Cancer is one of the more co
ncrete medical underwriting problems that underwriters see. In order for the producer to have some idea of what a rating might be for the client, he or she can ask the underwriter by phone call or email. So what specifics does the underwriter need to know? They are the same ones that underwriters must discover in order to use their company’s reinsurance manual:
1. Type of cancer (breast, prostate, colon, etc)
2. What the pathology report says about the cancer
a. Stage, for example, “T1N0M0”
b. Grade, for example “well-differentiated” or grade 2 or, for prostate cancer, “Gleason 3+3=6”
c. Margins of the specimen removed: free of cancer or not free of cancer
3. How was the cancer treated? Generally it would be by radiation, chemotherapy, surgery or some combination of these.
4. What was the date of the last form of therapy? For example: if radiation follows surgery, then it would be the date of the last dose of radiation.
5. What type of surveillance testing is being done?
a. Type of test (colonoscopy for colon cancer, PSA for prostate cancer or mammogram for breast cancer, etc)
b. Date of most recent test and its result
6. Has there been a recurrence of the cancer, if so, when?
7. Is the client currently in remission (is free of cancer)?
This information can be found in the medical records, often included in the most recent pages of the physician following the client for cancer and from the client himself or herself. If you are able to relate as much of this information as possible to the underwriter, he or she will be able to give you an accurate rating for this condition from which you can plan your strategy with confidence.
Contact me if you have any questions or comments.
Dr. Jack Cotlar
Conventional wisdom is that the process of selling life insurance involves only the interaction between producer and client; it is only the client who needs to be “sold” in making the transaction. This is not correct. Who is the other “decision maker” in the sales process? It is the carrier’s underwriter. Why? The answer lies in their job descriptions.
Successful entrepreneurs know that what separates them from the competition is doing a few things of value really well. Often, one of these is a task that others ignore. In the life insurance industry, some producers either ignore the field underwriting piece of the case development, i.e. they simply don’t do it, or they delegate this task to staff that are not trained in this area. Life insurance company carriers have well trained professionals, underwriters, who make a risk assessment based upon the financial and medical data they see and this determines how much your client will be asked to pay for the product you sell. This simple concept should provide incentive to apply some of the sales energy into case management. What do I mean “case management”? This in part means to gather the necessary financial and medical data, ask the questions and record the answers on the insurance application (to gain first-hand knowledge and to cement the producer-client relationship), anticipate what the underwriting issues are or might be and take necessary steps to preempt underwriting problems. Any underwriter would say, “the devil is in the details”. This characteristic as it relates to medical underwriting is often outside the producer’s comfort zone. Because it is, any producer has an opportunity do standout from the others and to provide the kind of expertise your clients expect.
Question: You have a client who is applying for a large amount of life insurance coverage and he sees a therapist for anxiety. The “APS” or attending physician’s statement you receive from the therapist is a one-page document that cites a diagnostic code for “anxiety” or only a diagnosis and no other useful descriptive information. You are concerned that the carrier’s