
Life Insurance Underwriting Strategies for Applicants with Heart Disease
Heart disease is the leading cause of death in the United States. Most forms of heart disease develop over time, making age the leading risk factor. Behavioral variables, including a poor diet, tobacco use, build, and a sedentary lifestyle, are major contributors. High blood pressure and cholesterol levels accelerate the development of some forms of heart disease. Gender and genetics play major roles. Heart disease is more commonly diagnosed in men, and at an earlier age. It is believed that estrogen has cardioprotective properties that delay the onset of heart disease in women by about 10 years.
There are many causes and forms of heart disease. One common form involves the narrowing of key arteries that supply the heart with oxygen. Untreated blockages can lead to heart attacks. Elevated blood pressure can cause the heart to become less efficient over time, leading to congestive heart failure. Heart valves can become calcified, causing narrowing and impeding blood flow. The nerve fibers that normally facilitate a precisely timed and regular heart rhythm may become damaged, causing arrhythmias or heart blocks. As we age, our heart is likely to be impacted at some level by one or more of these changes.
Expected Underwriting Outcomes:
Age is a key variable in underwriting heart disease; mild disease with onset in the mid-60s or later can often be insured at standard rates. A 30-year-old with a history of heart attack, continued tobacco use, and suboptimal medical follow-up may only qualify for guaranteed issue or an ADD policy. Most applicants fall somewhere in between.
Insurer Selection is Key:
Given the prevalence of heart disease, several highly rated brand name insurers have developed specialized expertise in underwriting one or more forms of heart disease. Unfortunately, there is no one best insurer for all applicants. Therefore, it is best to gather a few key facts in advance of a formal application. Our underwriters can use that information to negotiate preliminary underwriting assessment from several insurers, identify the most aggressive carrier, and model approximate product pricing for you. You and your client can then make an informed decision on the best way forward. Answers to the questions below will enable us to identify our industry’s top solution(s) for your client.
Pre-Formal Underwriting Questions:
- What is your name:
- What is your date of birth:
- What is your gender? F ____ M ____
- When were you first diagnosed with heart disease?
- What symptoms led to the diagnosis (e.g., chest pain, heart attack, TIA, trouble breathing, palpitations, stroke, weakness):
- Variant(s) of heart disease diagnosed, with dates (e.g., AFibs, congestive heart failure, valve disease, MVP, arrhythmia, LVH):
- Treatment(s) completed, with dates (e.g., stent placement, bypass surgery, valve replacement, ablation, angioplasty):
- If stents were placed, how many? ___ Which arteries were stented? ____________________
- If bypass surgery, how many vessels were bypassed? ___ Which arteries were bypassed? ______________
- Date of your most recent EKG: _________ Date of most recent stress EKG: _________
- Date of your most recent echocardiogram: ________ Date of most recent stress echocardiogram: ______
- Date of most recent calcium scan (EBCT): ______ Score: _____ Percentile: ____
- Date of your most recent Holter monitor: _________
- Date of your most recent angiogram (angioplasty, PTCA, cardiac catheterization: _________
- Pacemaker installed? Y___ N ___ If yes, date: ______
- Defibrillator installed? Y ___ N ___ If yes, date: ______
- Build: H _____ W _____ Change in past 12 months: ______
- Recent blood pressure reading: ____ / ____
- Cholesterol levels: Total ____ HDL ___ LDL ___ Triglycerides _____
- Homocysteine level: _____
- List all prescription medications you are taking & what you are taking them for:
- List all non-prescription medications and dietary supplements taken regularly (e.g., aspirin, niacin, omega 3):
- Describe any regular exercise program: _________
- Do you use any form of tobacco or marijuana? If so, describe type and frequency of usage:
- Are there any other medical conditions for which you are being treated? If so, describe:
- How frequently to you follow-up with your healthcare provider?