🎯 Bottom Line Up Front
This comprehensive guide explains how insurance companies evaluate epilepsy across different seizure types and control levels, clarifies which clinical factors most influence rate classifications, identifies documentation strategies that optimize approval odds, and provides realistic premium expectations based on seizure-free duration and overall management quality.
Americans living with epilepsy
Seizure-free period for optimal rates
Achieve seizure control with medication
Understanding Epilepsy: Types and Classifications
Key insight: Life insurance underwriters classify epilepsy along multiple dimensions including seizure type, underlying etiology, age at onset, and control status, with each classification carrying distinct risk implications and mortality associations.
Epilepsy encompasses a diverse group of seizure disorders with varying presentations, causes, and prognoses. The International League Against Epilepsy classification system helps underwriters assess risk based on specific seizure characteristics and underlying pathology.
Generalized Seizures
Both Brain Hemispheres Involved
- Tonic-clonic (grand mal)
- Absence (petit mal)
- Myoclonic seizures
- Atonic (drop attacks)
- Higher injury risk
- More conservative underwriting
Focal (Partial) Seizures
Localized Brain Region
- Aware (simple partial)
- Impaired awareness (complex partial)
- May progress to generalized
- Variable severity
- Outcome-dependent underwriting
Unknown Onset
Classification Uncertain
- Inadequate information
- Unwitnessed events
- Requires further evaluation
- Conservative rating until clarified
Beyond seizure type, the underlying cause significantly influences underwriting assessment. Epilepsy etiology falls into several broad categories with distinct prognostic implications.
| Epilepsy Etiology | Characteristics | Insurance Implications |
|---|---|---|
| Idiopathic/Genetic | No identifiable structural cause; presumed genetic predisposition | Often begins in childhood; many respond well to treatment; favorable if well-controlled |
| Structural/Symptomatic | Brain injury, stroke, tumor, infection, or developmental abnormality | Underlying condition drives risk assessment; variable outcomes depending on cause |
| Post-Traumatic | Following significant head injury or trauma | Timing matters (early vs late onset post-injury); severity of trauma assessed |
| Metabolic | Result of metabolic disorder, electrolyte imbalance, or systemic disease | Correcting underlying cause may resolve seizures; favorable if resolved |
| Unknown | No clear etiology identified despite workup | Uncertainty creates conservative underwriting; comprehensive evaluation required |
Professional Insight
“The phrase that transforms epilepsy underwriting is ‘well-controlled on medication with no seizures for X years.’ When applicants can document extended seizure-free periods with stable medication regimens and regular neurologist follow-up, we can position cases very favorably. The challenge arises with recent diagnoses, frequent breakthrough seizures, or medication non-compliance. An applicant with childhood-onset idiopathic epilepsy who’s been seizure-free for 5 years on monotherapy might achieve Standard rates. Someone with structural epilepsy from traumatic brain injury having monthly seizures despite polytherapy faces postponement or heavy table ratings. The diagnosis puts you on the underwriting radar, but your control level determines your outcome.”
– InsuranceBrokers USA – Management Team
⚠️ High-Risk Seizure Types and Presentations
Certain seizure characteristics raise particular underwriting concerns:
- Tonic-clonic (grand mal) seizures: Complete loss of consciousness with injury risk from falls and accidents
- Atonic seizures (drop attacks): Sudden loss of muscle tone causing falls and head injuries
- Status epilepticus: Prolonged seizures or repeated seizures without recovery; medical emergency
- Nocturnal seizures: Seizures occurring during sleep; higher SUDEP risk
- Seizures while driving: Previous accidents or loss of consciousness behind the wheel
- Seizures with prolonged post-ictal state: Extended confusion or impairment after seizure
- Refractory epilepsy: Seizures continuing despite trials of multiple medications
How Life Insurance Companies Evaluate Epilepsy
Key insight: Modern epilepsy underwriting employs a risk stratification framework that prioritizes seizure frequency and control above all other factors, then layers in considerations of seizure type, underlying cause, medication complexity, and associated risks.
Life insurance medical underwriting for epilepsy follows a systematic evaluation examining multiple clinical dimensions. Understanding these specific assessment criteria allows applicants to prepare documentation addressing underwriter concerns directly.
| Evaluation Factor | What Underwriters Examine | Impact on Rating |
|---|---|---|
| Time Since Last Seizure | Duration of seizure-free period in months/years | Most critical factor: longer seizure-free = better rates |
| Seizure Frequency | How often seizures occur when not controlled | Weekly/monthly seizures much worse than yearly/rare events |
| Seizure Type | Generalized tonic-clonic vs focal vs absence | Generalized tonic-clonic receives most conservative rating |
| Age at Diagnosis | When epilepsy first diagnosed | Childhood onset often more favorable than adult-onset |
| Underlying Cause | Idiopathic vs structural vs post-traumatic | Benign causes better than structural brain lesions |
| Medication Regimen | Monotherapy vs polytherapy; medication complexity | Single medication optimal; multiple drugs suggest difficult-to-control disease |
| Medication Compliance | Adherence to prescribed antiepileptic drugs | Non-compliance dramatically worsens outcomes |
| EEG Findings | Brain wave patterns, epileptiform activity | Persistent abnormalities suggest ongoing risk |
| Brain Imaging | MRI/CT findings; structural abnormalities | Tumors, malformations, or significant damage worsen rating |
| Complications History | Status epilepticus, injuries, accidents, hospitalizations | Any serious complications significantly worsen assessment |
| Driver’s License Status | Whether permitted to drive; any seizures while driving | License restrictions suggest recent/ongoing seizures |
| Occupation | Whether job involves heights, machinery, driving | High-risk occupations compound epilepsy concerns |
| Neurologist Follow-up | Regular specialist care and monitoring | Consistent follow-up demonstrates appropriate management |
For more insights on how various medical conditions affect coverage decisions, see our comprehensive guide on Life Insurance Approvals with Pre-Existing Medical Conditions.
✓ Optimal Epilepsy Profile for Insurance
Applicants with these characteristics typically receive most favorable underwriting outcomes:
- Extended seizure-free period: 2-5+ years without any seizure activity
- Stable medication: Well-controlled on single antiepileptic drug at consistent dosage
- Favorable etiology: Idiopathic epilepsy or resolved acute symptomatic cause
- Childhood onset: Diagnosed in youth, now well-controlled in adulthood
- Focal seizures only: Never experienced generalized tonic-clonic seizures
- Excellent compliance: Perfect adherence to medication regimen
- Normal imaging: MRI/CT showing no structural brain abnormalities
- Regular monitoring: Consistent neurologist follow-up with stable EEGs
- No complications: Never experienced status epilepticus or serious injuries
- Driver’s license: Legally permitted to drive, demonstrating medical control
- Safe occupation: Employment not involving heights, machinery, or commercial driving
Seizure Control: The Most Critical Factor
Key insight: Time since last seizure represents the single most powerful predictor of underwriting outcome, with risk classifications improving progressively as seizure-free duration extends from months to years.
Insurance underwriters view epilepsy through a control-based lens that fundamentally divides applicants into controlled versus uncontrolled categories. Within controlled epilepsy, further stratification occurs based on seizure-free duration, creating a natural progression of improving outcomes over time.
Active Uncontrolled Epilepsy
Seizures Within Past 6-12 Months
Typical Outcome: Postponement or Decline
- Recent seizure activity indicates inadequate control
- Medication adjustments ongoing
- Risk of injury, accidents, and SUDEP elevated
- Most carriers postpone until 12-24 months seizure-free
- Frequent seizures (monthly/weekly) may result in decline
Exception: Some high-risk carriers may consider with heavy table ratings (F-H) if seizures are infrequent (1-2 per year) and non-convulsive.
Recently Controlled (6-12 Months Seizure-Free)
Typical Outcome: Table D to Table H
- Initial control achieved but insufficient time to demonstrate stability
- Breakthrough seizure risk still elevated
- Medication regimen may not yet be optimized
- Conservative ratings reflect uncertain long-term control
Expected ratings: Table E-G (125-175% premium increase) for most profiles. Better outcomes possible for very mild epilepsy with rapid control achievement.
