Posts filed under 'Anxiety'
Relieve that stress and get away from it all for a little camping. Pictured above is what a few thousand people call getting away from it all every year during the Ride the Rockies bicycle tour. A little bike ride through the mountains with 2000 people. What, are they nuts?
I have long contested that anxiety disorder is an affliction primarily contained to big cities which by my definition is any city that you can’t be out of by car in five minutes or less, preferably less. Between narrow, winding mountain roads, people on vacation in rented motor homes (they’ve never driven one before), 2000 bicycles and sleeping in tents just inches from each other, I can see how anxiety disorder, at least for me, could be cleverly cloaked as an “enjoyable getaway”.
I suppose if stress relief comes in the form of getting away from work and your normal routine, even something as crazy as Ride the Rockies might be just the right medicine.
Now, of course, to why I write this blog. How do life insurance underwriters look at anxiety disorders and what makes them comfortable about approving policies that really don’t penalize the poor people who live in, for instance, Denver?
I have often thrown out a list of underwriting thresholds that are used to evaluate bipolar disorder and make the comment that the list is also pertinent to anxiety disorder and depression. For the sake of this post I’ll tweek that list to specifically address anxiety.
1. Someone who has not been hospitalized for anxiety related issues other than for diagnosis?
2. Someone who is compliant with their treatment, both medications and regular followups?
3. Someone who, in spite of anxiety is leading a stable family life or social life?
4. Someone whose anxiety doesn’t impact a stable work life?
5. Someone who is not on disability for anxiety disorder.
6. Doesn’t need multiple medications to control the anxiety.
From an underwriting standpoint anxiety is much less complicated than bipolar disorder or depression and given the list above, which probably would include the majority of those with anxiety issues, good rates are certainly within reach.
Bottom line. I live in a small town called Salida, Colorado and without literally going hours out of my way, if I go to visit family in Wyoming I have to go through Denver. I have determined that I have transient anxiety disorder. It disrupts my mood to drive through Denver. But that’s all personal and not relevant to the poor, medicated people that live there.
June 17th, 2009
You know what really is great about being able to get good rates and place policies in force for those with bipolar disorder? The families are so grateful because of all they’ve been through with the demeaning treatment and declines they have received at the hands of other insurance companies.
It’s a good feeling knowing that any policy goes in force and another family is protected. It’s really quite another to call up a person who has been declined by three companies and let him know we got an approval. And not just an approval, but an approval at preferred best rates, the best rate class available for anyone.
Now, to be sure, I won’t claim I can get preferred best rates for anyone with bipolar. Standard is a far more likely outcome even with a very stable, controlled disorder, but there are those, and I think there are a lot of them, who are exceptionally stable, exceptionally compliant with treatment and exceptionally well controlled with their medication that can, when the underwriter is feeling good, get best class rates. Such was the case of a client approved today. He went into the process just hoping not to be declined again and came out of it able to budget $1,000,000 of 30 year term insurance instead of the $500,000 he was hoping to get approved and settle for.
His was an interesting case because the underwriter at one point was seriously suggesting a much higher rate. The issue was that in the trial the underwriter had said the best rate was possible unless the client was on anti-psychotic medication. He is and has been on Trileptal for some time. It took some time to get the underwriter to see that Trileptal was really just Tegretol, an anti seizure medication, that had been altered slightly for use with bipolar. In the end reason prevailed and the underwriter conceded that he was definitely not on anti psychotic medication.
Just a reminder about what it takes to get to approvals and good rates with bipolar:
1. Someone who has not been hospitalized for bipolar disorder other than for diagnosis?
2. Someone who has not attempted suicide or had bouts with suicidal ideations?
3. Someone who is compliant with their treatment, both medications and regular followups?
4. Someone who is leading a stable family life or social life?
5. Someone who is exhibiting a stable work life?
6. Someone who is not on disability for bipolar and does not have issues with drinking or drugs? If there’s a problem here, then the answers to 3, 4 and 5 are no.
7. Better rates are available for those that aren’t on anti psychotic medication or multiple medications.
Bottom line. This isn’t to say that if you don’t fit the above list perfectly you won’t be able to get an approval, but from a lot of experience I can tell you that straying very far from the list goes down hill fast. Having said that, it should be noted that most are in agreement that the majority of those with bipolar disorder, anxiety disorder or depression would meet the criteria.
