Posts filed under 'obesity'
In reviewing my last post concerning some of the <a href=”http://hinermangroup.com/blog/2008/12/26/life-insurance-underwriting-improved-in-2008/“>changes in underwriting of life insurance</a> that occurred in 2008, I found some paralells between that and some of the most significant <a href=”http://www.msnbc.msn.com/id/28392976“>medical breakthroughs</a> of the year. Could it be that underwriters are doing their homework?
From the discovery that BMI is not always a true indicator of the percentage of body fat and therefore not a good measure of diabetes risk, to the discovery that eating foods that contain “resistant starch” as a way to help fight obesity and bolster weight loss, medical researchers are, year by year, getting a better handle on how we can get a better handle on our health.
A clearer picture of <a href=”http://www.msnbc.msn.com/id/28392976?pg=7#Health_PVN_Breakthrough2008″>treatment for type 2 diabetes</a> came from one of the largest studies done so far. Critical in the findings is early detection through risk factor education. Discovered early and treated aggressively, type 2 diabetes doesn’t have to have to be the 800 pound gorilla in the room. Studies showed that combining treatment for diabetes with treatment for cholesterol, triglycerides and blood pressure gave better results than treating diabetes alone.
Breakthroughs in the detection and treatment of colon and breast cancer will likely prove to be a boost to 5 year survival rates. While not a guarantee of any immediate impact on life insurance underwriting, these are the types of things that help pick apart the “one size fits all” underwriting of the past. Simply put, it is becoming harder and harder to justify the same mortality assumption for someone who has done all the right things relating to early detection and proper treatment of cancer with someone who hasn’t.
Bottom line. Life insurance underwriting is constantly evolving and while the best rates out there will never be available for everyone, with the right independent agent using the right companies, a fair shake is a more likely outcome than ever.
December 29th, 2008
Today would be no exception to my rule that men really don’t see a world that has consequences until they are old enough that they see the consequences happening to others their own age, or even to themselves.
I spent part of yesterday evening in the emergency room with my nephew who had finally conceded that three hours worth of rapid heart beat (85-110) and high blood pressure (160/110 as measured at Walmart) was reason enough to see a professional. He is 38 years old and by his own admission, inactive and at 6′3, 250, overweight.
I cut him some slack last night, but today let’s discuss his experience. His self admission of being overweight was actually cutting himself some slack. He knows about body mass index (BMI) as well as I do and he knows that his build puts him solidly in the obesity category. “Overweight” is a way many of us use to gloss over the fact that obesity carries with it a number of potential health issues, only one of which became all to real to him last night.
As we waited for lab results and talked, he admitted that he hadn’t been to a doctor in three years. This is a guy who reads my blog and knows my opinion of guys (yes, including me) and their stupidity about their own health. He confessed that his real concern with the labs that were being worked on was that he would be found to have type 2 diabetes, one of the risks of obesity, a risk he knows about all too well because he is also a life insurance agent who works with diabetics frequently. He admitted that he has had concerns about his blood pressure because of his lifestyle. All that is to say that he was aware that he was probably due for some health problems.
My nephew was no different than my average client laying in the emergency room last night. He knew he has been heading down the wrong road for a while. He knew that, at some point, his lack of attention to his health could hurt him or kill him, yet he did very little to change that direction. He bought a bike that he doesn’t ride. He doesn’t like to walk, so he doesn’t. The only thing last night that set him apart from the average guy is that he went to the ER knowing that he has an adequate amount of life insurance in force.
So, why regular checkups? For my nephew, one good reason would be that he would be hearing from a professional that he was treading on thin ice with obesity, a recipe for disaster. For all of us it could well give us that advantage of an early diagnosis of something that can be serious left undetected. If we flip through life with our immortality shield up, never getting checkups, a heart attack could be how you find out you have heart disease or diabetes. A stroke could be the way we find out about hypertension, the silent killer. Regular checkups are wake up calls that don’t hurt.
Bottom line. Prayers were answered last night and my nephew, with a fresh look at life, should be fine. We should all work harder at being proactive about our health. There are people that would miss us.
December 14th, 2008
One of the things that is hard to drive home to people who are looking for life insurance is the cost of waiting to correct a situation that is keeping them from the rate class they want. Probably the single issue where this comes up most frequently is obesity.
Just a quick example. Let’s use me at age 55, good health. I’m 5′10 and for the sake of this example I weigh 260#. I want $250,000 of 20 year term and I can only budget about $1200.00 per year. The problem is that at 260# the best rate class I qualify for is standard and the best annual rate is $1482.50. So, being my typical customer I tell myself that I will go on a diet to get down to 225#. Then I will be in a standard plus rate class. Just 35#. I can do it.
