Archive for October, 2007
In an article on our soon to be “released” prostate cancer website I review all of the treatment options available. For elderly men, those between 65 and 80, with low to medium grade prostate cancer, “watchful waiting” is often considered to be a reasonable option.
The logic behind watchful waiting is that if the cancer is a slow growing cancer, the chances are that an older man will likely die from some other cause before the cancer is really a mortality risk. By being “watchful” or monitoring the cancer, if the nature of the cancer changes or if it progresses further than a doctor and patient are comfortable with, it still leaves time and the option of other prostate cancer treatments.
In an article in PSA Rising, it is suggested that a study shows the mortality experience to be about 30% higher over a 12 year period in men who use the watchful waiting method as opposed to active intervention.
There were some questions left unanswered for me in the article. It seems to me that the “no news is good news” attitude could lead to a more lax attitude toward watchful waiting after a number of years. I admit that there is still a mortality issue to be looked at, but it could also be that watchful waiting loses some regiment after a while and that the increased mortality really is a result of those who have either quit being watchful or have become lax about it.
This thought is substantiated to some degree in a study that followed men for just over 6 years and found that there was no significant difference between those who had more radical treatment and those who employed watchful waiting. Remember that watchful waiting is most often suggested only in older men with low grade cancer. The mortality experience began to change after that 6 year period.
This, from my simplistic point of view, tells me that if watchful waiting is your choice, rather than becoming more confident and relaxed with time, perhaps being more vigilant is really what is needed. Prostate cancer is still a very curable cancer, and if actively treated when it first shows signs of becoming more aggressive, there shouldn’t be any reason to expect anything other than an acceptable result.
Bottom line. From a life insurance standpoint, watchful waiting is not an avenue that will be accepted at all by most companies and probably not accepted with reasonable rates by any companies. While medically acceptable, underwriters really have a problem wrapping their minds around and binding their companies to coverage for someone who is actively not treating their cancer.
October 26th, 2007
There really isn’t anything funny about this situation, but I always find myself shaking my head and thinking how odd it is!
I talked to a man who inquired about life insurance today. He had an extraordinary health history. He had type 2 diabetes diagnosed about ten years ago, and it was not well controlled. Since being diagnosed with diabetes he has had two heart bypass surgeries because of progessive heart disease. He has had one heart attack. He had an implanted pacemaker and defibrillator.
He is married and has a mortgage. Responsibilities! And he smokes.
As I write this I am still shaking my head. What is this guy thinking? He obviously has a desire to die and get it over with, but he wants to buy life insurance on his way out. That is just not the way it works folks.
People who take care of themselves and are making an effort to prolong their lives can usually get life insurance. People who are running headlong in the opposite direction simply don’t.
Bottom line. Diabetes complicates heart issues to the extent that insurance companies would be very leery of insuring someone with chronic heart disease and diabetes. When you cap that off with the person smoking post heart attack……it’s just not going to happen.
October 25th, 2007
NBC’s weight loss “reality” show Biggest Loser crossed the line this week. I have steadfastly supported the show and the weight loss and have stayed the course in using this as a forum to discuss obesity and the collateral health issues it causes.
When a participant turns the whole thing into a complete game and abandons the intent and integrity of the show by gaining 17 pounds in a week, knowing that he had the votes to stay on the show, he is a loser that turned a good, well intended program into a loser.
I will continue to blog about the issues but I will not support the program any more.
Bottom line. Obesity and the collateral health issues make obtaining life insurance difficult, make life itself difficult, and are a serious subject worthy of a better effort than NBC put forth.
October 25th, 2007
In an effort to serve more completely the needs of those whose health can make getting affordable life insurance a challenge, Hinerman Group is moving ahead with new “health challenge specific” websites.
My passion has always been to foster discussion and provide information to those, like me, who don’t fit into the Superman rate classes that we all see advertised and would love to have. The truth is that, depending on the company, only 10%-15% of those who apply for life insurance actually qualify for those rates.
