Posts filed under 'gastric bypass'
America has spent trillions of dollars monitoring, spying on and fighting enemies abroad since its’ inception. Now it would appear that we are being overtaken from the inside, not by armed terrorists, but by fat. Obesity is out to kick our behinds.
Now I’ve got good news when it comes to availability of affordable life insurance when people are overweight, but first let’s shake this subject out a little. Our country thinks it has a health care crisis on its’ hands now? At the rate we’re getting fatter, in 2020, 2010 will seem like the good old days because along with obesity, unchecked obesity, comes cancer, heart disease, diabetes and a host of other expensive catastrophic illnesses.
I happen to live in Colorado and while Colorado is the only state in the country that is under 20% obese, as of last year it was at 18.9% in adults and somehow that’s not making me feel like we ought to be proud of the job that we’re doing. When you factor in children you can see that we’re right in the mix for not passing on our barely passing obesity grade to our kids.
So, before I go telling someone that is 6′ and 400 pounds that I can get them approved for life insurance, I just want to scream at our country, all of us collectively, WE’RE SINKING OUR OWN SHIP AND IT’S BECAUSE WE ATE TOO MUCH!!!!! If you’re overweight, get a grip. Get exercise. It’s free. Quit eating so much. You don’t need it. Get help. Losing weight is more fun with a friend. Get a gastric bypass if it is just simply too much to conquer! Nothing to be ashamed of because it really is a decision about life or death.
Now the good news. Even though you have eaten yourself into a position where your body is looking for diseases that can kill you, if you’re still healthy, even with the weight there is affordable term insurance out there. Get it while you’re healthy because no one is going to sell it to you if you’re overweight and your health is headed over a cliff. We’ve helped a lot of people get coverage they had been told they could never get.
Bottom line. Don’t wait. Don’t wait to see your doctor and discuss options. If he says exercise, don’t wait. If he says diet, don’t wait. If he recommends more drastic measures, and a second opinion agrees, don’t wait. If you don’t have life insurance and you still have your health, don’t wait.
March 16th, 2010
The standard guideline for life insurance underwriting of gastric bypass surgery has generally been two years out from surgery and one year of weight stability.
In other words most companies don’t really want to participate in your mortality post surgery, especially during the dramatic weight loss period. This is the period that most complications occur. And the second half, one year of weight stability is simply to make sure you don’t learn some stomach stretching exercise and overcome the surgery through shear will power. It apparently isn’t an easy thing to do and most bypassees are heavily invested in the results staying positive, but over the years I have worked with a few clients that have managed to overcome their new, tiny stomach.
I recently, kind of back to back, worked a couple of cases where those guidelines were lost with a new logic by one of the companies that has always been good with obesity and gastric bypass issues. One case was 7 months out from surgery and another was at 1 year. Both had achieved maximum weight loss and had been stable for only two months. This company decided to treat both of them as if the weight had been lost through diet and exercise by adding half of the weight loss back in and basing the rate class on that weight. This ended up with one client being tentatively quoted at preferred plus and the other at standard plus, phenomenal compared to the postpones or highly rated offers they got from all the other companies I shopped it to. Being skeptical I sent both offers back for another review and confirmation, and they were confirmed as likely outcomes.
It’s too early to declare this as the new standard for gastric bypass underwriting, but there seems to be a crack in the ceiling that’s worth beating on.
Bottom line. For me there is the lesson that I keep learning over and over. Every case is worth shopping. You never know when a company is going to change their stance on some impairment.
December 14th, 2009
I’m often asked whether being declined for insurance, or highly rated, will influence how another company looks at a new application. The answer is truly an emphatic NO!
Each company has their own underwriting criteria and their own philosophy and their medical director has their own opinion on health issues and what it all turns out as, is very little agreement between companies on how, especially harder health issues, should be viewed.
A case in point is a case I just shopped where a client had a gastric bypass within the past year and his weight had stabilized only a few months ago. I truly shopped this expecting a lot of declines, postpones and highly rated offers. I wasn’t disappointed in those areas, but was amazed when one company came back and said “possible preferred plus”. Flying in the face of the most common logic with obesity and gastric bypass, this company decided that since even adding back in half of the weight lost kept the person within preferred plus build criteria, they felt comfortable quoting it. I went back for a second opinion and they stuck with it.
I have a substantially more complicated case I’m working on that involves melanoma, border line diabetes, pulmonary function issues from 25 years of smoking and some cardiac issues that showed up on an echocardiogram. This case was approved at a table 7 by Prudential and was subsequently shopped and appears it will be approved at a table 2 by United of Omaha.