This is where the cost of waiting kicks your overweight rear. Let’s say I really go nuts and actually lose 50# in the next twelve months. I’m only a year older and now I qualify for standard plus rates, right? Not quite where I wanted to be, but instead of $1482.50, the rate is $1325.00. Wrong. Life insurance underwriters have caught on to the fact that dramatic weight loss is almost always temporary, so whatever you lose in a years time if it’s over 20#, you get half of it added back on for underwriting purposes. So, I lost 50# and I get 25#, added back on, making me 235#, and I am still in a standard rate class.
So, I beat the odds and maintain my weight at 210# for a year and now I truly qualify for standard plus rates. The problem is I am 57 and the rate is now $1452.50.
But the real issue with postponing life insurance for rate gratification is that during that two years you didn’t do anything to lock in your insurability. So, let’s say that during that period one of the obesity buddies shows up. Let’s take diabetes. Your rate would be at least 50% higher than the $1452.50. What about cancer? That would likely render you not insurable at all until after treatment and a waiting period.
Bottom line. Buy your life insurance now, even if you only buy 10 year term insurance. At least it locks in your insurability. Then work on your weight or your cholesterol or whatever is keeping you away from your dream date with your dream rate.
November 26th, 2008
Being in the life insurance business and having been on the business end of passing on checks for death benefits, I have a real sense of just how much life insurance is needed by the families that receive it and a real passion for helping others understand that buying life insurance isn’t about expense, it’s about peace of mind.
In the years that I have been posting this blog, the world according to Ed, I’ve been a bit rough on men. Maybe not rough enough though. Men have this real thing about life insurance. They seem to think it’s all about them and the money that they will have to spend to ensure that, even if they don’t, their spouse will make it to retirement financially OK. They think it’s betting against themselves. They think they would be better off just putting that money in investments so that they can enjoy it, never considering that there are significant odds against them seeing retirement.
When I say significant, let’s put that into betting context. I know people who buy multiple lottery tickets every month with a 1 in a bazillion chance of winning, or those who buy scratch tickets every payday with a 1 in 250,000 chance of winning anything other than the money you’ve blown through the years on all the losing ticket. So, what are the chances that life insurance will be needed between young adulthood and your mid sixties, what we used to fondly think of as retirement time.
Well guys, if you knew that those fairly small life insurance premiums were covering a 1 in 6 chance would it become something worth thinking about? 1 in 6 men who make it to 25 in our country don’t make it to 64. For women it is 1 in 9. That isn’t betting against yourself but rather doing the prudent thing to cover a very real risk for those who are dependent on you.
And the cost! I know everyone is rethinking how they spend money these days. Is there any chance that we have an inordinate amount of our income going to play and toys? Is it possible that with just a little creative thinking we could divert a bit of that play money to peace of mind money?
Bottom line. All of us know someone who has died far too young in a car accident. You are in a serious minority if you don’t have a family member who has died prematurely from cancer or a heart attack. And consider all those around you for who obesity is an ingrained part of life and that with that lifestyle comes the risk of diabetes and so much more. What part of life insurance doesn’t make sense?
November 19th, 2008
Following quickly on the heels of the obesity epidemic has been the type 2 diabetes epidemic that is sweeping the country. With $billions being thrown around like dimes these days I was surprised that a headline with $billions even caught my attention. The estimated annual cost of type 2 diabetes in our country is $218 billion.
I would like to throw out a little different view of that staggering figure. Type 2 diabetes and all of it’s associated collateral health issues such as heart disease produce a substantial mortality experience in our country. I think someone would have to bury their head in the sand pretty seriously to not understand that diabetes and its’ complications are responsible for an astounding number of deaths each year.
When you consider that in the context of the number of people who are uninsured or under-insured, when those deaths occur families are going to be left with health care debt that will bankrupt many of them. Life insurance may be the only thing that will prevent that financial disaster from occurring.
The good news is that for many with type 2 diabetes life insurance is very affordable. The key of course is to get insurance while the diabetes is well controlled or in the early stages and hasn’t yet caused any other health issues. Here is just a quick review of the points that an underwriter looks at when reviewing a diabetes file for insurance.
Age of onset is part of the equation. After age 50 is optimal. Before age 50 will cost more, but the higher rate class is often offset by the lower cost for age. Control of the diabetes as measured by a blood test of glycated hemoglobin, the hbA1c, is critical. Well controlled diabetes tends to be less detrimental to the body. An A1c of less than 7 is good, less than 6.5 is optimal. Finally, whether their are related health issues, a measure of how far the diabetes has progressed is taken into account.
Bottom line. With $200 billion plus being racked up each year in costs associated with diabetes, the financial fallout for the families can be a terrible cost. You know me and my belief that if you have a family you should have had life insurance in force all along, but if you don’t and you have diabetes, apply for life insurance now.
