Life Insurance Underwriting Strategies for Applicants Sleep Apnea
Sleep apnea refers to the temporary cessation of breathing, or episodes of shallow breathing, interrupting normal sleep cycles. This common condition is diagnosed, and treatment effectiveness monitored, via sleep studies (polysomnography (PSG).
Risks associated with untreated sleep apnea include high blood pressure, lung damage, cardiovascular disease, depression, and an increased risk of accidents due to excessive daytime sleepiness.
Initial treatment recommendations often consist of weight loss, abstinence from alcohol, and non-use of sleeping pills. If these do not achieve desirable results, mechanical devices, such as a Continuous Positive Airway Pressure (CPAP) or bilevel positive airway pressure (BiPAP) often achieve excellent results for patients who find use of the devices tolerable. Surgical treatments, such as uvulopalatopharyngoplasty (UPPP), reshaping the tongue or jaw, is effective in some patients. Extreme cases require tracheotomy, which is curative, but requires the permanent placement of a tube in the neck.
Expected Underwriting Outcomes
Sleep apnea severity is measured by the number of apneas (periods of breathing cessation) and hypopneas (periods of shallow breathing) per hour (apnea-hypopnea index (AHI)) and blood oxygen saturation levels.
Complications from untreated sleep apnea include increased risk of accidents due to excessive sleepiness while driving, high blood pressure, and heart disease.
Very mild disease (low AHI and near normal blood oxygen saturation levels), good daily documented compliance with CPAP/BiPAP, no adverse MVR history, and otherwise excellent health are helpful.
Some insurers are comfortable in offering preferred – sometimes even super preferred – premiums to untreated applicants with minimal disease, or those with more moderate sleep apnea, but a well documented history of excellent CPAP/BiPAP compliance, otherwise great health, and a clean MVR. Low table table ratings are common for mild to moderate untreated sleep apnea. Applicants with severe untreated sleep apnea are usually postponed until successful treatment & compliance can be documented. Guaranteed issue or accidental death policies may be available until such documentation becomes available.
Insurer Selection is Key
Several highly rated brand name insurers have developed specialized expertise in underwriting applicants with sleep apnea. 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. We 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.
Pre-Formal Underwriting Questions
- What is your name?
- What is your gender? F ___ M ___
- Date of birth:
- What type of sleep apnea do you have (most common is obstructive sleep apnea, OSA):
- When were you first diagnosed with sleep apnea?
- Is it considered mild ___, moderate ___, or severe ___?
- How is your sleep apnea being treated?
- Have you had surgery to treat your sleep apnea? If so, which type, when, and what was the result?
- What is the date of your most recent sleep study (polysomnogram) and what did it show?
- Have you been diagnosed with high blood pressure, heart disease, or another illness? If so, please describe:
- What is your build (height/weight)? ___________ Change past 12 months: ________
- Do you use any form of tobacco or marijuana? If yes, please describe type & frequency of usage:
- Have you had any driving violations or accidents in the past 5 years? If so, please describe, with dates:
- Please list all prescription medications you are taking and what condition each is treating:
- Are there any other medical conditions for which you are being treated? If so, please describe:
- How frequently do you follow-up with your healthcare provider?
- Can you think of any other information that might be relevant to insurance underwriting negotiations? If so, please share: