Posts filed under 'bipolar disorder'
I went to the big city with my wife the other day. Now understand that I dislike shopping about as much as a person can, but a couple of times a year I will give in, amuse my wife, and do it with a smile.
That is in sharp contrast to shopping for the best life insurance deal for a client, something I do daily and with gusto. It pays off big time for my clients. Today we got an approval for a client who has bipolar disorder. He had thrown it to the wind several times and was declined with the exception of a highly rated approval by one company.
We shopped it were able to get a standard rate approval for this client, a full $5000 a year under the best offer he had received from his other applications. There are rewards for being methodical and not haphazard when it comes to shopping and there are rewards for not assuming that just because most companies are going to beat up on an individual, that one company won’t bust through and get the job done.
This particular client fit perfectly into the criteria that I’ve laid out in this blog so often for bipolar, the steps to a good approval.
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. Best rates come when a person is not using anti psychotic drugs for control
Bottom line. Shopping with gusto is something I can do as long as it’s for life insurance and not shoes.
March 15th, 2010
So you just got declined for life insurance and you’ve decided that life insurance companies suck. The truth is you may have just had a goose lay a golden egg for you.
So, the good news in a decline? It almost always means that you either had the wrong agent or the wrong company, or both and you now know why you were declined. OK, I know you’re waiting for the good news. The good news is that if you know why you were declined and you take that information to the right agent who takes it to the right company, you will more than likely get approved.
If I’m you, the first question that comes to mind is how do I find the right agent? Well, I wish I could tell you it was as simple as going to www.rightagent.com, but alas, it’s a real estate agent site. So, narrow down what you’re searching for, and fire up the search engines. Don’t get sidetracked by agencies that are obviously using every key word they can just to attract attention. Look for links to agency blogs that actually show that there is some knowledge of your particular health issue and some expertise in being able to find good rates.
Then interview them. Call and ask questions. You know your health issue. Find out if they know it too. Do they ask you questions about your health issue that make sense? Do they seem to be digging for relevant information? Can they explain to you why the information they need is relevant to a life insurance underwriter?
When you feel like you’ve found a knowledgeable independent agent, lay it all out for them. Tell them you’ve been declined and by what company or companies. Tell them about the interactions you had with the agent or agents that worked on your declined applications. Tell them everything you know about your health issue and if they ask you to call your doctor for copies of tests or more information, do it for them.
Does it have to be an independent agent? I think not using an agent that has the freedom to go to the best company for your situation is foolish. You want an agent that has absolutely no allegiance to any company. You don’t want an agent who is trying to rack up points with a certain company to win a production prize. Their only focus should be who will approve you and give you the best deal.
Bottom line. Most people who contact us do it when they’ve been declined. I have this vision of someone being declined, for instance, for bipolar disorder and angrily typing into Google “bipolar life insurance”. Call up Ed Hinerman and see if he really knows anything about how to get life insurance if you have bipolar disorder. If not, go to the next.
February 24th, 2010
Life insurance is not underwritten based on your take on your health or your mental state. If it was the case, everyone would be approved at preferred plus.
We have built a very good reputation over the years for being able to turn declined life insurance applications into approvals. A lot of times the reason for the decline is an obvious error on the part of the client. For instance, say they had bipolar disorder and decided to get their life insurance from their Farm Bureau agent. After all, he didn’t seem to have any problem insuring your car or your home, right?
In those cases, many times, it really is just a matter of getting all of the facts according to the client, presenting it to a large number of companies, going with the best offer and presenting an approved policy.
But sometimes when you listening to the story about the decline, things just sound a little out of whack. It’s in those cases that I will often ask the client to supply a copy of the records that seem to have been the primary cause of the decline. That’s the best way to cut right to the meat of issue and determine what we need to be presenting to underwriters.
Let’s use bipolar disorder to make a point. If a person with bipolar applies for life insurance and they kind of skirt the issue by saying they’ve had, for instance, a few bouts of depression in the past, the application will get declined. If they admit bipolar disorder but paint a perfect, glowing account of a life free from bipolar symptoms, but their records paint a different picture riddled with manic trips to the ER or depression so crushing that they are on disability because they can’t deal with the world, it’s a decline.
If, on the other hand, a pre-review of the records gets all of the skeletons out of the closet and those are all divulged informally in a trial process with multiple underwriters, there is a very good chance that there will be an approval. There will still be plenty of underwriters that will say no thanks, but they won’t get the formal application.
I’ve used the following criteria in several posts about bipolar underwriting and the criteria is listed on our bipolar specific website. Based on this post and an interview I did with a prospective client today I am adding a few addenda (bold faced).
