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UW Impairment

Life Insurance Underwriting Strategies for Applicants with Diabetes

The common use of the term “diabetes” typically refers to diabetes mellitus, a group of metabolic disorders that cause increased blood sugar levels. High blood sugar levels cause damage to blood vessels, which in turn can lead to a eye damage, kidney damage, heart disease, and strokes among other conditions. From a life insurance underwriting perspective, the most important variables are the type of diabetes, the age of onset, the level of blood sugar control over time, and complications from the condition.

Classification of Diabetes Mellitus:

The two most common forms of diabetes are classified as Type 1 or Type 2. Type 1 diabetes refers to diabetes caused by the destruction of the insulin producing cells of the pancreas, often very early in a person’s life. The far more common form of the disease is Type 2. This condition is caused by cellular changes that make the entry of insulin, and thus the normal processing of blood sugar levels, more difficult. Our increasingly sedentary lifestyle, excessive calorie consumption, and the resulting rise in obesity have led to a significant increase in Type 2 diabetes among life insurance applicants in recent decades.

Variables Impacting Life Insurance Underwriting:

The three most important variables that determine underwriting outcomes are:

Type of diabetes Type of diabetes
Age at onset Age at onset
Level of diabetic control over time Level of diabetic control over time

Type 1 diabetics require the administration of insulin, either via several injections per day, or, increasingly, via insulin pump. Type 2 diabetics usually control their condition with a combination of diet, exercise, weight loss, and on or more pill-based medications – although insulin injections are sometimes necessary to control blood sugar levels.

Age at diagnosis for diabetes is important as the effects of diabetes are cumulative. In other words, the longer one has diabetes, the greater the effect. Developing diabetes at a young age has a far greater impact on early mortality than diabetes that develops late in life.

Life insurance underwriting offers also depend heavily on good blood sugar level control as documented via periodic glycohemoglobin A1c tests. Medical records that show A1c levels close to 7.0 over recent years are highly favorable to underwriting.

Insurance Company Selection:
Several highly rated brand name insurers have developed specialized expertise in underwriting applicants with diabetes. There is no one best company for all diabetic applicants. However, if it is possible to gather a few key facts in advance of an application, it is usually possible to identify the most cost effective insurer to provide coverage. Answers to the following questions are most relevant:

What is your date of birth: What is your date of birth:
Do you have Type 1 or Type 2 diabetes? Do you have Type 1 or Type 2 diabetes?
At what age were you first diagnosed with diabetes? At what age were you first diagnosed with diabetes?
What is your most recent A1c reading? What is your most recent A1c reading?
Range of A1cs over the past year? Range of A1cs over the past year?
Do you use prescription medications to control diabetes? If yes, which ones: Do you use prescription medications to control diabetes? If yes, which ones:
Do you use insulin? Do you use insulin?
Any diabetes-related conditions (e.g., retinopathy, nephropathy)? Any diabetes-related conditions (e.g., retinopathy, nephropathy)?
What is your build (height/weight)? Change over past year? What is your build (height/weight)? Change over past year?
What regular exercise do you do? What regular exercise do you do?
Do you use any form of tobacco or marijuana? If so, describe usage: Do you use any form of tobacco or marijuana? If so, describe usage:
Are there any other medical conditions for which you are being treated? If so, describe: 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? How frequently to you follow-up with your healthcare provider?

If you wish to explore our industry’s most competitive underwriting solutions based on your insurance need, send me a message or give me a call and let’s strategize re case design, insurer selection, and underwriting strategy.

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