Differentiate Yourself Through Underwriting Advocacy

Never before has a strategic, hands-on approach to underwriting been more critical.

Too often, producers select carriers, products and even strategies without fully considering the underwriting impact. But after more than a decade of underwriting advocacy, I can say that almost without exception, a proactive emphasis enhances results.

Among affluent clients, underwriting advocacy is increasingly becoming a requirement and a key differentiator. This is especially true in instances of complex risks, larger cases or older cases in which significant coverage is already in force.

Essentially, the job of an underwriter is to match individual medical profiles and health histories of applicants with existing risk classes that range from preferred best to standard to substandard to declined. But as we all know, individuals often do not fit neatly into a specific risk class. Medical profiles can be vague, incomplete or simply inaccurate. That’s where underwriting advocacy comes in.

Just as determining and addressing objections, prior to approaching a prospect, is an essential sales skill, optimal underwriting results often hinge on knowing what needs to be overcome prior to submitting a case to a carrier. Knowing what price to expect and managing customer expectations accordingly is also essential. Communicate to customers that price is not dictated by the product; price is a function of underwriting. Indeed, products are fixed. Underwriting is subjective and negotiable.

Focus on presenting your customer’s medical history and APS in the most favorable light possible. As a matter of course, include a cover letter that addresses your customer’s lifestyle and commitment to caring for any medical conditions. Personalize the case. Do your clients play 18 rounds of golf without using a cart? What are their hobbies? Did their mother or father live to be 100? Are they engaged in any volunteer work? Do they have a dog that they walk every day? Include pictures, when appropriate, that depict your customers as vital individuals engaged in life.

Presenting a customer’s case in the best possible light often means doing whatever is possible to control the parameters among the various carriers. For example, I recently worked on a case of a 69-year-old female who had had back surgery 2 years before. All but 2 of the carriers involved did not require a treadmill. In such a case, the first step should be to try and find out why the treadmill was required. If it turns out that the treadmill is an obstacle that cannot be overcome, consider leaving the 2 carriers that require it out of the initial process, to avoid the risk of tainting the outcome.

Alternatively, if it turns out that the treadmill requirement cannot be waived, another option is to inquire about the possibility of having her heart pharmacologically stressed using Dobutamine, in lieu of subjecting a customer with a bad back to a treadmill.

Active engagement and a commitment to doing whatever possible to direct the process in your customer’s favor not only enhances underwriting outcomes, it demonstrates your expertise and sets you apart in the market.

A few years ago, I had a case of a customer who had taken Phen-Fen. The carrier required an echocardiogram, and the handwritten report from the doctor was damagingindicating heart valve damage. This is the type of information that cannot be overcome from a life insurance standpoint. There were a few anomalies, however, such as a handwritten report and measurements that were inconsistent with normal expectations based on previous measurements. I got a video of the ultrasound from the hospital and sent it out for a second opinion. It turned out that her heart valve function was fine. It appeared that it had been misrepresented by her doctor in order to construe evidence for a lawsuit against the manufacturer of the drug. Legal and ethical considerations notwithstanding, this example again demonstrates the importance of looking beneath the surface and examining information critically.

Another recent example again points to the importance of taking a proactive stance and questioning results that are not in sync with your customer?s expectations. During a medical exam, the customer?s physician felt what he suspected to be a bruit on the carotid artery, which could be an indication of plaquing. The physician ordered a carotid ultrasound. The radiologist performing the ultrasound wrote “TIA” on the report, indicating that a mini-stroke had occurred. The customer, however, went back to his doctor, who performed additional tests and concluded that no stroke had occurred, and the TIA indication was due to a misunderstanding on the part of the radiologist. The case went from decline to standard.

Effective underwriting advocacy begins with an understanding of the inherent level of subjectivity in the underwriting process and a determination to overcome, whenever possible, all obstacles to obtaining optimal results for your customers.

Take the position that you have a right to know and a right to question. Seek the input of experts and argue the case. Reference medical literature and pharmaceutical Web sites that indicate the side effects of the medications that your customers are taking. When necessary, act as a lawyer.

Ultimately, underwriting advocacy incorporates medical expertise, negotiating skills, the respect and rapport among underwriters, and strong conviction that your best clients’ cases are too important to be left to a processing mill.

Teague E. Wright is vice president, underwriting, for NFP Insurance Services Inc. She can be reached at twright@nfp.com.


Reproduced from National Underwriter Edition, June 11, 2004. Copyright 2004 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.