Posts filed under 'hepatitis'
Well, no…..or maybe yes……it all really depends. I hope this information has been helpful.
Seriously though, underwriting of Hepatitis C really comes down to a few key factors. First, is the disease in remission and second, how much damage has the liver sustained? Remission, if achieved, usually comes after treatment with interferon.
The goal, the measure of remission, is whether liver functions are normal and a negative viral load has been achieved. While it varies depending on the progression of the hepatitis, generally the treatment and return to normal labs will take two to five years. Once those benchmarks have been achieved it is possible to get standard rates from some companies. Prior to those benchmarks being achieved companies vary between highly rated policies or a decline.
The other factor looked at is the results of liver biopsies. Obviously any serious liver impairment has long term health consequences and each case would have to be reviewed by a medical director to determine the extent of the risk. Again, like the previous variables, if liver damage is relatively minor or non existent, standard rates should be attainable through several companies.
Bottom line. Hep C is not the end of the world for reasonable life insurance rates and the rumor going around that once you have Hep C you are uninsurable is simply unfounded. Seek out an independent agent and have them shop it for you.
October 29th, 2008
When you apply for life insurance it is not a given that you will get what you want or what you believe you deserve. By far the majority of policies are approved with no surprises. A smaller percentage are approved but at a different rate. And a small percentage are declined by the insurance company because they perceive the risk to be unacceptable.
So why do declines happen? What are the most common reasons that a perfectly good application can result in complete rejection? What impact does a decline have on your ability to get insurance through another company?
The most common reasons are:
1. Something comes up on the lab results that neither you or the agent knew about. It has not been an uncommon occurrence for clients to find out, due to the life insurance exam, that they have prostate cancer, hepatitis, diabetes or the beginning stages of coronary artery disease (CAD). I know I blog all the time about how you can get life insurance with these conditions, but that assumes that you know about it, are treating or have treated it, and it is cured or under control. This reason for decline happens most frequently with people who don’t see the value of an occasional physical.
2. Non compliance with your doctor. For those who do visit the doctor occasionally, there is often a recommendation to have something looked into further or perhaps a recommendation to come back for a follow up in 6 months. Sometimes the doctor will give you a referral for say, a stress test or additional lab work. Plenty of folks blow those things off because they feel fine and can’t see wasting the money. Life insurance underwriters have a zero tolerance for people who don’t do what is recommended by the doctor (that they went to for a checkup and advice).
3. Stupidity. I had a client who had colon cancer about 13 years before he came to me. They removed part of his colon, did chemo and radiation, and he had not been back to a doctor since. It really kind of takes gall to even apply for life insurance with that attitude. Why would a company insure you when you don’t even care if you live?
4. Assuming that some past medical history doesn’t matter. Even though I start my relationship with every client with a health interview that starts with the preface, “Have you ever been diagnosed with or been treated for…” and ends with “Is there anything that I haven’t asked that might come up in your medical records..”, people will choose to leave something out because they don’t believe it’s relevant. When the medical records are acquired and the decline hits, the responses run along these lines. “I didn’t think anything mattered after 10 years”. “My doctor said I was as good as new after my heart surgery”. “Well, I didn’t think that was any of your business”. The quotes you receive and the end result are only as good as your honesty and forthrightness. Nothing is irrelevant until the underwriter says it is.
5. Alcohol abuse. When you drink heavily there is a high likelihood that your liver functions will be elevated. If liver functions are elevated on labs, it triggers the running of an additional test called a CDT. The CDT is an alcohol marker that, while not a diagnostic tool for alcoholism, is a very accurate test indicating whether a person is a heavy drinker. Suffice it to say that a glass of wine with dinner won’t impact your liver or show up on a CDT. A six pack a day is likely to do both.
I am often asked what impact a decline has on a person’s chances of getting insurance in the future. The answer, of course, depends. If the decline is for any of the reasons above and you don’t take care of the problem or become more honest, the result will be the same.