Bottom line. Most companies really don’t care what other companies think. They live by their own rules and guidelines.
November 30th, 2009
We just wrapped up a life insurance application with a successful approval at a standard rate class, the best we could have hoped for even in the absence of the bypass history.
We have been dog determined to point out through this forum that the social stigma and risks that have often been attached to gastric bypass or lap band surgery is far outweighed by the almost immediate health benefits.
Probably the most dramatic of those is the crazy fast impact that a gastric bypass attack on obesity can have on type 2 diabetes. It is truly not uncommon for people who have been battling diabetes for years to actually be able to get off of medication within just a few weeks of surgery and have their glucose levels remain low on their own.
Of course from a life insurance standpoint, the results can take a person from truly not insurable to standard or better rates in just a few years time. Generally companies will want to see weight level off and stabilized for a year before they will reward a person with standard rates. Since weight loss usually goes on for 6 months to a year, a good rule of thumb is that the life insurance reward is going to show about two years post surgery.
In the case we just got approved the client who is 6′2 and was 405#, has been stable at 265# for over a year. He is no longer treated for diabetes or high blood pressure. And he is able to provide his family with life insurance protection that because of his weight and risk factors was simply out of reach before.
Bottom line. Gastric bypass surgery is probably not for everyone, but considering the mortality risks associated with unchecked obesity, it’s worth a look.
September 28th, 2009
I’ve written before about the dramatic and often amazing results that extremely overweight people have see in regards to their diabetes when they undergo gastric bypass surgery.
Gastric bypass is a procedure that essentially creates a dramatically smaller stomach by stapling off the majority of the stomach and leaving just a “pouch” for the food to pass through. With this much smaller stomach a person gets full quicker, and that combined with eating the right things, a healthy diet, creates rapid weight loss and in many cases an almost instant reversal or cure of type 2 diabetes.
Such is the case in an interview posted by TuDiabetes today. The story tells about a woman whose diabetes was really poorly controlled even on medication and within a week of the bypass she was able to come off of medications completely and her glucose levels were lower than they had been in years.
The decision to have gastric bypass surgery is not to be taken lightly and has risks that need to be considered, but for many those risks pale in comparison to the risks face by continued obesity and out of control diabetes. There really is no soft way to explain how damaging the combination is and how it can lead quickly to a loss of the quality of life, if not the loss of life itself.
Life insurance underwriters view gastric bypass carefully knowing that there are risks from the surgery and the dramatic weight loss for the first year or so, but within a few years the weight loss and improved overall health often lead to much better rates than a person would have received prior to the surgery, if they were insurable at all at that point.
Bottom line. Gastric bypass has always had a stigma attached, just as obesity has. To put it bluntly, there are a lot of people who probably say under their breath that it’s just a case of a fat person taking the easy way out. But let’s be real. There isn’t anything easy about the situation they are in and when they choose the surgery there’s nothing easy about the way out…..and it saved and changed their lives.
May 29th, 2009
There was a time when I had a whole different view of obesity and gastric bypass. I think the majority of folks still look at the whole thing through somewhat jaded and certainly uneducated eyes.
I will just be right up front and ask to be forgiven for the way I felt about the issue. I truly had no idea back then just how hard it can be to break the cycle of obesity and I truly had no idea just how at risk of premature death someone could be if they were extremely overweight. I just thought of it as a control problem and a gastric bypass as an easy way out.
After years of study I have a much different view of obesity and just how difficult it is to make meaningful changes in your weight and I also had a much greater appreciation for just how much danger a person was in the longer the weight stayed on. The risk of high blood pressure and stroke, diabetes and heart disease are not things that can be taken lightly and certainly aren’t health issues that, if a person has a way of stopping them, should be put off or ignored.
The studied truth is that for those whose health is at risk due to obesity, gastric bypass is starting to not just be seen as measure of last resort, but as a prudent medical decision. Studies have shown that most people being treated for hypertension or type 2 diabetes can be off of medication completely within just a few weeks of having the surgery. In the truest sense the bypass surgery isn’t just a treatment, but a cure.
From a life insurance standpoint, gastric bypass is viewed cautiously until the weight loss has stabilized. This usually takes about a year. It’s during this year that complications can still crop up. Then, most of the companies that are good with obesity issues will want to see a year of stability before they will approve at standard or better rates.
Bottom line. Gastric bypass surgery is not just an obesity easy button. It’s a measured decision that can help save a person’s life.
