I think I’ve been very clear over the years about unexplained information in medical records and how life insurance underwriters deal with it. They ask questions!

Sometimes the mystery information isn’t relevant once it is explained. Sometimes the information doesn’t even pertain to the patient. I think I’ve shared this before, but several years ago a client was declined after a review of medical records due to not admitting a history of heart disease.

After calling the client with the news, she was adamant that she had never had any kind of cardiac event and had never consulted a doctor for any potentially cardiac related symptoms. After speaking to the underwriter, he said that the records clearly mentioned the word angioplasty. He gave me the page number and said the word was circled. I passed this on to the client who pursued a review of her medical records. She and her doctor were finally able to nail down the reason for the note. It seems she had a friend who was going to undergo an angioplasty and she had asked the doctor to explain what it was. As he explained, he doodled and subsequently left the word angioplasty in the records of someone who didn’t even know what it was.

Doctors are notorious for doodling or writing down some thought with no further explanation. And generally I become the messenger, being shot on sight because the underwriter is asking for clarification. It means homework for the potential insured and while some don’t mind, most feel as though they are being asked to do the work that someone else should do.

This came to a head with one client the other day when I called and asked if she could get a letter from her doctor explaining why he had circled a certain condition on two separate visits, something not done on any other visits. Without clarification the company was willing to offer coverage at a higher rate than originally quoted. With an explanation we could likely have had a policy issued at the same rates originally quoted. She refused. She said it was obvious to her and if it wasn’t obvious to the insurance company, then they were just trying to gouge her for additional premium. The circled condition with no explanation needed clarification. She shot the messenger and withdrew her application.

Bottom line. Underwriters have to try to make sense of your medical records. If you think that’s easy, you’ve either never been sick or never looked in your medical records. If an agent comes back to you asking for clarification, it’s not because the insurance company wants to raise the premium, but rather because they are looking for an explanation that would help them avoid that.

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