Crohn's Disease impaired risk underwriting

             
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Crohn's Disease

Obtain a tentative life insurance offer for an impaired underwriting risk that involves Crohn's Disease by completing the form below:

* required information

**Please use TAB key to proceed to the next question field, not the ENTER key.**      

Applicant's Name*:
Applicant's Address*:
Applicant's Phone Number*:
Applicant's E-Mail Address*:
Date Of Birth:
Sex: Male Female
Height:
Weight:
Occupation:
Death Benefit:
Type of Product: Term Universal Whole Life
Second to Die Variable
Have you ever used tobacco or nicotine products? Yes No
If yes, what type of product did you use? (Select all that apply)
Cigarettes Cigar Pipe Other
2. Date of first symptoms:
3. Date of diagnosis?
How was it diagnosed?
By history? Yes No
By x-ray studies? Yes No
By biopsy of bowel? Yes No
4. Current symptoms:
5. Current medications:
If on Steroids, Type?
Dosage:

How long have you been on them?
6. Any surgery? Yes No
When?
7. Additional Comments?

 

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Crohn's Disease

Crohn's disease is one of several inflammatory bowel diseases that affect approximately half a million people in the United States. It is a chronic disease that causes inflammation of the digestive tract, typically the small intestine or colon.

Affecting men and women about equally, current theory indicates that bacteria and viruses in the intestinal tract cause an abnormal response by the body's immune system. Some researchers believe that there may be an environmental link. While it can affect people of any age, it most often affects people between the ages of 15 and 35. A second group at elevated risk is people between the ages of 50 and 70. Other risk factors include smoking, family history, and being in higher socioeconomic groups. In addition, Crohn's disease appears more often in the northern latitudes and among Jewish people of European descent.

Individuals with Crohn's disease may experience symptoms for days or weeks at a time and then enter a period of remission that lasts days, weeks, or even years. Symptoms vary by individual and typically develop gradually over time. They may be mild, with minimal impact on quality of life; or severe, with major impact on daily living. In unusual cases, complications may be life-threatening.

The most common complication of Crohn's disease is intestinal blockage, which may require surgery if other treatments to resolve it are not successful. Another common complication is the appearance of fistulas. These are tunnels caused by ulcers that can grow through the affected areas, enter tissue in surrounding organs such as the bladder, the vagina, or skin, and become infected. Malnutrition is another common complication that can occur as a result of decreased appetite and poor intestinal absorption. 

Diagnosis can be difficult due to the gradual development of symptoms and the similarity of Crohn's symptoms with the symptoms of other inflammatory bowel diseases. Diagnosis begins with a thorough physical exam. Blood tests are used to check for elevated white blood cell counts, which indicate inflammation, as well as
decreased red blood cell counts, which can indicate anemia due to intestinal bleeding. Stool samples can also give an indication of intestinal bleeding or infection. Additional tests that may be needed include a Gl series, colonoscopy, x-rays, CT scans, and magnetic resonance imaging (MRI).

SYMPTOMS

4Fatigue
4Fever
4Diarrhea
4Anemia
4Joint aches
4Weight loss
4Loss of appetite
4Abdominal pain
4Rectal bleeding
4Elevated white blood count

Crohn's disease cannot be cured.
The goals of treatment are to relieve symptoms, control the inflammation, and correct nutritional deficiencies. The type of treatment used may vary according to the location and severity of the disease as well as the presence of any complications. Treatment may consist of drug therapy to control inflammation and infection, to suppress the immune system, or to treat bacterial overgrowth in the intestine. Nutritional therapy may be needed to control undernourishment. Fluids and electrolytes are used to treat dehydration as a result of diarrhea.

Finally, surgery may be indicated to relieve symptoms or correct complications that do not respond to other types of treatment. Surgery may be used to remove the inflamed portion of the intestine. However, the inflammation typically returns near the original site of inflammation. Some people will require a colectomy, which is removal of the entire colon. Up to two-thirds of people with Crohn's disease will require some type of surgery.
When examining a case, underwriters look at the date of onset, surgical history, the frequency and duration of attacks, significant weight loss, medications taken during the attack, and maintenance medication taken to prevent flare-ups. Offers can be as favorable as standard for life insurance and preferred for long-term care insurance.


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                                             Crohn's Disease impaired risk underwriting