But often a decline by one company may get a completely different result from another company. Very often it is simply a case of the wrong agent taking your business to the wrong company. Could be that the underwriter just had an attitude or made a mistake. We are very successful at turning bad declines into good approvals. To me the nice thing about working a declined case is that all the cards are on the table and when I shop it, I know exactly what company to go to for an approval.
Bottom line. A decline on a life insurance application doesn’t mean you can’t get life insurance and many times you can end up with very reasonable rates. A good independent agent is needed simply because you want a broad range of companies to choose from and generally they will understand the steps to take with your initial bad experience.
June 11th, 2008
There must be a couple of million people in the US licensed to sell life insurance. If you take in the giant internet mega agencies, all of the independent agents, and all of the captive agents (work for just one company), the possibilities for purchasing life insurance become staggering.
Put in context, there are probably as many, if not more doctors. Does that mean that no matter what is wrong with you, there are 2 million choices for a place to go for treatment? I’m thinking not. If you have a cold, a cardiologist is likely not going to see you, and if you’ve had a heart attack, it’s highly unlikely that your general practitioner won’t refer you to a specialist. There are those unfortunate times when GP’s think they know the answer to everything and attempt to treat serious illness in house, but those are rare.
Life insurance is one of those areas where the millions of choices doesn’t mean you have millions of appropriate choices. For the average very healthy person under 50 probably any independent agent or agency can do a good job of finding a low rate with a good company. As I’ve mentioned before, young healthy buyer beware though. Even though the mega agencies on the internet can find competitive rates, they have a bad habit of signing lucrative bonus contracts to push the bulk of their business toward a certain company. The good news is that the company is generally competitive. The bad news is that, as I’ve noted in so many previous posts, competitive doesn’t mean best. An independent agent doesn’t do the volume and therefore we are never offered these type of contracts. Speaking for myself, I place every case with the best possible price and product for my client. Seems like the right thing to do.
One other note on our perfect health client. Stay away from your auto and homeowner’s agents. You will be outrageously overcharged for life insurance because it isn’t what they do. Sure, they have a product and they are licensed, but having a license doesn’t mean you know what you’re doing and having a product doesn’t mean the price isn’t way too high.
But I want to make a very important distinction. Just like the doctor scenario, if you have some medical issue, a knowledgeable independent agent is where you want to go. We are the specialists in the life insurance business. Just a quick list of what I am talking about will help separate the GP’s from the specialists. If you have diabetes, Hepatitis C, heart disease, a history of cancer, a seizure disorder, mood disorders such as depression, anxiety or bipolar, and on and on. These are issues that it is hard for the average agent to provide good service on. These are issues that will get automatically declined with most property casualty companies (auto, homeowners).
How do you know you’ve called the right person or stepped in the right door? All insurance agents make money from the culmination of a sale, the placing of a policy in force. They all want your business and the truth is that most of them are struggling. There is a real tendency in the business for agents to take on business that they have no idea what to do with, just in hopes that it works out. It usually doesn’t. You know you’ve found the right agent if they show a knowledge of your particular issue by the questions they ask. If they don’t ask questions they don’t have the information it takes for them to come through for you. If they don’t seem to know, for instance, the difference between type 1 diabetes and type 2 diabetes, they don’t have any business working for you.
Bottom line. Before you commit to applying through an agent, be confident that they know what they’re doing. In my next post I will reveal the secret weapon for weeding out the BSer’s from the straight shooters. It works every time, guaranteed.
May 28th, 2008
Barry Bonds now has more home runs than anyone in history. 756!! I tried hitting 50 mph balls in a batting cage one time and hit like one out of twenty or so and it was not home run material. I’m impressed. Some people say he got there with the use of steroids. I won’t take sides on that issue, but let’s talk about how a life insurance underwriter would look at steroid use.
Life insurance underwriting is all about assessing the risk factors that go along with a particular issue. For diabetes, it’s heart disease. For Hepatits C, it’s liver damage and the side effects of interferon treatment.
Although this view is from a youth standpoint, I think the article I read on the American Academy of Pediatrics website gave a very good overview of the risk factors risk factors of steroid use.
