Archive for October, 2007
Well, let’s just roll two of my top topics into one blog and see if we can bring a little common sense to bear on the causes of cancer.
If a poll was taken and people were asked to name the leading causes of heart disease and cancer, I suspect (because it would be my guess), that most people would guess smoking. Certainly it would be at the head of the class for cancer. I mean there’s lung cancer which is almost never linked to anything else. I mentioned in a recent post that smoking increases the risk of death from prostate cancer. Smoking substantially increases a person’s risk of developing cancer of the larynx, pharynx, oral cavity, esophagus, bladder, kidney, and pancreas.
Now a major report comes out and essentially says that obesity is “a cancer risk that approaches and may even surpass smoking”.
If you add to that smoking gun the fact that obesity is a major culprit in diabetes, heart disease, and a host of other mortality laced health issues, suddenly cigarette smoking isn’t public enemy number one. But don’t think for a minute that life insurance underwriters have jumped off of their smoking rate bandwagon. If not public enemy number one, smoking has to be public enemy number one and a half.
The good news is that tests have proven that if you quit smoking and haven’t damaged yourself too severely, the effects are somewhat reversible. The same can be said for being overweight. I can’t tell you the number of people I’ve talked to that have totally controlled their diabetes or their high blood pressure by losing weight.
Bottom line. For now smokers take a bigger insurance hit than most obese people. A study like this can be an underwriting eye opener though. I don’t think it will mean better treatment for smokers, but could be the impetus for reconsidering how obesity is underwritten. And hang on if you happen to be an overweight smoker….
October 31st, 2007
A what you say? To put in more meaningful terms, if your employer died today, would the company continue to exist? Is there a plan in place to keep the business going? If not, is there a plan in place to soften the economic impact on employees, especially key employees in the event of an untimely death?
Safe to say that there isn’t a day that goes by that a small business in this country isn’t faced with this situation, and if left unplanned for, it is not just a blow to the family of the deceased, but to everyone who depended on their jobs to take care of their families. A succession plan is simply a road map for the company, the heirs and the employees to follow to ensure the last economic impact on all.
Often in small businesses there is a key employee that, in the absence of the boss, could step in and run the company without any severe loss of momentum. Given the resources, this person could well step in and take over as the new owner and the company would have its’ future intact. Those resources, in the form of business life insurance, can be planned for in a succession plan.
In that model, an insurance policy could buy the family out and provide working capital for the transition. Legal documents would transfer the ownership of the company and its’ assets to the new owner.
Another avenue would be if the family wanted to maintain ownership and control. A life insurance policy that provides a pool of working capital is a prudent step. Even though the family may have a good working knowledge of the business, until customers see that a business if on solid ground, there may be some hesitancy about continuing a flow of orders until they are comfortable with the new leadership. In many cases, in spite of best efforts, customers will be lost. The capital to weather that storm and work toward new accounts and a new customer base will be crucial to the surival of the company.
Bottom line. Life insurance, usually in the form of term insurance, is an inexpensive way to ensure that faithful employees can continue a company beyond your death. If there is no desire or possibility that the company could or would continue on, life insurance can provide a reasonable severance resource that will help those employees move on.
October 31st, 2007
Over the years I have talked with more than one woman who, when face with a breast cancer treatment decision, chose to have a double mastectomy. Their reasoning always revolved around completing removing the chance for a recurrence.
In an article I read today, the trend toward removing the second, unaffected breast, has increased dramatically, almost threefold, since 1998. While there has been a study done that indicates this trend, a follow up study is planned to try to determine the reason for the trend.
Lead author for the study report in the Journal of Medical Oncology, Dr Todd M. Tuttle, noted that “although there may be sound reasons for undergoing double mastectomy (avoidance of future mammograms and preventing a new cancer), the procedure does not improve breast cancer survival.”
It’s important to note that breast cancer can recur after a mastectomy and that it doesn’t necessarily recur in the other breast. Recurrence is actually more likely in the originally affected site, “(in the treated breast or near the mastectomy scar) or as a distant recurrence somewhere else in the body. The most common sites of recurrence include the lymph nodes, the bones, liver, or lungs.”
Bottom line. From a life insurance standpoint, the very personal decision about whether or not to have a single or double mastectomy doesn’t come into play. The deciding factors remain the same. The stage and grade of the cancer and the time lapsed from the completion of treatment.
October 30th, 2007
I had an email from a potential client today that said “I am looking for reasonably priced life insurance where there are no health questions and/or physical exam. If your group can fullfill these requirements than you can contact me”.
There are a lot of people who think life insurance companies are too nosy. Consider people purchasing business life insurance where the company would like you to simply divulge every financial detail of the business. I actually share the business person’s concern that much of what the companies ask for is unnecessary to the life insurance company and rather confidential.
“No health questions and/or exam?” “Reasonably priced?” I’m thinking he wishes his mother would still do his laundry too.
Since all life insurance pricing is based on mortality assumptions, the more a life insurance company knows about the risk, the more reasonably they can price the product. If they don’t know anything about the risk, it follows that the only way to cover themselves and the risk pool they represent (that would be you), is to offer less reasonable rates and products to those who don’t want to talk about their health or be examined.
To meet his needs we’re really talking about a guaranteed issue product. Guaranteed issue, just as the name implies, will issue insurance to anyone with usually the only caveat being that they have to fall between 40 and 60 years old. How can they do it? First, it is a whole life policy, so the premiums are high. The death benefit is generally limited to $50,000, so the risk is held down. And lastly, they have a 2-3 year waiting period before the death benefit is activated, giving them some cushion before they really assume the risk. During that waiting period, if a death occurs, the company will normally return all premiums paid plus a modest amount of interest to the beneficiary. That’s what you get with no questions and no exam.
Another option is no exam but some questions. Usually call a simplified issue policy, it relies on the application and information from the medical information bureau. These policies can be applied for on line and issued within hours. They are generally at standard or worse rates no matter how good your health is and they are generally capped at $250,000 to $300,000. This is the type of product that is usually used to underwrite children’s life insurance.
Bottom line. The best prices for life insurance, whether term insurance, universal life or whole life, will come with a full medical disclosure and an exam. Make the company comfortable with the risk and they will reward you with the best rates.
October 30th, 2007
What if your father died at age 52 of a heart attack? He was overweight. He smoked and led a sedentary lifestyle. He simply didn’t do anything to take care of himself and appears to have paid the price.
Now there is you. Never smoked. Never drank. You get plenty of exercise. Your weight has always been well controlled. Is it fair that a life insurance company would change your rate class because of your father’s health history? I suspect if this was an impromptu poll of 100 people, not one would say that is a fair course of action by an insurance company.
Family history is about as contentious an issue as you can find in life insurance underwriting. It isn’t plain and clear like cholesterol being high. It seems to smack of unfairness to penalize you for the shortcomings of your father or mother. Indeed it’s like being charged and convicted of a crime that you never committed.
Well, that’s one side of the story. From the other side is an insurance company that is trying to view the issue in a larger context. Is it possible that your father had heart disease that was not caused by his lifestyle? The company can’t pull your father’s medical records to review that possibility. We all know people that abuse themselves to death, but their death doesn’t come until age 92. If his heart disease wasn’t caused by his lifestyle, is the cause hereditary? Have you proactively been tested to rule out heart disease or are you standing on your own belief that it was your father’s lifestyle that caused his premature death?
In fairness to life insurance companies, the penalty for family history is generally not a large one. Many companies will consider proactive medical evidence to support a better rate. There are even a few companies that will completely negate the family history if you have lived past age 60 (the family history cutoff for most companies).
Bottom line. Most of us aren’t very understanding of any reason that a life insurance company raises a rate over what we expected. We all want the best rate. The best you can do is to find an independent agent who can work with your particular issue and find the company that best suits your needs.
October 30th, 2007
We talk all the time about how losing control of one part of your health inevitably has a compounding effect on other areas of your health. Stress, or anxiety, is certainly not an exception to that rule.
In a recent post we talked about how some amount of stress, channeled efficiently, can actually be a good thing. A way to increase efficiency and productivity.
For the fortunate few that can achieve that balance, stress is OK. For the majority though, stress is a physical and psychological drag. Nearly half of Americans say that stress has a negative impact on their personal and professional lives. One third say they are under extreme stress.
Stress has to be dealt with somehow and when managed poorly, it is often the management that causes collateral health issues. People under stress often change their eating habits, gaining weight. We’ve discussed on a number of occasions the domino effect that weight gain, leadning to obesity, can begin if left unchecked.
Other ways that people deal with stress have serious social and physical consequences also. People who smoke, smoke more. People who drink, drink more. People who abuse, abuse more.
It is certainly simpler suggested than done, but there are positive ways to deal with the stress that life deals us on a daily basis. Healthy behaviors noted to manage stress included 54% listening to music, 52% reading, 50% exercising or walking, 40% spending time with family and friends, and 34% praying.
Bottom line. Just like any strain on the body, life insurance underwriters are most concerned with the domino effect. If stress isn’t relieved somehow, other problems almost always follow.
October 29th, 2007
I hope in previous posts I have made it abundantly clear that smoking cigarettes and looking for low life insurance rates is an oxymoronic walk in which you can’t get there from here.
I have also gone on a bit about the reasons that life insurance underwriters are as hard as they are on people who smoke.
Recently in a post about prostate cancer I passed on the results of a study that showed that men who smoked were no more likely to get prostate cancer than those who didn’t smoke. But they were substantially more likely to have a higher grade, more aggressive type of prostate cancer, and a higher mortality experience from the cancer.
