Posts filed under 'blood pressure'
Our family is going through an issue that, after some thought, I’ve decided is worthy of discussion in the context of life insurance. Like the breast cancer I’ve discussed that my mother is just completing treatment on, while I’ll use my parents as an example, they are just that, an example of a problem that is pervasive and can absolutely impact your ability to get life insurance at the best rates possible.
They have outgrown the expertise of their longtime general practitioner and because of that they are not getting the kind of follow up that an insurance underwriter would like to see in order to consider someone for better rates.
When your medical life becomes more complicated, whether that is from gastro intestinal issues, sleep problems or even high blood pressure, quite often your primary care doctor will give you a referral to a specialist. The problem arises when they don’t refer you and just treat symptoms even though they have stepped outside their area of expertise, general medicine.
This complicates things from a life insurance standpoint because underwriters can see that you are not getting the proper advice and treatment. They can see that the doctor is prescribing medication and that they aren’t doing the proper followup tests. An example from my own family is the prescribing of Coumadin with the followup blood tests, the PT-NR, that should be done monthly to monitor your blood clotting ability. The doctor prescribed the medication and hasn’t been doing the followup tests. If my Dad was younger and applying for life insurance, he would be declined simply because he wasn’t getting the treatment and followup he needs.
My Mom has always had a hard time sleeping and the same GP, rather than referring her to a sleep specialist, has chosen to treat her himself. Unfortunately that treatment has been a real hit and miss, try this and try that type of approach. He has gone through several medications and some of those were inappropriate for someone her age. A life insurance underwriter would decline her because of this inconsistency.
There is simply a time when you, as a patient, need to realize that your doctor has stepped out of their box of expertise. It can drag a medical problem on for too long. It can make it worse and it can impact your ability to get life and health insurance.
Bottom line. This isn’t about your doctor and the relationship you’ve had for years. It’s about the care you need and deserve. It’s about resolving health issues in an expedient and professional manner.
September 25th, 2008
I understand that most people go and stay where they are the most comfortable. That’s why so many people end up buying overpriced life insurance through their auto and homeowner’s agent, agents that are captive to companies like Farmers, State Farm, Farm Bureau and Allstate.
An independent agent can offer two things that will set them apart in the life insurance arena to such a distance that you will wonder where the auto and homeowners guys get off even claiming they sell life insurance.
First, and I have documented this in previous posts, the rates available through life insurance companies can be as little as half of the premium you would pay for comparable coverage through one of the Farm companies. The agents don’t have a choice. That is their product and I honestly believe that most of them don’t know any better and believe that their rates are just fine. After all, if they weren’t just fine, why would people be buying them. A case I mentioned just recently with Farm Bureau was on a young couple that was paying $51 a month for both of them for $100,000 of 10 year term on each.
This couple has two very young children and to start with, 10 year term insurance isn’t the right product. They needed at least a 20 year term to make sure things are covered until those kids grow up. We were able to get them $250,000 of 20 year term each and they are paying $33 a month total. So, numero uno, independent agents have the best prices available to them.
Second is underwriting. The folks underwriting life insurance at auto and homeowners companies are very likely told not to accept any risk, perceived or real. So even the smallest of issues is blown into an underwriting nightmare. I worked with a woman over the weekend that was told by her State Farm agent that at her age and her health, she should probably just forget about getting life insurance. She is 66 and the only health issue is borderline high blood pressure. She is well on the way to getting the coverage that she really needs at a very good price.
Bottom line. It is the independence that makes the difference. If your agent hasn’t got a choice of companies and and variation of underwriting guidelines, they are stuck hoping you don’t notice just how bad their products are. Shop around.
September 22nd, 2008
Remember the good old days when livers were done in by drinking too much? Cirrhosis of the liver can eventually lead to liver failure or liver cancer, kind of a no win situation unless you have a spare hidden in the closet.
Now studies show that obesity can lead to a situation called non alcoholic fatty liver disease, which left unchecked (you don’t lose weight), can lead to cirrhosis, failure and cancer and eventually to that hunt for a spare liver. This is becoming alarmingly frequent in young people who, unfortunately, are rarely tested for liver functions.
I will continue to beat this obesity issue to death just on the off chance that someone, even if they aren’t in the market for life insurance, will read and learn that the number of ways that those extra pounds can kill you is simply staggering. Diabetes, high blood pressure, heart disease, stroke, several kinds of cancer and yes, liver disease.
