Posts filed under 'smoking'
I went off a bit on some of the more ridiculous combinations with smoking the other day. Smoking and asthma. Smoking and heart disease, etc. Some guy (blog name Joe Camel (clever)), took some hard swings at the life insurance industry for being so mean to smokers. Fortunately for me smokers run out of breath quick and the hard swings turn to frail flailing.
So let me throw a little different spin on this subject and see if makes the point. 120,000 people a year die from COPD (chronic obstructive pulmonary disease), almost all of them smokers. COPD is the number four killer in the US behind heart disease, cancer and strokes.
The American Lung Association shared some interesting facts about the little talked about COPD.
It seems that COPD is another one of those silent killers, not unlike high blood pressure or hypertension. Often the symptoms are shrugged off as natural consequences of smoking or lifestyle. Things like smoker’s cough, or just feeling your age or feeling out of shape. The longer they are shrugged off, the more damage your lungs suffer.
Bottom line. Whether you agree with life insurance companies and their underwriting guidelines around smoking, do the right thing. My wife and I recently vacationed in Mexico and in the duty free shop at the airport they were selling huge boxes of cigarettes. I think each box must have held 10 cartons or something. On the top was the brand name of the cigarette and on the side, in huge letters that covered the whole side of the box, it said SMOKING KILLS! Sounds like someone down there understands the statistics.
May 22nd, 2008
To me this is another great example of our education system really missing the mark as far as what they perceive to be the most valuable information a young adult needs to get on with life. It is, and isn’t amusing that a high school student is required to pass Algebra in order to graduate, but they don’t have to be able to balance a checkbook and they don’t understand credit.
It is also less than amusing that human physiology is really just a study of the parts, and not an education in what can go wrong with the parts and why. High school students are never really exposed to the true risk factors of heart disease. They don’t understand that smoking, obesity and a sedentary lifestyle is a very real set up for a heart attack.
Blissful ignorance is hardly the gift of education. And it is this blissful ignorance that propels many children into adulthood destined to have serious health issues. It is this lack of education that will leave many of them unable to procure affordable life insurance when they reach that time in their life where they have family or business interests that need protection.
Bottom line. Our education systems are stuck where they are, so we, as parents, need to pick up the ball. Our children should not leave our homes unprepared. As they grow older we should never shy away from providing information they need to make prudent choices about their health, about credit and mortgages, and yes, about life insurance.
May 20th, 2008
A perfectly healthy person who smokes can expect to pay, best case, twice as much as a person who doesn’t smoke for life insurance. I’ve been on that soap box often enough that I don’t know that I need to beat it to death anymore.
With that being said, there are other times when smoking can have an even more profound impact on underwriting. An underwriter I know and work with on a regular basis calls the extra premium or sometimes the decline that results from smoking in addition to certain health issues as a “you just can’t fix stupid tax”.
We’ll start with the flagrant examples and work our way back toward some of the more subtle. By the way, all of these examples are from people who have actually called me attempting to get life insurance. A person who has diagnosed COPD (chronic obstructive pulmonary disease) and still smokes has apparently missed something somewhere and is a slam dunk decline.
A person with an otherwise insurable history of cancer, if they smoke, would either suffer a much higher rating or be declined because they haven’t quite grasped the fact that there is a direct correlation between abusing your body and bad things happening.
One that comes up fairly frequently is the person who has suffered a heart attack or been diagnosed with CAD (coronary artery disease) and still smokes. Hellooo!!!! The doctor said you need to quit. Your wife said you need to quit. The surgeon general said you need to quit. Your mother is going to outlive you because you refuse to get a grip and do the right thing.
Asthma and smoking. Depending on the severity of the asthma, this can be reasonably insurable to highly rated. It’s frankly never made a lot of sense to me. If you have trouble just breathing air, why would you substitute smoke for air? Kind of like if you had trouble swallowing water, substituting mud.