June 17th, 2009
I was asked by my office manager this morning if bipolar disorder/manic depressive disorder was more prevalent in people around her age, in her 30’s, than people my age, in my 50’s, because the majority of people who react to our advertising and blogs are younger.
My thoughts were that the response we get doesn’t necessarily mean that more people in her age group have mood disorders, but may be more indicative of two things.
1. Bipolar disorder, anxiety disorders and depression today are better understood and less feared by underwriters than when I was her age. If, for instance, I had been diagnosed with bipolar disorder 20 years ago my chances of getting any insurance company at all to consider accepting my mortality risk would have been somewhere very close to 0. I might have tried several times to get life insurance for my young family but with the chances at or near 0 of being approved, I would likely have racked up a string of declines.
2. By now, in my mid 50’s, I would have done the best I could to put some other plan in place knowing that life insurance companies didn’t want anything to do with me. Why, at this point, would I want to back track and put myself through the humiliation again?
I also reminded my office manager that we have been very successful in helping those my age and older who we have heard from. They actually, in the mind of underwriters, have something of a leg up on younger clients in that they are survivors and have stability written all over them. Bipolar disorder is one of those things that can tear you down at its’ worst and make you a stand out success at its’ best. By age 50 if someone has bipolar disorder they have most certainly taken one road or the other (through no fault of their own), and someone in their 50’s on the good side of things has established stability and control, business and family life with some certainty.
From the view of a life insurance underwriter, whether you are a 32 year old software engineer or at 56 year old actor or CEO, the same criteria lead to the best rates.
1. Someone who has not been hospitalized for bipolar disorder other than for diagnosis?
2. Someone who has not attempted suicide or had bouts with suicidal ideations?
3. Someone who is compliant with their treatment, both medications and regular followups?
4. Someone who is leading a stable family life or social life?
5. Someone who is exhibiting a stable work life?
6. Someone who is not on disability for bipolar and does not have issues with drinking or drugs? If there’s a problem here, then the answers to 3, 4 and 5 are no.
7. Better rates come with fewer drugs and without the need for anti-psychotic drugs.
Bottom line. Get the word out. Life insurance at fair rates is available at fair rates for people suffering the full spectrum of mood disorders. If you know someone who you think may have missed out on this evolution of underwriting, talk to them and steer them toward the answer they may have missed 20+ years ago.
June 9th, 2009
We’ve done a lot of work for clients with mild to moderate, usually situational, depression or anxiety disorders. The truth is the more crazed and frenetic our society and lifestyle become, the more people are looking for a little bit of help coping.
It’s probably a good thing too. Can you imagine today in America if suddenly everyone who is being treated for depression or anxiety or any other mood disorder wasn’t being treated anymore? Time to hide in the basement. Road rage would go epidemic.
Life insurance underwriters can feel pretty comfortable in giving someone preferred or even preferred plus rates if their mood disorder is fairly mild, hasn’t been going on so long that it would be looked at as a chronic issue, and they are compliant with treatment and doing well. They are definitely understanding and willing to work with situational depression. Situational depression is usually fairly short lived and treatment is just there to bridge the gap between the event (the situation) and getting back on your feet.
Non situational, chemical imbalance type mood disorders can still qualify for preferred or preferred plus rate classes as long as they issue is well controlled and a person is functioning normally. No lost time from work or hospitalization would be good for starters. A stable family life is usually a good indicator
that things are well controlled.
More severe mood disorders such as bipolar disorder probably won’t get to preferred rates in most cases, although we have been able to get a few clients there. A more realistic goal would be standard plus or standard given the following criteria. By the way, these guidelines are good measures for any mood disorder.
1. Someone who has not been hospitalized for bipolar disorder other than for diagnosis?
2. Someone who has not attempted suicide or had bouts with suicidal ideations?
3. Someone who is compliant with their treatment, both medications and regular followups?
4. Someone who is leading a stable family life or social life?
5. Someone who is exhibiting a stable work life?
6. Someone who is not on disability for bipolar and does not have issues with drinking or drugs? If there’s a problem here, then the answers to 3, 4 and 5 are no.
