries an increased risk of colon cancer when present for 10 or more years.
The other main type of inflammatory bowel disease, with similar symptoms and treatment, is Crohn’s disease. Crohn’s disease refers to inflammation of any part of the gastrointestinal tract, from mouth to anus. The most commonly affected areas include the small and large intestine and parts of the rectum.
Causes & Risk Factors
The cause of ulcerative colitis and Crohn’s is unknown. However, both environmental and genetic factors often play a role. The risk of disease is increased if there's a family history of inflammatory bowel disease. Ironically, ulcerative colitis is less common in smokers, and smokers who have UC tend to have a milder form of the disease. Having had an appendectomy at a young age decreases the risk of developing UC. Generally speaking, the condition is milder and easier to treat if smaller and lower areas of the colon are affected. In severe cases, the entire colon becomes inflamed, possibly requiring removal of part or all of the colon in order to treat.
The mortality risk for Crohn’s disease is different from that observed with UC. In Crohn’s disease, there is an accumulation of inflammatory products in the wall of the intestine, rather than on the internal surface, as is seen with UC. This accumulation can lead to a complete blockage of the intestine, which may require emergency surgery. Another risk is that the inflammatory material in the wall can become infected. This may lead to bacterial abscess and contamination of the blood — a potentially critical condition.
Underwriting for Colitis & Crohn's Disease
Here are the primary questions to ask a proposed insured who presents with a history of colitis, Crohn’s disease, or other gastrointestinal issues:
- What was the age of diagnosis?
- What is the severity? Would your doctor characterize it as mild/moderate/severe?
- When was the last flare-up? What is the frequency of the episodes?
- What is the specific type of GI issue? How is it treated?
- How much of the GI tract is involved?
- Any surgeries done or being contemplated?
When underwriting UC or Crohn’s disease, the underwriter is going to consider a number of factors in determining the rating class. These include current status, the extent of colon involvement, time since diagnosis, treatment, complications, and results of recent colonoscopies. To help gather the details needed for us to provide an accurate quote, please click here to download the colitis and Crohn's questionnaire.
We can often get offers of Standard Plus or Standard on the milder cases, with good follow-up and limited colon involvement. Low to moderate table ratings should be expected for more moderate cases of chronic ulcerative colitis and Crohn’s disease. Severe cases with significant and frequent episodes of inflammation may lead to a postponement until further treatment. Underwriting any form of intestinal disorder can be positively impacted by good nutritional habits, use of vitamin supplements, regular exercise, and good weight control. A cover letter should address any positive lifestyle habits or additional information you’d like the underwriter to know.Download the Questionnaire
As always, we're here to help you answer questions, and provide the best underwriting services possible to help you place cases.
Click here to contact our underwriter, Mike Woods, with specific underwriting questions about colitis & Crohn's disease.