Either life insurance underwriters aren’t buying into what researchers and doctors are saying about the PSA, prostate specific antigen test, or in the case of one underwriter she’s just believing what he wants to believe to get through this case and not look like she conceded anything.
I have a client whose PSA was found to be high on life insurance labs 3 years ago. The company postponed the application pending a review by a urologist. Even though the readings were just out of the normal range at 4.56 he had a needle biopsy done and one core did show a trace of low stage, low grade prostate cancer which the pathologist labeled as “latent”. The biopsy was done 7 days after the insurance labs and a follow up PSA was done 2 days later that showed 3.4. He and his doctor decided that watchful waiting was prudent. As they watched and aggressively waited over the next 3 years his PSA steadily came down to 2.95 just a few weeks ago. The aggressive part was that even though everything was going fine he voluntarily had 3 more needle biopsies done, all negative for cancer. Negative biopsies and a declining PSA led to a trial quote of standard plus by the same company that had postponed him three years prior, the same rate this company would have given someone who had successfully treated the same stage and grade of cancer.
Then it hit the fan. On his insurance exam the underwriter says his PSA was 4.83 so they changed their offer from standard plus to table 3, double the rate quote. Now I’m not calling them liars, but it seems extremely odd that if you have a client who claims his most recent PSA was 2.95 and the insurance labs say 4.83, just as they did 3 years ago they should have sent a copy of the labs to the PI so he could go immediately to his doctor. Instead they ordered records and plunked along for 6 weeks after they say they knew his PSA was elevated. They don’t send him any labs. They don’t give me, as the agent, a heads up that this case was going to be rated due to his current high PSA. There was no suggestion that anything was out of the ordinary.
In the meantime my client was off for another regular visit to the urologist for a biopsy and PSA. Just 3 weeks after the company claims he is at 4.83, his biopsy again comes up negative and his PSA test is at 2.95. He would have gone sooner if he had been given a heads up by the insurance company that his PSA was high again. This man is proactive and aggressive about watchful waiting. He isn’t looking at watchful waiting as a chance to kick back and ignore the problem even when all appearances are that there is no problem.
So, as an agent working on behalf of my client I am wondering what’s with the huge discrepancy between insurance and urologist labs? They did use different laboratories, but both used nationally certified lab companies and both used the standard of 0 to 4 as the normal range. It would seem that his PSA was wildly fluctuating, but with as little as 9 days and 3 weeks between the insurance and urology tests, there isn’t time for wild fluctuation. It is kind of incredible that both times the margins between the differing labs are within the much talked about 25% margin of error for the PSA test.
Bottom line. Who knows? But it does seem that this client has been compliant with both the language of the postpone from the company 3 years ago and his urologist of just one week after the postpone. He’s followed directions and it’s time for the life insurance company to pony up and live up to their trial. I will post the results of this battle when it ends and the name of the company for better or worse. If you have any questions or have had a similar situation and need help, call or email me directly. My name is Ed Hinerman. Let’s talk.