I may have just uncovered some of the mystery surrounding the dreaded life insurance lab result call the CDT, an easy way to refer to Carbohydrate Deficient Transferrin. It’s what is know in life insurance as an alcohol marker. This test, when abnormal, is supposed to be indicative of heavy consumption of alcohol, not a place life insurance companies want to bet their actuarial bucks. On life insurance labs the CDT is only reported as normal or abnormal. If your results are normal, you’re good. With abnormal CDT results you are likely going to be declined, although some underwriters hold back from calling it an automatic decline. “Basically every case is looked at pretty thoroughly and we look for red flags for alcohol. But if we are not able to find any and the CDT is truly the only thing, we possibly could do pretty well on it. I’ve see them go out as low as Standard”, said one of the underwriters I spoke with.
I was contacted by a possible client who had been declined due to his CDT and a mention of occasionally having the desire to drinking heavily in his medical records. He then sent me an independent test he had done through his executive health program. This was after the life insurance exam and he provided it as evidence that he was not a heavy drinker, lab results showing that he was in the normal range for a CDT test. Since I had never seen ranges before I was interested to see that his reading of 1.3% was in fact in the normal range on a scale where the values show NORMAL <1.3% INCONCLUSIVE 1.4-1.6% and ELEVATED >1.6. In the narrative of the result it said that a CDT value in excess of 1.6% is considered elevated and “may” be consistent with chronic alcohol abuse. It goes on to say that a reading in the normal range is consistent with low or no alcohol use during the previous two weeks.
So I went in quest of what “value” life insurance companies use when they say abnormal. Are they saying everything in the >1.6% elevated range is abnormal. At first I called CRL, the lab that processes almost all of the life insurance labs in the country and they said they weren’t allowed to talk about that because each company is free to tell the lab at what level they want the lab to mark the results as abnormal. I then went to a couple of chief underwriters that I know and one, the underwriter in the first paragraph, said she wasn’t at liberty to give out exact values. The second one I went to, a true believer in life insurance agents knowing as much as possible about the mysterious world of underwriting as possible, sent me the following from his medical director. “I just called our lab and the operator connected me to “Joan” in the clinical lab area and she stated < 2.5 % as normal. Please note labs do at times change their normal range dependent on their internal statistics. I believe the 95% percentile of the general population is < 1.7% using conventional “normal range” of two SD this would mean normal would be < 1.7%.” So with this particular company it appears they’re using the same reference points as the client’s executive physical which put <1.7% in the normal or inconclusive range. And for life insurance purposes they have set their normal/abnormal cut off at 2.5%, roughly 30% higher than the point at which your doctor would be asking some serious life style questions. I found a doctor case example on line that is worth a quick look.
Bottom line. So, the question has always been, “how fair” are insurance companies being in the treatment of CDT abnormalities”? With one caveat, that being the error rate of the test, it would appear that life insurance underwriting is cutting a lot of slack before they raise the red flag and even more before they blow the whistle. With the bar set at 2.5%, life insurance companies rule out a weekend of drinking with the boys or girls. It would take something more like 2-4 weeks of excessive drinking. The error rate or false positive rate, depending on the research you read can be rare or common, but everyone does admit it can happen. If you have any questions or truly believe you have been declined due to a false positive CDT, call or email me directly. My name is Ed Hinerman. Let’s talk.