Posts filed under 'Anxiety'
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
We have been blessed with a lot of success in helping those with well controlled bipolar disorder, anxiety disorder and depression, find life insurance companies who will, first and foremost, give them a fair hearing and secondly, make fair offers on coverage.
I was contacted recently by a person that had been diagnosed with cyclothymia, a mild form of bipolar disorder. At first, being unfamiliar with cyclothymia, as opposed to just bipolar 1 or bipolar 2, I immediately googled it which helped me to structure the wording of the email I sent out for trial offers. I didn’t cite Google, but was pleasantly surprised when an underwriting response from one of the life insurance companies included a definition from Google as part of their reason for offering preferred or preferred plus rates. The following is the response I received.
“Cyclothymia is a chronic bipolar disorder consisting of short periods of mild depression and short periods of hypomania (lasting a few days to a few weeks), …per definition in Google. Feel tentative Preferred Non Tobacco even the possibility of Preferred Best since description below implies good control with no major episodes.”
It is refreshing to me that underwriters are using all of the technological tools available to help them correctly assess mortality risk. While it may seem like a logical thing to do, the underwriter who actually digs and fits the pieces of the puzzle together is rare.
Bottom line. While I am excited because underwriters are starting to embrace technology, we should all be excited to see the words preferred and preferred best in the same sentence with bipolar disorder. All the pieces of the puzzle have to fit in order for that to happen, but it is attainable.
September 12th, 2008
As we’ve discussed many times, good life insurance rates are available if you have bipolar disorder if you meet certain criteria, underwriting guidelines. For the purposes of underwriting, while the companies may call them guidelines, assume they are rules. You are simply not going to slide by sort of meeting most of the criteria.
If I could sum up all of the criteria, it would be something like well controlled, or stable. But rather than a summary because I want people to know exactly what works and what doesn’t work going in, another review is in order. Remember that while these guidelines are pretty specific to bipolar disorder, they can be used for any mood or mental disorder including depression, anxiety disorders and attention deficit disorder.
1. No suicide attempts ever and no notations of suicidal thoughts in the last 10 years in your medical records.
2. No hospitalization for bipolar in the last 10 years other than for the purposes of diagnosis.
3. Compliant and proactive with prescribed treatment. No taking it when you feel like you need it and not taking it when you feel like you don’t. I guarantee you that it doesn’t say “as needed” on your prescription.
4. Stable family and work life. Underwriters understand that people change jobs, and unfortunately marriages don’t always work out, but inability to hold a job is different than changing jobs. A marriage not working out is different than one that is devastated by out of control bipolar.
5. You need to be able to exhibit social functionality. You can’t be on disability for bipolar. Being on disability means you are not able to function normally.
6. No drinking problems.
These criteria don’t preclude even the majority of people with bipolar disorder. To the contrary, from all I’ve learned in working with the bipolar community these criteria probably describe the majority. We have been able to successfully find the coverage that people from CEO’s to stay at home moms have needed in order to protect their families.
Bottom line. Not all companies will approve you even if you meet those criteria. Some will decline you just on the mention of bipolar disorder. That is just a quirk of the industry and the reason you should seek the assistance of an independent agent. An agent with experience in mood disorders will know what to ask, where to shop it and how to get it approved.
June 26th, 2008
There must be a couple of million people in the US licensed to sell life insurance. If you take in the giant internet mega agencies, all of the independent agents, and all of the captive agents (work for just one company), the possibilities for purchasing life insurance become staggering.
Put in context, there are probably as many, if not more doctors. Does that mean that no matter what is wrong with you, there are 2 million choices for a place to go for treatment? I’m thinking not. If you have a cold, a cardiologist is likely not going to see you, and if you’ve had a heart attack, it’s highly unlikely that your general practitioner won’t refer you to a specialist. There are those unfortunate times when GP’s think they know the answer to everything and attempt to treat serious illness in house, but those are rare.
Life insurance is one of those areas where the millions of choices doesn’t mean you have millions of appropriate choices. For the average very healthy person under 50 probably any independent agent or agency can do a good job of finding a low rate with a good company. As I’ve mentioned before, young healthy buyer beware though. Even though the mega agencies on the internet can find competitive rates, they have a bad habit of signing lucrative bonus contracts to push the bulk of their business toward a certain company. The good news is that the company is generally competitive. The bad news is that, as I’ve noted in so many previous posts, competitive doesn’t mean best. An independent agent doesn’t do the volume and therefore we are never offered these type of contracts. Speaking for myself, I place every case with the best possible price and product for my client. Seems like the right thing to do.
One other note on our perfect health client. Stay away from your auto and homeowner’s agents. You will be outrageously overcharged for life insurance because it isn’t what they do. Sure, they have a product and they are licensed, but having a license doesn’t mean you know what you’re doing and having a product doesn’t mean the price isn’t way too high.