Bottom line. Life insurance underwriting allows for insuring smokers in most cases. Higher rates will always apply when comparing smokers to non smokers. I’ve never been shy about ripping the heads off underwriters when I think they’ve got it wrong. When it comes to smoking combined with smoking caused or exacerbated health issues, I believe they’re right on target.
May 15th, 2008
I have no idea, but if someone has had a heart attack I know that one thing that won’t hurt their feelings is finding affordable life insurance rates. While I may not have a clue about broken hearts, I can shed some light on what life insurance underwriters look for when underwriting heart disease and heart attack cases.
The difference in underwriting is very subtle between heart disease (CAD)
and heart attacks. The real difference has to do with the problem being diagnosed before or after damage (ischemia) has occurred in the heart. If the damage is minimal the underwriting outcome will be virtually the same. As the damage level increases, rates become higher due to the weakened condition of the heart and subsequent possible shortened mortality.
Having said that, life insurance underwriters look at several key factors in weighing the risk.
1. Age of onset. This one isn’t too hard to imagine the impact. Just consider for a moment the difference in your reaction upon hearing that a 35 year old cousin had heart bypass surgery versus hearing that his father, a 60 year old, had the same occurrence. There isn’t anything normal about a young person having cardiac issues, so age of onset is important to underwriting. Generally, prior to 50 is going to increase the rates and prior to 40 will increase the rates dramatically.
2. How many vessels were involved? Whether there was a heart attack or not, we are generally talking about either bypass surgery or placement of a stent through angioplasty. The number of vessels is some indication of not only severity, but chance of recurrence. A one vessel issue will receive more aggressive underwriting than, say, four or five vessels.
3. Recurrence. It is not uncommon with chronic CAD for a person to have to go through more than one procedure. If these are less than three months apart it is generally looked at as one event and wouldn’t be considered chronic. Often these occurrences are years apart and that presents an obvious increased risk to the insurance company. As long as the heart, as shown through the results of a stress test, is still strong, insurance should be attainable although at higher rates.
4. Heart damage. Before accepting a risk on a cardiac case, insurance companies will want to see a stress test done post heart attack/bypass/angioplasty. Even 10 or more years out from the event, if a person hasn’t had a stress test within the previous two years, insurance companies will likely require one before considering approval. The primary assessment of heart damage from the stress test is the left ventricular ejection fraction (LVEF). This, simply put, is a measure of how efficiently your heart is pumping blood. A normal LVEF would generally be around 65%-70%. Insurance companies will generally not consider coverage if the measurement is below 50%.
5. Lifestyle. Underwriters pay close attention to whether or not the event got your attention. If you’ve had a cardiac event and, say, continue to smoke, if you are approved it will be at an extraordinarily high rate. Most companies will simply decline to accept the risk. They also look at fitness issues such as exercise and obesity.
Bottom line. Fair rates on life insurance are available for the majority of people who have been through a cardiac event. Thanks to modern medicine far less damage occurs on average than used to occur. What this means for insurance companies is that, rather than knocking someone out of the running for life insurance, it keeps them in the running and with the survival of the wake up call and lifestyle changes, mortality experience is good. You’re going to be around for a while.
April 16th, 2008
People act shocked and amazed when they find out they don’t get those life insurance rates advertised everywhere. I think somewhere inside they knew it would happen because those are non smoking rates and they smoke. And all that flashed fine print on the insurance ads can hardly be seen through the smoke. Surely though, they’ve seen the warning on the pack that says smoking has NOT been linked to great life insurance rates.
Even the companies that are actively seeking smoking clients will charge twice as much for a preferred smoking rate as they will for a preferred non smoker. Some are three times more and there are a few trying to send a message with rates four times higher. I’m thinking the underwriters at those last two sets of companies may have read somewhere that there are statistical links between smoking and cancer, smoking and heart disease, smoking and etc, etc, stroke, etc, etc………..