1. Someone who has not been hospitalized for bipolar disorder other than for diagnosis? This includes ER visits and outpatient programs.
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 verifiable stable family life or social life?
5. Someone who is exhibiting a verifiable 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.
Bottom line. Within given parameters there are good rates to be had for life insurance even if you have bipolar disorder. The first step is to give it all up for the sake of accuracy and full disclosure. It may not feel good, but the result will.
February 18th, 2010
I was involved in an exchange on the Bipolar Disorder Forum of eHealthforum not too long ago. A person had been declined for life insurance and wanted to know if anyone knew the way out of the jungle.
The person asking for help had been declined for life insurance three times due to bipolar and they were ready to throw in the towel, three strikes you’re out. One wife shared that they had been able to get life insurance on her bipolar husband.
Another agent suggested that it was unlikely they could get traditional life insurance given all of the declines and that they should consider a guaranteed issue graded death benefit policy. This is exactly the problem with too many agents. They see a decline, assume it’s completely justified and either walk away or recommend guaranteed issue, all without knowing anything other than the general diagnosis.
I shared my general thought on most declines and that is that, rather than being a dead end, it simply means that it is a case of the person having used the wrong agent who used the wrong company. It is absolutely true that there are underwriters out there who will die never having had the pleasure of processing an approval on a bipolar application, but we work with underwriters all the time who, given reasonable parameters, will give their blessing to the same application in an instant.
I offered the same criteria I try to include every time I speak to the subject of any of the mood disorders, depression, anxiety, ADD, and especially bipolar disorder. Given these parameters and the right agent there is a high likelihood of approval at reasonable rates.
1. Other than for diagnosis, no hospitalization for bipolar in the last 10 years
2. No suicide attempts or suicidal ideations
3. You can’t be on disability for bipolar
4. You have to be compliant and consistent with your treatment, both medicine and consistent psychiatric followup
5. You have to have a stable home and work life
6. The best rates are usually when treatment doesn’t include anti-psychotic drugs
Bottom line. With the number of life insurance agents out there, and the fact that at any given moment most of them are brand new or working for large internet agencies that don’t put a lot of emphasis on quality and effort, the chances of you finding the right agent who can find the right company are slim. I don’t say this to discourage anyone, but rather to possibly change your focus from a shotgun approach to a more focused search. Talk to a prospective agent and ask questions about bipolar disorder. If they don’t know how to answer your questions I assure you they are not the right agent.
February 6th, 2010
There are plenty of people who would argue that 2009 could have been flushed down the toilet and not missed, and my prayers go out to all of those whose lives were derailed by the recession. For those I wish a dramatically better new year.
But, when it comes to life insurance underwriting of the impaired risk variety, it was a year that started strong and improved from beginning to end. When I started working with clients with bipolar disorder two years ago my goal was to simply find a few good companies that were open to the idea of approving policies. Nothing earth shattering, just approvals. Working with about eight different companies the picture soon started to come together that not only were approvals possible, but given certain criteria, very good approvals were not out of the question. The criteria below seemed to be the crux of what meant the most to those companies that were willing to admit that not everyone with depression or bipolar disorder was an imminent mortality risk.
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. The best rates came when multiple meds were not involved and anti psychotic drugs were not part of the treatment plan.
We continued to see some leeway creep into underwriting for type 2 diabetes. One company stepped up and decided to stretch underwriting of late onset (post age 60) diabetes within certain guidelines to include, absent other risk factors, preferred plus rates. While age of onset is still a big factor for anyone with diabetes, compliance and control as measured by the A1c was still the benchmark with 7 or below being favorable and below. We saw one false positive when someone at Transamerica apparently misunderstood what they heard at a meeting and announced to the world that Trans was no longer looking at early onset as a negative. Not sure where they are working now, but hope it works out better for them.
Bottom line. We always have been able to and still can get the best rates in the country for the perfectly healthy, but for the rest of us it’s all moving in the right direction as well.
January 4th, 2010
I have been working with a physician who has bipolar disorder and we were declined on our first life insurance application through Transamerica. Trans has pretended to be more aggressive or creative or whatever, on their trials than they actually are on formal applications, but at least for a few paragraphs that isn’t the point of this post.
I’m often asked what impact a decline has on the next attempt to apply for life insurance. People are naturally concerned that if one company doesn’t like them the word will spread and they might be completely out of the game. Actually, nothing could be further from the truth.