November 18th, 2008
Over the years we have offered discussion on how to get the best possible life insurance rates even though your health is less than perfect. The truth is that with perfect health and family history you can probably find good rates at any number of sources and how to go about it is not a big issue.
But let’s be real. The truth is that those who have at least some health issue are more numerous than those who don’t. Those with more serious health issues such as diabetes, heart disease and obesity or mood disorders such as anxiety, depression or even bipolar disorder are not the majority of those seeking life insurance, but they are the group in the greatest need of hands on experienced help in finding the right company and the right rate.
There is probably nothing I have harped more on over the years than compliance and control. These are the first things that a life insurance underwriter will look for, and lack of either might very well be the last thing they look at when reviewing your application.
Are you compliant, truly steadfastly compliant with your prescribed treatment? Do you take your medication as prescribed or, for instance, do you just take medication when you feel like your blood pressure is high? Have you taken seriously the lifestyle changes that your doctor has recommended? Do you keep regular appointments and do you complete any suggested testing?
With compliance comes control, but I’ve found the biggest challenge in this area is your own education about your condition. If you have diabetes, do you know what your hbA1c is? If you’ve had a post cardiac issue stress test do you know what your ejection fraction is? If your cholesterol is an issue do you know what ranges are considered normal and high and do you know what your HDL and LDL are and what they mean? If your blood pressure is being treated do you monitor it on a regular basis and do you actually know the difference between diastolic and systolic? Do you know what it means when one of them is higher than it should be?
I guess what I am getting at is the difference between being told by a doctor that you’re doing OK and knowing for yourself based on test results just exactly how you are doing. A good example would be if you have diabetes and on your blood test your hbA1c is 7.5 and your doctor says you’re doing OK. Let’s just keep monitoring it. If you knew from your own studies that a reading of 6.5 was better than OK, in fact excellent, you might ask your doctor what it would take to get to better control.
I’m not saying that it’s not good to know you’re doing OK, but I know from experience that doctors aren’t big on education and OK really is good enough for most of them. But is good enough for them really your goal?
Bottom line. Compliance and control are the most important keys to the best possible rates when your health isn’t all that you wish it was. In an age where online health education is just a click away, there really isn’t a reason not to know not only how to manage your health, but how to measure it.
November 15th, 2008
They’re the rates you see advertised all the time and they are definitely the rates that everyone would like to be paying for their life insurance coverage. But do you qualify?
First let’s dispel with a few old myths. Your age and the amount of insurance have nothing at all to do with whether you qualify for the best rate class. Being younger doesn’t make you better qualified and asking for more insurance doesn’t mean you are less likely to be approved for the best rates. What matters is your health history, your family history and your lifestyle.
Build matters. Every company has a build chart. 5′5″ and 160 pounds gets the best rates, 190 pounds doesn’t. 5′10″ and 190 pounds gets the best rates, 210 pounds doesn’t. Life insurance companies are more lenient than the standard BMI charts, but they are there and underwriters are serious about them. They know there is a link between obesity and any number of health issues with high mortality experience such as diabetes, heart disease or cancer.
Your lab results, both blood and urine have to be in the normal range. If you haven’t been to a health fair or had a physical with blood and urine profiles, you may be in for a surprise when you apply for life insurance. It is fairly common for people to discover their perceived perfection is flawed when they are faced with the reality of lab results. Cholesterol, liver functions and glucose (blood sugar) are just a few that pop up and surprise people.
Your family history matters. If you had a parent die before age 60 of a heart attack or stroke, underwriters aren’t going to lend a sympathetic ear to your tales of your parent’s lifestyle. They will look you straight in the face and tell you that in spite of the fact that your father weighed 400 pounds and smoked and drank and never exercised, they don’t have any proof that he wasn’t predisposed genetically to heart disease.
They will look at your driving record. They will ask about any past drug or alcohol treatment. They’ll ask about your hobbies and they, not you, gets to decide if it’s risky. They’ll ask about foreign travel and again, they decide if what you do is risky.
Bottom line. The best rates in life insurance are worth shooting for, but before you get your heart set on them you might want to have a serious talk with an independent agent and see if you are really going to stack up.
November 10th, 2008
Type 2 diabetes is one of those anomalies, like obesity (which happens to be the leading cause), where there seems to be an aversion to calling it what it is, an epidemic. It reminds me a bit of the economic situation in our country and the aversion to using the word recession. Call it a meltdown, but don’t use the R word.
