Posts filed under 'blood pressure'
In Job 12:11 it says “Does not the ear test words, as the palate tastes its food?” When a life insurance agent gives you a quote that you know sounds a little too good, do you question it or set yourself up for disappointment by choosing to believe something that, deep down, you really know isn’t accurate?
It’s OK to tell an agent to back up their quote with something from the company they are suggesting. Two things I share fairly often are copies of company underwriting guidelines and copies of underwriting trial quotes that show to a client that I’m not just throwing out low ball quotes in hopes of snaring their business. The quotes are based and formulated from facts and backed up by the company.
Let’s pick this apart a little. Say you have presented your health history to an agent and you are treated for high blood pressure. The agent quotes the best rate class with Savings Bank Life, one of the most competitive companies out there. The approval, if the blood pressure is well controlled, will actually come back at preferred, their second best rate.
Most customers I’ve talked to have heard or believe that high blood pressure treatment will affect their rate, so if you had questioned this agent up front, he or she would not have been able to back up the quote with either SBLI’s underwriting which states for their best rate class, “Blood Pressure: No treatment, past or present, 135/85 up to age 60, 145/90 age 61 and over”. They certainly would not have been able to produce a trial or quick quote from SBLI underwriting saying that blood pressure treatment is OK at their best rate because it clearly isn’t.
If you had been fortunate enough to have an independent agent who knew their underwriting they could have quoted Banner Life, “Blood Pressure: Currently well controlled with or without treatment, with no readings in the past two years greater than 136/86″, or Minnesota Life, “Blood Pressure: Must be better than 135/85 with or without treatment”. Both companies distinguish themselves in simple underwriting by offering their best rate class for treated blood pressure, where the competition is a full rate class behind, 20% to 30% higher.
If there is the chance of a 20% to 30% error on something as simple as blood pressure treatment, consider the chance for egregiously wrong quotes if an agent doesn’t consult with underwriters before quoting something like arrhythmia or type 1 diabetes.
But the point, and I should get back to it, is that you as a life insurance customer are completely justified in asking an agent to show you some kind of proof that, in the absence of some information neither of you knew about, they can come through with the rate they quoted. Really, we usually know if the rate we’re being quoted is just a little too good and while it might feel good to think we might get those rates, it feels bad when we don’t and especially bad when we find out that the agent should have known that to start with.
Bottom line. The proof in life insurance is in the approval, but before you commit to an agent or a company there is a couple of ways to get pre-proof. Test the words of the agent.
November 16th, 2009
There’s nothing that will raise your blood pressure quite like finding out that you are going to have to pay more for your life insurance because you are treated for high blood pressure. Even when it’s well controlled almost all companies feel they need to bump you down one rate class, almost a 30% increase in premiums.
Most life insurance companies would argue that their best rate class is reserved for those who don’t have any health issues. No medical history to speak of. No medications. Just walking, talking little pictures of perfect health. But wait.
One company that bumps you a rate class for blood pressure treatment will allow their best rate class if you have type 2 diabetes and happen to be over 60. Another will bump you a rate class for the hypertension while allowing their best rate class for bipolar disorder in some cases. It’s important, I think, to note that neither of these companies have any provision, any criteria, where you can qualify for their best rate class with treatment for hypertension.
That’s the bad news when it comes to applying for life insurance with treated blood pressure. The good news is that there are a few companies out there who don’t see eye to eye with the rest of the life insurance world on this issue. Just as most companies see treated, well controlled cholesterol as a good thing, Banner Life and Minnesota Life believe that high blood pressure, treated and well controlled is not an issue that should keep you from their best rate class. They, in a sense, reward the fact that you acknowledge the problem and that you are taking care of it.
Banner Life does want to see a two year period where blood pressure readings have been under 136/86, not an unreasonable request. A track record of control is a good thing. Minnesota Life goes a step further and as long as your blood pressure on the exam is 135/85 or better and you are being treated, in the absence of any other factors that would bump you out of the best rate class, you win.
Bottom line. Not all companies are created equal. Most companies have an area where they take a stand that makes them a “go to” company for a specific set of clients. This is, again, why using an independent agent with access to a large number of companies is a real value added for you as a customer.
July 27th, 2009
Guilty as charged. I am one of those recovering saltaholics that grabs the salt shaker and tops off a meal before I’ve even taken a bite to see if it needs it. I love salt and although I am getting better about at least giving something a taste first, the truth is, well, I’m still recovering and fall off the wagon occasionally.
