Anxiety and related mood disorders are extremely common; most people will have related experiences from time to time.  From a life insurance underwriting perspective, the greatest concern lies with a new diagnosis, moderate & severe bouts, and chronic disorders.  In preunderwriting a risk, we need to differentiate between mild, temporary, situational disturbances that resolve within weeks or a couple of months from those that are moderate, severe, and chronic.

Of greatest concern to insurance company medical directors are newly diagnosed moderate or severe forms of anxiety; it is often very difficult to get a good feel for a long-term prognosis.  Morbidity and mortality risks come from significant self-medication via alcohol & drugs, accidents, and suicide in the most extreme settings.

Anxiety often classified as mild, moderate, or severe.  Sometimes specific forms of anxiety are diagnosed.  These forms include social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), and various phobias.  Treatments include therapy and a variety of standard approved and off-label experimental medications.

Underwriting Outcomes:

Temporary bouts of mild anxiety that can be explained by situational circumstances (job loss, divorce, illness, loss of a loved one) tend not to cause underwriting issues.  It’s important to make the underwriter aware of the unique temporary nature of the circumstances that have led to an apparent transient anxiety.

Underwriting is more challenging for applicants who self-medicate with alcohol and/or drugs and who do not seek professional treatment.  Evidence of difficulties with family, at work, or motor vehicle reports that show reckless driving, DUIs, or accidents will lead to moderate table ratings or postponements until there is evidence of effective professional treatment.

As the field underwriter, you can make a big difference for your client.  Help us paint the most positive vision of the applicant in the underwriter’s mind.  Does the applicant seek regular medical advice to manage the condition?  Therapy?  Is the condition stable?  Is it getting better?  Does the applicant have a strong support network via family, stable job, church, participation in clubs or social events?  Help us develop positive variables that are not typically asked on a formal application.  These “soft details” give us the best chance of finding that sympathetic ear, as we negotiate the fact pattern with insurers that specialize in underwriting anxiety disorders.

Insurer Selection is Key:

Insurance companies have a very difficult time pricing the unknown.  For anxiety disorders, there are often lots of unknowns, and much of what is known, is subject to interpretation.  Conservative insurers tend to rate or pass on these risks.

Several highly rated brand name insurers have developed specialized expertise in underwriting anxiety disorders.  They are particularly receptive to incorporating favorable lifestyle variables into their underwriting assessments.

Unfortunately, there is no one best company for all applicants with anxiety disorders.  Therefore, it is best to gather a few key facts in advance of an application.  We can then use that information to obtain a preliminary underwriting assessment from several insurers, identify the best carrier for the risk, and provide you with approximate product pricing.  This underwriting strategy makes it much easier for the advisor and applicant, relative to applying somewhere, and then having to move the case to another insurer.  The questions below can be used to obtain relevant underwriting facts in advance of a formal application.

Pre-Formal Underwriting Questions:

• Your name:
• What is your date of birth:
• What is your gender?  F ____   M ____
• When were you first diagnosed with anxiety?
• What form of anxiety has been diagnosed (mild, moderate, severe; panic disorder, OCD, PTSD, SAD, agoraphobia, other phobias):
• Was there a specific causative experience (job loss, divorce, illness, loss of a loved one)?
• If there is a specific trigger (causative event) for the experience, is it still present, or has it been resolved?
• What symptoms did you experience that led to the diagnosis?
• Current symptoms, if different:
• If the anxiety comes and goes, number of bouts since onset:
• Have you ever been (or are you currently) on disability leave of absence from work or school because of your anxiety?  Describe:
• How often do you see a therapist?
• How frequently do you see your regular medical doctor or psychiatrist?
• List all medications prescribed to treat your anxiety:
• Beyond therapy and medications, list any other types of treatments:
• Would you say your anxiety is stable, getting worse, or getting better?
• Date of last hospitalization for anxiety, if ever:
• Date of most recent documented suicidal thoughts: ______ Attempts: ______
• Describe alcohol use pattern over the past 12 months:
• Outline any drug use, including marijuana, over the past 12 months:
• List major driving violations in the past 7 years, especially reckless driving, DUIs, accidents:
• Build (height/weight): _______  Change in past 12 months: _________
• Describe all favorable variables (e.g. stable job, supporting family, church involvement, hobbies, social network and activities):
• Are there any other medical conditions for which you are being treated? If so, describe:
• List any prescription medications you are taking & what you are taking them for:
• Describe any regular exercise: _________
• Do you use any form of tobacco? If so, describe type and frequency of usage: