Problems In Life Insurance Underwriting for Heart Conditions

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When given the opportunity, we do everything we can to get anyone with a heart condition the best life insurance rate and value. 

While the majority of the heart patients we do business with do qualify for the rates we quote up front, there are times when higher rates are offered. 

The problem in quoting up front is that we usually need to rely only on the information that you give us to quote accurate rates and to choose the best insurance companies for you.  

Your cardiologist probably tells you you’re doing great, and you probably are, but you may not know what abnormalities are showing up on your echocardiogram, EKG, cardiac catheterization results, holter monitor results, etc. 

All of these cardiac test results will have key information that can better enable us to shop your case and find you best offer. 

On cases that are more complicated, we’ll usually ask you to send us copy of your most recent cardiac test results if you can easily obtain them.   

Your Privacy Is Important To Us

If you’re hesitant to send medical records or medical test results, we understand.

We always tell everyone to white out their name and any identifying information prior to faxing or emailing records to us.  

Having shopped my own cardiac case, which was no easy task, and thousands of other tough heart cases, we’ve learned a thing or two and have gotten very good at finding the best offers possible for anyone with any heart condition. 

We also have a system to re-shop your case if the first offers don’t pan out.

Case Studies- Tough Cardiac Cases 

Male age 60 with long standing but stable atrial fibrillation which causes him no symptoms, for which he takes aspirin daily, and sleep apnea that he uses a mouthpiece to control. Overall, he has excellent health otherwise, as he’s a personal trainer, exercises regularly, and eats very well. 

Based on the above and on past Afib cases we’ve shopped, we quoted him a $500,000- 15 year term with a most probable best case range of cost of $277 to $369 per month.   

The higher of the 2 rates above is usually the best case rate class based on his medical history, but we were hoping we could get credits for excellent health otherwise and because his Afib has been stable for some time.    

Since anything can turn up in underwriting, we had him apply to the two most probable best insurance companies for him.

Medical Records Show What’s Really Going On 

Upon receiving his medical records, there were some abnormalities in his echocardiogram including mild to moderate pulmonary hypertension, the mitral and pulmonic valves showing mild regurgitation, and the tricuspid valve showing mild to moderate regurgitation.  

There were also some minor issues in his lab results from insurance exam including his GGT liver function being slightly elevated and both his fructosamine and hemoglobin A1C were borderline, which could increase his likelihood of developing type 2 diabetes someday.  

Both company A and company B offered him higher $500,000- 15 year term rates as follows: 

Company A: $491 per month
Company B: $620 per month 

Never Accept a Higher Offer…Without a Fight

Whenever we get an offer that is higher than expected, we always try to negotiate for a lower offer. 

If that doesn’t work, or when there may possibly be a better option, we shop the case to other insurance companies to get other offers. 

This continued shopping for a better offer is what sets us apart from our competition, as no other companies (that we know of) are doing this.

Shopping the case after we get approvals is more work for us, and it takes us more time, but we are committed to getting every heart patient the best offer possible!

So how do we “re-shop” the case?

On the Afib case above, we sent the following summary out to 8 more “aggressive” insurance companies for their opinion: 

Male – NS – */**/1957
Exam – fam hx – Father 64 MI –heart dis diag’d age 60; Mother died age 70 IPF –Build 5’9 226lbs BP 116/74 114/78 and 118/80 Pulse 64
4/16 – constant cough of the chest. Acute sinusitis; cough
2/16 – cardio – OSA; Afib chronic; pulm HTN;  chol
1/16 echo – LA mildly enlarged; RV mildly enlarged, RV 3.5cm; RA mildly enlarged. Nl AR. AV – tricuspid, mildly calcified and sclerotic w/o visibly impaired cusp excursion. MV mild leaflet thickening w/ MR. Mild to moderate regurg. PAP 38mmHg; RA pressure 15mmhg. Venous – dilated IVC w/ poor inspiratory collapse c/w elevated mean RA pressure (RAH) a/p mildly thickened and myxomatous mitral and tricuspid leaflets w/ mild MR/ Mild –moderate TR. Mild PI. Mild Aortic sclerosis. Mild RA/RV enlargement w/ RAH. Mild LAE. Borderline LVH w/ preserved systolic function. Mild –moderate pulmonary HTN. PASP decreased slightly from 43 to 38mmHg compared to 2013 – Measurements – RVDd 3.5; IVSd 1; LVIDd 5.9; LVIDs 3.7; LVPWd 1.1; AR 3.5; A ascend diam 3.4;
LA 4.2; EF 55%
8/15 – check up – meds – Xanax – BP 119/80 Pulse 80 – 70 inches 221lbs – PE nl – a/p nl PE
12/13 cath  – nl LVSF. Mildly elevated LVED pressures consistent w/ diastolic relaxation abnl. No sign stenosis to LM. LAD w/ no angio sign stenosis. No sign stenosis of Circumflex. No sign stenosis of RCA
12/13 myocardial perfusion – moderate amt of anterior wall ischemia. No infarction
11/13 echo   – conclusion – thickened and myxomatous mitral and tricuspid leaflets w/ mild – moderate MR/TR. Bilateral enlargement w/ RAH. Mild RV enlargement. Borderline LVH w/ preserved systolic function. Mild – moderate pulm HTN
11/13 – Sleep study AHI 5 

Based on above, we received two declines, two possible Table 2s, one possible Table 3, two Table 4s, and one Table 6 offer.   