Some life insurance companies will allow a person, who has smoked for 20 or 30 years, quit for 12 months and get preferred non-smoking rates. I know they say that damage from smoking starts to reverse itself shortly after you stop smoking, but all the way to preferred in one year. I’m all for people getting great rates, but…. it seems to me that the companies are probably charging non smokers too much to start with if they will allow that kind of underwriting.
Bottom line. I suspect there are smokers and ex-smokers who might not jump on to my bandwagon. My suggestion. Quit smoking and go grab those preferred non-smoker rates before those companies come to their senses.
April 7th, 2008
For all of you that have applied for life insurance and smoke cigars, and didn’t use the right company and agent, you’ve felt the sting of smoker rates. In general, cigarette smokers will spend 2-3 times what a non smoker will spend on life insurance given everything else being equal.
I’ll try not to get on my soapbox too much about how it should be obvious why that’s the case with cigarette smoking. With links to just about every malady known to mankind, an insurance company would be crazy not to figure that into their mortality assumptions and rates. The best you can do as a smoker is to find an independent agent that has access to the best rates available. Right now, in most cases, that would be with Liberty Life and Western Reserve Life.
If you happen use tobacco in some other form such as cigars or chew, and run into an agent that doesn’t know any better, they will probably just quote whatever smoker rate they can find and hope you buy it because, well….because you’re a tobacco user and that means more premium and more commission.
A good indpendent agent on the other hand is going to know that with Prudential you can get non smoker, non tobacco user rates even if you smoke cigars or chew all day long and test positive for nicotine on your exam.
Bottom line. Cutting your rates in half by finding an agent who knows where to take your business and where not to makes sense somehow……unless you want to spend too much money.
March 24th, 2008
There are plenty of life insurance companies out there who will look the other way on cigar smoking as long as you are truly an “occasional” smoker. Each company has their take on what occasional means.
For a few companies you need to save those cigars for true celebrations, and then only for a few a year. You need to pick and choose your occasion wisely if you want them to ignore the habit in underwriting with some companies allowing as few as 2-4 per year. There are companies that must have golfing, cigar smoking CEO’s, These companies have stretched occasional to as many as a dozen a year.
Keep in mind that while these companies are allowing this use without underwriting penalty, they expect you to have negative nicotine results on your labs (yes they test for it). So, if you are an occasional user and would like the break offered, let your agent know so that they can advise you to lay off any occasions for a month prior to your exam. All of us in the business have had clients who have just been overcome with the joy of the moment and can’t resist smoking a cigar the day before an exam. Positive nicotine results lead this group of companies to assume that you are a common smoker and if you stay with them you will pay smoker rates, easily 2-3 times what you were expecting to pay.
The big alternative, and there is really only one left, is Prudential. They stand alone. They allow tobacco or nicotine use, except for cigarettes, even with positive nicotine in the labs at non smoker rates. So, for all of those who chew, smoke pipes or cigars, Pru has a deal that today is not found anywhere else. This is not a small deal if you fall into the category of a tobacco user other than cigarettes. This is huge and can cut your life insurance cost in half.
Bottom line. You’ll never hear about this if you don’t use an independent agent. You’ll never know about this if you aren’t completely honest with your agent about your tobacco habits. Don’t make yourself and your agent look foolish by assuming that you can slide that cigar use past the underwriters.
March 18th, 2008
Smoking is often touted by those who partake as a way to calm themselves. Of course, from a life insurance standpoint, calm or not, smoking carries so much health baggage with it that rates for smokers are dramatically higher than non smokers.
A recent study suggests that the feeling of calmness may be deceiving as women seem to have a significantly increased risk of high blood pressure (hypertension) if they smoke. Along with that increased risk comes the risk of heart disease.
We have discussed many times that blood pressure and cholesterol are the two most common surprises on insurance exams. Hypertension isn’t called the silent killer for no reason. Especially if it is borderline or mildly elevated, a person may not notice the symptoms, or it may come on over a period of time and it just blends in and a person doesn’t notice anything out of the ordinary.