While the effects can be as minimal as increased acne, the use of steroids also carries some heavy duty mortality issues such as “high blood pressure, unhealthy cholesterol changes, heart disease, blood clots leading to stroke, and liver damage, jaundice, or liver cancer.”
I think that would be reason enough for a life insurance underwriter to take note of steroid use, whether in a young person or an adult.
Bottom line. I like the Tiger Wood’s example. Work out every day, eat right and practice. Get married and have a baby too. It gives you another reason not to do unhealthy things.
August 9th, 2007
The old axiom “the cure is worse than the disease” may hold some truth from a life insurance underwriting standpoint. I can’t imagine an underwriter that would give equal consideration to well controlled diabetes if the control is at the risk of a drug induced heart attack.
With the FDA voting 22 to 1 to allow continued sales of Avandia, it’s sure to be around for a while. Kind of a head scratcher when they also voted 20-3 to accept the evidence that Avandia increases the risk of heart attack.
I read some very good commentary on that issue by Bev Sklar who posts for The Diabetes Blog.
Bottom line, like interferon treatment for Hepatitis C, I would be surprised if more conservative underwriters don’t start looking at what drug keeps your hbA1c in check. Just one more argument for an independent life insurance agent who keeps check on subtle underwriting changes.
August 2nd, 2007
Hep C is the most common chronic blood borne infection in the United States. The insidious nature of the disease is such that often people will not experience symptoms for years, even decades, after they are infected. Life insurance underwriting for Hep C is a careful process and is really broken down into two parts.
The first part is the obvious. You have the disease and it was treated. What medical problems did the disease cause while you had it and what is the current status of the disease and it’s main target, the liver. Current status can be summed up with lab tests that show liver functions and the viral load. To determine potential problems that a person may have incurred from the disease it is very common for a liver ultrasound or biopsy to also be done to see what damage the liver has incurred.
The other underwriting factor is the impact of the treatment . The most common treatment today is interferon. While it is successful in reversing about 50% of Hep C cases, it’s side effects are not light weight. Along with things you might expect like fatigue, interferon can cause flu like symptoms, loss of appetite and in some case large fluctuations in blood sugars which can lead to diabetes.
From an underwriter’s point of view, better than standard rates can be given if liver functions are within the normal range and you have a negative viral load. There also should be a liver biopsy that shows little or no permanent damage to the liver. The concern is that in prolonged untreated cases, cirrhosis can be an issue.
Once the issue of the liver is hurdled, any residual effects from the treatment have to be considered. Generally there will be a waiting period after the completion of interferon treatment before a good offer can be made. The waiting period will vary depending on the level of the disease upon diagnosis, the agressiveness of the treatment and how well your body handled the treatment.
The waiting period can be from 1 to 10 years depending on all the variables before the best possible rates can be approved. That doesn’t mean insurance can’t be obtained, but it may cost more for an interim period.
Bottom line. Know all the test results before contacting an independent agent. Actual copies of the lab and pathology reports are helpful. If, given your situation, you don’t qualify for the best possible rates right now, put what you can in force and work with your agent each year to review and try to improve on the rates until you get what you need locked in.
July 26th, 2007
There is certainly no lack of unjustified respect for some of the biggest names in life insurance in the country. If you’ve seen their name on television or in magazines it kind of sticks with you and you probably, like most folks, assume that big and famous, means good prices. In life insurance you can just about take it to the bank that the opposite is true.
Those companies that we all know, with the notable exception of Prudential, are making a killing selling overpriced term insurance, whole life and universal life to customers that really don’t check it out and find out what they can really get. Just today I saw an example of a Hartford quote on a woman who is a breast cancer survivor. The Hartford quote was fully 200% higher than the competitive companies like Prudential for the exact same product.
Don’t get caught up in big names. Get an independent life insurance agent to shop the market for you and find the best possible rate, still with highly rated companies, and be rewarded with fair prices. It doesn’t matter if you are completely healthy, or have had cancer, coronary artery disease, type 1 or type 2 diabetes, a stroke, or hepatitis, a good independent agent will beat the rich and famous companies every time.
March 20th, 2007
