Author Bowtie Team
Updated on 2025-05-27
Disclaimer: This article is translated with the assistance of AI.
Recently, an insurance executive shared on social media about the challenges his son with autism faced in getting insured, sparking industry discussions. Why is it hard for children with autism to get insurance?
What Is Autism?
Autism Spectrum Disorder (ASD) is a developmental disorder present from birth. Since 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has unified previously separate categories such as “autism,” “Asperger’s syndrome,” and “pervasive developmental disorder not otherwise specified” under “Autism Spectrum Disorder.”
Individuals with autism experience varying degrees of difficulties and developmental differences in social communication, cognition, emotions, and behavior. According to DSM-5, autism can be classified into three levels of severity: “requiring very substantial support,” “requiring substantial support,” and “requiring support.”
Children Autism Cases Rising in Hong Kong
1. Census and Statistics Department Data
Since 2001, the Census and Statistics Department has periodically released the Persons with Disabilities and Chronic Diseases Thematic Report , which includes estimated figures for the percentage of children under 15 years old with autism in Hong Kong. As shown in the table below, this percentage has shown a multiple-fold increasing trend since its first release.
Table: Percentage of Autism Children Under 15 Years Old in Hong Kong
| Survey Period | Hong Kong Percentage of Autism Children Under 15 Years Old |
| January to December 2000 | 0.1% |
| November 2006 to December 2007 | 0.3% |
| January to December 2013 | 0.7% |
| August 2019 to December 2020 | 1.4% |
Source: Census and Statistics Department.
- * The definitions or methods of the above studies may differ.
2. Education Bureau Figures
The Education Bureau regularly publishes data on autism students in public ordinary primary and secondary schools. The number of autism students in both primary and secondary schools is on an upward trend. Over the past 9 academic years, the number of autism students in primary and secondary schools has increased by 57.69% and 165.13% respectively, with a total exceeding 13,000 people.
Data Source: data.gov.hk
Why Are Autism Numbers on the Rise?
The rising trend in Hong Kong’s autism numbers is not a standalone case. Since 2000, autism statistics in many countries or regions worldwide have shown an upward trend, with many reasons , mainly:
- Changes in autism diagnostic criteria;
- Widespread use of early screening tools;
- Increased awareness of autism among the public and healthcare professionals.
Underwriting Standards for Autism Patients
According to 10Life research , the underwriting standards for autism patients in the insurance industry are not yet unified. Generally, medical insurance underwriting requirements are stricter than those for critical illness insurance. Some insurance companies accept underwriting for mild to moderate cases of critical illness and medical insurance, but there may be age restrictions.
Current Procedures
Insurance companies primarily assess risks based on actuarial data and research results. However, the data from insurance companies and medical literature may not accurately reflect the actual risk situation of the current autism population. This is because:
- Changes in the autism population: In recent years, changes in autism diagnostic criteria have led to an increase in diagnoses, especially for mild cases. Therefore, overall, the risk in past autism populations is higher than in the current population.
- Data lag: Insurance companies and medical research typically require long-term observation (possibly ten years or more) to accurately assess risks, and underwriting guidelines are updated based on relevant data.
Based on existing data, autism patients have a higher risk compared to the general population:
- Mortality rate: Approximately 2 to 3 times that of the general population
- Medical expenses: At least 4 times that of the general population
Data Source: Reinsurance companies
- * Different insurance companies may have varying risk assessments.
Facing these higher risks, insurance companies usually adopt the following strategies:
- Additional premium ( Loading ): Typically not exceeding 150% to 300% (depending on the insurance company or product), as excessively high premiums might negate the leverage effect of insurance, making it similar to self-insurance.
- Coverage restrictions : Exclusions may be added to the policy to balance risks.
- Declination : For cases with higher risk assessments, the insurance company may choose to decline coverage.
What Is Self-Insurance?
Self-insurance is a risk management approach where an individual or organization bears potential losses themselves, rather than transferring the risk to an insurance company. This is often used when avoiding or transferring risks is relatively costly.
For example, an employer might set aside funds to provide medical coverage for employees instead of purchasing group medical insurance. At the individual level, it could involve opting out of certain insurance policies and saving an emergency fund to cover future accidents or losses.
Future Trends
As cases of mild conditions increase, more insurance companies are expected to introduce specialized products for individuals with autism, particularly in the voluntary medical insurance sector. These products may balance risks and coverage by imposing certain limitations to enable underwriting for autism patients.
Bowtie’s Key Considerations for Underwriting Autism Patients
Bowtie currently accepts individuals aged 18 or above with autism for life insurance, critical illness insurance, and voluntary medical insurance. During the underwriting process, we conduct a comprehensive assessment of the insured’s situation. Here are the 5 main considerations:
1. Autism Severity Assessment Results
We review the doctor’s diagnostic report to understand the severity of the insured’s autism. The assessment may include aspects such as social interaction, communication skills, and behavioral patterns.
2. IQ Assessment Results
We examine the latest IQ test results to evaluate the insured’s cognitive abilities.
3. Presence of Any Mental, Neurological, or Congenital Conditions / Behavioral Issues
We assess whether the insured has any mental, neurological, or congenital conditions, behavioral issues, or other related disorders that could impact overall health risks.
4. Impact on Daily Life
We consider the extent to which autism affects the insured’s daily life, such as their ability to communicate independently, self-care capabilities, or need for assistance from others.
5. Employment Status or Enrollment in Education
We review the insured’s employment status or educational level to assess their social adaptability and potential for independent living.
Get Insured While You’re Healthy!
Insure your child while they are healthy to easily secure coverage from insurance companies. As they age, health conditions may change, leading to more restrictions or even denial of coverage. Therefore, planning insurance early for your child is not only a wise investment for the future but also provides extra protection and less worry as they grow.
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