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Routine Health Care Helps Sink Life Insurance Application

As a responsible adult, Joe sought routine health care for life’s little aches, pains, and concerns. His medical history would sink his application for life insurance. Joe is being punished for using his employer sponsored health insurance.

Routine health care services can result in the denial of a life insurance application.

Joe contacted me, a health insurance agent, to help him transition from his employer sponsored health insurance to an individual and family plan. Joe was retiring from a stressful job and looking forward to retirement with his spouse. Because he was leaving his employment, he was also losing his group life insurance policy.

Routine Health Care Services and Denial of Life Insurance

Joe wanted to make sure his spouse would be secure if for some reason he died before her. After we enrolled him and his spouse in a health plan, we turned our attention to a term life insurance policy. Joe was looking for a modest amount of life insurance to cover the home mortgage and give his spouse a little cushion. We applied for a $250,000 death benefit with a 20-year term.

The medical underwriting, which reviews medical records, picked up one anomaly; Joe’s primary care physician had ordered an MRI and it had not been completed. Joe had visited his doctor with a complaint of some memory issues or brain fog. The doctor ordered an MRI. The health plan denied the MRI as not rising to the level of being medically necessary.

In lieu of an MRI, Joe underwent cognitive tests and passed with no problems. Of course, by this time, Joe had left his stressful job and was feeling much happier with a lot less anxiety. However, the life insurance company was not satisfied. They continued to dig into Joe’s past medical history.

We heard you had a bike accident when you were 12

The life insurance underwriters wanted to know about the purported concussion he suffered when he was young in the 1970s. Joe knew the approximate date when his bicycle crashed and he hit his head, but he didn’t know who the doctor was. He remembers that after being checked out at the hospital, his mother was advised to wake him up every couple of hours. He was never diagnosed with a concussion. Joe did break one of fingers in the fall. The underwriters were not interested in his digits, just the memory of a 12-year-old kid, being a kid.

What about your colonoscopy?

Joe also had a routine colonoscopy, like we are all encouraged to do after our 50th birthday. The colonoscopy removed some benign polyps, pretty routing stuff. The life insurance underwriters wanted to know the doctor’s name, date of last colonoscopy, how many polyps were removed, and if he was advised to have a follow-up colonoscopy. All the type of information that was in the medical reports.

Then out of blue – an indication that the underwriters had all the information – the life insurance company asked about a sleep study Joe had taken. When was the sleep study? Who was the doctor? They didn’t have to ask, they had the information, it was all a test to see how truthful he was. Joe, as always, answered promptly, with no hesitation. Joe had nothing to hide.

People punished for seeking health care services

Over the course of Joe’s routine health care visits, he sought help for depression. That appears to be the clincher for the underwriters. Before they would issue any life insurance policy, they wanted to see the results of future health care visits for depression, memory, and sleeping issues. Now that Joe is retired, most of those health care concerns have evaporated. The health issues Joe was experiencing during his career were normal for most people with a stressful job.

I’ve talked to Joe on numerous occasions. We’ve had long talks, as I’ve had with many of my clients, laughing over life and current events. Joe is pretty normal. Joe is probably in better shape than I am. He is grounded and responsible. He is being punished for addressing health care issues that most of us face. Based on Joe’s experience, the life insurance company would lock their doors if I tried to submit an application. I’ve talked way too much to my doctors about my life and I saw them typing furiously all of it into my medical notes. It might make for an interesting story.

Life Insurance overrated

I’ve never been a big promoter of life insurance. The state of our health care system is that if you have health insurance, most people don’t die, they keep you alive, one way or the other. Consequently, most term life insurance policies never pay a death benefit. The better proposition is to put money into your retirement fund and have a very small life policy to cover unexpected funeral expenses.

The lesson is that seeking routine health care services will possibly sink any future life insurance policy application. Heck, even having an elevated cholesterol level will increase the life insurance rates. I’m not sure why anyone would want to give money to companies who punish you for being a responsible human being. Joe and his spouse will survive. They just won’t have the level of comfort and planning that a modest life insurance policy would provide in retirement.


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