What does a life insurance company look at when fully underwriting a policy? For example in addition to the blood and physical testing and questionaairre do they have access to medical informaction, medical databases or doctor/paitent information?

I will be having elective wls in the near future. and would like to secure a policy prior to the surgery. The policy is for 900k so I am assuming it is an extensive process. . . None of the questions on my application ask anything that would make me disclose this information.

  1. 1313 POINTS
    Lenny Robbins
    Principal, LifeNet Insurance Solutions, Redmond, WA
    An underwriter will examine medical information that an applicant provides. Based on that information medical records may be ordered. Also, life insurance carriers access the MIB or Medical Information Bureau. Only codes and not personal information are provided to the carrier based on any past applications, and checking is simply part of due diligence to avoid fraud. Most policies require a paramedic exam as well. In addition, a medical history will usually include health questions on immediate family members.

    The elective surgery will most probably result in a "postpone" on the part of every carrier, especially if planned within a few months. After that they will want to wait until you have been released by your physician. While the question MAY not be asked in the application, it will fall under at least one question upon receipt of the policy.
    Answered on January 21, 2015
  2. 11498 POINTS
    Jason Goldenzweig
    Co-Founder, TermInsuranceBrokers.com, Goldenzweig Financial Group, Las Vegas, Nevada
    A medical exam for the coverage typically consists of a paramedical exam (height/weight check and vitals checks such as pulse and blood pressure readings), a blood test, and a urine test - sometimes an EKG and/or cognitive testing may be required for older age individuals).

    Even if it's not asked specifically on the application itself, the carrier will see the input regarding the wls (I'm assuming stands for "weight loss surgery") surgery in the APS from your doctor. For any fully underwritten life insurance program, the carrier will request a copy of an APS from your doctor, in addition to the completion of a medical exam conducted for the insurance policy).

    An APS is an Attending Physician Statement - in short, it's a doctor's summary of your medical history records. For example, if you were being treated for diabetes, it would cite your A1C reading history, prescriptions prescribed for the condition, when it was diagnosed, etc. In the APS, the carrier will see in the doctor's notes that you have discussed getting the wls surgery (I'm assuming that "wls" is supposed to stand for "weight loss surgery") and ask if a surgery has been scheduled and/or completed.

    If it hasn't been completed yet, a carrier will postpone approving you for the coverage because you have an outstanding medical procedure on the books that's still supposed to get done. From a carrier's perspective, their risk of a claim is greatly increased when they know a surgical operation is upcoming as complications can always occur during any surgery.

    Please note, after a weight loss surgery procedure and you've ideally lost a large amount of weight and want to apply for coverage, part of that weight loss can be added in to a carrier's calculation of height/weight profile. The reason for this is quick weight loss for people (whether via surgery, diet and exercise, liposuction, etc.) can often result in some individuals gaining a percentage of that weight back - unfortunately not everyone always keeps all of the pounds off. So if you apply for coverage within 12 months of that rapid weight loss, a carrier may add half the weight loss amount back to your total. For example, if you weight 300 pounds and loss 120 pounds after a procedure, now you're sitting at 180 pounds. If you applied for coverage soon after having lost that 120 pounds, the carrier would add 60 back to your total and base the underwriting on a height/weight profile of 240 pounds (180+60). The purpose of the 12 month differential is to show stability in the person's weight loss and that they have a good chance of keeping off the weight.

    Please also note, alternative options will still result in the same outcome (e.g. non-medical life insurance) because a question on almost every application will ask in some format "are there any outstanding tests or other medical procedures outstanding or waiting to be completed". You would only be able to secure a graded policy with a low face amount ($25k or $50k maximum), which does not appear to be in the ballpark of the coverage you're looking to secure (you noted $900k in your question's statement).

    If you have a policy already in force, you can elect to convert all or a portion of it to permanent coverage. The conversion would keep the risk class that the original policy had and would simply just calculate the rates based on your age.

    I hope the information is helpful - please feel free to contact me for help with your coverage and if you have any other questions. Thanks very much.
    Answered on January 21, 2015
  3. 63333 POINTS
    Peggy Mace
    Most of the U.S.
    It sounds like you have a decision to make: A. postpone or cancel your elective weight loss surgery so that you can get the life insurance now, or B.postpone getting life insurance until after you have your weight loss surgery.

    If you have found a policy for which you qualify weight wise, are not suffering health complications from your weight, and need $900,000 of coverage for a loan or other reason, you could probably qualify by simply postponing your surgery for a year.

    Of course, if your health is at risk, getting the surgery can not only help your health, but improve your life insurance rates in the future.
    Answered on January 21, 2015
  4. 4249 POINTS
    Gary Lane
    President, Lane Independent Agency, Southern California
    There are a variety of reasons medical questions are asked. The obvious is to see if the applicant has an serious, life threatening ailments. This could be recent cancer (within 5 years), heart disease, etc. But another reason not often thought about, is honesty and truthfulness. Most applicants do not realize that the carrier can and normally will check your medical records. They will normally see what your health is like. Then then compare it to what you disclosed. If you falsified your information, do not expect to get covered. If it was minor, they may simply increase the premium from your quote. Either way, you should be telling the truth, just like mother told you to. Thank you. GARY LANE.
    Answered on January 21, 2015
  5. 37376 POINTS
    David G. Pipes, CLU®, RICP®
    Business Development Officer, T.D. McNeil Insurance Services, Fresno, California
    Concealing information on an application for life insurance can result in a death claim being denied, particularly if the application is shortly before death. Most applications for life insurance ask if you are contemplating surgery, or have been advised to have surgery. Your attending physician will probably disclose this information if he or she is asked.
    Answered on February 3, 2015
  6. 5877 POINTS
    Stan Cox II
    Insurance Adviser - Broker, SC Insurance Services, Oahu, Hawaii
    Medical history for yourself and immediate family is considered in the underwriting process. Insurance companies are really good at determining a persons mortality rate based on their health, occupation and avocation, and family medical history. So those parameters along with current age are the main factors that determine premium.

    The extent of medical testing is generally determined by the amount of benefit one is buying. Typically for a $200K benefit or less only a small blood and urine sample are taken along with a blood pressure check. Over $200K may also include ECG and additional tests.
    Answered on May 25, 2015
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