About 50% of those who apply have some challenge that will cause them to teeter between insurable and uninsurable, depending on the company they apply through. It is these people I hope to reach through our new websites. I want to provide an independent agent’s view to the subject and educate people on exactly how you attack finding the best possible rates.
To that end our diabetes website went live a few weeks ago and our obesity site came up yesterday. In the very near future you will find sites that are dedicated to prostate cancer, breast cancer, private pilots, sleep apnea, heart disease, and women. I am very open to suggestions for other sites to serve the under served.
Bottom line. Most agencies make their mark and their living providing life insurance to the healthiest 15% of clients. The other 85% need an advocate for their situation and an agency that will work hard to make sure they have the best possible opportunities to provide the family protection they need at affordable prices.
October 25th, 2007
There are a lot of women out there who pay attention to the advice that comes from the Oprah show and when it comes to finances, it’s Suze Orman. Run from this woman if she tries to give you life insurance advice.
As a life insurance professional I found it disturbing that anyone would allow this woman to give life insurance advice to a national audience. Her advice is dangerously generic and her grasp of product knowledge, well, certainly wouldn’t get her an insurance license.
With broad statements like “the only type you need is term insurance” and “you might buy a 25-year term policy” really show her ignorance. While term insurance does fit most needs, Suze needs to understand that she is talking to women of all ages and needs. One size does not fit all and if she knew her products, she would know that there are only about 5 companies out of 2000 in the US that sell a 25 year term and it is disproportionately priced between 20 and 30 year products, making it a terrible deal compared to either. A woman would be better off buying a 30 year term and dropping it after 25 if she doesn’t need it. If she happens to have another child, that extra 5 years will be a great deal.
Then she uses her bully pulpit to suggest that people look for their life insurance from selectquote.com. Selectquote is a huge mega life insurance sweatshop that pushes clients toward the companies that give them the best contracts, not the companies that will provide clients the best value. They have also made themselves infamous for having the same commercial on national television for the past 5 years suggesting that a couple with two toddlers buy 10 year term products. It’s a bait and switch commercial. Anyone with toddlers that buys less than a 20 year term is getting horrible advice.
With Oprah spending tons of money to educate children in Africa, you would think she would make a better effort to provide accurate, useable information to the women who look to her for advice right here at home.
Bottom line. The kind of generic, cute advice that comes from talk shows should be reviewed by talking the information over with a professional.
October 24th, 2007
Obesity, which often leads to heart disease, the number one killer of women, has now been linked to the number two cancer in women, breast cancer.
Let’s be frank about this. I am constantly reading studies and articles and I have yet to find anything that would lead me to believe that excess weight is anything but hard on your body. It, in non medical terms, seems to be the straw that bends and often times breaks the camel’s back.
Today I read that weight gain during adulthood, as opposed to women that keep a fairly constant weight, leads to a higher incidence of breast cancer in post menopausal women who didn’t use hormone replacement therapy.
This may seem like I’m kind of stretching for links. All of the pieces have to be in place for this scenario to be significant, but it is just one more case where, in the absence of weight gain, the scenario doesn’t play out. A person just doesn’t have to dig deep to find this information. Another article shows a link between obesity and cervical cancer . Another American Cancer Society study shows that obesity could be directly involved in as much as 20% of cancer cases in women.
From a life insurance underwriter’s standpoint, out of control weight gain is more than just BMI, it represents risk from a number of directions. From the standpoint of the out of control weight gainee, it’s time to take a serious look at the train you’re on and where it’s headed.
Bottom line. If you are overweight and it hasn’t caught up with you yet, in the form of collateral health issues, you need to find an independent life insurance agent who can help you put life insurance in place at an affordable rate. After the health issues start, that same shopping is going to be much harder and far more expensive. It may even be out of reach.
October 24th, 2007
The answer to that question would be….no cancer to underwrite! It seems that since cancer has been diagnosed and understood, there has been a constant supply of studies and advice on how to prevent cancer.
Prevention of cancer! How good would that be? Think of the economic and emotional devastation that cancer causes each time it strikes a family.
