Life insurance exam -what're they looking for?

A clean bill of health will grow your wealth!

For more information, call 800-472-5367 or email insurance911@yahoo.com

Insurance companies will consider your rate based on three standards of disclosure to verify the components of your health.  The standards which yield the lowest rates to you are those which compel you to the greatest disclosure.  As such there are three standards by which all policies are issued.

  1. Guaranteed Issue Life Insurance Policies (GBL): No Medical Questions.  No Exam.
  2. Simplified Issue Life Insurance Policies (SIWL): No Medical Exam but you answer to several medical STATEMENTS, not warrantees, which MAY be verified by interview and/or inquiry to your Doctor and/or the Medical Information Bureau.
  3. Medically Underwritten Life Insurance Policies (Term,UL,WL): The Insurance Company is looking to verify, at their expense, the statements you have made on your application as to your medication (s), medical conditions (s), family history, driving record, use of controlled substances.

GBL Policies are ALWAYS some form of cash value life insurance.  These Universal Life (UL) and Whole Life (WL) policies are issued to the highest table rating (H) offered and require a waiting period of 2-3 years for the policy to be in force before the full death benefit is paid.  They also offer a full refund of premium plus interest if the insured dies (other than by accident.)  These are known in the vernacular as Final Expense or Burial Policies.  Some Insurance Companies will offer these policies to people living with AIDS or CANCER.

SIWL can be Term WL or UL policies but are priced by the Insurance Companies at VERY high standard rates.  If the Insurer approves the policy, the effective date of the policy is the date of application.  There is no waiting period and the policy is subject to the standard two year incontestable period and suicide provisions granted to standard issue life insurance policies.

Term, WL & UL policies underwritten at the most competitive rates will subject the proposed insured to the most rigorous underwriting.  At the Insurance Company’s expense, a third party Medical Examiner will meet you at your convenience to answer the medical questions you made on your application.  (IF YOU SUBMIT TO THE MEDICAL EXAM AND FAIL TO SUBMIT THE APPLICATION YOU ARE RESPONSIBLE FOR THE COST OF THE EXAM.)

  1. Verify your height/weight and your attending Physician’s contact information.  If you do not regularly see a Doctor, your best class may be only standard.
  2. Record your blood pressure & pulse and/or EKG.
  3. Ask you to render blood & urine.  You may ask that a copy of the lab results be mailed to you.
  4. Sign another release for access to your MIB file and separate notification that your blood & urine will be tested for controlled substances and the presence of HIV/AIDS.

HIPAA guidelines dictate the availability of this information.  If you wish to question the underwriting decision that is based on any information gathered during underwriting then that information must be released to you and then you can share that information with your Insurance Agent.

Considering all your medical information plus vocation, avocation, travel plans, driving and criminal record: you will be assigned an underwriting class (FOR THAT COMPANY) which will range from super-preferred, preferred elite, preferred plus, preferred, Standard Plus (a/k/a elite) or Standard.  These base class rates may be subject to an additional surcharge imposed by Table Rating (A-H) and or Flat Rate.  Smokers have a class of their own.

 Health qestions

Your health affects your life expectancy.  If you have regular physical exams you are considered to be “well followed.”  The probability that you will discover an illness and seek treatment is an indication that you will live longer than someone who does not.  If you endure a health condition that could compromise your life expectancy it will increase your premium.

Your blood sample will be tested for certain medications, HIV Antigens, cholesterol and lipids, liver or kidney disorders, diabetes, hepatitis antigens and PSA’s (specific to your age and gender.)  Your urine sample will also be tested for the presence of nicotine, certain medications and controlled substances. 

Your lab results will be sent to the underwriter for consideration in concert with other information you provided on the application.  Only the underwriting staff has access to this information.  Your agent does not have access to information not disclosed on the application.  You may request a copy of the lab results by asking your agent. Some insurers will automatically MAIL you a copy.  Only you can share HIPAA protected information with your agent once you release it.  If there’s a problem with your results, consult with your personal physician.  Abnormal lab results need to be discussed with your agent. 

