Posts filed under 'Depression'
Some life insurance underwriters are easily frightened. It really seems they are too busy “underwriting” to really study the cases they are considering and when they are drawn out of their comfort zone, well, they just go screaming into the dark.
I wrote some months back about how we had shopped a case of bipolar disorder where the client/patient was taking Lamictal. One of my “go to” companies for bipolar came back with a “not interested” response. Curious as to how that happened I spoke with the underwriter and she said that her trial offer had clearly stated that the offer was good only if the client was not on anti-psychotic medications.
I forwarded several articles showing that Lamictal is not an anti-psychotic and actually an anti-seizure medication. Finally with the aid of the medical director we were able to get the policy approved as applied for.
Now I am shopping a case where the client is being treated for depression with Abilify, a drug many of you have seen on TV recently as the new drug on the block for bipolar disorder. There was a clear division in underwriting opinions between those who have heard of Abilify’s use for depression and those who watch too much TV.
Genworth’s response was just the tip of the downward spiral with “Minimum Table C due to depression treated with Abilify (schizophrenia treatment)”. West Coast Life went a little deeper with “Probable decline, as the main use of Abilify is for schizophrenia.” Then several companies took the innocent until proven guilty route, “assuming there is no history of bipolar disorder, suicide attempts/ideation or major depression criticisms, the best offer available would be Standard Plus.
It’s a long ways between standard plus and decline or even table C. And this kind of knee jerk reaction even happens when you answer their worst fears question up front. I put in the trial that the client wasn’t diagnosed with or treated for anything other than post partum depression. I also put in the trial that the client is a physician. Not a lot of schizophrenic docs out there that I’ve heard of.
Bottom line. That’s why I shop them and why I ask the questions up front and send back up documentation with trials if a drug can be used for more than one issue.
July 14th, 2009
You know what really is great about being able to get good rates and place policies in force for those with bipolar disorder? The families are so grateful because of all they’ve been through with the demeaning treatment and declines they have received at the hands of other insurance companies.
It’s a good feeling knowing that any policy goes in force and another family is protected. It’s really quite another to call up a person who has been declined by three companies and let him know we got an approval. And not just an approval, but an approval at preferred best rates, the best rate class available for anyone.
Now, to be sure, I won’t claim I can get preferred best rates for anyone with bipolar. Standard is a far more likely outcome even with a very stable, controlled disorder, but there are those, and I think there are a lot of them, who are exceptionally stable, exceptionally compliant with treatment and exceptionally well controlled with their medication that can, when the underwriter is feeling good, get best class rates. Such was the case of a client approved today. He went into the process just hoping not to be declined again and came out of it able to budget $1,000,000 of 30 year term insurance instead of the $500,000 he was hoping to get approved and settle for.
His was an interesting case because the underwriter at one point was seriously suggesting a much higher rate. The issue was that in the trial the underwriter had said the best rate was possible unless the client was on anti-psychotic medication. He is and has been on Trileptal for some time. It took some time to get the underwriter to see that Trileptal was really just Tegretol, an anti seizure medication, that had been altered slightly for use with bipolar. In the end reason prevailed and the underwriter conceded that he was definitely not on anti psychotic medication.
Just a reminder about what it takes to get to approvals and good rates with bipolar:
1. Someone who has not been hospitalized for bipolar disorder other than for diagnosis?
2. Someone who has not attempted suicide or had bouts with suicidal ideations?
3. Someone who is compliant with their treatment, both medications and regular followups?
4. Someone who is leading a stable family life or social life?
5. Someone who is exhibiting a stable work life?
6. Someone who is not on disability for bipolar and does not have issues with drinking or drugs? If there’s a problem here, then the answers to 3, 4 and 5 are no.
7. Better rates are available for those that aren’t on anti psychotic medication or multiple medications.
Bottom line. This isn’t to say that if you don’t fit the above list perfectly you won’t be able to get an approval, but from a lot of experience I can tell you that straying very far from the list goes down hill fast. Having said that, it should be noted that most are in agreement that the majority of those with bipolar disorder, anxiety disorder or depression would meet the criteria.
