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I’m working with a former Selectquote life insurance client. He applied through them and his application was postponed due to a PSA (prostate specific antigen) on his life insurance exam labs of 4.67, below 4 being normal. The company wanted the proposed insured to see a doctor and figure out why it was elevated. This is a knee jerk reaction that some companies have to an abnormal lab. They set it aside and don’t order any medical records or ask any further information because, well darn it, the lab result was abnormal and that’s just not their problem.

Postpones aren’t an approval and they aren’t a decline. A life insurance underwriter can postpone your application because there was a test recommended and it hasn’t been completed. There is often confusion between doctors and patients on whether a test is really, truly recommended or if the doctor is just saying you could do that test if you are curious what the outcome would be. Underwriters can also postpone your application, like above, because they see something on your labs or in your medical records that they want to know more about before they will approve or decline the application. Depending on the issue in question I often suggest we talk to other underwriters before you commit to testing. Not all companies or underwriters are created equal and a new underwriter might be just fine moving ahead without further testing.

Let’s say you saw the doctor because you were constipated and after poking and prodding and long discussions about your diet he says to try a laxative and, if that doesn’t work he would like you to consider having a colonoscopy. He recommends a good laxative and writes a referral for a colonoscopy and enters the whole encounter in your records, but since he’s a typical doctor he doesn’t make it clear that the colonoscopy is only to be scheduled if the laxative doesn’t solve the problem. You go home and get unplugged and your habits return to normal and you don’t schedule the colonoscopy. Down the road you apply for life insurance and the underwriter comes across a referral from a colonoscopy and can’t find where that was completed and your records don’t clearly explain that the referral was really just Plan B if needed. Your application is then postponed until you either get a colonoscopy or a letter from your doctor saying that you don’t need it. It’s usually not too brutal to clear these things up, but when it was 6 years ago and 3 doctors ago it can really throw a wrench in the gears.

Regressing to another subject at my age is a dangerous thing. I just glanced at the title a realized that I’m way off target. Useful information I hope, but back to the client that was postponed. Had the company ordered records for the client they would have seen about a four year history of elevated PSA’s, successfully treated as prostatitis. The proposed insured talked it over with his doctor and knowing that the life insurance company concern was prostate cancer, he scheduled and completed a needle core biopsy that confirmed there was no cancer and there was one core positive for prostatitis (inflammation of the prostate). There were no abnormal cells and nothing like high grade PIN (prostatic intraepithelial neoplasia), pre cancerous cells. It was at this point that he contacted me. I reviewed the history with him and got a copy of the insurance labs and the biopsy and shopped it. We got several offers and applied for the one I felt was our strongest chance.

Even though his PSA had gone up again on the new insurance exam, the underwriter was savvy enough to look at the history and combining that with the knowledge that 1. PSA’s often rise for a while after a biopsy and the exam was less than 4 weeks post biopsy and 2. the client’s father has a 30 year history of elevated PSA readings, not unlike the client, with five biopsies that were all negative and is now a happy, healthy 80 years old, the client was approved for life insurance. Notice how I finally sneaked a reference to family history in there?

Bottom line. There are plenty of reasons the PSA’s elevate and cancer isn’t all of them. If you have questions or have a situation where you were declined or highly rated for life insurance because of an elevated PSA that you would like to discuss, call or email me directly. My name is Ed Hinerman. Let’s talk.