Just a few plugs for common sense. If you are obese and don’t have any of these things going on yet, buy life insurance now. If you are obese and can’t lose weight through traditional methods, seriously consider gastric bypass. Forget those people who say that’s just taking the easy way out of your problem. This is about your life and saving it. Just consider it. Talk to your doctor.
Bottom line. The weight of obesity is crushing our nation and especially the young people. Overweight teens have no concept of the problems they will be facing in their 30’s and 40’s if they don’t do something now.
September 9th, 2008
Occasionally when I am doing an interview to determine what rate class a person will fall into and what company will be best for them, I am asked if they will look less critically at the health issues if they ask for a smaller amount.
This often comes as questions like, “What if I apply for two $250,000 policies with separate companies instead of $500,000 with one company?” The thinking, and it has some logic to it, is that if a company is exposed to less risk maybe they won’t look at the health history or another issue as critically. That could end up with this logic, rather than a large policy approved at a standard rate, two smaller policies might be approved at preferred rates.
Unfortunately for the life insurance shopper underwriting doesn’t work that way. The truth is that while a company may do more tests and more intensive scrutiny of medical records at higher amounts, if a person has elevated liver function, high cholesterol or problematic family history, the company will award the same rate class whether the face amount is $100,000 or $10,000,000. If that weren’t the case then everyone with health issues would be buying multiple small policies rather than the amount they need in one policy.
I mentioned that the underwriting requirements do get more stringent at higher amounts. Here is a standard table of requirements starting with A being children under 18 at lower face amounts to H, I, and J where the requirements are for older ages and high face amounts. Actually they aren’t in exact order as A, B and E are for applicants under age 18. Note that none of them require a full blood draw.
A Non-Medical
B Paramed, Urinalysis, Attending Physician Statement
C Paramed, Urinalysis, Blood Profile
D Paramed, Urinalysis, Blood Profile, EKG
E Paramed, Urinalysis, Attending Physician Statement, Dried Blood Spot
F Paramed, Urinalysis, Attending Physician Statement, Blood Profile, EKG
G Urinalysis, Blood Profile, EKG, Physician Exam
H Urinalysis, Attending Physician Statement, Blood Profile, Physician Exam, Treadmill EKG
I Urinalysis, Blood Profile, Physician Exam, Treadmill EKG
J Urinalysis, Attending Physician Statement, Blood Profile, Physician Exam
Bottom line. While the up front requirements may differ, the results are all measured the same. Again, high blood pressure is high blood pressure whether the applicant wants a modest amount of insurance or tens of millions.
August 25th, 2008
Virtually all life insurance companies take your immediate family health history into consideration at some level. They don’t all view it the same and they certainly don’t all treat it the same, but it is in their guidelines and they seldom waiver.
This probably ticks people off far more than finding out something is wrong with their own health picture such as having high cholesterol on the life insurance exam or perhaps high blood pressure. Probably one of the toughest for a client to swallow is when a company penalizes them because a parent who smoked dies prior to age 60 of lung cancer when the client, having watched that whole scene, has never touched a cigarette. Another that is just about as tough a pill is when their rate is effected because their father died of a heart attack at age 48 after drinking, smoking and eating their way into the obesity hall of fame when they don’t smoke, don’t drink and exercise regularly.
So, is it fair? Well, the way I see that is if it happens to me, then no, but if I’m a life insurance underwriter, then yes. I have discussed this at length with underwriters and they understand that taking a black and white stance on family history will be unfair to some. But, any underwriting guideline that is black and white and produces the same result for a rate class for everyone, is going to be unfair to some.
Just a few examples of the latter and then back to family history. All companies use build charts and approve rates based on your build. They know that plenty of people who are 5′10, 250# live to ripe old ages, but they also know that at that weight the chances are much greater of having diabetes, heart disease and cancer. All companies test for cholesterol and approve rates that reflect your cholesterol numbers. They know that plenty of people with high cholesterol never develop heart disease or have heart attacks, but they know that the chances are greater of that happening if you have high cholesterol.
So, family history. Even though your father appeared to have done himself in by smoking, drinking and eating doesn’t mean that you are not genetically predisposed to heart disease. And just because you don’t smoke like your parent who died from lung cancer doesn’t mean that you aren’t genetically predisposed to cancer.