7. Generally better rates are available when control is achieved with anti seizure drugs such as Depakote rather than anti psychotic drugs.
Bottom line. Mood disorders, from simple to complex, with good control can usually be underwritten for life insurance at standard or better rates. Talk to a knowledgeable independent agent today to start working on insurance quotes.
May 12th, 2009
It’s been a fascinating couple of years. I will sum it up by saying that we have helped a lot of people get life insurance who never thought they could. And what better way to celebrate the information we’ve shared and the victories we’ve had than with a shared meal, a key word salad.
Diabetes has been at the forefront of our life insurance efforts from the very start. We’ve made huge headway in finding aggressive underwriting for type 1 diabetes and type 2 diabetes. I think our strong point has been in education. There are a lot more people out there today that know what their A1c is than when we started.
I’ve been very clear about where some of the problems lie in our industry. The AARP/New York Life collaboration, on what can only be described as a sick crime against older folks, continue to offer the worst term insurance and whole life insurance in the business. They are simply not the advocate they claim to be.
I’ve stepped on some toes along the way. Selectquote and Zander Life insurance have taken exception to some of my observations. Being a Dave Ramsey fan and I think, ultimately, a reasonable person, I did apologize to Zander. In spite of Selectquote’s berating commentary, I still stand by my assertion that they are biased in what companies they offer (otherwise they wouldn’t be so easy to beat) and I still believe that Suze Orman should go back to waitressing. As to their assertion that I only use Selectquote and Suze Orman for search engine optimization, well, I don’t, even though they think I do. If I didn’t think there was better service elsewhere and more honest advertising, I would never have mentioned Selectquote.
We’ve touched on scuba diving and Prudential being a leader in great rates for recreational divers. Pru also stomps the competition on prostate cancer, sleep apnea and mild anxiety issues. While providing direction on those issues we have also been able to provide direction for those involved in skydiving and foreign travel to places where kidnap and ransom insurance is more than just a casual thought.
We’ve stayed abreast of the economic meltdown and recession that have whacked us all and tried to help people understand how best to handle their life insurance needs in these tight times.
We’ve held lengthy discussions about obesity and the impact it can have on other health issues such as hypertension or high blood pressure, cholesterol, heart disease, heart attack, stroke and cancer. We’ve discussed the risk and benefits of gastric bypass surgery as a means to avoid the life threatening side effects of being over weight.
Probably our biggest response has been from those suffering from depression and bipolar disorder. We reached a group of people that have truly been black balled in the insurance industry and we’ve been able to find some level headed underwriting and hit some major home runs for those who have the name tag but lead normal lives.
We have bared the facts behind the black eye of all black eyes in the insurance industry, the non guaranteed whole life, universal life and variable universal life policies and explained the alternatives in the permanent insurance market. There is nothing that provides greater value and peace of mind than a rock solid guarantee.
We’ve had frank discussions about business life insurance such as key man insurance and buy/sell life insurance. We did a whole series on women and life insurance. We’ve provided direction and information to private pilots that they aren’t getting anywhere else. We’ve talked about the guts of the policy when it comes to the two year suicide and incontestability clause and the accelerated death benefit and the beneficiary rights and the beneficiary issues for those who aren’t in a legal relationship such as a gay couple or an unmarried couple.
Bottom line. And the list goes on and on. We’ve tried to leave no stone unturned and no question unanswered in our quest to find life insurance for those whose mortality risk might be more challenging than average. As an independent agent it has been gratifying to have so many ways to help those who have been mishandled by the wrong agent or the wrong company. As we continue to reach out my prayer is that all who need help find it, and that more agents consider serving those who are harder to help.
March 18th, 2009
The truth is that I doubt if anyone makes it through life without situational anxiety or depression and there are days when I would swear the whole world is ADD, so what’s the big deal? For years a lot of the more conservative life insurance companies have with held the best due to these minor league impairments.
And the truth is that the more conservative companies may still bump someone a rate class due to minor emotional issues, but most of the companies who are really staying abreast of their underwriting have conceded that real life happens and when someone seeks treatment for it and gets their ship righted, they shouldn’t be punished.
Just within the last few days I’ve seen approvals for ADD treated with Ritilin, situational anxiety treated with Lexapro and situational depression treated with Wellbutrin, all at best rate classes from Prudential, ING Reliastar, Banner and others.