June 17th, 2009
I was asked by my office manager this morning if bipolar disorder/manic depressive disorder was more prevalent in people around her age, in her 30’s, than people my age, in my 50’s, because the majority of people who react to our advertising and blogs are younger.
My thoughts were that the response we get doesn’t necessarily mean that more people in her age group have mood disorders, but may be more indicative of two things.
1. Bipolar disorder, anxiety disorders and depression today are better understood and less feared by underwriters than when I was her age. If, for instance, I had been diagnosed with bipolar disorder 20 years ago my chances of getting any insurance company at all to consider accepting my mortality risk would have been somewhere very close to 0. I might have tried several times to get life insurance for my young family but with the chances at or near 0 of being approved, I would likely have racked up a string of declines.
2. By now, in my mid 50’s, I would have done the best I could to put some other plan in place knowing that life insurance companies didn’t want anything to do with me. Why, at this point, would I want to back track and put myself through the humiliation again?
I also reminded my office manager that we have been very successful in helping those my age and older who we have heard from. They actually, in the mind of underwriters, have something of a leg up on younger clients in that they are survivors and have stability written all over them. Bipolar disorder is one of those things that can tear you down at its’ worst and make you a stand out success at its’ best. By age 50 if someone has bipolar disorder they have most certainly taken one road or the other (through no fault of their own), and someone in their 50’s on the good side of things has established stability and control, business and family life with some certainty.
From the view of a life insurance underwriter, whether you are a 32 year old software engineer or at 56 year old actor or CEO, the same criteria lead to the best rates.
1. Someone who has not been hospitalized for bipolar disorder other than for diagnosis?
2. Someone who has not attempted suicide or had bouts with suicidal ideations?
3. Someone who is compliant with their treatment, both medications and regular followups?
4. Someone who is leading a stable family life or social life?
5. Someone who is exhibiting a stable work life?
6. Someone who is not on disability for bipolar and does not have issues with drinking or drugs? If there’s a problem here, then the answers to 3, 4 and 5 are no.
7. Better rates come with fewer drugs and without the need for anti-psychotic drugs.
Bottom line. Get the word out. Life insurance at fair rates is available at fair rates for people suffering the full spectrum of mood disorders. If you know someone who you think may have missed out on this evolution of underwriting, talk to them and steer them toward the answer they may have missed 20+ years ago.
June 9th, 2009
Most of the life insurance cases I work are shopped to multiple companies just so I can be assured that the insurance quote I am providing really is going to be as good as it gets and ultimately the client gets the most bang for their buck.
When I shop I am looking for the company that sees a subtle difference in the mortality risk. Most of the time the trial offers I get are bunched around the same rate class and the winner is the company that sees a case as standard plus rather than standard, preferred rather than standard plus, or a table 2 rather than a table 4. Every once in a while I get a reaction from an underwriter that is incredibly out of line with the information I provided and obviously a knee jerk reaction to, well, to something.
A case I am currently working on brought this kind of reaction from Banner Life. This client had a condition called Fuch’s dystrophy of the eye. It is asymptomatic at this point and truly, in a worst case scenario, at some point in the future might require a cornea transplant. All of the other trial offers I got ranged from preferred to standard based on treatment for mild depression, disregarding the Fuch’s as insignificant from a mortality standpoint. This was what I expected, except for Banner. They declined to make an offer due to the Fuch’s dystrophy.
I emailed back and asked for an explanation of their trial non offer and so far haven’t received anything, but I suspect that the underwriter reviewing the case had a knee jerk reaction to the word dystrophy and didn’t bother to research this particular malady to see what impact it would really have on the overall life expectancy.
Another case I was working was for someone that was being treated for depression, rather mild depression, but was being treated with a drug that is used for bipolar disorder. Most companies came back about where I would expect them to, somewhere between preferred and standard, but one company declined to offer due to bipolar disorder. It was the underwriter’s knee jerk reaction to the medication, which is a primary drug for bipolar disorder but is also used for depression that led them decline rather than clarify the facts.
Bottom line. Underwriters are human too and they occasionally misread the information presented or I present it in a way that doesn’t clarify a situation enough. But, for whatever reason the knee jerks and that company is out of the running for now. That is why we always shop to multiple companies. The more eyes that see the case the more likely that we will get a fair hearing and a good offer.
