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There are three main ways a new life insurance policy
is priced: Underwritten policies are those where you answer questions
on your personal and family medical history and undergo a medical exam
arranged by the insurance company; a simplified issue life insurance
policy application asks you some medical questions but does not require
a medical exam; and a guaranteed issue life insurance
policy requires no questions and no medical exam. If you're healthy, or
even if you have a few medical problems, you're likely to get the best
insurance value from an underwritten policy, which is priced
specifically for you. Simplified issue and guaranteed issue life
insurance policies set a price that assumes risk that you may not have.
Whether you're buying term or whole life insurance, you'll likely be
asked to undergo a medical exam. These are typically performed by
licensed paramedicals who are often independent contractors hired by
the insurance company. They will schedule a visit to your home for the
exam and bring all the necessary supplies. The life insurance company
foots the bill for the exam.
Tips on a better exam
Certain health conditions simply cannot be masked, but to obtain the best possible results, here are some recommendations.
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When
you submit your completed application for your life insurance policy,
your agent or life insurer will call a paramedical service to let them
know you require an exam. The service will then contact you to arrange
a convenient time and place. You must have the exam or your application
won't be processed. The life insurer may still request an
attending physician's statement (APS) from your doctor, but you cannot
have the life insurance medical exam done by your own physician.
In a basic exam, the paramedical will take your medical history (even
though you've already supplied it on your application), height and
weight, blood pressure, pulse, and blood and urine samples. Beyond
that, tests will vary based on you. For example, MetLife will order an in-home EKG for applicants
age 50 and older who are applying for face amounts of at least $1
million. For applicants age 70 and older who are applying for $2
million policies and higher, MetLife forgoes the paramedical exam and
requires an exam by an M.D. chosen by MetLife (not your own doctor).
The doctor will ask the same medical questions as a paramedical and get
your height, weight, blood pressure and pulse, plus do a brief medical
exam such as listening to your heart.
Jacki Goldstein, Vice President of Life Underwriting at MetLife,
emphasizes that this is not a comprehensive medical exam and does not
include sensitive issues, such as a breast exam for women. Goldstein
also stresses that the M.D. life insurance exam is not a substitute for
good routine medical care.
When age and face amounts get higher, a treadmill test may be
required. For example, MetLife requires treadmill tests for applicants
who are at least 50 and applying for over $10 million in insurance or
applicants 76 and older applying for $5 million or more. If you're applying for a low face value policy, you may not
even be asked to do a paramedical exam. For example, if you're age 40
and applying for $50,000 of life insurance, MetLife requires no
specific tests or measurements. And for some cases, MetLife asks for a
"simple paramed" exam, encompassing the basic measurements and blood
and urine work but without the paramedical question list. Guidelines
for tests will vary among life insurers.
| Insurers check to see if you have a health condition that could eventually affect your life expectancy. |
The
life insurance company wants to know if you have any health condition
that could shorten your life — which in turn affects the insurer's risk
and your policy premium. When samples of blood and urine are collected,
the insurer tests for HIV, cholesterol and related lipids, liver or
kidney disorder, diabetes, hepatitis, prostate specific antigen (PSA)
and immune disorders. The urine sample might go through routine
analysis, plus screening for certain medications, cocaine and other
drugs. Results go to the life insurer's home office for an
underwriter to review. You can usually send a written request if you
want a copy of the results, and some insurers will automatically send
you a copy of your lab work. If there's anything of concern about the
lab results, you would need to consult your own doctor. Goldstein says,
"It's not uncommon to have abnormalities that don't mean anything." A life insurance underwriter then reviews your application
and the results of your medical exam. They decide your life insurance
rating, which sets your premium. If there are lingering questions about
your health, they may request additional information or medical tests.
In the very rare event you are unknowingly quite ill — chronically or
terminally — your application would be declined and you would have to
look for a high-risk carrier or one that offers guaranteed issue life
insurance.
Smokers pay higher premiums for life insurance
because of their higher mortality rate. If any nicotine shows up in
your results, you'll be considered a smoker. The test also detects
nicotine from a transdermal patch.
If
your test results correlate with the classification used for your
original life insurance quote, you'll have no problem getting that
rate. If a medical problem is discovered, you might be offered a life
insurance policy with a higher premium.
| If you disagree with a rating you receive, contact your agent. |
There
are two types of risk ratings: "flat" ratings, sometimes called
temporary flat extras, and "table" ratings. Underwriters assess health
conditions based sophisticated table to determine how to rate certain
health conditions. For instance, an underwriter might apply a flat rating for a
short period of time for a person who has just had surgery. On the
other hand, a person with high-blood pressure could receive a table
rating, which increases premiums by a set amount for the duration of
the policy, depending on your medical condition and age. If you
disagree with a rating you receive, contact your agent. Agents can find
out if the rating can be revised based on supplemental medical tests to
prove you qualify for a better rating. Even if you end up declining the life insurance policy, your
test results become part of your record in MIB Group's database
(formerly the Medical Information Bureau), a clearinghouse of medical
information that insurers share which stores information for seven
years after you apply for a life, health, disability income, long term
care or critical illness insurance policy. MIB is jointly owned by
about 470 insurance companies. So, if you go shopping around for other
life insurance, remember that your medical information is accessible to
other insurers in the near future. Note that MIB's database does not
contain actual medical records but rather codes that represent medical
conditions and tests, hazardous hobbies and even your bad driving
record.If you want to check your MIB file, or dispute information in
it, you can obtain one free report annually at www.mib.com
Life
insurance medical exams are really quite routine. But if you want to
avoid a medical exam at all costs, you could buy a simplified issue
life insurance policy, which requires only that you answer a few
medical questions, or a guaranteed issue life insurance policy, which
requires neither an exam nor questions.
Keep in mind, though, that if you're in general
good health, or even with a history of some health issues, you'll
likely get a much better rate by buying the underwritten policy that
requires a medical exam.
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