The good news is that blood pressure is often easily controlled by lifestyle changes, and in the absence of the ability to make that change, also easily controlled with medication. Certainly a change to not smoking is going to have benefits across the board. After 12 months of no nicotine use, life insurance rates can be cut in half or more.
Bottom line. High blood pressure is just one more reason to consider giving up on smoking. The list of health issues connected to smoking is constantly growing. The truth is that there are no benefits to it, only downsides.
January 31st, 2008
There are essentially three treatment methods for blocked arteries of the type that can lead to a heart attack. The original and still widely used vessel bypass surgery, angioplasty with a stent inserted in the vessel, and for minor blockage, medication to reduce the risk of increased blockage.
A recent New England Journal of Medicine study showed that the conventional bypass surgery had a higher survival rate in multi vessel cases. While the difference isn’t huge, when it’s your heart and your life it certainly seems worthwhile to discuss the pros and cons with your cardiologist.
From a life insurance view, underwriting coronary artery disease generally focuses on four areas. Age of onset is huge. The earlier the diagnosis, the tougher it is to get good rates. A good rule of thumb is that the best rates will come with a diagnosis in your 50’s. Between 40 and 50 is still doable, but generally rated a little higher. The good news is that quite often the higher rating is offset by the younger age. Prior to age 40 and chronic instances are a tough sell. It can be done if the patient is doing all the right things.
The number of vessels is important. The more vessels that are blocked gives some indication of how pervasive the CAD is.
Other risk factors plays a key role. Probably the one combination that leaves underwriters asking “Where’s your sign?”, is someone who has been diagnosed with CAD and is still smoking. Other risk factors that don’t float with CAD are diabetes, high blood pressure and obesity.
Finally, the condition of your heart as measured by a stress test after you’ve completed whatever procedure you elect to have. Underwriters pay particular attention to the left ventricular ejection fraction (LVEF), a measure of how strong the heart pushes blood out of the left ventricle.
Bottom line. A good independent agent can find fair rates for people post bypass or angioplasty. The general rule of thumb is that underwriters will want to see a year after the procedure and a stress test.
January 24th, 2008
I’ve explained in plenty of detail how life insurance rates are effected by smoking. In general, a person who smokes will pay 2-3 times more than a non smoker in comparable health. There is just no question that underwriters believe that there is a significant mortality risk connected to smoking.
But, what about when you quit? We hear all the time that from a medical standpoint, once you quit the negative impacts begin to reverse themselves fairly quickly. I thought I would give a quick overview of how a dozen or so insurance companies view the subject. In question will be what different company’s stances are when you have been nicotine free for a year, 2 years, 3 years and 5 years.
American General - Standard after 1 year, standard plus after 2 years, preferred after 3 years and preferred plus after 5 years.
Banner - Standard plus after 1 year, Preferrred after 2 years and Preferred Plus after 3 years.
The picture is already painted. When you quit smoking it makes a huge difference what company you go to.
Genworth - Standard after 1 year, Select after 2 years, Preferred after 3 years and preferred best after 5 years.
Indianapolis Life - Preferred after 1 year, preferred plus after 4 years.
John Hancock - Preferred after 2 years and preferred plus after 5 years.
Mass Mutual - You can get their best rate after just 1 year as a non smoker. Unfortunately their rates make up for their attempt at compassion.
Liberty Life - Preferred plus after 1 year and their rates are competitive unlike Mass Mutual.
West Coast Life - Preferred rates after 1 year and preferred plus after 5 years.
Your focus and that of your independent agent, once you have met the 12 month nicotine free threshhold should be seeking out the best possible rate and locking it in. Keep in mind that once that non tobacco rate is locked in, even if you insanely go back to smoking, they can’t change anything. Even though you are a smoker again, your rates will remain tobacco free.
Bottom line. Quit smoking! It’s bad for you. It’s bad for people around you. It’s bad for your health and your life insurance rates.
January 9th, 2008
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