But I want to make a very important distinction. Just like the doctor scenario, if you have some medical issue, a knowledgeable independent agent is where you want to go. We are the specialists in the life insurance business. Just a quick list of what I am talking about will help separate the GP’s from the specialists. If you have diabetes, Hepatitis C, heart disease, a history of cancer, a seizure disorder, mood disorders such as depression, anxiety or bipolar, and on and on. These are issues that it is hard for the average agent to provide good service on. These are issues that will get automatically declined with most property casualty companies (auto, homeowners).
How do you know you’ve called the right person or stepped in the right door? All insurance agents make money from the culmination of a sale, the placing of a policy in force. They all want your business and the truth is that most of them are struggling. There is a real tendency in the business for agents to take on business that they have no idea what to do with, just in hopes that it works out. It usually doesn’t. You know you’ve found the right agent if they show a knowledge of your particular issue by the questions they ask. If they don’t ask questions they don’t have the information it takes for them to come through for you. If they don’t seem to know, for instance, the difference between type 1 diabetes and type 2 diabetes, they don’t have any business working for you.
Bottom line. Before you commit to applying through an agent, be confident that they know what they’re doing. In my next post I will reveal the secret weapon for weeding out the BSer’s from the straight shooters. It works every time, guaranteed.
May 28th, 2008
I don’t know that I was shocked, but certainly took note the other night when, unless my memory is as bad as my wife says, I saw an advertisement for bipolar disorder medication during prime time.
The medication is Abilify and I am not posting this to endorse it or make any claim at all about its’ effectiveness. I will offer one article just so anyone that hasn’t heard about it has a base to start their investigation from. I did want to note that, just like hearing for the first time that life insurance is attainable for someone with bipolar disorder, there is a sort of “out of the closet” feeling to seeing it recognized as something that can be talked about openly.
The other end of the scale which I doubt we’ll see was America’s fond embracing of “ED” problems and the associated medications. Depression and medications for it have been advertised for years without going over the deep end. It has helped to raise awareness of depression and anxiety disorders. I hope that it can do the same for bipolar disorder.
We continue to experience success in placing reasonably priced life insurance cases for folks with well controlled mood disorders, whether anxiety, depression or bipolar. This is huge. If there was some way to quantify the number of people who are declined annually just for mentioning these types of issues on their application I have not doubt it would be huge. Staggering. And the crime (although it’s not really a crime) is that many companies will simply decline these cases off hand without getting medical records or any additional background information.
What we’ve found is that the few reasonable companies that employ the few reasonable underwriters in the business are actually doing their job. They are underwriting rather than offering knee jerk opinions, or buckling to a board of directors who have laid out a clear agenda of not insuring anyone who isn’t perfect in every way. The real blessing is that there is reasonable out there and it can be obtained.
Bottom line. We’ve had great success given a few parameters. Obviously it would be a case of adverse selection to offer good rates to those who are truly on the edge, hanging on to life by a frayed thread. But for those who have a history of keeping it together, being compliant with medication and treatment, and maintaining stable family and work lives, the door is open.
May 20th, 2008
This is a stressed out world we’re living in and it would be highly unlikely that you don’t know someone suffering from either anxiety or depression, and not too unlikely that the someone could be you. The more pressure the world exerts, the more likely that our coping mechanisms are going to need some help.
From a life insurance underwriter’s point of view, if the anxiety or depression is mild to moderate and a person is compliant with treatment and stable, rates as good as preferred are not out of the question. I have run into more and more people who are treated for both, but again, given the criteria above an underwriter would not likely pile up on a person due to “multiple impairments”.
I read an article just recently that suggested that rather than anxiety and depression being two distinct disorders, that in many it seems that the two impairments are really just separate manifestations of the same disorder. There appears, in fact, to be a genetic link between the two.
As we’ve discussed on a number of occasions, no matter what the impairment, from depression to anxiety to bipolar disorder, life insurance can still be attainable if your life can be characterized as stable. I’ve taken a bit of a beating over one of the other underwriting criteria that goes along with mood disorders, the fact that you can’t be on disability due the impairment. I’ve had several people cry foul on that guideline, but let’s be real. If you are functional and stable, you shouldn’t need to be on disability.
The best demonstrators of functional and stable are family and work life, and no recent hospitalization due to the impairment. Attempted suicide really throws a damper on the whole thing.
Bottom line. A good independent agent knows what to ask and how to present it to provide you with the best possible chance of getting affordable life insurance. Don’t try this with your local State Farm agent unless you feel like racking up a decline or two before you finally find approval.
May 19th, 2008
I was recently contacted by a person who had been declined by an insurance company (pretty much an every day occurrence here). This person had been treated for depression for quite a while, but successfully treated.
The person was leading a normal, stable life. Family, job, the whole thing has gone on without a hitch for the past several years. The hitch (for the insurance company) was that a few years ago this person’s doctor switched her to a medication generally only used for bipolar disorder. Not that it’s not effective for depression, because it is, but this person being on Lamictal led the insurance company to decline the application without ever pulling medical records. A bipolar drug was enough for them to freak out and go screaming into the dark.
