I recently came across a new underwriting twist that would apply primarily to mood disorders such as chronic depression and bipolar disorder, viewing a medication change as a negative event. Would it be better to not try for more stability, not try to improve by testing a new medication, not trying to find a combination without side effects.

There are times when a medication change does accompany a downward spiral of some degree and those events, taken in context, will cause at least some underwriting setback. When someone has to go to the ER due to an extended manic episode and the doctor decides to change prescriptions, until stability a regained through the new med it’s fair to rate a client or even postpone consideration. It is also very common for med changes to occur during periods of stability and successful treatment, making adjustments that can improve stability slightly or keep the stability already gained with fewer side effects.

It seems really out of context when you think about the fact that a med change with any other health condition is rarely even noted. When’s the last time an underwriter got his shorts in a bunch because someone switched from Simvastatin to Lipitor?

Anyone who has followed the treatment path of someone with bipolar disorder knows very well that it is a practice of gains by inches. Prescribing the home run the first shot is highly unlikely.

The real underwriting question here is whether starting a new med should be viewed as a negative, a setback. One underwriter I spoke to said that the reinsurance guides seem to indicate the answer is yes while his common sense didn’t match up with that assumption, leaving an area for reasonable consideration.

Bottom line. The best we can hope for with any life insurance underwriter is a mind clear of assumptions, a mind open to some events being positive even when the manual says negative. Fortunately we work with several of those and what are roadblocks in many cases can end up being just detours.