Dear friend,



This special report is written on the request of some of you. With the current interest & concerns on Spinal Muscular Atrophy, an illness which actor Chew Chor Meng had been diagnosed with, I hope this article will enhance your understanding on the illness, and how your insurance with work in this scenario.



Part 1: Understanding Muscular Atrophy

Muscular Atrophy is a genetic disease which affects the part of your nervous system that controls voluntary muscle movements. It is also known as Kennedy's disease, named after Dr. William R. Kennedy.

It is currently incurable, and affects on average 1 in 40,000 people. Muscular Atrophy is a progressive disease, because the condition tends to worsen gradually over the years. Men will usually develop the symptoms, while women tend to be the carriers. Symptoms usually appear between ages 30-50, but may affect the younger as well.

The sufferings include twitching, tremors, muscle cramps, progressive weakness and wasting in the legs, trunks, arms, shoulder, neck and face. These result in affecting one's speech, swallowing and movements, which finally will likely cause one to rely on the wheelchair or be permanently bed-ridden.



Part 2: Key Concerns of a Muscular Atrophy Patient

While this disease is incurable, it does not result in death. To me, the below would be the key concerns which have to be managed. While emotional & family support is important, I will keep this focused on the health and financial aspect.

- Loss of income due to the inability to travel or perform basic task

- High medical bills in hospital treatment and long term medical bills

- Cost of home nursing care, maid employment, health supplements, medications, aids

- Daily expenses especially since men are likely to be the main bread-winner

- Important expenses (e.g. children's university, home mortgage loan etc)

- Home renovation to become wheelchair friendly (e.g. toilet, steps, walking support bars etc)



Part 3: How will my Insurance Claims Work Here?

From the above concerns, the related insurance that is required will be:

1.) Total Permanent Disability (TPD) insurance

2.) 30 Critical Illness (CI) insurance (yes, Muscular Atrophy is one of the 30 illnesses)

3.) Income replacement (IR) insurance

4.) Hospitalisation insurance



Most of us will already have TPD coverage in our life insurance plans, while CI is usually added as a rider to the main plan. Let's assume you have $120,000 TPD cover, and a $50,000 CI rider attached to it.

Upon a doctor's diagnosis of the muscular atrophy, we should be able to obtain the claim of $50,000 first from the CI rider. After which, the main plan would be left with $70,000 for future claims due to either death or TPD.

So when can we claim the $70,000 for TPD? As the patient's condition worsens progressive, he can claim for TPD when he is unable to perform (aided or unaided) at least 3 of the "Activities of Daily Living" for a continuous 6 months. The ADLs includes WASHING, DRESSING, TRANSFERRING, MOBILITY, TOILETING & FEEDING. Once the $70,000 is claimed, the plan lapses.

Seperately, the income replacement insurance will be activated to provide for a continuous source of financial inflow, while your hospital plan can be used to cover for the immediate and future treatment needs which requires hospitalization. However, do note that the above is for your general reference only, as plans from various insurers may work differently.



Part 4: How much Insurance should I Need?

As most of us would already have some amount of insurance, the question then is – how much is enough? Let's take for example, a sole bread-winner age 40, and lives till 70. Normally, his family expenses amount to $2,500 monthly. Here, we need to round up a bit for additional home care needs.



New monthly expenses = S$3,000

No. of Years required = 30 years or 360 months

Total amount required = 360 months x S$3,000 = $1.08 million



It seems a lot, but note we have not taken into account a few factors, such as the spouse going back to work, inflation, thriftier spending habits and current savings etc. You can either insure yourself up to the $1.08million, or simply use an income replacement insurance that pays you S$3,000 a month.

For hospital insurance, do make sure your current plan (using medisave) is "As Charged", covers till age 100 and also check that you have the rider (using cash) to cover for the co-insurance & deductibles portion that is not covered by the medisave plan. DO NOT rely on company insurance, because you will not likely have a job here! The hospital plan is a key part as it helps you retain your cash for your family's own use, and not use it to pay any present or future hospital bills.



Part 5: What Can I Do Now?

My recommendation is simply to do a review on your current insurance plans, to see if you have the adequate amount of coverage in the right areas. Also check on your existing Shield plans to make sure that it is the latest "As Charged" version.

If you are interested to understand more or do a solid review to give you the peace of mind, simply reply this email and I will get back a.s.a.p to you. Thank you, and I hope you will find the above a useful read.