May 19th, 2009
We’ve done a lot of work for clients with mild to moderate, usually situational, depression or anxiety disorders. The truth is the more crazed and frenetic our society and lifestyle become, the more people are looking for a little bit of help coping.
It’s probably a good thing too. Can you imagine today in America if suddenly everyone who is being treated for depression or anxiety or any other mood disorder wasn’t being treated anymore? Time to hide in the basement. Road rage would go epidemic.
Life insurance underwriters can feel pretty comfortable in giving someone preferred or even preferred plus rates if their mood disorder is fairly mild, hasn’t been going on so long that it would be looked at as a chronic issue, and they are compliant with treatment and doing well. They are definitely understanding and willing to work with situational depression. Situational depression is usually fairly short lived and treatment is just there to bridge the gap between the event (the situation) and getting back on your feet.
Non situational, chemical imbalance type mood disorders can still qualify for preferred or preferred plus rate classes as long as they issue is well controlled and a person is functioning normally. No lost time from work or hospitalization would be good for starters. A stable family life is usually a good indicator
that things are well controlled.
More severe mood disorders such as bipolar disorder probably won’t get to preferred rates in most cases, although we have been able to get a few clients there. A more realistic goal would be standard plus or standard given the following criteria. By the way, these guidelines are good measures for any mood disorder.
1. Someone who has not been hospitalized for bipolar disorder other than for diagnosis?
2. Someone who has not attempted suicide or had bouts with suicidal ideations?
3. Someone who is compliant with their treatment, both medications and regular followups?
4. Someone who is leading a stable family life or social life?
5. Someone who is exhibiting a stable work life?
6. Someone who is not on disability for bipolar and does not have issues with drinking or drugs? If there’s a problem here, then the answers to 3, 4 and 5 are no.
7. Generally better rates are available when control is achieved with anti seizure drugs such as Depakote rather than anti psychotic drugs.
Bottom line. Mood disorders, from simple to complex, with good control can usually be underwritten for life insurance at standard or better rates. Talk to a knowledgeable independent agent today to start working on insurance quotes.
May 12th, 2009
I’ve certainly questioned the IQ of more than one life insurance underwriter over the years. I may have even insinuated that a few didn’t even make into on to the IQ scale.
But the truth is there are two types of underwriters working on life insurance applications for us. The first, a group we try to avoid, have an underwriting manual in front of them at all times and if they are God fearing Christians, that manual is second in importance only to the Bible. The guidelines in their manual are followed faithfully and without question. If someone has bipolar disorder and the manual says to decline them, there is no room for looking at it from another direction or all directions, it is still a decline.
If two women had a localized breast cancer and one treated the cancer very aggressively, say with a double mastectomy, chemo and radiation, while the other decided that she would do the minimum acceptable treatment, the manual treats them exactly the same. There is no room for the fact that one method has a much higher survival rate than the other. It’s not broken down that way in the manual.
The second group of underwriters believe that the black and white manual provides guidelines and not rules and that since they are guidelines, there must be room to consider extenuating circumstances. These are the underwriters we seek out when we shop cases. These are the underwriters that give people hope that there is in fact intelligent life inside the walls of insurance companies.
It is this unique group that understands what to look for and what questions to ask in order to determine if someone with bipolar disorder is a poor risk, or as in the case of many, a completely acceptable risk. It is this group that understands that obesity in the absence of risk factors doesn’t present the same mortality risk as someone who is overweight and has coronary artery disease. It is this group that we look to for a sane review of a case involving sleep apnea, situational depression or family history. It is this group that sees beyond the health problem and factors in how a person is handling that problem, not inside the manual but in real life.
Bottom line. If you have an independent life insurance agent who has been around long enough to figure out underwriters to go to and underwriters to run from, you have found the path of least resistance and the path to success.
April 15th, 2009
I am 56 and I can tell you honestly that 3 years ago I had never read a blog, didn’t know what it was or what it was for. I just knew that for my business to grow, for us to reach more and more people blocked out of life insurance for the same old reasons by the same old companies, my website needed to be more than one of the millions just sitting out there.