Before everyone runs to the store to buy some, let’s make sure we’re all on the same page. The cases above were truly well controlled. One thing they all had in common was that the issue didn’t affect their lives other than having to take medication and with the depression and anxiety, the issue was resolved and there was no further need for the medication. Situational truly means situational. It the depression or anxiety disorder goes on for a long time, say a few years or more, most insurance companies would call it chronic. Generally the best rate classes fall off the radar with chronic just about anything.
While still insurable, best rate classes are also out of the picture for more chronic and complicated issues such as bipolar disorder. We’ve had great success with bipolar as long as they fit within the following criteria. Safe to say that the same criteria would have to apply to get a good offer on chronic depression.
1. No hospitalization within the last 10 years for bipolar, other than for diagnosis
2. No suicide attempts or ideations
3. Compliant with all medical and psychological treatment
4. Must have a stable family life
5. Must have a stable work life (and no, being laid off in a recession wouldn’t count against you)
6. You can’t be on disability for bipolar
7. You can’t also have collateral issues with alcohol or drug abuse.
Bottom line. If your life hasn’t spun out of control there are generally good rates available for you. Being diagnosed isn’t the issue as much as how you’ve taken control of the situation.
March 11th, 2009
Up until a few years ago sleep apnea, even well controlled with a cpap, was just one of those health issues that you could expect wouldn’t get much better than a standard plus approval from the best of life insurance underwriters.
The same could be said of situational depression and minor treated anxiety. But along with bipolar disorder that I talk about so often, underwriting has really focused, especially in these areas, on becoming kinder and gentler. The truth is that mortality risk with these issues truly only comes when they are not well controlled and a patient is no compliant with their treatment.
If the patient takes these things seriously and is motivated to stay healthy, a life insurance underwriter isn’t going out on much of a limb to approve these issues at preferred and even preferred plus.
Sleep apnea for instance, left unchecked can have serious health consequences that range from the problems that arise out of insufficient sleep, to high blood pressure and even an increased risk of heart attack or stroke. Taken seriously, well controlled sleep apnea has virtually no health risks because use of a cpap stops the incidence of apnea. Well controlled sleep apnea has also been known to save marriages as the freight train equivalent snoring stops.
Just one quick caveat. Obesity is one of the leading causes of sleep apnea. If you control the sleep apnea and ignore the obesity, don’t expect preferred rates.
Bottom line. There are companies out there that understand, believe in and underwrite control. If you have sleep apnea, talk to a knowledgeable independent agent today and see how affordable life insurance can be.
January 16th, 2009
There is probably no better feeling for me (and my clients) than turning their previous experience of being declined for life insurance into an approval for the insurance that they want for their family. For those who have been declined, it’s the same feeling as asking someone out on a date and being turned down.
When the next chance comes along, rejection is fresh in your memory and it’s a little hard to take the plunge again. But when that approval does come through, well, home run, fireworks, Acceptance with a capital A.
We were just able to help a man who has bipolar disorder and anxiety disorder get approved at an affordable rate after Erie Life had declined him just a few months ago. As we’ve discussed so often, there are companies that seem to have their own emotional disorders when it comes to underwriting emotional disorders. The word bipolar sends them screaming into the dark without even a cursory investigation to see if the person might be one of the large percentage of very functional and stable bipolar candidates for life insurance.
Because we are very clear up front about what it takes to get approved and because we ask and answer all the questions that surround an application for someone with depression, bipolar disorder or anxiety, our batting average is pretty good. That is not to say that we get life insurance for everyone who wants it, but we are able to right the ship for many who have previously applied with the wrong company or through the wrong agent.
Bottom line. There is no magic to getting life insurance if you are young, healthy and have never had a health or mental issue. But, if you are in the majority you should seek the help of a knowledgeable independent agent and save yourself from the unpleasant experience of rejection.
December 23rd, 2008
Still fresh in my mind is the story a client related to me about her experience of being declined for life insurance due to bipolar disorder. This was news to her since she didn’t have bipolar disorder.
In talking through the situation with her she did bring up the fact that she was treated for ongoing depression with the drug Lamictal. Lamictal has several uses, but because of the magic of television advertising, probably the best known is its’ use for bipolar disorder. It isn’t mentioned in the ads, but it is also commonly used for seizure disorders and, lo and behold, depression.