Good Control (1-2 Years Seizure-Free)
Typical Outcome: Table B to Table E
- Substantial control period demonstrates medication effectiveness
- Breakthrough risk significantly reduced but still present
- Medication stability established
- Many carriers begin offering reasonable rates at this timeframe
Expected ratings: Table B-C (50-75% increase) for favorable profiles; Table D-E (100-125% increase) for more complex cases.
Excellent Control (2-5 Years Seizure-Free)
Typical Outcome: Standard to Table C
- Extended seizure-free period substantially reduces recurrence risk
- Stable long-term medication regimen established
- Most carriers comfortable with this control duration
- Standard rates possible for best-case scenarios
Expected ratings: Standard to Table A (standard to 25% increase) for simple well-controlled cases; Table B-C (50-75% increase) for more complex profiles.
Extended Control (5+ Years Seizure-Free)
Typical Outcome: Standard to Table B
- Half-decade or more seizure-free demonstrates excellent long-term control
- Risk approaches general population in some studies
- Some carriers offer standard rates at this duration
- Optimal outcomes for favorable epilepsy types
Best-case scenario: Standard rates achievable for idiopathic epilepsy, childhood onset, monotherapy, 5-10+ years seizure-free, normal imaging, excellent compliance.
Professional Insight
“The most common question we receive from epilepsy patients is ‘how long do I need to be seizure-free to get decent rates?’ The answer varies by carrier and case complexity, but general patterns are consistent. At 12 months seizure-free, you’re typically looking at table ratings of D-F. At 24 months, that improves to B-D. At 36-48 months, Standard to Table B becomes realistic for favorable cases. Each additional year of seizure-free history incrementally improves your position. We’ve seen applicants receive Table F at 18 months post-seizure, then reapply at 36 months and achieve Table B—same medical profile, just additional seizure-free time, saving thousands in premiums over the policy term.”
– InsuranceBrokers USA – Management Team
Breakthrough Seizures and Impact
A single breakthrough seizure after an extended seizure-free period creates underwriting challenges but doesn’t necessarily reset the clock to zero:
- Isolated breakthrough: Single seizure after 3+ years seizure-free may be viewed more favorably than frequent seizures
- Identifiable trigger: Seizure due to medication non-compliance, illness, or sleep deprivation may be considered circumstantial
- Medication adjustment: If breakthrough led to dose increase and subsequent control, documents recovery process
- Timing matters: How long since the breakthrough seizure occurred factors into current assessment
- Pattern evaluation: Isolated events treated differently than pattern of recurring breakthrough seizures
Applicants who experience breakthrough seizures should wait 12-24 months after re-establishing control before applying to demonstrate stability. Comprehensive documentation explaining the breakthrough event and subsequent management strengthens the application.
Medication Management and Compliance
Key insight: The complexity of antiepileptic drug regimen and documented medication compliance provide underwriters with critical insights into disease severity and patient reliability, significantly influencing rate classifications.
Antiepileptic drug therapy represents the cornerstone of epilepsy management, and underwriters carefully evaluate both the medication regimen itself and the applicant’s adherence to prescribed therapy.
Monotherapy
Single Antiepileptic Drug
- Simplest medication regimen
- Indicates easily controlled epilepsy
- Fewer side effects
- Better compliance typically
- Most favorable underwriting
Common examples: Levetiracetam, lamotrigine, valproate, carbamazepine
Polytherapy (2 drugs)
Two Antiepileptic Drugs
- More complex regimen
- Suggests initial monotherapy insufficient
- Increased side effect potential
- Variable underwriting impact
- Acceptable if well-controlled
Assessment factor: How long on current regimen; seizure control achieved
Multiple Drug Therapy
Three or More AEDs
- Complex refractory epilepsy
- Multiple medication trials failed
- Difficult-to-control disease
- Significant side effect burden
- Conservative underwriting
Typical outcome: Heavy table ratings or postponement even if currently controlled
| Medication Factor | Favorable | Concerning |
|---|---|---|
| Number of AEDs | Monotherapy (single drug) | Three or more medications |
| Dosage Stability | Same dose for 2+ years | Frequent dose adjustments |
| Medication Changes | Stable regimen, no recent changes | Multiple medication switches in past year |
| Compliance | Perfect adherence documented | Admitted non-compliance or seizures due to missed doses |
| Side Effects | Well-tolerated, no significant issues | Serious side effects requiring monitoring or changes |
| Drug Levels | Therapeutic levels on monitoring | Subtherapeutic levels or non-compliance indicators |
⚠️ Medication Non-Compliance: Critical Red Flag
Medication adherence represents one of the most controllable factors in epilepsy management, and documented non-compliance creates serious underwriting concerns:
- Breakthrough seizures due to missed doses: Demonstrates unreliable behavior and increased risk
- Subtherapeutic drug levels: Laboratory evidence of inadequate medication intake
- Self-reported non-adherence: Admitting to skipping doses or irregular compliance
- Prescription fill patterns: Gaps in refills or inconsistent medication procurement
- Physician documentation: Notes describing compliance challenges or concerns
Non-compliance may result in decline or postponement even if epilepsy is otherwise well-characterized and potentially controllable. Underwriters view medication adherence as predictive of future behavior and risk management capability. Conversely, documented excellent compliance with perfect seizure control represents the strongest possible profile.
