impaired risk

Liver fibrosis is the replacement of functioning hepatic tissue with fibrous tissue. Alcohol overuse, hepatitis of any kind, and nonalcoholic steatohepatitis (NASH) often leave behind damage with not only an active process but one where compromise may persist long after the cause has been controlled or eradicated. Knowing how to assess liver fibrosis in the aftermath of these conditions is an important part of underwriting liver disease.

Blood taken from insurance examinations are subject to many possible influences. Delays in handling, processing, and different atmospheric conditions may causes changes to lab results as opposed to those you would avoid when the labs are processed locally.

Urine drug testing is a cornerstone of the overall testing in proposed insureds and yields a lot of valuable underwriting information. So how long do a lot of drugs stay in the system and at what time frame would they be likely to trigger a positive test?

Multiple endocrine neoplasias are inherited disorders that include a variety of combinations of endocrine and nonendocrine tumors and affect different endocrine glands.  The diseases run in families enough so that genetic counseling is advised when any first degree relative is affected.

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.