Insurance problems among inflammatory bowel disease patients: results of a Dutch population based study

M.G.V.M. Russel, B.M. Ryan*, P.C. Dagnelie, M. de Rooij, J. Sijbrandij, A. Feleus, M.A.M. van der Hesselink-Kruijs, J.W.M. Muris, R.W. Stockbrügger

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Insurance problems among inflammatory bowel disease patients: results of a Dutch population based study.

Russel MG, Ryan BM, Dagnelie PC, de Rooij M, Sijbrandij J, Feleus A, Hesselink M, Muris JW, Stockbrugger R.

Department of Gastroenterology, University Hospital Maastricht, Maastricht, The Netherlands.

BACKGROUND AND AIMS: The majority of patients with inflammatory bowel disease (IBD) have a normal life expectancy and therefore should not be weighted when applying for life assurance. There is scant literature on this topic. In this study our aim was to document and compare the incidence of difficulties in application for life and medical insurance in a population based cohort of IBD patients and matched population controls. METHODS: A population based case control study of 1126 IBD patients and 1723 controls. Based on a detailed questionnaire, the frequency and type of difficulties encountered when applying for life and medical insurance in matched IBD and control populations were appraised. RESULTS: In comparison with controls, IBD patients had an 87-fold increased risk of encountering difficulties when applying for life assurance (odds ratio (OR) 87 (95% confidence interval (CI) 31-246)), with a heavily weighted premium being the most common problem. Patients of high educational status, with continuous disease activity, and who smoked had the highest odds of encountering such problems. Medical insurance difficulties were fivefold more common in IBD patients compared with controls (OR 5.4 (95% CI 2.3-13)) although no specific disease or patient characteristics were identified as associated with such difficulties. CONCLUSIONS: This is the first detailed case control study that has investigated insurance difficulties among IBD patients. Acquiring life and medical insurance constituted a major problem for IBD patients in this study. These results are likely to be more widely representative given that most insurance companies use international guidelines for risk assessment. In view of the recent advances in therapy and promising survival data on IBD patients, evidence based guidelines for risk assessment of IBD patients by insurance companies should be drawn up to prevent possible discriminatory practices
Original languageEnglish
Pages (from-to)358-362
Number of pages4
Issue number3
Publication statusPublished - 1 Jan 2003

Cite this