✓ Demonstrating Excellent Medication Management
Strengthen your application by documenting these positive factors:
- Consistent prescription refills: Regular timely refills with no gaps
- Therapeutic drug monitoring: If applicable, drug levels consistently in therapeutic range
- Medication compliance tools: Use of pill organizers, reminders, or tracking apps
- Pharmacy records: Complete refill history showing adherence
- Physician attestation: Neurologist letter specifically stating excellent compliance
- Seizure freedom correlation: Clear connection between medication adherence and seizure control
- Lifestyle accommodation: Demonstrable commitment to taking medications consistently despite travel, schedule changes, etc.
High-Risk Factors and Complications
Key insight: Certain epilepsy-related complications and risk factors dramatically worsen underwriting outcomes beyond the baseline seizure disorder assessment, with some complications potentially resulting in decline regardless of current seizure control.
Life insurance underwriters evaluate epilepsy not just on seizure frequency but on associated risks and complications that substantially elevate mortality and morbidity concerns.
Status Epilepticus
Medical Emergency
- Prolonged seizure (>5 minutes) or repeated seizures without recovery
- Can cause permanent brain damage or death
- Requires hospitalization and intensive treatment
- History significantly worsens underwriting
- Recent episode may result in decline
SUDEP Risk
Sudden Unexpected Death in Epilepsy
- Sudden death in person with epilepsy, no other cause found
- Highest risk: frequent tonic-clonic seizures, poor control
- Risk factors compound underwriting concerns
- Young adults particularly vulnerable
- Major consideration in all epilepsy underwriting
Injury History
Seizure-Related Accidents
- Fractures, burns, head injuries from seizure falls
- Motor vehicle accidents during seizures
- Drowning risk (bathtub, swimming)
- Pattern of injuries suggests poor control
- Occupational hazards compounded
Cognitive/Psychiatric Issues
Associated Conditions
- Depression and anxiety common in epilepsy
- Cognitive impairment from seizures or medications
- Increased suicide risk in epilepsy population
- Each condition assessed separately
- Compounds overall risk profile
⚠️ High-Risk Occupations with Epilepsy
Certain occupations dramatically amplify underwriting concerns due to safety implications of potential seizures:
- Commercial drivers: CDL holders face strict medical certification requirements; seizure history often disqualifying
- Pilots: Aviation medical certification prohibits most epilepsy diagnoses
- Heavy equipment operators: Construction, manufacturing, mining machinery operation
- Heights work: Scaffolding, roofing, cell tower technicians, window washers
- Electrical work: Risk of electrocution during seizure-related incidents
- Professional divers: Underwater seizures potentially fatal
Applicants in these occupations with epilepsy diagnoses may face occupation exclusions, disability income coverage as primary need, or decline for life insurance regardless of seizure control. Lower-risk occupations receive more favorable consideration for same medical profile.
