I guess on some level I get that if you have coronary artery disease, you will always have it and I get that people with early onset CAD, actuarialy life insurance speaking are a worse life insurance risk than someone who is diagnosed, say, in their 50’s. But there are some absolute exceptions that rule of thumb and it has to do with those guys in their 30’s and 40’s who are diagnosed with or without a heart attack, make a radical lifestyle change and render themselves essentially immune from their heart being the cause of their death.
I’m working a couple of cases right now that are just defying my life insurance underwriting imagination. I would be hard pressed to lay out these cases any clearer than to just share the details as I sent them to the underwriters. The first guy, CEO of a small business needing life insurance, I described went like this, “Summary from Mayo Clinic. In 2003, after MI, he had a bare metal stent to his right coronary artery. The next year, in 2004, he went on to have a drug eluting stent to his proximal right coronary artery. Then he had brachytherapy for restenosis, and then in 2006 he had two drug eluting stents placed to his PDA and PLV bifurcations. Those were Taxus stents. Then in 2007 he had a stent thrombosis while on Plavix and aspirin, dual antiplatelet therapy, but in the setting of an influenza illness with occlusion of his distal right coronary artery. He has, since the diagnosis of CAD 8 or 9 years ago undergone a vigorous lifestyle change with changing his diet to a strict vegetarian, whole food diet, and this has led to a greater than 100 pound weight loss, and through that process he has come of all of his antihypertensive medicines and now exercises regularly with weightlifting and running as well as biking 30 miles a day, 4 times a week. Through all of this he has had no return of his angina symptoms which he described as fairly typical. He also has a negative stress test with a LVEF of 55%. He takes Simvastatin and Aspirin”.
This guy is 48, so this whole thing started when he was 37. No question he had CAD after his heart attack, but the subsequent four years of what life insurance underwriters want to characterize as chronic CAD and multiple angioplasty, was really a four year ordeal of trying to find stents that wouldn’t react with his arteries. Having survived four years of cardiologists trying to get that right, this guy has done all of the right things and that has shown all of the right results. While most life insurance companies didn’t want anything to do with this case, there were a few that got it and see this survivor of an early heart attack as a good mortality risk.
The other is actually an older gentleman, now 70 and the request I sent in said, “One vessel stent after stress test revealed blockage 10 years ago. Was on statins at the time. Complete lifestyle overhaul, diet and exercise resulted in losing 40 pounds. Pre diabetic 10 years ago, with weight loss A1c is and has been stable and normal at 5.4. Has never had an A1c 6 or over. Never on meds for pre diabetes and hasn’t been on any statins since shortly after angioplasty. Doctor said life style change would do more than statins. Regular physicals including labs all normal”. There were a number of life insurance companies that didn’t want to cover this individual because he has CAD and isn’t on any medication and he had prediabetic A1c’s and never went on diabetes medication. That is what we so fondly refer to in life insurance as the underwriter playing doctor. Just because that isn’t the normal progression and outcome of events, they assume that death is still lurking around the corner. Well, NOT! We were able, again, to get a few companies that saw past what could have been and dared to look at what actually is.
Bottom line. Giving weight to life style changes that work is called life insurance clinical underwriting. It takes guts for a life insurance underwriter to buck the norm and declare the truth in the face of so many dusty underwriting books and underwriters. If you have questions or feel like you’ve been offered a bad deal in the face of major life style changes, call or email me directly. My name is Ed Hinerman. Let’s talk.