In an article today, there was good news and bad news for women who smoke. The good news is that unlike prostate cancer, smoking does not seem to increase the probability of a higher stage or grade breast cancer.
The bad news is that smoking does seem to diminish the effectiveness of cancer treatments. There is also a lingering question about the long term effect that smoking may have on a breast cancer tumor. Even though it may not cause the cancer to be a faster growing or more aggressive cancer, will it cause the tumor to be harder to treat or make the possibility of recurrence higher?
Bottom line. From a life insurance standpoint, there really is no upside to smoking. The truth is that a woman who has been successfully treated for a low to moderate stage breast cancer can expect, in the long run, to get better rates than a woman who smokes and has never been sick a day in her life.
October 29th, 2007
Mitral valve prolapse sounds a little ominous, and to see the knee jerk reaction some life insurance companies have when they underwrite it, you would swear it was right up there with heart attacks. Not so.
Mitral valve prolapse is simply a slight thickening in one of the four heart valves. It doesn’t cause any problems with heart function and in the absence of other heart issues, it doesn’t get any worse with time and most certainly does not carry any mortality risk.
Many companies have been writing MVP at standard rates for as long as I can remember. That would put it in to the same bucket with diabetes or perhaps prostate cancer. Mitral valve prolapse is simply not that vicious. This overview
by emedicinehealth.com kind of puts things in perspective.
As an independent agent I am constantly quizzing underwriters about their stance on different health issues. This is one where there is substantial disagreement from company to company, and while many will stick to their standard rates, there are many that, in the absence of complications, don’t see the need to rate MVP at all.
Bottom line. It pays to not take one company’s decision as an industry fact. Engage an agent who is willing to do more than process applications, an agent who is willing to dig for the best possible offer for you.
October 28th, 2007
Well, shake up a bottle of soda, unscrew the lid, and when you get through cleaning up the mess, let’s discuss the problem with high blood pressure. While you probably aren’t going to explode all over the kitchen if your blood pressure is high, it is no stretch of the imagination to understand that increased pressure can strain things a bit, quite a bit.
There is no pre-determined blood pressure level where you will start to litereally be injured by the extra strain that hypertension puts on your body. Much of that depends on your over all health other than the blood pressure. If you are also dealing with other health issues such as obesity or diabetes, your body parts and systems are under attack and pressure from several directions at once. The more you pile on, the more likely that some system will fail.
It’s interesting to note the number of people I’ve talked to who have been diagnosed with hypertension in combination with being overweight. The story is consistent. Those who have used diet and exercise to deal with the weight are rewarded by a natural lowering of their blood pressure. Take one strain off your body and it seems to have a better chance of bringing everything back into control.
So what’s the big deal with blood pressure? I’ve already admitted that you probably aren’t really going to explode, but if left uncontrolled, there is a very real chance that high blood pressure can lead to an aneurism, kidney damage or stroke.
Bottom line. From a life insurance standpoint, whenever blood pressure is out of the normal range, expect that it will impact your rates. Underwriters know that undiagnosed or uncontrolled blood pressure didn’t earn the name silent killer for no reason. If your blood pressure is dramatically out of control, expect insurance companies to decline to offer coverage until it is brought under control and has a stable history.
October 28th, 2007
My mom sent me a letter to the editor from their local newspaper the other day, a letter in which the claim was made that government was suppressing a known, proven cure for all cancer, ground apricot pits, also known as laetrile.
This writer lumped the FDA, drug makers and all doctors into a conspiracy to overcharge and undertreat people by making the sale of laetrile illegal. Mom is a little sensitive to the issue of doctors and cancer right now as my dad has been fighting bladder cancer for the past year.
I decided to do a little research and see what the world says about apricot pits. I found one rather extensive article that gave an in depth history of the development and use of laetrile. It was a bit lengthy and in the end didn’t have much good to say about the use of pits, but certainly one side of the story. I think it is worth noting that this article follows the history of this treatment back to the early 1800’s.
The other side of the story, the one offered by the writer of the letter my mom read, seems a bit more like a pitch to sell a book and apricot seeds. While they do claim to offer scientific facts, in my research I didn’t find any that led to any reliable source. I take that back. They did quote the Bible in several places and I do consider the Bible to be a reliable source. Having said that, I suspect that God frowns just a bit on the use of his word to sell books and apricot seeds.
My nephew may have hit the nail on the head. He said that apricot seeds will absolutely cure cancer…..if they get stuck in your throat. Then the cause of death isn’t cancer.
Bottom line. From a life insurance standpoint, underwriters will likely not buy into laetrile as a cure for cancer. That may not set well with proponents, but the fact remains that it simply doesn’t have the documented track record it takes to receive favorable underwriting.
October 26th, 2007
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