Our focus at Hinerman Group has always been to seek out and help those that our industry has painted into what we call the impaired risk corner. If you’ve been there, whether because you have diabetes or bipolar disorder, you know there is something that just isn’t right about being told that a company “doesn’t want to accept your risk”. You know you’re not dying. You know, just because you have bipolar disorder or depression that you are not going to commit suicide. You know that your heart attack or your prostate cancer was a wake up call, not a death sentence. You know that breast cancer has changed your life, but won’t end it. Our goal has been and will always be to snatch you from the insurance jaws of defeat and find a path to victory.
To that end, the brilliant mind in Hinerman Group, my office manager/web master/head geek, has asked me to begin twittering. Well, slap me again, but I’m looking at twittering and not getting it. Now mind you I believe I understand blogging at this point and I believe it has reached hundreds, if not more, that we have been able to help, but twittering??
I thought I understood it when she (my head geek), suggested that I just post life insurance news and I guess I got that, especially at a time when there is no lack of day to day changes going on in the life insurance business. Especially at a time when we are finding victory after victory for our chosen group, the less than perfect folks like me out there.
So I did, and then I “followed” a few folks that I thought might have common interests and then some began “following” me, and I was back to square one. I didn’t get it. @JoyofDiabetes seems to have a lot to say and has quite a following, but he mostly seems to talk about his minute to minute life. Regular things like taking the kids to soccer or his wife being out of town. How do I blend in with that and just let people know I am available to talk about their problems getting life insurance without being booed out of the stadium for being a “salesman”.
Now, mind you I have never “sold” in my blog. I have suggested to people how to find the better rates and suggested how to avoid pitfalls and suggested how to avoid those agents and agencies and advisers that clueless, but in over 900 posts I have never said call me….buy from me….! So, twittering, or tweeting…….?
Bottom line. I trust the person that has brought me light years from where I started and if she says twitter, well, I will. My prayer is that it will help as many people as my blog has, if not more. So my twitter thing is @HinermanGroup. Let me know how I can be of assistance.
March 22nd, 2009
It’s been a fascinating couple of years. I will sum it up by saying that we have helped a lot of people get life insurance who never thought they could. And what better way to celebrate the information we’ve shared and the victories we’ve had than with a shared meal, a key word salad.
Diabetes has been at the forefront of our life insurance efforts from the very start. We’ve made huge headway in finding aggressive underwriting for type 1 diabetes and type 2 diabetes. I think our strong point has been in education. There are a lot more people out there today that know what their A1c is than when we started.
I’ve been very clear about where some of the problems lie in our industry. The AARP/New York Life collaboration, on what can only be described as a sick crime against older folks, continue to offer the worst term insurance and whole life insurance in the business. They are simply not the advocate they claim to be.
I’ve stepped on some toes along the way. Selectquote and Zander Life insurance have taken exception to some of my observations. Being a Dave Ramsey fan and I think, ultimately, a reasonable person, I did apologize to Zander. In spite of Selectquote’s berating commentary, I still stand by my assertion that they are biased in what companies they offer (otherwise they wouldn’t be so easy to beat) and I still believe that Suze Orman should go back to waitressing. As to their assertion that I only use Selectquote and Suze Orman for search engine optimization, well, I don’t, even though they think I do. If I didn’t think there was better service elsewhere and more honest advertising, I would never have mentioned Selectquote.
We’ve touched on scuba diving and Prudential being a leader in great rates for recreational divers. Pru also stomps the competition on prostate cancer, sleep apnea and mild anxiety issues. While providing direction on those issues we have also been able to provide direction for those involved in skydiving and foreign travel to places where kidnap and ransom insurance is more than just a casual thought.
We’ve stayed abreast of the economic meltdown and recession that have whacked us all and tried to help people understand how best to handle their life insurance needs in these tight times.
We’ve held lengthy discussions about obesity and the impact it can have on other health issues such as hypertension or high blood pressure, cholesterol, heart disease, heart attack, stroke and cancer. We’ve discussed the risk and benefits of gastric bypass surgery as a means to avoid the life threatening side effects of being over weight.
Probably our biggest response has been from those suffering from depression and bipolar disorder. We reached a group of people that have truly been black balled in the insurance industry and we’ve been able to find some level headed underwriting and hit some major home runs for those who have the name tag but lead normal lives.
