Monday, October 12, 2020

Pre-Exisiting Conditions

Pre-existing conditions have been mentioned in the news of late, mostly because of the debate surrounding the Affordable Care Act (ACA), otherwise known as Obamacare. In regards to major medical insurance coverage, people can currently still be covered for illnesses that they may have had recently or, in many cases, still have. 

When it comes to life insurance, disability and other related types of insurance, pre-existing conditions are still considered by the insurance carrier's underwriters. This doesn't mean that someone will be refused a policy, but depending on the situation, it can be difficult to get and/or more expensive.

Different kinds of coverage will have varying types of underwriting restrictions. For example:

Life Insurance - Underwriters consider a large swath of items when looking at covering your life. Things like smoking, obesity, previous illnesses, current illnesses, dangerous hobbies, DUI's and family history all get looked at. A few years ago I had a client who was morbidly obese but wanted some life insurance. We found her a plan, but it was "rated up", which means that the company increased her premiums to reflect the risk they would be taking on by insuring her. 

There are companies who offer "guarantee issue" plans, but they are expensive and will sometimes limit the death benefit in the first two years. Obviously, the people who apply for these policies know that their health is not good and are rarely surprised by the rate jumps. 

Disability Income Insurance - As with life insurance, many of the same factors apply. I had a client who flew a small airplane once a week for work. I thought it would be an issue until the underwriter told me that "if he crashes that plane, he won't be disabled, he'll be dead." She issued the policy.

When I work with people who are looking at company sponsored group benefits, pregnancy often comes up in the disability conversation. Most of the carriers will cover the time after delivery for a few weeks, but with limits, and the applicant may have to wait up to 10 months for coverage to be effective.

Long Term Care - In my experiences, this has always been one of the insurance products that have the toughest underwriting guidelines. The underwriters like to "connect the dots" with the information they have. For instance, I had a lady who, years before her application, had fallen off the bottom rung of a ladder, resulting in a hairline fracture of her kneecap. Now she had been diagnosed with osteoarthritis, so the underwriter decided that she had brittle bones. It took a candid conversation with the underwriter to explain that the two were not related and the policy was issued. 

In another case, I had a gentleman who had some heart issues and smoked a few cigars each week. The underwriter declined his application citing that the cigars could contribute to a cardiac event. Not long after the gentleman died of a heart attack. 

As you can see, there are a lot of issues and concerns that go into issuing these insurance policies. As an agent, we have to be fairly good at knowing about our carriers and their underwriting guidelines. I had a conversation last week with one of our partners who markets long term care insurance. We were discussing a company that I had not been aware of previously. When I asked about them he said," They are great if you are healthy." That's all he had to say. 

We do our best to help you find the best policy for your needs and in your budget. Check out our website and book a phone consultation. And please stay healthy!

Chris Castanes is the president of Surf Financial Brokers, helping people find affordable life and disability insurance coverage. He's also is a professional speaker helping sales people be more productive and efficient and has spoken to professional and civic organizations throughout the Southeast. And please subscribe to this blog!

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