The Role Of Compliance And Control in Life Insurance!

I can remember a time when hardly a post left my computer without the words compliance and control somewhere in the text. The issues are no less important now and since it seems to be something that has popped up in several cases lately, well, let’s just kick it around for old times sake.

Control is pretty well understood. Let’s start with some examples of the absence of control. Me around ice cream. Blood pressure of 150/95 or higher, cholesterol over 300 with no offsetting high HDL. How about someone with diabetes whose hbA1c is 9.8? Someone with a mood disorder whose mood swings render them unable to lead a normal, stable life? An alcoholic or drug addict? Life is ripe with chances to lack control and life insurance underwriting is especially watchful for those areas.

A lack of control can show up in two ways, both problematic to life insurance underwriting. The first is that you are being treated for something, high blood pressure for instance, and your blood pressure continues to be consistently above the normal range. You’re under a doctor’s care but there is still a lack of control. There isn’t any doubt that the goal of the doctor is to get your blood pressure within the normal range and keep it there, but unless it’s already there and consistently there, life insurance underwriting will not give you credit for control.

The other instance is when something is way out of normal and you don’t know about it. It used to be shocking to me the number of people who would find out on an insurance exam that they had diabetes or even hepatitis C. If you don’t get regular checkups and symptoms come on slowly so you don’t suddenly feel abnormal, you may be out of control and not even know it. A dangerous place to be because out of control is when a medical situation can cause damage to your body.

Compliance. This topic bites more life insurance applicants than you can imagine. Has your doctor ever prescribed you medication and you didn’t like the way it made you feel so you quit taking it, or only took it when the symptoms were worse than the way the medication made you feel? This next one is me. Has your doctor ever recommended a test or a referral to a specialist or a return visit to check on a situation and you decided you didn’t have the time, the money or the inclination to follow their advice. Life insurance underwriting calls this non compliance and it can put a screeching halt to your life insurance application.

It’s like I give my doctor so much latitude to be right, and then I generally give myself about equal weight when it comes to anything but emergency situations. I mean if my leg is broken and the doctor says go to the hospital that falls within their area of expertise. But, if I’ve been noticing some pain in my leg when I go on my daily walk and the doctor recommends a $3000 mri of my lower extremities, I’m thinking it doesn’t hurt quite that bad. I’m being my own doctor and patient and underwriters don’t buy that kind of doctor/patient relationship. For them you either do what the doctor says or get a legitimate second opinion from another doctor saying it isn’t necessary. No loose underwriting ends. If there was a recommendation there has to be an action to resolve it.

Bottom line. This area of our lives and our medical records is one of the most common reasons for life insurance declines or postpones. If you only take your Lithium when you are having a bipolar episode that’s non compliance and you will be declined. If you have been told to get a sleep study and decided you really don’t need it, an underwriter will postpone a decision on your application until you have completed the sleep study or received a legitimate second opinion stating it isn’t needed. If you have any questions about compliance and control, well, call or email me directly. While I may not be a good example, I do know a lot about life insurance underwriting of the topics. My name is Ed Hinerman. Let’s talk.