A high salt/low potassium diet is a pretty reliable ticket to the land of high blood pressure, stroke and some types of asthma. A topic of considerable attention lately has been the unbelievable amounts of sodium found in some of the most popular dishes in some of the most popular restaurants most of go to at least occasionally. Sometimes it seems to me that restaurants offerings are kind of self defeating. They make meals taste good by adding large amounts of salt and it often tastes so good that people are driven to eat every last bite, which unchecked leads to obesity.
Now perspective is a good thing. No reason to freak out if there really isn’t a reason, right? They (whoever they are) say that the maximum sodium intake for an adult should be about one teaspoon daily. I am an admitted saltaholic and if I were presented with a salt free day’s worth of meals, I doubt that I would add an entire teaspoon over the course of a day. That’s a lot of salt!
My downfall comes when I eat dinner out at a restaurant that knows two things for sure. 1. We, as a nation, love salt and want it on most everything we eat and 2. The more salt we eat the more beverages we tend to drink. Chili’s restaurants are one of the most consistent abusers of sodium out there. That one teaspoon is roughly equal to 2300 mg. Just a few of Chili’s sodium busting treats are their boneless buffalo chicken salad which sounds healthy but has 4400 mg of sodium, about twice what you should take in on a daily basis. Then there is their Southern Smokehouse Bacon Big Mouth Burger which tops the sodium scale at 4150 mg.
PF Changs has proven to be the king of salt. Their Hot and Sour Soup Bowl tips the scales at an amazing 6878 mg. 3 times the daily recommended maximum in one bowl of soup. I’m wondering if that soup really, really tastes bad and they hope that enough salt will cover it up.
Given the kind of abuse your body goes through at these restaurants, it’s a wonder that life insurance applications don’t ask where and how often you eat meals out. While hypertension and even a stroke can be underwritten at good rates, if a person is hanging out at the who’s who of salty foods, they have to present a higher mortality risk than those who actually monitor their salt intake at almost any level.
Bottom line. Eating right is simply not part of the American way of life and our habit of ignoring how food is prepared, especially the salt and fat that is used, is a recipe for obesity, type 2 diabetes, high blood pressure and stroke. It may be time to ask for sodium confessions before we order a meal.
May 18th, 2009
Sleep apnea is one of those health issues that can elicit anything from a best rate class approval to a decline depending on two things, which company’s underwriter was involved and if you are truly treating the issue seriously.
A layman’s sleep apnea definition might give the wrong impression of why underwriters are concerned. Apnea is actually a period during sleep when a person quits breathing. It is almost always, when they start breathing again, followed by a loud snore or gasping. Sleep apnea is not a mortality issue in the sense that people quit breathing and don’t start again. Think of it as a more severe instance like those when you have been reading or something relaxing and you just haven’t been breathing deeply, and you suddenly have the need for a good deep breath.
So the issue isn’t about whether a person will forget to start breathing or not. Our body takes care of that quite well, albeit a bit loudly. The real issues have to do with the stress put on your body by two things. First, especially in more severe apnea where a person can quit breathing up to 50 times per hour, there is an issue with a lack of oxygen during sleeping hours. The other is that sleep apnea simply disrupts normal sleep patterns and makes for a tired, sleep deprived person the next day.
So the real mortality issues become sleep deprivation and the possibility of a higher rate of accidents, and the oxygen deprivation causing high blood pressure, heart disease and stroke. The other less talked about mortality issue is that your spouse may cause you substantial harm because of your snoring.
So, what do underwriters want to see for optimal results? A good sleep study that defines the problem as mild, moderate or severe. Mild or moderate bring the best results from a rate class standpoint. Probably the biggest issue for an underwriter is what you do about the apnea and how compliant you are with whatever treatment is chosen. If you have a sleep study with a cpap on that shows the cpap reduces your instances of apnea to almost nothing, but you then only use the cpap once in a while, or half the night, compliance is poor and control isn’t good. You aren’t going to win any underwriter points. Surgically corrected obstructive sleep apnea, if success is documented by a study, can put you back into best rate class running barring any other risk factors, such as obesity.
Bottom line. There are real reasons for underwriter caution with sleep apnea, but if you are serious about your approach to treatment there’s no reason you can’t walk away paying very reasonable rates.
May 1st, 2009
Compliance and control! I haven’t beat that drum in a while, but that doesn’t change the fact that those two issues are the major underwriting issues in almost all life insurance applications where health is less than perfect.