We have bared the facts behind the black eye of all black eyes in the insurance industry, the non guaranteed whole life, universal life and variable universal life policies and explained the alternatives in the permanent insurance market. There is nothing that provides greater value and peace of mind than a rock solid guarantee.
We’ve had frank discussions about business life insurance such as key man insurance and buy/sell life insurance. We did a whole series on women and life insurance. We’ve provided direction and information to private pilots that they aren’t getting anywhere else. We’ve talked about the guts of the policy when it comes to the two year suicide and incontestability clause and the accelerated death benefit and the beneficiary rights and the beneficiary issues for those who aren’t in a legal relationship such as a gay couple or an unmarried couple.
Bottom line. And the list goes on and on. We’ve tried to leave no stone unturned and no question unanswered in our quest to find life insurance for those whose mortality risk might be more challenging than average. As an independent agent it has been gratifying to have so many ways to help those who have been mishandled by the wrong agent or the wrong company. As we continue to reach out my prayer is that all who need help find it, and that more agents consider serving those who are harder to help.
March 18th, 2009
The truth is that I doubt if anyone makes it through life without situational anxiety or depression and there are days when I would swear the whole world is ADD, so what’s the big deal? For years a lot of the more conservative life insurance companies have with held the best due to these minor league impairments.
And the truth is that the more conservative companies may still bump someone a rate class due to minor emotional issues, but most of the companies who are really staying abreast of their underwriting have conceded that real life happens and when someone seeks treatment for it and gets their ship righted, they shouldn’t be punished.
Just within the last few days I’ve seen approvals for ADD treated with Ritilin, situational anxiety treated with Lexapro and situational depression treated with Wellbutrin, all at best rate classes from Prudential, ING Reliastar, Banner and others.
Before everyone runs to the store to buy some, let’s make sure we’re all on the same page. The cases above were truly well controlled. One thing they all had in common was that the issue didn’t affect their lives other than having to take medication and with the depression and anxiety, the issue was resolved and there was no further need for the medication. Situational truly means situational. It the depression or anxiety disorder goes on for a long time, say a few years or more, most insurance companies would call it chronic. Generally the best rate classes fall off the radar with chronic just about anything.
While still insurable, best rate classes are also out of the picture for more chronic and complicated issues such as bipolar disorder. We’ve had great success with bipolar as long as they fit within the following criteria. Safe to say that the same criteria would have to apply to get a good offer on chronic depression.
1. No hospitalization within the last 10 years for bipolar, other than for diagnosis
2. No suicide attempts or ideations
3. Compliant with all medical and psychological treatment
4. Must have a stable family life
5. Must have a stable work life (and no, being laid off in a recession wouldn’t count against you)
6. You can’t be on disability for bipolar
7. You can’t also have collateral issues with alcohol or drug abuse.
Bottom line. If your life hasn’t spun out of control there are generally good rates available for you. Being diagnosed isn’t the issue as much as how you’ve taken control of the situation.
March 11th, 2009
I had posed a question to the Latino community a few weeks ago asking whether a life insurance website in Spanish with a direct line to bilingual staff would be something helpful. New York Life recently unveiled exactly what I was talking about. Yes, this is the same New York Life that rips off the over 50 population through AARP’s life insurance program.
The difference, the upgrade if you will, that we could offer through Hinerman Group would be exactly what we now offer in English that sets us apart from New York Life. We are independent with as many as 40 companies in our portfolio at any given time. We seek out the opportunity to serve the under served. We want to serve people with health issues that most agents and companies don’t want to deal with.
We constantly find better prices and get better underwriting results than New York Life whether you are in perfect health, or if you are among the millions out there with diabetes, heart disease, a history of cancer or depression, who have been shunned by insurance companies or told by insurance agents that you are uninsurable.
So, in our quest to better serve the under served, the question still remains. Does the Hispanic community really want to be served in Spanish? Is a Spanish website and a Spanish speaking insurance professional really something that would be useful?
Bottom line. For us it’s all about service. If we can do something to help out a group of people who aren’t getting what they need from the insurance industry as it is, we want to help.
March 1st, 2009
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