Refractory Epilepsy: Complex Underwriting
Refractory or drug-resistant epilepsy (seizures continuing despite adequate trials of two or more appropriate AEDs) presents particularly challenging underwriting scenarios:
- Definition: Ongoing seizures despite optimal medication management
- Prevalence: Approximately 30% of epilepsy patients have refractory disease
- Treatment options: May require epilepsy surgery, VNS implant, ketogenic diet, or investigational therapies
- Underwriting approach: Even with surgical intervention, outcomes depend on post-surgical seizure freedom
- Typical outcome: Heavy table ratings (F-H), postponement, or decline depending on current control and treatment response
Applicants with refractory epilepsy who undergo successful surgical resection achieving seizure freedom for 2-3+ years may eventually qualify for moderate table ratings. However, continued seizures despite multiple interventions typically result in decline from standard carriers, necessitating high-risk specialty markets.
Essential Medical Documentation
Key insight: Comprehensive neurological documentation demonstrating seizure type, underlying cause, treatment response, and extended control period eliminates underwriter uncertainty and enables accurate risk assessment.
Complete Documentation Package for Epilepsy Applications
Assemble these documents before initiating your application:
- Neurology consultation notes: Complete records from past 2-3 years showing ongoing epilepsy management
- Initial diagnostic workup: Records from time of diagnosis including presenting symptoms and circumstances
- EEG reports: All electroencephalogram studies showing brain wave patterns and epileptiform activity
- Brain imaging: MRI or CT scan reports showing structural findings or absence thereof
- Seizure diary or log: Documented history of seizure frequency and characteristics over time
- Current medication list: All antiepileptic drugs with dosages and duration of current regimen
- Medication trial history: Previous AEDs tried, why changed, response to each
- Pharmacy records: Prescription refill history demonstrating medication compliance
- Drug level monitoring: If applicable, therapeutic drug monitoring results
- Driver’s license status: Current license and any restrictions or reinstatement documentation
- Emergency department records: Any ER visits for seizures, injuries, or status epilepticus
- Hospital discharge summaries: If any hospitalizations related to epilepsy
- Surgical records: If epilepsy surgery performed, complete operative reports and outcomes
- VNS or RNS documentation: If neurostimulator implanted, device information and programming
✓ Optimal Neurologist Summary Letter
Request your neurologist provide a comprehensive letter for insurance purposes including:
- Epilepsy classification: Specific seizure type(s), whether generalized or focal
- Underlying etiology: Idiopathic, structural, genetic, or unknown; imaging findings
- Diagnosis date: When epilepsy first diagnosed and initial presentation
- Seizure history: Frequency and severity over time; pattern of control
- Current status: Date of last seizure; seizure-free duration if applicable
- Medication regimen: Current AED(s), dosages, duration on current regimen, stability
- Medication compliance: Specific statement about adherence quality
- Treatment response: How well controlled; any breakthrough seizures and circumstances
- Complications: Any history of status epilepticus, injuries, or serious events
- Prognosis statement: Expected long-term outlook and probability of continued control
- Functional status: Impact on daily activities, work, driving
- Monitoring plan: Frequency of follow-up and surveillance strategy
Our guide on Top 10 Best Life Insurance Companies in the U.S. (2025): Expert Broker Rankings can help identify carriers most likely to provide favorable consideration for neurological conditions like epilepsy.
Expected Rate Classifications by Epilepsy Profile
Key insight: Rate classifications for epilepsy range from Standard (best-case scenarios with extended control) to decline (active uncontrolled seizures), with the vast majority of applicants falling in the Table B through Table E range depending on seizure-free duration and case complexity.
✓ Standard Rates (Achievable for Best Cases)
Applicant Profile:
- Idiopathic epilepsy diagnosed in childhood or adolescence
- 5-10+ years completely seizure-free
- Well-controlled on monotherapy with stable medication
- No generalized tonic-clonic seizures, only focal or absence types
- Normal brain imaging (MRI/CT)
- Normal or mildly abnormal EEG
- Perfect medication compliance documented
- No complications, injuries, or status epilepticus history
- Active driver’s license without restrictions
- Age under 50
- Excellent overall health
Premium Impact: Standard rates. Typical $55-80/month for $500,000 20-year term for healthy 40-year-old.
Table A-B (Mild Premium Increase)
Applicant Profile:
- Well-controlled epilepsy, 3-5 years seizure-free
- Monotherapy or simple two-drug regimen
- Favorable seizure type (focal or absence)
- Benign underlying cause or idiopathic
- Excellent medication compliance
- No recent complications or injuries
- Regular neurologist follow-up
- Normal or near-normal brain imaging
- Permitted to drive
Premium Impact: 25-50% increase. $70-110/month for $500,000 20-year term for 40-year-old.