There are those that say the clean life is the way to win finish the race cancer free, but who hasn’t known someone who smoked and drank and ate wrong all the way into their 90’s and then just wore out. And, who doesn’t know someone who did every minute of life exactly the way science would recommend and died from cancer in their 40’s.
I guess all a person can do is pick a path and hope. I read an article today that had a long list of suggestions on food and supplements that might give you an edge. Then there is the green tea method. Like I said, no shortage of advice.
From a life insurance standpoint, there is no doubt that skipping cancer in your life, and in the long run, not having a family history of cancer, will save you and your children money. Even in the best case, a history of cancer is going to prevent almost any chance of ever seeing the best rates again. Just because your doctor says you have the cancer beat after 5 years or 10 years, doesn’t mean that insurance companies share that optimism.
Bottom line. Living a healthy lifestyle may not keep you from getting cancer, but it will help you feel better and will keep your life insurance rates lower (my post a few days ago on tobacco use).
October 23rd, 2007
I often use news stories to make a point about life insurance. Ran across a story today that I won’t use, but just want to pass along…..just on the off chance that you didn’t have any focus for your prayer today.
October 23rd, 2007
I have mentioned before that if we all knew the date and time and perhaps the reason for our death, well ahead of time, it might change the need for life insurance dramatically. With time to plan it is possible to put money somewhere other than life insurance and provide for those left behind.
Not a week goes by that someone doesn’t decide, usually on the advice of a financial planner, that rather than buying life insurance, they can put that same money away each month or each year in an investment. The idea, of course, is that when they get old, rather than having “thrown that money away” on life insurance, they will have this great nest egg to use.
There are several problems with this approach, the most obvious being that we really don’t know when we’re going to die. We can guess at our mortality by using averages. There were nearly 43,000 deaths in car wrecks in 2006. An additional 4500+ deaths happened on motorcycles. Pedestrian deaths topped 5000. 27,000 died from prostate cancer. 41,000 women died from breast cancer. This is just a small sample of the unexpected deaths in 2006.
If these people used the “put it away” rather than buy life insurance method, I suspect the majority may have fallen short of their plan’s goal.
Another downfall to the idea of putting an amount equal to the life insurance premium away in investments is, quite simply, that most don’t do it. While a person might be somewhat invested in keeping life insurance in force, diverting money from a potential investment to another use is a fairly common occurrence.
Bottom line. Life insurance is not an investment, and investments are a poor substitute for life insurance. Death is rarely an event that can be nailed down by long term planning and life insurance is the most economical way to deal with the financial impact of premature death.
October 23rd, 2007
I remember a case a year or so a go when a client had undergone some very minor outpatient procedure during the underwriting of a life insurance application. The reason for the operation was hardly a mortality issue and he was back to work within a few days.
I was a little surprised when the company postponed making a decision until the client had gone for follow up visits and was officially released from any additional follow up. At the time it seemed a rather severe action given the minor nature of the procedure. But, in thinking it through, I remembered that I was hit with a staph infection almost six months after a hospital stay to repair a broken leg. When it all played out, the broken leg was nothing compared with the battle with the infection.
With drug resistant strains of staph infection now becoming more common, life insurance companies are correct in their caution, since hospitals and medical facilities still remain the most common place to contract the disease.
In the case I mentioned above, the client continued to have some minor discoloration and puffiness in the incision area for a month or so after the operation. Ten years ago that would not have been any cause for concern, but with staph infection and particularly the drug resistant strain on the rise, there is, even in my normally optimistic mind, room for concern about a mortality issue until everything is completely healed.
In the case of my broken leg, even more than 5 months post surgery, even after the bone was healed to the point that I was walking and even beginning to run, there was still redness and occasionally a few drops of clear discharge at the incision site. I really never gave it much thought until I was back in the hospital again, this time with a life threatening infection.
Bottom line. Life insurance companies will postpone decisions if you have a planned medical procedure. They will postpone a decision if you have had a medical or surgical procedure and have not yet been released from care. I hope this sheds some light on what appears to be an over reaction on the part of life insurance underwriters.
October 22nd, 2007
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