The good news is that, as I mentioned up front, not all companies share the same beliefs, and a good independent agent can usually find a company that will take most of the sting, if not all of it, out of any family history issues.
Bottom line. Rather than taking offense or trying to justify family history, ask your agent how they can take what you have and make it work for you.
August 20th, 2008
There aren’t many weeks that go by without hearing from someone who has finally figured out that they should have life insurance…..because their own mortality has been flashed before their eyes. This can come in the form of losing a friend or loved one or perhaps being in an accident and coming out with that thought in your head that, “Oh my God, I’m alive and probably shouldn’t be”.
Those are the easy ones to deal with. A wake up call with no harm done. But all too often the wake up call is because of some dramatic change in our health. People who have been diagnosed with cancer or who have had a heart attack tend to have a sudden, often fervent desire to look into the life insurance that they have been ignoring for years. They realize that they have blown the chance at getting good rates on the protection they now want and are desperately hoping that somehow this one health scare will be looked at by life insurance underwriters the way one speeding ticket would be looked at by an auto insurance company.
We all look for those second chances in life. Unfortunately, when it comes to the best rates that a life insurance company offers, with serious health issues there really are no second chances out there. If you are easily jolted into action by something minor like your cholesterol being a little too high, or with a few companies, your slightly high blood pressure needing a little medical nudge to get back to normal, you’re still in the running. Just about anything more serious than that will bump you at least one rate class, if not more.
So, and this is what all Americans really want to know, how do you beat the system? First and foremost you need to have a serious talk with yourself about your responsibilities and how, even though you are young and healthy, if something happens you will have failed to take care of those who depend on you. Second, you need to get over (we’ve all been here) that young, healthy feeling of immortality. You may live to be 120 and you may die tomorrow or be diagnosed with a terminal illness next month.
That’s the bad news. The good news is that for healthy people life insurance is probably the least expensive insurance you will have in your portfolio. Get it while you’re healthy. Get it while you’re still a good deal.
Having said all of that, should people with health issues give up on owning life insurance? No! It will cost more than your completely, disgustingly healthy cousin, but for almost everyone it is still available and with the help of a good independent agent, you can get the job done.
Bottom line. Life insurance is a good deal for family protection even when you don’t qualify for the best rates. Where else can $50 or $100 a month buy your family hundreds of thousands of dollars worth of peace of mind? Look into it today.
July 9th, 2008
A lot has been made over the years about diet and exercise being key components of a successful battle with hypertension or high blood pressure. But from the fringes we keep hearing snippets about drinking a glass of wine a day, eating dark chocolate and other things that seem oddly out of place.
Diet and dark chocolate! Diet and dark chocolate! Almost seems oxymoronic. I know from my experience that when I’m munching down dark chocolate, the word diet is secretly deleted from my brain during that moment. Maybe that is the power of antioxidants. Maybe they aren’t really good for you, they just erase guilt from your mind so, a little wine, a truffle….life is good.
But such is not the conclusion of studies that show that antioxidants actually do lower high blood pressure. This happens through a process of antioxidants inhibiting something called free radicals (sounds like something out of the 60’s).
This ability to inhibit free radicals can have far reaching effects, staving off high blood pressure which can prevent strokes and helping to prevent some of the big boys like heart disease and cancer.
So, will you get lower life insurance rates if you explain on your application that you eat blueberries or dark chocolate or (yum), dark chocolate covered blueberries from Harry and Davids, daily? Well, not from the mere mention of the fact you won’t, but a healthier you is a better life insurance risk and that should lead to lower rates.
Bottom line. Do what your mom told you. Eat chocolate and drink wine….and eat your vegetables. Science is on her side.
June 24th, 2008
We all know about the link between high blood pressure and strokes and/or heart attacks. In my slightly unscientific mind it is something like blowing up a balloon a little too much a few too many times.
There is a thing called white coat syndrome, named such because of the white coats that most doctors used to wear when they would see you in their office (they’re much more casual now). Anyway, the result of white coat syndrome is that a person whose blood pressure is normally, if not always, in the normal range, will without fail have a spike in their blood pressure readings when they have their blood pressure taken at the doctor’s office.
