| You
will probably be asked to have a medical examination
when you apply for life insurance,
depending on your age and the amount of insurance you're
buying. This can include a basic
physical exam, urine specimen, blood work, EKG, and
X-ray. For high amounts of life
insurance, such as $2,500,000 and up, treadmill EKGs are usually required, too. You
generally will not be subject to medical underwriting
(meaning the exam requqirements)
if you're under about 40 years old and are applying
for less than $100,000 of life
insurance. However, the older you are, the less insurance
you can buy without an exam. For
instance, you may be able to buy $50,000 without an
exam if you're 45, but by age 50 that
amount could drop to $10,000. It really depends upon
your health and insurance company
guidelines. Forget
about fudging your medical history a bit in order to
get a better insurance rate.
Insurance companies will track down your medical dossier
through the results of your exam or
through the Medical Information Bureau (MIB), a clearinghouse
of medical information that
insurers share. Even
if you're buying life insurance through the Internet,
there's still no way to avoid the
medical requirements of an insurance company. | Tips
On A Better Exam Certain
health conditions simply cannot be masked, but to obtain
the best possible results,
here are some recommendations. - Get a good night's rest the night before your exam.
- Don't
drink for at least eight hours before the exam.
- Don't
smoke or chew tobacco for at least on hour before the exam.
- Avoid
coffee, tea, or other caffeinated drinks like cola
for at least one hour prior to
the exam.
- Limit salt intake and high-cholesterol food 24 hours before your exam.
- Don't
engage in strenuous physical activities 24 hours before the exam.
Source:
Exam & Profile Services, Beaver Dam, Wis.
|
Typically,
insurance medical exams are done by paramedicals who
are licensed health
professionals and who are often independent contractors
hired by the insurance company.
Paramedicals can also perform employment physicals
and drug screening. They're quick at what
they do — you'll usually get a call within a day
and are examined within three days.
Julie Possner, a paramedical examiner with Exam & Profile
Services in Wisconsin, was an
licensed practical nurse (LPN) for eight years and
a paramedical for another eight years.
She performs exams full-time for insurance companies
and notes that "this summer has been
very busy," largely due to competitive rates that have
prompted consumers to re-shop their
life insurance.What You'll Need Done
Here's
how it works. There are medical questions on Part I
(some insurers call it Part A) of
a life insurance application that are usually completed
by your agent in your presence; Part
II (or Part B) is the medical form and is used whether
the exam is performed by a
paramedical or a doctor. In
a basic exam, the paramedical will take your medical
history, physical measurements, and
diagnostic specimens. Nearly all exams can be done
on a mobile basis, since many
paramedicals carry their own supplies and have centrifuges for blood sampling. If
you're a 35-year-old who is applying for $250,000 of
insurance, most life insurers want a
paramedical exam, a urine specimen, and a blood profile.
Although the company might order
what is called an attending physician's statement (APS)
from your doctor, you cannot have
the exam done by your own physician. After
taking your application for life insurance, your agent
(or someone in the agent's
office) will call one of several paramedical services
that specialize in mobile exams to
give them information on you, on the amount of insurance
you're applying for, and the name
of the insurance company. Most paramedical professionals
stay current on insurers'
underwriting requirements (every insurer has a chart
that lists medical requirements based
on your age and the amount of insurance for which you're applying). A
paramedical will call you to schedule your appointment,
either at your home or your
office, and might even see you in the evening. If you
can't schedule this appointment,
you'll usually have the option of going to a clinic.
The exam isn't optional — you must
have it or your application won't go through. Declining
to take a test isn't an option and
will only send red flags to the insurer. The insurance
company pays the paramedical
directly, so you're not financially responsible for the exam or any lab work. Medical
underwriting differs slightly from company to company.
For instance, American Family
Life Insurance Co. requires the agent to collect saliva
from a person age 16 to 40 who is
applying for a policy between $50,000 and $149,999.
A 60-year-old who is applying for
$200,000 would undergo a basic exam, give urine and
blood samples, and have an EKG. This
company requires a urine specimen whenever the applicant
is over age 60, whenever a blood
profile is required, and when the applicant says he
or she is a nonsmoker. Insurance
companies are particularly interested in confirming your smoking status for obvious reasons. Obesity
may require you to have a medical exam, even if you
fall below the age and amount
guidelines, because being overweight may cause a coronary
risk. If you're overweight
and
smoke, have diabetes, family history of coronary artery
disease, high
cholesterol, or high blood pressure, MetLife, for example,
will require a treadmill or
exercise test. What Are They Looking For?
