Over the years, I have worked with so many clients who when they are applying for life insurance are shocked when they are declined or “health rated” lower than they anticipated. So I thought it would be insightful to look at a few things everyone should know when applying for health insurance: what carriers look at and how they make decisions.

What They Check: Basically everything to do with your health, criminal and driving record.. Insurance companies have access to The Medical Information Bureau (MIB) that has a summary of all your doctor's visits and outcomes. If they want detail, insurance underwriters will require an “Attending Physician Report” (APS) which is more detailed on every visit, test and the physician's notes for the last five years. They can also require a “paramed exam” in which a technician will take your blood pressure, a blood and/or urine sample and height and weight measurements. Insurance companies can also request a “Milliman Medical Report” that also lists all medications and prescriptions you may have taken or are currently taking.

Young and Healthy: If you are under thirty (30), do not smoke, are not obese, have a DUI, been to rehab or have a history of cancer or epilepsy the process is pretty straight forward. The company will do a short interview with the applicant and no labs will be required to get approval. Most applicants are approved at a “preferred’ or “preferred plus” rating.

The Higher the Death Benefit, The Closer They Look: Anytime the death benefit exceeds 10-15 times the income of the applicant, it will raise a red flag and require an explanation. If the death benefit is say $100,000, the carrier may not require medical paramed exams or physician reports, maybe just a client interview or questionnaire. But if the death benefit is in excess of $1.5M better believe they are going to do full due diligence no matter the age of the applicant.

Obesity Matters: Obesity will not trigger an automatic denial, but does lead to lower a health rating and hence higher premiums. Depending on the level of obesity depending

on height and weight, an applicant can expect to pay anywhere from a 25%-300% increase in premium from a standard plus rating.

Smoking Matters: Smokers can expect to pay at least 200%-300% the premiums of non-smokers of the same age and build. Many companies do distinguish those who will have an occasional cigar from a full time smoker. “Chew” or smokeless tobacco use counts the sales as cigarettes. If someone lies on an application about tobacco use and it is later found out the applicant used tobacco and died due to smoking related conditions, the insurance company can withhold payment of the death benefit due to fraud.

Non Medical Issues: Insurance Companies can and do deny coverage to applicants that have been convicted for DUI, expedition of speed, been treated as an inpatient for drug or alcohol issues, international travel to potentially dangerous or politically unstable countries and/or high risk sports such as sky diving or mountain climbing.

Non-Starters: There are certain conditions that will lead to an automatic denial from almost any carrier. They include melanoma or cancer in the last five (5) years, epilepsy, HIV Positive, Alzheimer’s, ALS, Parkinsons and a conviction Driving Under the Influence in the last ten (10) years.