Studies have shown that white coat syndrome has little or nothing to do with a conscious fear of going to the doctor, the doctor or nurse themselves, or the office. It is apparently some kind of subconscious reaction. But, conscious or subconscious, the result is spikes in blood pressure that, if they were the norm, would have to be treated as they are generally spikes to very high levels.
The dance I wonder about in all of this is, if a patient is determined to have white coat syndrome and not treatable hypertension, what if there are other things that subconsciously elevated their blood pressure also? Could it be blood pressure spikes are a fairly frequent occurrence and that the only place it is noted is at the doctor’s office? I wonder how a doctor can determine that, even though a patient tells them the readings at the local drug store or with a home monitor are normal, that readings if they were taken in a traffic jam or at the dentist’s office or during football games, aren’t elevated also.
If the visit to the doctor’s office is just the tip of the blood pressure iceberg, it seems that there is a real chance of people with chronic blood pressure spikes running around out there not getting the medical help they should. Call me a skeptic, but if something can trigger this subconsciously in a doctor’s office it seems that you’re talking about a fairly strong subconscious.
From a life insurance standpoint well controlled, treated high blood pressure is really not a big deal. Most companies will offered preferred, if not preferred plus rates. If you are applying for life insurance and have been told that you have white coat syndrome, tell your independent agent right up front. This gives your agent a chance to do a couple of things that may help you put the syndrome in context for the insurance company.
First, your agent can let the examiner know so they might take more than the normal three readings. Often successive readings will get lower. The examiner will also know to time a blood draw so that it doesn’t impact the blood pressure readings by creating a nervous situation. Second, the agent can let the company know about your diagnosis of white coat syndrome so that they are not surprised by readings in your medical records. And lastly, you should make sure that your doctor has, in fact, diagnosed white coat syndrome and noted it in your medical records. If it isn’t addressed in your medical records the insurance companies will not buy it as a defense for high blood pressure.
Bottom line. White coat syndrome has been a real diagnosis for a long time. Whether or not I completely buy into it, if it is well tested and documented, it can be used as an affirmative defense against otherwise damaging high blood pressure readings on an insurance exam or in your medical records.
Just a personally skeptical aside. If I was told I had white coat I believe I would asked to be tested across a broad spectrum of psychologically stressful situations. I would hate to go through life merrily believing I had some subconscious quirk that elevated my blood pressure only in one situation, only to find out when I suffer a stroke talking to a mortgage banker that the issue was more wide spread than was thought.
June 2nd, 2008
We continue to get inquiries and continue to have success in finding affordable life insurance for people with a history of sleep apnea. This is another one of those areas where the majority of companies still have a knee jerk reaction built into their underwriting guidelines that produces either a highly rated or decline outcome.
This outcome could be appropriate in some cases of severe apnea combined with other risk factors such as morbid obesity and poorly controlled blood pressure. The problem is that the majority of companies don’t allow for the fact that there are different levels of severity and different levels of control. To put it simply, from a mortality impact standpoint there is a huge difference between poorly controlled severe sleep apnea with other risk factors, and, for lack of a better term, your garden variety well controlled mild sleep apnea with no other risk factors.
Generally speaking, from an underwriting standpoint, if the apnea is mild to moderate, well controlled by use of a cpap, and the user is compliant with use and followup, rates as good as preferred can be found. Preferred rates would obviously be contingent on the person meeting preferred guidelines in all other areas. Well controlled sleep apnea and a build of 6′0, 330#’s doesn’t get you there.
Bottom line. An independent agent should know what questions to ask and what companies to shop your business to in order to get the most bang for your life insurance buck.
May 21st, 2008
I know at times I pour it on pretty thick about the whole lifestyle thing, but lifestyle simply cannot be overstated when it comes to its’ impact on life insurance underwriting.
As posts go this one is short and to the point. Through diabeticconnect.com I found a review of a book
that really puts the spotlight on the impact of lifestyle on health. Again, I would like to recommend Diabetic Connect as a resource. I mentioned in a post a few days ago that I believe they will be the new best advocate on the block for those with diabetes.
Bottom line. Positive lifestyle changes increase your chances of avoiding or controlling issues like type 2 diabetes, high blood pressure, obesity or cholesterol. Avoiding or controlling those types of issues can only have one type of impact on life insurance rates….positive!
May 20th, 2008
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