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EPICC Underwriting

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Become A 3-Point Shooter By Understanding The proBNP

Just as basketball fans had to get used to the 3-point shot first debuted by the NBA in the 1979-80 season, we must get used to current trends in underwriting.
 
A blood test was introduced into the game and has been around for several years now. It’s called the proBNP.
 
What is it? The proBNP blood test is a marker for overall cardiovascular risk and a marker of long-term mortality in individuals with heart disease. It is released by the heart as a natural response to when the heart is not strong enough to pump adequate blood and nutrients to meet the body’s needs – when it is deprived of oxygen, or when the main heart muscle is enlarged from working too hard.
 
If the proBNP is abnormal on an exam lab panel, some carriers will automatically decline the applicant or ask for an additional cardiac work-up at the his/her expense in order to reconsider.

However, if the proBNP is favorable on an exam lab panel, carriers may be able to use the result as an underwriting credit for applicants ages 70 and up.

Here’s an example:
  • Male, Age 75, Non Smoker; Seeking $500,000 of UL coverage
  • History of a TIA (mini-stroke) 3 years ago
  • Followed closely by his physician
  • Insurance lab panel showed a proBNP of 55 (normal)
Under normal circumstances, this would be a mild substandard rate – however, with the credit, he can now qualify for Standard. That’s a 3-pointer and a win-win for us all!
 
Contact your Life Underwriting Department for more information.
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Get ‘Credit’ For The Work You Do

A carrier’s underwriting assessment involves the review of the overall medical history and the application of crediting tools to improve upon and provide the best underwriting class possible.
 
Here is a case study that demonstrates how credits can make a difference in the sale, by reducing the premiums:
  • 54-year-old female
  • Applying for $1 million of term life
  • Has type 2 diabetes; treated with Metformin
  • Build is 5’3”; 220 lbs.
Initial work up Table 4.
 
But with credits for:
  • Lifetime non-smoker
  • Income of $100,000
  • Preferred or better driving record
  • Negative cardiac testing
  • Controlled blood pressure
Final offer is Table 2!
 
Do what’s best for your clients with health history. Contact our Underwriting Department for assistance with your impaired risk cases.
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Underwriting Outcomes That Will Make Your Heart Skip A Beat

Cardiac related impaired risk cases can get somewhat challenging in underwriting. There are many different types of heart conditions – from coronary artery disease to arrhythmias to congestive heart failure and everything in between.
 
With each of these conditions, there are many different factors the carriers consider when determining their underwriting decisions. We know just what to look for in these cases, and which carriers to seek out for the best possible outcomes.
 
Take for instance this recent cardiac success story:
  • 72 year old male, lifelong non-smoker
  • Applying for $3 million of permanent coverage
  • Has a history of two-vessel Coronary Artery Disease and an abnormal EKG finding of Right Bundle Branch Block (heart block)
  • Good compliance with recommended cardiac follow up and testing
We put our noses to the grindstone and worked the emporium to match the case to a carrier willing to offer a Standard rating!
 
It is a win-win when our Underwriting Team is involved with your cases, we leverage our experience to win it for your clients and for you. Get to the heart of the matter – we get the offers you need, to get your clients the insurance they need.
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Help Us Help You: The Art Of The Cover Letter

The best way to present a good picture of your case and help avoid delays or even a possible decline is by submitting a cover letter with the case.
 
It doesn’t have to be Pulitzer Prize-worthy, just a clear and concise explanation.

Don’t necessarily count on the brief information requested on the app to paint the full picture for an underwriter.

Expand on the following in a cover letter:
 
  • Restatement and/or fuller explanation of the purpose of the coverage
  • Method of the determination of the face amount
  • The relationship(s) among the owner, insured, beneficiaries and premium payer
  • Full description of applied for and inforce coverage on other family members (if for personal purposes) or other key people (if for business purposes)
  • Available documentation if needed – e.g. trusts, financial information, business agreements
  • Any other information concerning circumstances that might raise questions with the underwriter (e.g. where the amount of insurance is more than the standard financial guidelines)
Playwright George Bernard Shaw said, “The single biggest problem in communication is the illusion that it has taken place.”
 
The Apostle Paul said, “A letter covers a multitude of sins!”
 
Don’t rely on the illusion of clarity that often hovers over an application as it is passed around the circle. We have several on board who fancy themselves literary and will help draft and submit the cover letter you need. Call and ask!
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Underwriting Family History = Preferred Underwriting Class To Make The Sale!

This A+ carrier’s underwriting guideline provides one more option for your client with a less than favorable family history.

When it comes to underwriting, this carrier takes an aggressive approach and looks closely at controlled impairments.

Let’s take a look at this Underwriting Case Study:
  • 55-year-old male
  • Non-tobacco user
  • Applying for $5,000,000 of UL coverage
  • Receives annual checkups from his Primary Care Physician
  • Favorable build, blood pressure readings and lab work including lipids
  • Current medications include Lipitor and Lisinopril
  • Recent, imaged study recorded as normal in medical records
  • Father died at age 58 of coronary artery disease
Their offer: Preferred!
 
In this case study of family history with heart disease, this carrier can apply a credit for individuals that have one single family member that died prior to age 60 due to heart disease. With good risk factors and favorable cardiac work up (stress test, EBCT), a family history of death prior to age 60 from heart disease can qualify for a potential Preferred!
 
Contact our Life Underwriting Department to learn more about how we can help you make that next sale!
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Obesity + Lap Band Surgery = Standard

Obesity in the United States has been increasingly cited as a major health issue in recent decades. While many industrialized countries have experienced similar increases, obesity rates in the United States are among the highest in the world.
 