I have used that soapbox most often pertaining to diabetes and the fact that without the two C’s, you are not going to like the rates you are approved at (best case) or the fact that you get a decline (worst case). But compliance and control weigh heavily on most health issues from high blood pressure to bipolar disorder.
Compliance could be defined as doing what it takes to stay on top of the health issue. If you have diabetes, for instance, compliance might mean that you check your glucose regularly and that you take your medication exactly as it is prescribed. There is a real tendency for people to get lax with these things and check glucose or take medications when they are having those low glucose kind of feelings. There is also a tendency to be lax about the quarterly followup visits that most doctors want to see. Having full labs done every three months is exactly the way to stay on top of your diabetes and away from all the collateral health issues that could pop up.
So, the same things that are going to positively impact your health are what the underwriters are really looking for. If obesity is an issue, a doctor monitored diet and exercise program. If sleep apnea is an issue, consistent use of a cpap machine. If skin cancer such as basal cell carcinoma is an issue, regular visits to a dermatologist is prudent and reasonable.
Bottom line. Doing the right thing pays dividends. Ignoring them carries a penalty.
April 24th, 2009
Let’s don’t mince words on this subject. If someone is 40% overweight they are twice as likely to die prematurely than someone of average build. It’s not the fat that kills you, but the strain that all that extra weight puts on your body making you a prime target for obesity caused health risks.
The point I want to drive home and the key to reasonable life insurance rates for the overweight is to consider the insurance before any other health issues show up. Weight by itself can increase your life insurance rates, but not to the extent that weight plus diabetes or weight plus heart disease or weight plus cancer will.
A good example of this is a client just recently, who at 6′3″ and 325#, was able to get a standard rate through Prudential because all of the risk factors were excellent. He had blood pressure and cholesterol numbers that anyone would love to stuff in their medical records. His glucose was 87 on the exam. We talked at length and he recognized that he had a need for life insurance and that there was simply not a better time. He knew that because of his weight, his long term health could be an issue.
I was recently contacted by a man who had undergone gastric bypass surgery several years ago and had been told that, because of that surgery, he was uninsurable. Gastric bypass carries less of a stigma than it used to. It used to be looked at as kind of a lazy man’s diet, and a dangerous one at that. But more recent studies have shown that the reward of the drastic action may in fact trump the risks of whittling away at weight a few pounds at a time. The person who contacted me ultimately got a standard plus offer from Banner Life insurance, a classic case of having contacted the wrong agent who applied with the wrong insurance company the first time around.
Bottom line. It won’t cost you anything to find out what life insurance would cost you right now, but the cost of waiting could be the addition of health complications.
April 9th, 2009
It’s just a bad feeling when a life insurance company declines to offer you coverage. They don’t want to accept the mortality risk!! Do they think you’re dying? Is there something your doctor isn’t telling you? Will you ever be able to get life insurance, or are you black balled now?
I can’t tell you how many inquiries come through our website that start, “I’ve been declined by XYZ company due to whatever”. That person’s thinking is that they may never be able to get life insurance for their family’s protection. My thinking is that this is a good place to start! We know who declined the person and we know why so the mission is pretty simple. We need to find a company that doesn’t share the same underwriting philosophy, or figure out if the case was just presented poorly and needs a more complete presentation to put an underwriter at ease.
Supposedly there are about 2000 companies that write life insurance. For many it is just a product they have because they wouldn’t want to miss any chance to make money from you. You certainly don’t think life insurance when you hear State Farm, Farmers or Farm Bureau, but they are licensed to sell life insurance. The only problem is they really don’t care if they do and for that reason their underwriting is definitely anti-approval unless you’re in perfect health and even then their prices stink.
That thought aside, for a minute let’s just assume there was a way to apply with all of the companies at once, all 2000. If you had well controlled high blood pressure you might be approved by
most of the companies, but once you got past the top 100 you would find the rates rather unattractive. If you had a history of asthma I suspect you might be declined by 25% of those companies and the rates after the top 50 would be rather painful to look at.
If you had well controlled type 2 diabetes with no other risk factors I suspect you might get 50-100 approvals and the 10 best rates would be the only rates that didn’t grab your gag reflex and get it going. If you had a history of a low stage and grade prostate cancer you might get 20 approvals and 2 or 3 of those might have a price worth considering. If you have very well controlled bipolar disorder
you might get 5-10 approvals and 2 of those might be workable.