Table C-D (Moderate Premium Increase)
Applicant Profile:
- Controlled epilepsy, 2-3 years seizure-free
- May have history of tonic-clonic seizures but now controlled
- On stable medication regimen (1-2 drugs)
- Good but not perfect compliance
- Structural cause identified but stable (old head injury, resolved infection)
- Occasional mild EEG abnormalities
- No recent serious complications
- May have had isolated breakthrough seizure with explanation
Premium Impact: 75-100% increase. $95-140/month for $500,000 20-year term for 40-year-old.
Table E-G (Significant Premium Increase)
Applicant Profile:
- Recently controlled epilepsy, 1-2 years seizure-free
- History of frequent or severe seizures before current control
- Polytherapy (2-3 medications) required for control
- Generalized tonic-clonic seizure type
- Structural brain abnormality present
- History of complications or injuries from seizures
- Recent medication adjustments
- May have had status epilepticus in past (not recent)
- Compliance concerns addressed but historical issues
Premium Impact: 125-175% increase. $125-200/month for $500,000 20-year term for 40-year-old.
Table H, Postponement, or Decline
Applicant Profile:
- Active uncontrolled seizures within past 6-12 months
- Frequent seizures (monthly or more often)
- Refractory epilepsy despite multiple medication trials
- Recent status epilepticus or serious complications
- Multiple AED regimen (3+ drugs) with suboptimal control
- Documented medication non-compliance
- Serious injuries from seizures
- Seizures while driving or high-risk occupation
- Progressive neurological condition causing seizures
- Brain tumor or other serious structural lesion
Outcome: Table H (200% increase), postponement for 12-24 months until control established, or decline depending on severity and circumstances.
Professional Insight
“Rate classification in epilepsy cases correlates more tightly with seizure-free duration than almost any other factor. We maintain detailed tracking data showing that applicants at 12 months seizure-free average Table E ratings, at 24 months average Table C, at 36 months average Table B, and at 60+ months achieve Standard rates in approximately 40% of favorable cases. The progression is remarkably consistent across carriers. This data-driven pattern underscores the value of strategic timing—applying at 18 months versus waiting until 30 months for the same applicant can mean the difference between Table D and Table B, potentially $2,000-3,000 in premium savings over a 20-year term.”
– InsuranceBrokers USA – Management Team
Application Strategy and Timing
Key insight: Strategic application timing coordinated with seizure-free period milestones, combined with comprehensive documentation preparation and understanding of alternative coverage options, optimizes outcomes for epilepsy applicants across all severity levels.
✓ Optimal Application Timeline Strategy
Active Seizures (Within Past 6 Months):
- Action: Do not apply for traditional coverage (will be declined or postponed)
- Focus: Work with neurologist to optimize medication regimen and achieve control
- Documentation: Maintain detailed seizure diary to establish seizure-free date when achieved
- Alternative: Consider guaranteed issue small policy if immediate coverage critically needed
Recently Controlled (6-12 Months Seizure-Free):
- Action: May consider applying if coverage urgently needed, understanding heavy table ratings likely
- Strategic consideration: Waiting 6-12 additional months typically improves rating by 2-4 table classes
- Best candidates for early application: Mild focal epilepsy, rapid control achievement, excellent compliance, favorable age
- Documentation focus: Emphasize medication compliance, seizure-free period, positive prognosis
Good Control (1-2 Years Seizure-Free):
- Action: Reasonable timing for most applicants who need coverage
- Expected outcomes: Table B-E depending on profile complexity
- Advantage: Substantial control period demonstrated, medication stability established
- Carrier selection critical: Some carriers much more favorable than others at this timeframe
Excellent Control (2-5 Years Seizure-Free):
- Action: Optimal timing for majority of applicants
- Expected outcomes: Standard to Table C for favorable profiles
- Advantage: Extended stability substantially reduces underwriter concerns
- Documentation: Comprehensive package showing long-term stability and management
Extended Control (5+ Years Seizure-Free):
- Action: Best possible timing, standard rates achievable for many cases
- Strategic consideration: Balance additional waiting with age-related premium increases
