impaired risk

While grief and sadness may be normal physiologic responses to stressful situations, depression is not.  Whether that depression translates into conditions that affect insurability or threaten a person’s well-being is always a difficult assessment for underwriter and clinician.

A proper handling and understanding of what the client and advisor need to present to underwriting is the difference between success and failure.

It sounds a bit flippant, yet it is a request that medical directors and underwriters see quite often.  An informal application or quick quote comes in with a request about “history of brain tumor.”  Or maybe a question of pancreatic cancer.  The underwriter is expected to make an educated guess based on these minimal findings.  All tumors truly aren’t created equal, and people have individualized responses to different abnormalities.  The more information supplied the better chance there is for not only a placeable but a sustainable quote.

One of the toughest situations for an underwriter is the case that seems to have literally fallen off the cliff.  A condition that is significant, that is being followed, and that does have mortality consequences suddenly has no notes of any recency for six months or more.  Follow-up that appeared to be favorable virtually disappears, and the underwriter is left with guessing that things have continued to go reasonably well.  Or not...

A 64 year old female was submitted for life insurance with what the agent felt were “insurable problems.”  She was diagnosed with lupus 20 years ago but the disease had remained inactive, on no specific medications, normal kidney testing, and only with recommendations to stay out of the sun for photosensitivity reasons. 

Liver enzyme testing (LFTs) are part of virtually every blood profile obtained on a potential insured.  They are also one of the leading causes of a completely unexpected rating or decline on a case.  Most clients do not provide a specific history for an elevation, and no broker or agent expects such an outcome with what seemed to be a clean history.  Knowing how to approach this situation can be key to a favorable underwriting outcome.

Is it true, as stories suggest, you can die of a broken heart?  Likewise, can you have suffered a broken heart and get a standard life insurance policy?  The answer to both questions is yes.  The entity is known as Takotsubo cardiomyopathy, or as stress cardiomyopathy, and is very real.  

A tumor with a very serious prognosis, mesotheliomas are primary neoplasms that arise from either the pleura surrounding the lung or the peritoneum.  Most mesotheliomas are diffuse and malignant, while a minority (less than 25 percent) are localized and benign in activity. It’s important to recognize these growths as they have serious and rapid progressions when diagnosed in many cases.

Thyroid testing has become more sophisticated and much easier to interpret as the state of the art has progressed.  Whereas much of the old testing required a reference test in addition in order to correct for different individual body protein status, newer testing is much more sensitive and spot-on as a single reported value.  Each condition has one or two tests that make the best diagnosis as a primary test and tell the best story for diagnosis and treatment.

The world's biggest life and health insurers may be putting more energy into developing new underwriting strategies for older, sicker people than for younger, healthier people.