The decline from this company came without ever requesting medical records. There was a leap of assumption on the part of the underwriter that this client had put down depression, but the problem was really bipolar disorder and this leap of assumption was based solely on the medication. We shopped this case for her and detailed everything up front including what the other company had done and we were able to get her an approved policy at standard rates, a fair rate given her history of depression.
The knee jerk reaction from the majority of life insurance companies when it comes to depression, anxiety disorders and bipolar disorder is unfortunate. A large percentage of these folks are wearing the sign and taking the medication and leading normal lives. They hold down jobs, have healthy family and community lives, don’t sit around thinking about suicide, aren’t in and out of hospitals, comply with their treatment programs and in general are no more of a mortality risk than the average person that doesn’t have one of these issues or at least hasn’t been diagnosed with it yet.
A little friendly advice if you happen to be part of one of these groups and need life insurance. First, don’t go to your State Farm agent (or whoever handles your auto and homeowners). Those companies are licensed to sell life insurance but it is definitely not what they’re good at and the agent is licensed to sell the product, but they have no training in how to find you fair underwriting for your issue.
Second, don’t go to the big online insurance agencies. They are volume shops and writing a policy for someone with say, bipolar disorder, takes some time and doesn’t fit into their style of doing business. You are going to clog up their well oiled machine and while they might find you an approval, it’s not likely to be the best one out there for you.
Third, do find an independent agent who has a background and track record in dealing with your particular issue. You’ll know when you talk to them because we ask questions that will tip you off to the fact that we’ve been there before. We won’t just take down minimal information and run quotes for you. We’ll take a lot of information and then take the time to shop it for you.
Bottom line. Take heart! While the majority of life insurance companies are very conservative and would prefer to skirt around the whole issue of mood disorders, there are 15-20 companies out there that really have their head screwed on right and know how to fairly underwrite your case.
November 17th, 2008
Over the years we have offered discussion on how to get the best possible life insurance rates even though your health is less than perfect. The truth is that with perfect health and family history you can probably find good rates at any number of sources and how to go about it is not a big issue.
But let’s be real. The truth is that those who have at least some health issue are more numerous than those who don’t. Those with more serious health issues such as diabetes, heart disease and obesity or mood disorders such as anxiety, depression or even bipolar disorder are not the majority of those seeking life insurance, but they are the group in the greatest need of hands on experienced help in finding the right company and the right rate.
There is probably nothing I have harped more on over the years than compliance and control. These are the first things that a life insurance underwriter will look for, and lack of either might very well be the last thing they look at when reviewing your application.
Are you compliant, truly steadfastly compliant with your prescribed treatment? Do you take your medication as prescribed or, for instance, do you just take medication when you feel like your blood pressure is high? Have you taken seriously the lifestyle changes that your doctor has recommended? Do you keep regular appointments and do you complete any suggested testing?
With compliance comes control, but I’ve found the biggest challenge in this area is your own education about your condition. If you have diabetes, do you know what your hbA1c is? If you’ve had a post cardiac issue stress test do you know what your ejection fraction is? If your cholesterol is an issue do you know what ranges are considered normal and high and do you know what your HDL and LDL are and what they mean? If your blood pressure is being treated do you monitor it on a regular basis and do you actually know the difference between diastolic and systolic? Do you know what it means when one of them is higher than it should be?
I guess what I am getting at is the difference between being told by a doctor that you’re doing OK and knowing for yourself based on test results just exactly how you are doing. A good example would be if you have diabetes and on your blood test your hbA1c is 7.5 and your doctor says you’re doing OK. Let’s just keep monitoring it. If you knew from your own studies that a reading of 6.5 was better than OK, in fact excellent, you might ask your doctor what it would take to get to better control.
I’m not saying that it’s not good to know you’re doing OK, but I know from experience that doctors aren’t big on education and OK really is good enough for most of them. But is good enough for them really your goal?
Bottom line. Compliance and control are the most important keys to the best possible rates when your health isn’t all that you wish it was. In an age where online health education is just a click away, there really isn’t a reason not to know not only how to manage your health, but how to measure it.
November 15th, 2008
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