For example:

- High liver functions may have been the result of cold medication or antiobiotics that were not disclosed on the application.

- Adult Onset Diabetes (Type 2) previously undetected may manifest itself as uncontrolled diabetes and will result in a lower rate after an exhibition of control (1 year.)

- Uncontrolled Blood Pressure or Cholesterol may have been episodic at the time of the exam.

- Specimens testing positive for narcotics may have been the result of “heavy petting” with another person who had ingested the controlled substance.

- The presence of nicotine may have been the result of a celebratory cigar or second hand smoke.

- Anti depression medication was prescribed but not used at the dosage prescribed.

- Presence of Hepatitis Antigen may have been from shellfish or self-inoculation and not the result of moral turpitude.

- Lab Test Results are inconsistent with a Pathology report

- Custody of the specimen may be in question.

Medical Underwriting Criteria Super Preferred + (non-Tobacco) Male 6’0’’ 207 / Female 180

To gain perspective let’s review ONLY the GENERAL criteria for the best rate available:

- Blood Pressure: 136/86 well controlled WITH MEDS!! & no Average > in the past two years.

- Family History: No CV Disease/Cancer (ex>70 waived) in EITHER Parent/Sibling < age 60.

- Driving History: no dui, dwi, reckless, revocation, suspension < 5 years; Max 2 moving violations < 3 years.

- Tobacco use: or nicotine based products < 36 months (one celebretory cigar per month.)

- Cancer History: Only available on certain types of skin cancer.

- Cholesterol: under 220 without or WITH MEDS!!  And a max total ratio of 5.0

- Substance Abuse: No Abuse (maybe if greater than 7-10 years)

- Residency: Permanent Resident 3 yrs & either US Citizen or Perm Visa or Green Card.

- Athletic build: will be considered if chest, waist and thigh measurements are ordered with exam.

If you fit the classification used for your original life insurance quote, you’ll have no problem getting that rate - otherwise you may be offered a life insurance policy with a higher premium IF you do not quality for a “BEST EFFORTS” decision.  That is a “jump in Class” if all other factors are taken into consideration for a healthy life style to offset one failed element.

EXTRA RISK RATINGS

Underwriters assess premiums for health, vocational and travel conditions based on a table.

There are two types of risk settings:

- Temporary Flat Extra, and “table” ratings.  Underwriters assess premium class based on health conditions.

For instance, a flat rate may apply for a limited time if you just had an operation.  But if you have high-cholesterol, you could receive a table rating, which increases premiums for the duration of the policy.  If you disagree with a rating you receive, contact me.  I can try to revise your rating based on subsequent medical tests.  You could save hundreds of dollars every year for the life of the policy. 

If you do not accept the life inisurance policy, your test results become part of your recorded database for seven years at the Medical Information Bureau (MIB.)

The MIB is a clearing database (much like your CLUE REPORT on your property) shared by 460 insurance companies to pool data submitted by applicants and claimants of life, health, disability and long term care policies.  If you are shopping around me for other life insurance, remember that your medical information is assessible to other insurers in the near future.  The MIB’s database does not contain the actual medical records.  It is a repository of codes that represent medical claims, conditions, tests, hazardous avocations and Motor Vehicle Reports.  If you want to check your MIB file (or your CLUE REPORT) you can obtain one free report annually.

What will they say about me?

Underwriters and I have “seen it all.”  No one is as perfect as we portray ourselves to our children.  We are trying to protect them in case we fall victim to our own failures or someone else’s carelessness.  If you are in good health or even plagued with a history of dreadful health issues, you stand a good chance to get a better rate by submitting to a FULLY underwritten policy that requires a medical exam.  Your vital information is protected by HIPAA and an attentive agent will see that less than flattering information is addressed for the record.  Barring that you can apply for a Simplified Issue or Guaranteed Issue Policy and let the record be silent.