It is this underwriting mindset that leaves so many people in this country believing that they are uninsurable when, with the right independent agent and the right companies, that conclusion could not be any further from true.
I think to a very large degree it is the average life insurance agent out there that is the problem. They know how to pitch the product and fill out applications. When they are lucky enough to find a completely healthy client, place a policy and get paid, they believe they are in fact a life insurance agent.
It is this same lame excuse for an agent who will pitch the product and fill out the application and submit it, not knowing what question Lamictal might raise, that really messes up the business and gives a lot of people the idea that life insurance companies are unfair. Anytime there is a chance that an underwriter might do the unexpected, the case should be shopped. Lay it all out there and let the underwriter with his or her head screwed on right win the day. Take the business where they have already heard the details and know that there is more to the story than what appears on the cover.
Bottom line. Depression, anxiety and bipolar are all issues that, as long as they are well controlled and properly shopped, can produce very positive results for the person wanting fair rates on their life insurance. How do you know if the agent you are dealing with is the right agent? How do you know they have a clue? Ask them questions about your issues and see if they understand them. Quiz them about their success rate on those kind of issues. Don’t just listen to the pitch, throw it against the wall and see if it sticks.
May 9th, 2008
I wouldn’t presume to beat a dead horse, but so seldom is there any significant shift in life insurance underwriting that it bears as much good press as it can stand. While life insurance companies have, for a long time, been fairly tolerant of mild situational depression, many companies are now taking a new look at what used to be a group of automatically declined mood disorders.
I have gone on and on about the results we are getting with well controlled bipolar disorder. Bipolar still leaves the majority of underwriters running, screaming into the dark. Then there is a group of companies that has taken pause to look at the whole issue from a new direction. What if this person really is a functional, stable member of society? What if they really have a track record of compliance with treatment and what if they haven’t been in and out of the hospital? What is the real risk?
Anxiety disorders and long term depression are getting the same fresh look from these companies. By the way, these companies are some surprising new upstarts that are going out on a limb. This is the same group of companies that have led for years in underwriting difficult issues such as diabetes, epilepsy, heart disease, etc. They are on the cutting edge of prudent, fair underwriting. They are the companies that are making a difference in groups of people that have been shunned for a long time.
Bottom line. Spread the word. Fair rates are available for the less than perfect insurance risk. You and I may not get the rates we see splashed on TV, but in most cases we shouldn’t be looking a decline letter either.
April 14th, 2008
40 years ago it was a rare thing to hear of someone who was on medication for depression. Of course back then people really didn’t talk about “those kind†of problems very openly. Treatment options were generally restricted to visiting a psychologist, therapist, or psychiatrist.
Now conditions such as depression, bipolar disorder and anxiety are talked about and blogged about and the medications are more commonly known than most medications for cholesterol or back pain. I doubt if many of us don’t know someone who is taking Prozac, Zoloft or Paxil for depression. There’s plenty of anxiety to go around making us familiar with Xanax or Buspar. Most people are familiar with Lithium as a treatment for bipolar and more than you might think are aware that anti-seizure medication like Depakote is a common medication for controlling the manic/depressive symptoms.
Anxiety and depression have probably always been around and are now more openly discussed and fortunately more quickly diagnosed and treated. If someone with a mood disorder is compliant with today’s treatments, very often even their closest friends may not know what they are dealing with.
How do life insurance companies view the conditions and medications? You should know by now that I always start with what an underwriter looks for first. Compliance and control!!! Are you following the doctors orders and do you have control? In this case control would be defined as being able to carry on both a work and family life in a stable way.
Just a note about depression. There is an underwriting difference between situational depression and chronic depression. If someone close to you dies, depression is a normal response and would be considered situational. Generally treatment doesn’t last for years as a person adjusts to the loss or whatever the situation was. Chronic depression may or may not be brought on by a particular situation, but is often continually treated for years, if not for the rest of a person’s life.From an underwriting standpoint, a situational depression may receive more favorable underwriting, but both types of depression can be underwritten at better than standard rates, often preferred rates, as long as compliance and control are present.
Anxiety disorders are practically as common as headaches in our society and personally I understand why. I live in a small town because the big cities make me anxious. I don’t like being there. I don’t like driving there. I don’t know people who live in cities cope with it. Again, anxiety disorders are looked at the same. With the medication can a person function well? Are they compliant and is their condition under control?
Bipolar is underwritten with basically the same pattern. I should add here, and this goes for depression and anxiety also, if you are on disability due to the problem, that is not considered good control. If you are occasionally hospitalized, that is not good control. If you have attempted suicide, well, are you seeing the pattern?
Bottom line Better than standard and even preferred rates are attainable with mood disorders if you use the right independent agent. Control is the key.
April 3rd, 2008
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