All companies have drawn a line in the sand on just about every health issue you can imagine. That is the bad news. The good news is that for almost any health issue you can imagine there are companies, albeit only a few in some cases, that understand it and as long as treatment is successful, are willing to accept it as a risk.
So why do I consider a decline as a good starting point? Consider the numbers I just presented and consider the odds that your decline came from the wrong company. Declines very often have almost nothing to do with you and almost everything to do with a particular company’s underwriting philosophy.
Bottom line. The chances of turning a decline into an approval are actually very good if you have a knowledgeable independent agent working on your behalf. Don’t take no for an answer.
March 30th, 2009
I knew a guy who made cabinets for a living. He bid jobs through local contractors and directly to homeowners and I could never figure out how he arrived at the prices he presented. There didn’t seem to be a lot of equity between one quote and the next.
Now I know there are differences in materials and I suppose mileage to and from the job site might play into it, but well, it just didn’t add up, so I asked. He explained to me that the calculation was very simple. He could figure the materials right down to the nearest dollar with very little waste. He then added that figure to how much he felt he needed to live on during the period that it would take him to complete the job. If the job was calculated when he had a vacation coming up it tended to be higher than at other times. Very scientific!
Not sure what made me think about that. In life insurance the cost of the job is determined by the health of the applicant and a mortality table, a table that gives the average life expectancy of a person at any given age. Of course in the final price are things like reserve requirements, factors for whether it is paid annually or monthly and, who knows, maybe how much the president of the company feels he will need from each policy sold to live through the next month.
The health of the applicant is a big swing factor since obviously there are those health issues that have an impact on mortality. While we all know people who have lived to better than average mortality experiences while smoking, statistics would show that life expectancy for smokers is shorter than non smokers.
By manipulating the different factors such as family history, driving and drinking habits and whether you have or are treated for high blood pressure, you can see for instance how a 35 year old male who smokes, drinks more than 3 drinks once a week, has 3 or more traffic violations in the past 3 years, has a family history of heart disease and is treated for hypertension, has a life expectancy of 62.3 years.
Compare that with a 35 year old male non smoker, who doesn’t drink and drives very prudently, has a good family history and no problems with blood pressure with a life expectancy of 79.5 years. Even if all of the other factors are in his favor, just smoking reduces mortality by 7 years.
And that is just the surface of a very complex practice known as underwriting. When you consider that obesity is the leading risk factor for diabetes which is a leading risk factor for heart disease, and that each of those health issues has possible collateral health issues, well, sometimes I find it amazing that we can get good, affordable rates for someone who is overweight.
Bottom line. When you apply for life insurance the underwriter has to go figure. While they use mortality tables, they also follow guidelines that have a lot to do with company philosophy. Unless you are perfectly healthy and don’t have any risk factors, the underwriter will have to mix it all together and determine what part of the risk pool you should be paying for.
March 23rd, 2009
It’s been no secret since I followed the Biggest Loser reality series, that while the obesity and BMI challenged might pay a little more for their life insurance than folks that are under the BMI threshold for overweight, there are companies that do offer fair rates as long as there aren’t a bunch of other risk factors rearing their ugly heads.
A client just recently inquired and his build was 6′3, 325. He didn’t have any health issues. One of the best companies around for build is West Coast Life, but based on their underwriting take on this the $1,000,000 30 year term he wanted was going to be $3200+ annually, a budget buster. They stuck to their written guidelines and wouldn’t go better than a table C, which is 175% of the standard rate.
When I shopped it to Prudential, even though based on their guidelines it would have been about the same as West Coast Life, I got a refreshing answer from the underwriter. This underwriter knew the kind of issues to look for in someone who is overweight and they said they would go with a straight standard rate as long as:
“1. BP for last 12 months 130/85 or under
2. Fasting blood glucose 110 or under
3. Cholesterol 275 or under
4. HDL 40 or over
5. Chol ratio 7.0 or under.”
Well, he nailed it. His blood pressure was 110/68, glucose 79, cholesterol 168 and HDL 41 making his cholesterol ratio 4.1. I guess what struck me as refreshing about this whole scenario was that the underwriter wasn’t just throwing my client in a box with everyone of similar build. They started him in the box and told them what it would take to get out, and he did. Home Run!
Bottom line. Thanks to Prudential’s forward thinking underwriters my client is paying less than $1800 annually for the same policy that, best case, would have cost $3200 elsewhere.
March 20th, 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
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