All of the new offers above were higher than the lower rate for which this gentleman already qualified of $491 per month. 

We recommended he accept the policy from best company, and he ended up purchasing $250,000, since $500,000- 15 year term was more than he wanted to spend.  

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Mitral Valve Repair then Replacement at Young Age

Thirty-four year old male had a heart valve repair at age 21 and then a heart valve replacement at age 30.   

He indicated the main issue was that he had a bicuspid aortic valve with aortic stenosis, but all follow up checkups since valve replacement were “perfect” and “great.”

We shopped his case based on information he provided and got some Table 4 to 6 offers, and he decided to apply. 

After he applied, we obtained all of his medical records… which were not as perfect as we were expecting. 

You May Want To Get Copy of Your Cardiac Records 

In addition to his valve repair and valve replacement, he had postpericardiotomy syndrome. His aortic root was enlarged at 4.4 cm and his ejection fraction (EF) had gotten progressively worse since his valve replacement as follows: 

2013 Echocardiogram- EF 61%
2014 Echocardiogram- EF 56%
2015 Echocardiogram- EF 52%

While his cardiologist told him he’s doing great, from a life insurance underwriting standpoint he does have some ongoing issues which may very well require another intervention someday.   

Insurance underwriters like to see stability in cardiac test results.  These issues were enough to cause the insurance companies to decline him.   

We continued to look for other companies to make him an offer. We were able to find him coverage, but it was at a cost that was almost three times higher than the original rates he had applied for, and this was for graded benefit coverage only.   

Coronary Artery Disease with 1 Stent

Male age 44, one stent placed one year prior with no heart attack or heart damage.  He was not sure what vessel was stented but did tell us that “all follow ups have been good since.”

We quoted him a $500,000- 15 year term rate of $88 to $107 per month and told him the higher rate was more likely the best-case rate based on his age when diagnosed and/or if the stent was placed in his left main or left anterior descending vessels. 

Since there is never any guarantee of the rate that will actually be offered, we had him apply to the two most probable, best insurance companies.  

Do You Have Abnormalities in Medical Records that You’re Unaware of…

Upon receipt of his medical records, we learned that the stent was placed in his circumflex artery, but he also had a 75% to 80% stenosis or narrowing in his left anterior descending (LAD) artery and a 50% to 70% stenosis in his right coronary artery (RCA).  The LAD and RCA were not stented. 

He also had some abnormalities in the urine specimen from his insurance exam which we assumed were caused by a kidney stone, but this added some concern to the underwriters. 

The stenosis in LAD and RCA that were not stented also added some concern to this case due to the progressive nature of coronary artery disease and considering these vessels may need to be stented or bypassed in future.  

One of the insurance companies postponed him based on the above and the fact that he had an abnormal urine specimen which is believed to have been caused by kidney stones.  This insurance company wanted a second urine specimen that was normal before offering. Best case offer with clean urine was going to be $146 per month for $500,000- 15 year term. 

The second company offered him a $500,000- 15 year term rate of $132 per month, which is a good offer based on all of the cardiac details in his records and the insurance exam lab results.  We recommended that he take the offer, and he did.   

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Bottom Line- Obtaining Life Insurance With Heart Condition 

Anything can turn up during the underwriting process, whether it’s in your medical records or on your insurance exam results. 

There will likely be things in your medical records that your doctor has not discussed with you and that could possibly be a concern for life insurance underwriters. 

Life insurance companies will also test for things in your blood and urine that most doctors won’t test for, like NTproBNP, all liver functions, etc. 

Any life insurance quotes you are given prior to going through the underwriting process are rough estimates only.

Forget Best Quote, Only Accept Best Offer

If the person quoting you has little or no experience with underwriting your specific heart condition, then the original quote or estimate you’re given could be way off.

Or you could apply and then be declined for insurance… then what do you do?

If the agent, broker, or website you’re dealing with is like most and has no interest in putting in the work to shop your case effectively and/or if they have no system to shop your case, then you may feel like you’re “up a creek without a paddle.”

This is not the case anymore, as we re-shop cases that other agents could not place or were not willing to shop all the time!

If you have a heart condition and need help getting the best life insurance rate, please call us at 1-800-380-3533, click here to email us, or simply complete the form in the “accurate quote” link below, and we’ll do everything we can to get you the best offer!

Click Here for Accurate Heart Condition Quote