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Life Health > Health Insurance

Know The Ropes Of Placing Clients Who Have A Heart Condition

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Know The Ropes Of Placing Clients Who Have A Heart Condition


When attempting to obtain coverage for a person with a history of a heart condition, agents must be prepared to ask the applicant a host of questions in order for brokerages to attempt to get the best offer for the prospective insured.

The queries should include: Was bypass surgery done or did the client/prospect have angioplasty? How many vessels were bypassed? Has there been a post-operative thallium stress test and, if so, was it negative? Does the prospect smoke?

Knowing the persons family health history is, of course, also needed, as is any information about the prospects rehab program. For example, is he or she involved in any kind of exercise program?

There are numerous types of heart disease. Additionally, if the applicant has suffered a stroke, as much information as available should be obtained from the prospective insured and furnished to the general agency for their and the home office underwriting departments evaluation.

Underwriting responses differ widely from company to company. However, good brokerages will know which companies are comfortable with certain types of cases. (For instance, some companies will not touch a multiple bypass case if the client continues to smoke, but others will; your brokerage should know the difference.)

Knowing which companies prefer which type of cases is where the art of underwriting takes precedence over the science.

Do some people with a history of heart disease have a better chance of obtaining coverage than others? Absolutely!

Show me a multiple vessel bypass or a recent myocardial infarction case where the individual has quit smoking, laid off the rice pudding, started an exercise program, no matter how modest, and has lost some weight, and Ill show you a case on which our agency can get standard offers.

On the other hand, if the individual is still smoking a pack or so a day, gorging himself on moms apple pie ? la mode, and buying bigger pants, most underwriters will take a pass. Their attitude will be, “if he doesnt care, neither do we!”

The history of issuing insurance to those with heart disease has changed considerably over the years, as medical science has developed more and more sophisticated medical technology.

In the 1960s, I recall trying to insure a man who recently had heart transplant surgery. The underwriter told me: “We dont insure transplant cases.” Yet that prospective insured, a prominent local businessperson, lived nearly 30 years after his surgery.

Angioplasty and bypass surgery are terms that were never heard of 30 or 40 years ago. But they are as routine today as traffic accidents. What the agent should keep in mind is that the so-called tough cases arent tough at all until the general agent or underwriting company says they are a decline.

Agents can and should help locate, gather and furnish all pertinent medical information to make the underwriters job easier and speed the underwriting process. And, when needed, the agent should get his client/prospect involved; a prime example being asking the applicant to call the doctors office to request his/her personal medical history.

Further, the agent should ask the client/prospect if he or she has had recent follow-up visits or stress EKGs or any testing to quantify and qualify the current condition of the heart. Asking the applicant to find out his or her “ejection fraction” from the doctor enables the impaired risk general agency to quickly zero in on a salable offer.

In addition, an agent should know the experience level of the agency with whom he or she is working. For example, has the general agent been doing tough case underwriting for a long time or is your case the agencys very first? Does the agency have an experienced underwriter on retainer? Does the agency have a medical director available to evaluate cases before the cases are sent to the home office? The general agencys answer should be in the affirmative.

Finally, it behooves agents never to abuse a relationship with general agents who have gone the extra mile to help. For instance, it is bad form to go to a brokerage agency with a seemingly impossible case, obtain a great offer from that agency on that case, and then go to another agency for a few points more commission, be declined, then go back the first agency for help. Here, the Golden Rule still seems to work best. To paraphrase: “Do to your GA as you would have your GA do to you.”

, CLU, is president of Executive Brokerage Services Inc., a Pittsburgh, Pa., independent brokerage general agency specializing in the special risk market. His e-mail is:

Reproduced from National Underwriter Life & Health/Financial Services Edition, November 18, 2002. Copyright 2002 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.


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