The
insurance company is checking to see if you have any
health condition that could
eventually affect your mortality — and hence their
risk. When samples of blood, urine,
and oral fluid are taken from you, the insurer will
test for the presence of antibodies or
antigens to the HIV virus; cholesterol and related
lipids; liver or kidney disorder;
diabetes; antibodies to hepatitis; prostrate specific
antigen (PSA); and immune disorders.
The urine sample may go through routine analysis, plus
screening for certain medications,
cocaine, and other drugs. There
are two ways your blood can be drawn: through a finger
prick or drawn via a needle. A
younger person may be asked for a finger-prick blood
sample; however, if you're looking to
buy a large amount of life insurance, you may have to submit to a full blood profile. Results
are sent directly to the home office for the underwriter
to review. You can usually
send a written request if you want a copy of the results.
Jane Fore, assistant vice
president of life, new business at The Horace-Mann
Cos. in Illinois, says, "It's common to
ask for results of a [medical] profile. We'll release
the results to the person or their
doctor." An
underwriter, usually located at the insurer's home
office, then reviews your life
insurance application and the results of your medical
exam. They have the option to order
whatever additional medical tests they deem necessary
— and they will if their
suspicions are raised for any reason. In
the rare event you are unknowingly quite ill —
chronically or terminally —
you'd probably be turned down for coverage and would
have to look for a high-risk carrier or
one that offers guarantee issue life insurance. Don't Let Your Premiums Go Up in Smoke
Smokers
are penalized by the insurance industry because of
their higher mortality rate.
Possner of Exam & Profile Services says, "Cigarettes
[nicotine] will show up many days or
even weeks after use in somebody's urine. It will probably
still show up if someone has
refrained from smoking for a short time prior to the exam." If
any nicotine does show up, you'll be considered a smoker.
And the test even detects
nicotine that is delivered through a transdermal patch. What
if you're a cigar smoker? "You can have 12 cigars per
year, but not one cigarette. If
certain levels of nicotine show up in a cigar smoker,
they will also be considered a
smoker," explains Possner. The More You Want, The More They Want
If
you're applying for a very large amount of life insurance
— say, $1,000,00 to
$5,000,000 — underwriting criteria become more
stringent. For example, MetLife will
forgo the paramedical exam and request a doctor's exam
if you're over 41 and applying for
$2,500,000 of coverage. For amounts of $5,000,000 and
higher, you must see a
company-appointed internist. Underwriters
at First Colony Life Insurance Co., for example, will
ask for a doctor's exam,
too, in addition to urine, blood, and a treadmill or
stress EKG. A treadmill EKG means
you'll get on an exercise treadmill (or stationary
bicycle) to achieve a target heart rate
while your heart and blood pressure are monitored.
(This wouldn't necessarily be required of
a patient with a prior myocardial infarction.) Some
companies, like Pekin Insurance, also
require a chest X-ray. But
since most of us aren't interested in getting a $5,000,000
life insurance policy, those
requirements don't necessarily apply to the masses. Here's another example: A
35-year-old applying for $100,000 of life insurance
from MetLife and Pekin Insurance would
not need an exam, but would need a urine specimen and
a blood profile. That same person
would be required to submit a saliva specimen to the
agent for American Family Life but
would have to do an exam, urine, and blood for First Colony. If
you ace your medical exam, you should have no problem
getting your life insurance issued
at the rate quoted. However, if a medical problem is
discovered, you may be offered a rated,
or substandard, premium, meaning you won't be declined
but you'll have to pay a higher
premium if you want the life insurance. Jane
Fore explains the two types of risk ratings and provides
insight into the underwriting
process. The Horace-Mann Cos. issue "flat ratings"
and "table ratings." Underwriters assess
health conditions based on a tightly defined, industrywide
underwriting manual to determine
how to rate certain health conditions. "You're
taking all factors into account, and you're looking
at it from the mortality
aspect," she says. For instance, an underwriter might
apply a flat rating for short period
of time for a person who has just had surgery. Conversely,
a person with high-blood pressure
would likely receive a table rating (i.e. Table A,
Table B, etc.). Table ratings are based
on a percentage of the premium so Table A might be 120 percent of the regular premium. If
you disagree with a rating you receive, get your agent
involved. "Agents can argue the
rating. Sometimes it might mean ordering something
in addition to what we already have. More
information is the best way to go," says Fore. Even
if you decline the policy, this becomes part of your
permanent record in the MIB. So,
if you go shopping around for other insurance, keep
in mind this information remains at
every insurer's fingertips. By
Lisa Karam
Middleton
insure.com |