WHY I SHOULD KNOW THIS ...
What is body mass index ?
Body mass index ( BMI ) is a medical screening tool used to estimate the amount of body fat an individual has by using their height and weight measurements . It assists in assessing risk factors for certain health conditions . BMI is calculated by using weight in kilogrammes divided by the square of height in meters .
In most individuals , BMI correlates to body fat . The higher the number , the more body fat they may have . BMI alone does not diagnose health . Therefore , PPS uses BMI and other tests to assess health status and risks .
In the insurance industry , the BMI score determines whether an applicant belongs to the low- or high-risk category and proposes a premium amount accordingly . An outside normal range of weight , whether low or high , usually translates to a BMI outside the normal range of 18.5 to 24.9 .
WHAT IS PPS ’ S VIEW ON BMI ? Underwriting The application form requires a member to input their weight , height and waist circumference . Some applicants may be asked to have a short medical report done by a nurse who will then measure their height , weight and chest and waist circumference . PPS underwriters will work out the member ’ s BMI . If it is raised above a certain level , a loading will be placed on the policy . The cover may be declined if it is very high or if a member has significant co-morbid conditions .
Claims Members do not claim for obesity but rather for its complications . They are likely to claim for cardiovascular disease , e . g ., heart attack , stroke and musculoskeletal conditions , such as knee osteoarthritis requiring joint replacement . Obesity is also a risk factor for conditions such as gallstones and type 2 diabetes . There is also an increased risk of complications following surgery , e . g ., infection .
EXAMPLES Example 1 A 45-year-old male , working as a managing director , has been a PPS member since 1 June 2015 , with the PPS Sickness and Permanent Incapacity benefit as well as Critical Illness Cover . At the time of underwriting , he had a BMI of 35 and well-controlled hypertension , which resulted in a loading being placed on his benefits . In April 2024 , he suffered a heart attack and successfully claimed from both his Sickness benefit and Critical Illness Cover , demonstrating the value of his cover during a critical time .
Example 2 A 32-year-old female nurse became a PPS member on 1 April 2019 , with a PPS Sickness and Permanent Incapacity benefit in place . At the time of underwriting , she had a BMI of 36 , which led to a loading being applied to her cover . On 5 August 2023 , she was diagnosed with gallstones and underwent a cholecystectomy . Following the surgery , she developed wound sepsis , requiring an extended period of wound care . Fortunately , she had a successful sickness claim , providing her with the support needed during this challenging time .
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