A decline, while frustrating and a bit humbling, gives a good agent and you the ammunition you need in order to succeed the second time around. When a company declines an application, while they are hardly ever specific about the reason, they will generally give you a good idea what they didn’t like. For instance, “confidential information contained in Dr Smith’s records 2008″. The next step is to go through Dr Smith’s 2008 records line by line and see what jumps out as being potentially annoying from a mortality risk point of view.
Assuming it wasn’t a mention of homicide or suicide or some other egregious act of uncivility that would lead to an across the board decline, the next step is clear. Shop the case using the exact language from the records and admit in the request for offers that Trans declined the case. A knowledgeable agent will have enough background with the companies he or she represents to know if an offer is likely.
The good news using this approach is that any offers that do come through are pretty unflappable. They already know the bad news. In my experience about half of the time the approval comes back better than the trial because you gave them all the bad news in the trial and when they get the complete records they get to see the good news that comes with the package.
As to Transamerica, it seems that they are trying to wiggle back into impaired risk competition by giving aggressive trial offers. Based on the experience of my first two cases of bipolar that we ran Trans applications on I would say that they are more conservative than they are letting on. Not sure what is gained by that, but it is what it is. Both cases were placed with other companies. This most recent case was approved by Banner Life.
Remember, the criteria that needs to be there in order to get a reasonable approval with bipolar 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. Best case would not include treatment with anti psychotic drugs.
Bottom line. One company’s decline is another company’s next approval. If your agent gives up in the face of a decline, get another independent agent.
December 11th, 2009
It’s December and it’s been an outstanding year in helping those with bipolar disorder find the life insurance they need at affordable prices. Most of our successes have been snatched from the jaws of defeat that other companies have held our clients in. Most have been declined at least a few times before they find out that not all companies underwrite the same.
I’ve often shared the basic criteria it takes to get approved for life insurance if you are bipolar. It doesn’t work with just any company, but independent agents should have access to enough companies that, given the right criteria, an approval should be within reach.
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. Preferably someone who is not on anti psychotic drugs, although this isn’t set in stone.
We just an approval, a very good one, on a client and without using his name I believe he would be ok with me sharing what his psychiatrist said about him. It really typifies what you would find in a person’s records if they were tracking with the criteria above.
“I have seen the patient on a once a week basis since 2006. During this time period the patient has been stable and has functioned at a high level in his work. He is seeking new opportunities for expanding his knowledge and plans to work toward self employment.
The patient has not suffered any manic, hypo-manic or depressed periods during my time with him. He takes Depakote (mood stabilization) which has controlled his BPAD and he is compliant with taking medication. In other words, his BPAD has been well controlled, especially given the stresses of his job and additional education.
The patient’s mental status examinations have been consistent. He is early for his appointments, well motivated, well groomed, cooperative and pleasant. He has always been oriented to time, place, person and situation. His speech is of normal rate, tone and prosody. His mood is usually euthymic, with some degree of anxiety and sadness at times. The patient has never manifested suicidal or homicidal ideation. He has never been delusional nor experienced auditory or visual hallucinations. His concentration and memory have always been intact. His judgment and insight are good.”
I know there are plenty out there that think that these thoughts would apply to maybe 1 in 1000 of those with bipolar disorder and while this client is certainly a model to shoot for, he is just one of an astounding number of professionals who just also happen to have bipolar disorder.
The reason people (and underwriters) have negative thoughts about bipolar is that there are so many with the disorder who simply go unnoticed because they have milder cases and take their treatment seriously. You wouldn’t know they were bipolar unless they told you. For these people life insurance is only an obstacle if they pick the wrong agent who picks the wrong company.
Bottom line. One of the things that has really stood out about this past year is the number of CEO’s, doctors, dentists, psychiatrists and other professionals who have trusted in us to give the life insurance experience one more try and with almost all we have been successful.
December 5th, 2009
I wrote my first United of Omaha life insurance application in 1978. Those were the days of Mutual of Omaha’s Wild Kingdom, Marlin Perkins and the advent of yearly renewable term insurance.
They were a powerhouse company back then with all captive agents and a brand that most companies could only dream of. Their products were solid. Back then even health insurance had a good name if you bought it through them. Then they fell off the radar for a very long time, adrift amongst those companies who really wanted to remain closed to brokerage business but watched every year as their market share dropped.
So, like most companies in their position, they started dipping their toe in the brokerage water. They had some success but didn’t seem able to think quick enough to keep up with the dizzying term life insurance rate wars of the last 10 years and the need for competitive, as opposed to textbook, underwriting. Until recently.
