B-type natriuretic peptide (BNP) is a blood test that some life insurance carriers use as a screening test in their applicants, particularly those older than age 65.

N-terminal pro-BNP and NT-pro-BNP are other names for BNP. Its elevation may indicate heart disease, especially a higher probability of developing congestive heart failure. The levels are generally higher in women, older people and individuals with kidney disease; the laboratory has different values for different age groups. So what might a life insurance underwriter do with this information?  If the level is very low, the underwriter might look upon this as being favorable in terms of the probability of heart disease. If it is a little higher than the normal value for that age group, the underwriter may or may not take an adverse action (like placing a small to medium rating). If the test is very high, the underwriter is likely to place a high rating or postpone the case until the applicant is evaluated from a heart standpoint. In the absence of any information about the applicant's health, an underwriting decision might be based solely on the BNP value, not knowing with certainty if the abnormal or normal value is a "true" one or a "false" one. However when possible, this BNP value (be it normal or abnormal) should be assessed in context to other heart related data such as an echocardiogram's findings, exercise stress test results and/or how physically robust the applicant is. A more accurate underwriting assessment is generated when the value of a test put into context with other related information. The insurance producer who knows his client well is in a good position to work collaboratively with the underwriter and provide him or her with this missing information. A well-written and factually correct cover letter can accomplish this. Questions? Please contact me.

Important Notice:

The opinions and examples contained in this article are those of Strategic Medical Consulting, Inc. (SMC). As each case is fact sensitive, it would be ill-advised to take action on any given case based on the conclusions from examples that are included in this communication. Whether or not they are appropriate for a specific medical underwriting situation must be determined by the producer who will assume all responsibility should the outcome not be favorable. The examples illustrated herein are what SMC provides on a case-by-case basis for and to its clients. In addition, the opinions are not medical advice and they do not establish any physician-patient relationship.