- Re-rating opportunity: If obtained coverage earlier with table ratings, consider reapplying for better classification
⚠️ Common Application Mistakes
- Applying too soon after last seizure: Results in postponement or poor rating when patience would yield better outcome
- Incomplete seizure history: Vague descriptions of “occasional seizures” insufficient; specific dates and frequencies required
- Lack of specialist care: Self-reported epilepsy without neurologist documentation raises concerns
- Medication compliance issues: Admitting to missed doses or irregular compliance dramatically worsens outcomes
- Outdated medical records: Neurologist notes over 12-18 months old may trigger requirements for updated evaluation
- Minimizing seizure severity: Downplaying tonic-clonic seizures or complications discovered in medical records creates credibility issues
- Single carrier submission: Without comparison shopping, may accept suboptimal rating when better options exist
Alternative Coverage Options
Guaranteed Issue Life Insurance:
- No health questions or medical exams
- Available immediately regardless of seizure control
- Limited coverage amounts ($5,000-$25,000)
- Graded death benefit (2-3 years)
- Higher premiums but provides immediate protection
Simplified Issue Life Insurance:
- Health questions but no medical exam
- May accept well-controlled epilepsy with 2+ years seizure-free
- Coverage up to $500,000 possible
- Premiums 25-50% higher than fully underwritten
- Faster approval process
Group Life Insurance:
- Employer-sponsored coverage typically no underwriting for base amounts
- Valuable regardless of seizure history
- Maximize available coverage
- Not portable if employment ends
- Consider as foundation, supplement with individual coverage when control established
Accidental Death Coverage:
- Covers death from accidents only
- No medical underwriting
- Relevant given injury risk from seizures
- Significantly lower premiums
- Consider as supplement to primary coverage
For detailed guidance on non-exam options, see our Top 10 Best No-Exam Life Insurance Companies (2025 Update) guide.
Frequently Asked Questions
Can I get life insurance if I have epilepsy?
Yes, most people with epilepsy can obtain life insurance, though rate classifications vary based primarily on seizure control and duration of seizure-free period. Well-controlled epilepsy with 2-5+ years seizure-free often qualifies for Standard to moderate table ratings. Recently diagnosed or poorly controlled epilepsy faces postponement or heavy table ratings. The key is demonstrating excellent control through extended seizure-free periods, medication compliance, and regular neurologist care. Even individuals with more complex epilepsy can secure coverage through specialized carriers or alternative products. Working with brokers experienced in neurological conditions significantly improves outcomes by identifying carriers with favorable epilepsy underwriting.
How long do I need to be seizure-free to get good life insurance rates?
Rate classifications improve progressively with seizure-free duration. At 6-12 months seizure-free, expect table ratings of E-G (125-175% premium increase). At 12-24 months, ratings typically improve to Table C-E (75-125% increase). At 24-36 months, favorable cases may achieve Table B-C (50-75% increase). At 3-5 years seizure-free, Standard to Table B rates become realistic for many applicants. Beyond 5 years, standard rates are achievable for best-case scenarios. The optimal application timing balances seizure-free duration with age-related premium increases and coverage urgency. For most applicants without immediate needs, waiting until 24-36 months seizure-free produces substantially better financial outcomes than applying earlier.
Does the type of seizure I have affect my life insurance application?
Yes, seizure type significantly influences underwriting outcomes. Generalized tonic-clonic (grand mal) seizures receive most conservative assessment due to complete loss of consciousness and injury risk. Focal seizures without impaired awareness typically receive more favorable consideration. Absence seizures, while disruptive, often result in better outcomes than convulsive seizures. Atonic seizures (drop attacks) raise particular concerns due to fall and injury risk. However, seizure type matters less than control status—well-controlled tonic-clonic epilepsy with 3+ years seizure-free receives better consideration than poorly controlled absence seizures with monthly events. Document your specific seizure type and characteristics clearly, as this contextualizes the risk profile underwriters assess.
Will I be declined for life insurance if I’ve had status epilepticus?
