Older self-employed lose out on health insurance: What support can pensioners who rely on earned income expect if they should fall ill? Maria Scott reports

JOAN DE BETHEL of Rye in Sussex is in the happy position of having more work than she can cope with. The only problem is that it has come at the wrong time of life.

There is strong demand for the pottery cats she paints and she also exhibits paintings. At nearly 70, she sees no need to stop work and indeed cannot afford to, as she has no private income to supplement her state pension.

Mrs de Bethel, a widow, receivesless than pounds 300 a month from the state but has a mortgage on her home costing pounds 303 a month.

For about 10 years, Mrs de Bethel has had an insurance policy which paid her benefit if she was ill. She has drawn benefits from the policy in the past during periods of illness. The age limit on the policy is 70, however, and in any case the insurer, Sun Alliance, withdrew the product, sold only through brokers, from the market earlier this year.

'I am told all the insurance companies are now stopping at 65 and most at 60,' she said.

'I am now uninsured and this worries me a lot.

'Since there must be a lot of us in the same position as myself - the generations are getting older and some of us working longer - there would seem to be a need for a policy to cover us.

'I have only gotto get a septic index finger and not be able to hold a brush and I could be off work for weeks.'

Sun Alliance says it is still marketing a sickness and accident policy through its direct- to-the-public division but the age limit remains at 70.

Tom Bridgland of Bridgland Insurance Brokers, which sold Mrs de Bethel her policy, said: 'We don't know of an insurer that will take on Mrs de Bethel.

'These policies are not normally written after a certain age. The risk of a claim is greater among older people. You cannot force insurers to take on risks they don't want to cover.'

Penny O'Nions, a consultant with independent financial advisers, De Havilland Financial Management, says people who want to work past retirement date need to plan ahead. She points out that most permanent health insurance policies will pay benefits over a long term, but normally only to retirement age.

The ideal solution, she says, is to organise a decent pension so that you are not reliant on working at this age.

However, people who want to work could make life easier by buying medical insurance cover and perhaps a long-term care policy. 'These would enable an older worker at least to obtain medical treatment quickly and to get back to work as quickly as possible.'

Critical illness insurance, which pays out a lump-sum on diagnosis of serious illness, may also be used. But premiums for the elderly could be expensive and companies may be unwilling to take new policyholders after retirement age.

Another broker suggestedhospital benefit insurance, which pays a benefit when someone is in hospital. But the British Health Care Association, which represents these insurers, says that most schemes shut their doors to new members after retirement age, although one or two would take older people.

All is not lost for Mrs de Bethel however. She might be able to obtain some state help if she was to fall ill.

If she loses her income from work, she may be eligible for income support, according to a spokeswoman for the Department of Social Security, and this may also entitle her to help with her mortgage. The self-employed are able to claim sickness benefit from the state, but not if they are receiving a state pension.

(Photograph omitted)