They seem to have finally pulled it all together. They have competitive products, and they’ve pulled some of the best underwriting talent in the business to their team. They are now, right this moment, the team to beat in impaired risk underwriting. They got competitive and then they really threw a knockout blow by being the first company to seriously table shave term insurance with their FIT test, a series of questions that allow credits toward better rate classes. This lifestyle and health crediting program has allowed us to get better than normal rates for those with diabetes, bipolar disorder and pulmonary issues to name a few.
Bottom line. United of Omaha is positioned to take some serious market share if they stay the course. Their combination of pricing and creativity is coming at a time when everyone else is walking cautiously waiting for the recession to back off. Marlin would be proud.
December 3rd, 2009
I’m as guilty as anyone on this. I go to the doctor and they tell me what’s wrong and what to do about it. I go home and decide that either I’ve got a better idea or at least a cheaper one, so I modify the treatment plan and go on with life.
There’s a lot of times that works out. A person might have borderline diabetes and the doctor might prescribe medication. They go home and decide that the $100 a month medication can easily be replaced by free diet and exercise. Their glucose levels come back down to normal and all is well……until they apply for life insurance!
When the underwriters see medical records with a prescribed treatment plan that hasn’t been followed and hasn’t been discussed with the doctor, there’s a problem. Now, if you discussed with the doctor trying diet and exercise before medication then underwriting life is good. It’s all about including the doctor.
I am currently working on quotes for a guy who was diagnosed with bipolar disorder in his teens. After a few years he moved, quit the medications and started seeing a different therapist. He hasn’t had any problems since and is leading a normal, productive, non medicated life. I can tell you without having received the quotes that several companies will take exception to the fact that he quit the medication on his own after, whether it was right or wrong, having been diagnosed bipolar. My hope is that some will look beyond that original diagnosis and underwrite him based on more recent history.
Bottom line. If you disagree with your doctor on a treatment program, have a talk with them and let them know you would like to try a different route. If they don’t agree, second opinions are never a bad idea. If you can’t find anyone that agrees with your plan of attack and is willing to back it up by blessing it in their records, you are liable to hit bumps when you apply for life insurance.
December 1st, 2009
This is a theme I have pounded on for some time. There are the obvious cases where, for instance, someone with bipolar disorder who goes to their Farmers insurance agent should not expect a good outcome. Wrong agent with the wrong company.
In that case there is no competition for the agent’s business. A Farmers agent can only write for Farmers. They only have an underwriter who can review the case through the lens of Farmer’s philosophy and Farmer’s reinsurance agreements. They get one opinion for their clients when there are hundreds of opinions available to an independent agent. They are also stuck with the fact that property/casualty companies like Farmers, State Farm, and Allstate just to name a few, have life insurance available but they are very conservative because it isn’t their area of expertise.
Then there is the independent agent who has contracts with multiple companies but either doesn’t know how to shop a case or just doesn’t shop a case before applying. Not knowing how is usually a matter of not understanding the health issue and what underwriters need to know in order to evaluate the case. It is also a matter of not understanding the power of the trial offer. This combination which can either be sort of the right agent/wrong company or wrong agent/right company also ends in failure.
When all of the facts that an underwriter cares about are presented prior to a formal application and they approve a trial offer at, say, standard rates, they have painted themselves into a corner of sorts. The trial is only as good as the information presented and this is where it is essential that an agent understand what underwriters need to know and understand the underwriting issue and are dogged about making sure they client presents all the information accurately. If all the information needed is presented accurately and a trial offer is given, an underwriter is hard pressed to approve the application differently. If they find new information in the medical or psych records that wasn’t presented, all bets are off.
Not shopping a case on impaired risk cases is simply not doing your job if you are an independent agent. Many agents will simply send the application to their favorite company or the one the pays the best commission and hope they can make the sale when the bad news comes back. In this instance there is a fine line being walked that smells like bait and switch, but could just be ignorance or laziness on the part of the agent.
The right agent using the right company for each client has a high degree of success in getting cases approved at the rate initially quoted. The agent knows what underwriters need to know and insists on having the information before shopping the case. Many times when a certain part of a client’s health history isn’t clear to me I have told them that I need to see the medical or psych records in order to make sure that we present everything accurately on the trial. I’ve had customers walk when I ask them to go the extra mile. I’ve also had customers who had been declined several times get approved because we were able to present the facts on a trial to a wide range of companies.
Bottom line. How do you know it’s the right agent? If you have a serious health or mental issue, whether it heart disease or chronic depression, your agent should be able to understand what you’re talking about and should be able to ask intelligent questions about your condition. If they quote without asking questions or digging for more information you are, in all likelihood, talking to the wrong person.
November 11th, 2009
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