History of status epilepticus doesn’t automatically result in decline, but significantly impacts underwriting assessment and timing. Status epilepticus represents a medical emergency with elevated mortality risk and potential for permanent neurological damage. Recent status epilepticus (within 12-24 months) typically results in postponement or decline. Remote history (3-5+ years ago) with subsequent excellent seizure control and no recurrence receives more favorable consideration, though usually adds 1-2 table ratings beyond the baseline epilepsy assessment. Critical factors include how long ago status occurred, whether it was isolated or recurrent, what circumstances triggered it, whether medication non-compliance was involved, current seizure control quality, and preventive measures in place to avoid recurrence.
I’m on multiple epilepsy medications. Will this prevent me from getting coverage?
Multiple medications (polytherapy) don’t prevent coverage but suggest more difficult-to-control epilepsy, resulting in more conservative underwriting. Monotherapy represents the ideal scenario, indicating easily controlled disease. Two-drug combinations are acceptable and common, particularly if achieving good control. Three or more medications raise concerns about refractory epilepsy, even when achieving seizure control. What matters most is whether your current regimen, regardless of complexity, is effectively controlling seizures. If you’re seizure-free for 2-3+ years on a stable three-drug regimen, you can qualify for coverage with table ratings, though likely higher than someone on monotherapy with similar seizure-free duration. Document medication stability and effectiveness clearly in your application.
Does having epilepsy affect my ability to get Preferred rates?
Preferred rates are challenging but not impossible for epilepsy applicants. Requirements typically include idiopathic childhood-onset epilepsy, 5-10+ years completely seizure-free, well-controlled on stable monotherapy, no generalized tonic-clonic seizures, normal brain imaging, excellent medication compliance, no complications history, and excellent overall health. Even meeting these criteria, not all carriers offer Preferred rates for any epilepsy history. Many carriers cap epilepsy cases at Standard rates regardless of control quality. Strategic carrier selection through experienced brokers essential for identifying companies willing to consider Preferred classifications. Most epilepsy applicants achieve Standard to Table B ratings for favorable profiles, which represent excellent outcomes given the condition.
Can I get better rates if I reapply after being seizure-free longer?
Yes, strategic reapplication represents valuable option for epilepsy patients who obtained coverage with table ratings. Life insurance underwriting reflects your health status at application time. If you applied at 18 months seizure-free and received Table D, but now have 4 years seizure-free with continued excellent control, reapplying may yield Table B or even Standard—dramatic improvement. Cost-benefit analysis compares premium savings from improved rating against reapplication effort and any contestability period restart. For policies with $250,000+ face amounts and potential improvements of 2-3+ table classes, reapplication frequently saves $3,000-5,000 over remaining term. Optimal reapplication timing typically occurs at 36-48 months seizure-free if initially applied earlier, or at 60+ months for potential standard rate qualification.
Will my life insurance company find out if I have a seizure after I’m approved?
Insurance companies don’t actively monitor your medical status after policy issuance. However, if you die during the contestability period (typically first 2 years), the insurer investigates the claim and reviews medical records, potentially discovering undisclosed seizures or material misrepresentations. After the contestability period, claims generally cannot be denied except for premium non-payment or outright fraud. The critical point: always disclose your complete medical history accurately on applications. Material misrepresentation or fraud can void coverage even after contestability period. If you experience seizures after obtaining coverage, your existing policy continues unchanged at original premiums—rates don’t increase due to health deterioration. This underscores the value of obtaining coverage when your condition is well-controlled.
Ready to Explore Your Life Insurance Options with Epilepsy?
Our specialized team has extensive experience placing life insurance for individuals with epilepsy across all seizure types and control levels. We understand which carriers offer the most favorable neurological underwriting, how to optimize application timing based on your seizure-free period, and which documentation strengthens your case for better rate classifications. Don’t let epilepsy prevent you from securing the financial protection your family deserves.
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Can it be paid with a money order
William,
Yes, it is possible to pay with a money order in many situations. However, it’s important to note that acceptance of money orders as a form of payment depends on the specific policies being purchased and the individual preferences of the insurance carrier.
Some insurance carriers may accept money orders, while others may not. It’s always a good idea to check with the carrier beforehand to ensure that they will accept a money order as payment.
Thanks,
InsuranceBrokersUSA