There are several types of surgeries that fall under the group of “bariatric surgery” designed for people that are obese. Lap band surgery (laparoscopic adjustable gastric band), is an inflatable silicone device placed around the top portion of the stomach to treat obesity, intended to slow consumption of food and thus the amount of food consumed.

One of our Strategic Carrier Providers look favorably upon this type of surgery and with applicable credits, will make a favorable offer.

Let’s take a look…
A female client, aged 32 years, is seeking $500,000 of 10-year Term Life Insurance, history includes:
 
  • Build of 5’6 and 212 pounds
  • Blood pressure 120/76Lap band procedure 2 years ago
The initial underwriting work up – Table 2.
 
Then, the following underwriting credits were applied:
  • Optimal blood pressure
  • Lifetime nonsmoker
  • Regular preventative care
  • A1c Test < 5.7
  • Preferred driving record
Final Offer – Standard!
 
Our Underwriting Team is here to help with all of your impaired risk cases. Please contact us today – we will help you make the sales!
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Executive Underwriting – No Exams, No Labs

Many executives and professionals undergo executive physicals each year. These types of exams include a comprehensive health review, complete lab panels and cardiovascular testing.
 
These may be conducted at the individual’s personal physician’s office or through a formal program at major health care facilities, such as Mayo Clinic or Cleveland Clinic.
 
If your professional client has completed a comprehensive executive physical within the past 12 months, they may be eligible for permanent or term coverage through a streamlined underwriting process, without the need for an insurance paramedical exam and labs.
  • Ages 25-65
  • Up to $40 million of coverage
  • Medical records are required and must include the Executive Physical Exam meeting a minimum criteria of physical measurements with vitals (height, weight, blood pressure reading, pulse), medical history review, full panel blood and urine tests, and cardiovascular testing
  • Term, Indexed UL and Variable UL plans, including Survivorship (spouse must also have had an eligible physical in the past 12 months)
  • Preferred and Standard classes
  • Executive/Professional occupations; Minimum annual income $100k
Contact our Underwriting Team for assistance or more information.
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Adventures In Underwriting

Mountain climbing, scuba diving, auto racing, aviation… Adventure enthusiasts may find themselves faced with an extra rating and increased premiums if they participate in any of these types of higher risk activities.
 
But a recent Upgrade Program may help to remove an extra rating of up to $2.50 per $1000 of coverage for certain avocation scenarios. This program is available for both permanent and term plans.
 
For example:
  • 37 year old male, non-smoker
  • Seeking $1 million of Term coverage
  • Healthy with normal build, blood pressure and cholesterol
  • No adverse family history
  • 12 years of experience in trail, rock and mountain climbing – participates only in groups, never alone
  • 4-5 climbs annually in the Pacific Northwest
  • Highest elevation 13,000 ft
  • YDS (Yosemite Decimal System) class 5.0 to 5.4
Initial underwriting assessment included a $2.00 per $1000 permanent flat extra rating.
 
Under the program, this case was eligible for an upgrade to Standard NT without a flat extra rating.
 
Contact the Underwriting Team for help in finding the best possible underwriting outcomes on your avocation cases.
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Some Breathing Room For Your Clients With Asthma

Asthma is a disease that affects the lungs and results in temporary narrowing of the airways.  Symptoms include difficulty breathing, wheezing, coughing and tightness in the chest.  It affects over 8% of adults in the United States.
 
Diagnosis and severity of asthma is determined by lung function testing known as Spirometry.  Results are measured in percentages and values of 80% or greater are generally considered normal.

Individuals with this impairment may represent a significant underwriting challenge. However, PREFERRED may be possible for your asthmatic clients!

Criteria that could help applicants qualify for Preferred include:
 
  • No tobacco use
  • No hospitalization for asthma in the last 5 years; no other ailments
  • Spirometry showing normal results of FVC (Forced Vital Capacity) and FEV1 (Forced Expiratory Volume in one second)
  • Treatment may include intermittent (as needed) use of inhaled bronchodilators, brief courses of corticosteroids or low dose medication
  • No time off of work or school due to asthma symptoms
  • No underwater or high altitude avocations, whether ratable or non-ratable
  • Must meet all other regular, published Preferred criteria
So, breathe easier for your clients with an asthma history.
 
Call the Underwriting Team today for more information on this carrier and to see how we can help get the underwriting offers you need to make the sale!
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LTC Underwriting V.S. Life Underwriting

Long-Term Care and the cost of care can be overwhelming for most. In the past, traditional stand-alone LTC policies were the only way to insure long-term care expenses.

These days, there are more ways to obtain this valuable coverage – including LTC riders on Life Insurance policies.

Underwriting long-term care risks can be very different than underwriting for life insurance. LTCi underwriting takes into account medical impairments that impact ability to perform daily living activities. Whereas, life underwriting is more concerned about impairments that affect mortality, or life expectancy.
 
In some cases, your client may be eligible for life insurance at a favorable rate class, but may be rated or declined for long-term care.
 
This recent case study shows how different underwriting mortality vs. morbidity can be:
  • 62 year old female
  • Seeking $1 million of UL coverage with a Long-Term Care rider
  • Non smoker; normal build
  • Hypothyroidism diagnosed in 1980; well controlled on medication
  • Was seen once by a chiropractor for back pain with improvement
  • Diagnosed with scoliosis
Final underwriting decision: Super Preferred for life coverage; Standard for the LTC rider due to scoliosis and back pain history
 
Non-traditional long-term care insurance and chronic illness riders are the perfect solution for those impairments that would be declined for traditional LTC riders. These alternative riders are automatically available on eligible permanent products with little to no additional underwriting.
 
Whatever the case may be, there is a product we can pivot to, to cover long-term care needs. Contact your Underwriting Specialist, we’re here to help you sort through the different options and pre-qualify your client for this much needed coverage.

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