This month we celebrate Women’s History Month, but did you know that March is also National Autoimmune Diseases Awareness Month? This is not likely just a coincidence as autoimmune diseases are much more prevalent in women than in men. In fact, 23.5 million Americans are affected by autoimmune disease and almost 80% of that population is women. As a result, a considerable number of AgencyONE’s cases involve underwriting women with autoimmune diseases.
In this One Idea, we will discuss what autoimmune diseases are and examine a few that are seen most often in women and their impact on life insurance underwriting. Most importantly, you will gain an understanding that AgencyONE’s (predominantly female *wink wink*) Underwriting Team is equipped to successfully target and negotiate these histories resulting in a positive outcome on your next autoimmune disease case!
WHAT IS AN AUTOIMMUNE DISEASE?
Your immune system is an extensive network of organs and cells that are tasked with protecting your body from viruses, bacteria, fungi, and any other foreign invader that is attempting to do harm through infection, illness, etc. In some individuals, their immune system ends up attacking the body’s healthy cells for no apparent reason. The result of that attack is an autoimmune response by the body leading to autoimmune disease when healthy tissue is affected. Unfortunately, there is still no clear understanding as to why this happens, although there are theories, but, again, no definitive answers. However, what we do know is that there are several risk factors that can contribute to the development of autoimmune diseases. To name just a few, genetics, obesity, smoking, and even certain medications can all play a role.
WHAT ARE SOME OF THE MOST COMMON AUTOIMMUNE DISEASES IN WOMEN?
There are over 100 autoimmune diseases, but in the spirit of Women’s History Month we are going to discuss a brief list that are more common in women and those we most frequently see from the clients who our AgencyONE 100 advisors are asking us to underwrite.
Systemic lupus erythematosus (SLE) is the most common form of lupus. It deserves special attention in this discussion considering 90% of those dealing with the disease are women. With SLE, the body’s immune system attacks its own tissues resulting in inflammation that can affect multiple organs including the joints, lungs, kidneys, brain, skin, you name it!
Thyroid diseases, more specifically hypothyroidism and hyperthyroidism, are related to the body producing too little (hypo) or too much (hyper) thyroid hormone. The list of potential symptoms for each are varying, but they have quite a few risk factors in common. Women, over age 60, with a personal or family history of other thyroid problems and/or other autoimmune diseases (i.e., Type I diabetes) are at a greater risk of hypothyroidism or hyperthyroidism when compared to the overall population.
Rheumatoid Arthritis is another inflammatory autoimmune disease characterized by painful swelling typically occurring in the joints. However, it can wreak havoc on other systems within the body, such as the eyes, heart, and lungs.
Psoriasis is an autoimmune disease that initially affects the skin but can develop into psoriatic arthritis. The skin presentation of psoriasis tends to appear as red, patchy lesions with a silvery scale. They can be tender to the touch or itchy. If an individual with psoriasis notices joint swelling and pain, it is likely that their disease has developed into psoriatic arthritis.
WHY ARE AUTOIMMUNE DISEASES MORE PREVALENT IN WOMEN?
There are many hypotheses as to why women are more prone to autoimmune diseases than men, and there is an abundance of research available surrounding this topic. One 2020 review from NIH concluded that, “eighty percent of all individuals affected by autoimmune disorders tend to be women due to variation within the sex chromosomes and hormonal changes.” Luck of the biological draw? Add it to the list with menstruation, menopause…but I digress.
WHAT DOES AUTOIMMUNE DISEASE MEAN FOR UNDERWRITING?
With the majority of autoimmune diseases, our focus in underwriting is:
- Disease duration;
- Disease symptoms;
- Disease severity (mild/moderate/severe);
- Form(s) of treatment used; and
- Impact on additional body systems (i.e., cardiac involvement).
It is worth noting that the risk for developing heart disease is higher for individuals who have autoimmune disorders. Heart disease remains the leading cause of death in the United States.
Let’s look at a case we recently negotiated involving a female applicant living with systemic lupus erythematosus.
AUTOIMMUNE DISEASE CASE STUDY
Ms. Knowles is a 40-year-old non-smoking female with a history of Systemic Lupus Erythematosus which was diagnosed 10 years ago. Her mild symptoms are well controlled with 200mg of Plaquenil, an immunosuppressant medication taken daily. There is no renal, cerebral, cardiac, or respiratory involvement with her lupus. Additionally, Ms. Knowles does not report any other significant medical impairments. She maintains an optimal build and engages in aerobic exercise five times per week. Ms. Knowles is a successful businessperson seeking $10,000,000 of 20-year Term key person life insurance coverage. AgencyONE targeted her case at three of our carrier partners based on their underwriting competitiveness. Carrier X and Carrier Y offered Table B/2 rates due to her lupus history and treatment with Plaquenil. However, AgencyONE utilized the crediting opportunities at Carrier Z and negotiated a Standard Non-Tobacco rate!
This month we celebrate women and, at the same time, hope to spread awareness about the autoimmune diseases that can greatly impact their lives, their families, and the underwriting for the life insurance protection they need and deserve. The Underwriting Team at AgencyONE is here to help you and your female clients who may be suffering with Autoimmune diseases.