May 11th, 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
I recently had a person email to tell me they had been declined for life insurance because they had a successful gastric bypass surgery three years ago. They wondered if, since this had come at the hands of a reputable company, they were just saddled with the fact that they were uninsurable no matter what.
They were uninsurable when morbid obesity would have been a kind way to describe their situation and among other health issues they were also dealing with type 2 diabetes. Now, three years later their weight is stable and very respectable and they are no longer diabetic and they are being told that they are still uninsurable. What gives?
Gastric bypass has been on an underwriting roller coaster for the past several years. At first companies were accepting the new weight of an individual one year after the weight had stabilized. So, if you lost 100 pounds in six months and leveled off, at 18 months out from surgery you could get insurance that was based on your new weight. Then some companies jumped clear off the deep end and wouldn’t consider someone until 5 years post bypass. Most recently the trend has been toward two years post bypass and at least one year of stabilized weight.
The problem from a consumer perspective is that there are companies that have stepped off the ride at different points and because of that, without the guidance of an informed independent agent, a person can inadvertently, innocently pick the wrong company and get mowed over like the gentleman I described above.
The good news is that there is good news for those who have chosen to undergo a gastric bypass procedure in order to get their lives back under control. Life insurance companies recognize that the procedure has risk, but many of them also recognize that there is great reward and a new life once the risk has passed.
Bottom line. Gastric bypass has survived the stigma of being the easy way out and is now recognized as a life changing and life saving decision. With life insurance the key is finding a company that supports that idea.
March 30th, 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
With the percentage of Hispanics in the US being almost double what it is for Anglo Americans, the challenge of finding affordable life insurance to ensure the family heritage and legacy needs to be more focused than ever.
In most cases diabetes is ultimately insurable. Latino statistics aside, it still comes down to the same underwriting criteria. Good rates are available but those rates come with control and compliance. Life insurance underwriters don’t have a cultural mortality study that impacts rates, but they do have mortality risk studies that tell them what can be expected if a person isn’t compliant with treatment and if that ultimately leads to poor control of glucose levels.
The reason for underwriter’s concern and careful underwriting of diabetes is the host of collateral health issues that can ultimately make the disease deadly. Those with type 2 diabetes, especially poorly controlled, are at a substantially increased risk for heart disease, high blood pressure and kidney problems. If you factor in the major risk factor for diabetes being obesity, you drag along increased risk of stroke and cancer.
The good news is in good control. To put it bluntly, the good news lies with those who care enough to change their lifestyle and deal with it. Losing weight is huge in the fight with type 2 diabetes. For those who can meet that challenge through diet and exercise, it’s a home run. They have changed a life style and snapped the link that has them tied to a downward spiral with diabetes. Studies have shown that even those who need to employ a more drastic approach such as gastric bypass surgery, with the weight loss comes almost immediate improvement in their diabetes control. In many cases the drastic weight loss completely cures the diabetes.
So, what are life insurance underwriters looking at when they consider diabetes as an underwriting issue?
1. Age of onset. Type 1 diabetes is generally diagnosed between early childhood and age 30. The later the onset, the better. Children with type 1 diabetes are almost always not insurable for reasons that, while lame, are the facts of the issue. With type 2 diabetes, optimal chances for good rates would be with diagnosis after age 50. A few companies are leaning toward age 40 as long as all other risk factors are good, but prior to 40 there will be a hit with virtually all companies.
2. Compliance! Underwriters want to see people who have taken the bull by the horns and are exercising, losing weight, actively monitoring their diabetes with regular glucose checks. They also want to know that you see your doctor regularly (every three months is pretty standard) so that your doctor can monitor all the risk factors and also run blood tests that will include an A1c or hbA1c. Compliance with medications is crucial. Taking medication only when your glucose spikes isn’t compliant.
3. Control. As measured by the A1c, underwriters would consider excellent control to be an A1c of 6.5 or under, good control 6.5 to 7.5, and questionable control 7.5 to 8 and poor control over 8.
4. Education. Life insurance underwriters would like to know that you understand your diabetes probably to a higher degree than your doctor is willing to provide education for. That means self education and group diabetes education is a good idea. Don’t depend on your doctor to make you smart about your disease and what you should be doing about it.
5. Monitoring risk factors. The best rates come with good control and no other risk factors, so checking blood pressure and cholesterol, and staying ahead of any impending issues with regular checkups is imperative.
Bottom line. Diabetes is a life insurance showstopper and a life longevity demon if you allow it. Take control and the picture changes dramatically.
March 16th, 2009
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