There are 23 million cases of diagnosed diabetes in the US today and everything I’ve read indicates there are probably close to that many undiagnosed cases. If nearly 50 million people had excessive ear wax buildup, it would be an epidemic. If you add to that the nearly 30% of the population that is obese (again, the leading risk factor for diabetes), we are a country that is in more than just economic trouble.
The thing I find most troubling from a life insurance aspect is the trend I’ve seen over the past decade of working with diabetics for a large percentage of them not to address their diabetes or their obesity with any real sense of urgency. It’s like no one has explained to them that they are just a few steps away from heart disease and possible death. I lay that blame partly on the doctors who seem to be too busy billing people to educate them but I also, in this day of Google, can’t see why self education isn’t happening at a faster pace.
The good news is for those who do take their medical situation seriously. For those who do educate themselves and do the right things like losing weight, controlling their diabetes either with medication or diet, and making the lifestyle changes they have to make, life insurance can be very affordable. Optimally a person with type 2 diabetes can still get better than standard rates, a home run where highly rated or decline results can be the outcome.
The key to better rates from an underwriting standpoint is mainly condensed into three criteria.
1. Age of diagnosis needs to be after 50. Diabetes can be a progressive disease affecting the heart, kidneys, eyesight and more. When diabetes starts earlier in life it has longer to damage your body, so later is better.
2. Absence of complications. If the disease hasn’t progressed in other health issues that is an underwriting plus.
3. Compliant and controlled. Underwriters can tell from your medical records if you have taken your diabetes seriously by complying with your doctor’s prescribed treatment and if you have, they can see the control in your lab results, most notably the hbA1c.
Bottom line. Diabetes is at epidemic levels and we, as a country, need to collectively get a grip and deal with it, preferably by prevention rather than treatment. If you have diabetes and want to find out where you stand in regards to life insurance, contact an independent agent today.
October 31st, 2008
photo credit: Mykl Roventine
Life insurance rates for those that smoke cigarettes, depending on the company and any additional risk factors, can run anywhere from two to four times higher than a comparable non smoker.
What particularly drives underwriters crazy are those brilliant specimens out there who still smoke after having had a heart attack or having been diagnosed with COPD. These folks would be lucky if they got offered higher rates but the truth is that they are more likely looking at a decline with a capital D for Dumb.
I know I attack this subject like it’s a no brainer easy thing just to quit smoking, but recent studies seem to indicate that it is actually getting harder and harder to quit. For those who could just get a grip and do it, they’ve most likely already done that. For those who are truly addicted, it’s a rough road.
So, what happens if you can successfully quit smoking? What can you do to get lower life insurance rates? The first step is 12 months nicotine free. That means no smoking, no nicotine gum and no nicotine patch. Once you have reached that threshold, if you’re in good health you should be able to get as good as preferred non smoker rates just by applying and doing a new exam (Yes, they will test for nicotine).
If your health isn’t all that great, all the more reason to apply for a new policy. Remember that underwriters don’t see the logic of having health problems and smoking. Conversely they like and reward the fact that someone has successfully removed nicotine from their life in an effort to improve their health.
Bottom line. There are plenty of reasons to quit smoking and while it’s not always an easy thing to accomplish, it’s always worth the effort.
October 28th, 2008
If you talk to most life insurance applicants who fall into the obese or morbidly obese categories according the their BMI, they have usually been told that they aren’t insurable or that the prices are so high as to render uninsurable because they can’t afford it.
Let’s not dance around the subject. Life insurance underwriting is all about assessing mortality risk, your chance of dying compared to someone in average health. One of the things they consider are the risk factors that you have and the health issues you might, or in some cases are likely to acquire.
In the case of obesity, it is a known risk factor for high blood pressure, heart disease, stroke, cancer and diabetes. So honestly it is not just the weight that impacts the outcome of the life insurance application, but the compounded perceived risk. Given the risk factors, while you may not agree when you have to pay higher premiums, life insurance companies are actually pretty generous with their build charts.
As I was running quotes for a person 5′11 and 395 pounds today, I was impressed by the fact that, number one, he was insurable and number two, while he may not be able to afford all he wants, he can still afford to make sure that his family is taken care of. Back when I did a series of blogs on the TV show Fat March, it generated a lot of attention to see the contestants on that show go from uninsurable to insurable, to great rates as their weight came down. Probably the most important aspect of that show and that series of blogs was the great discussion it generated over not just life insurance rates, but how life style changes could have such a huge positive impact on health and longevity.
Bottom line. If your only issue impacting life insurance at this point is weight, bite the bullet and find an independent agent to shop for the best possible rate for you. The picture isn’t going to get any prettier if you drag your feet and other health issues pop up and compound the issue. While there is a point where weight alone can keep you from getting traditional life insurance, chances are you aren’t there even if you’ve had a decline letter or two.
October 7th, 2008
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