underwritingunderwriting communicating with producers session 40: february 28, 2006 session...

U N D E R WR I T I N G

COMMUNICATING WITH PRODUCERS

Session 40: February 28, 2006

Session Producer:

Karen Pope, Assistant Vice President

New York Life Insurance Company

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PANELISTS• Tom Bacher, Director of LTC Risk Management

Prudential Insurance Company of America

• Barry Fisher, President

Paradigm Insurance Marketing,

American Association for Long Term Care Insurance

• Beth Ludden, Long Term Care Product Leader, Genworth Financial

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From the Agent/Producers

• Top Ten List for Agents• Does an underwriter understand that clients

don’t always share all of their health history?• Are cover letters helpful or do underwriters just

toss them out?

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LTCi Underwriting “Whine” Tasting Tour

• #10 – My client just got diagnosed with the early stages of (Parkinson’s, Alzheimer’s, M.S., ALS, etc.) can I still get coverage?

• # 9 – What do you mean my client was declined!? I just got him a $1,000,000 life insurance policy at preferred rates.

• # 8 -- Why is diabetes such a problem? My client looks perfectly healthy!

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• # 7 – She’s only incontinent when she laughs hard?

• # 6 – All post-menopausal women take Fosamax; what do you mean I can’t get a super preferred rate class?

• # 5 – I met with a husband and wife last night. The wife did all of the talking; the husband didn’t say a word. Do you think there’s a problem?

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# 4 –Why can’t the *#$*%&$* company issue the husband’s policy the wife is perfectly fine?

# 3 – So the guy is a bit overweight, borderline diabetic, taking HBP meds, smokes and has difficulty walking, Why is this a decline?

# 2 – The telephone interviewer asked my client to count backwards from 20 by 3’s! I can’t do that either!


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#1

Can’t you get the

company to make a

business

decision?

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From the Underwriter

• What underwriters wish the agents/producers knew before the Application is taken

• What are the best pre-screen questions for certain conditions?

• What conditions cause morbidity issues and why? What is the long term care risk?

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Underwriters’ Wish List

• Completed application • Knowledge of the Underwriting Agent’s Guide• Agents providing complete information• An application completed legibly • Know the medical requirements for the

product you are selling

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• A pre-screened applicant does not equal an approval

• Know co-morbidity • Pre-screen calls – get full medical history

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Underwriters’ Wish ListPre-screen Info

62 yr male

6’2” 210 #

Hypertension on tenormin 140/75

Arthritis on mobic

Application

6’2” 200#

Hypertension &

Arthritis

Meds listed:

Tenormin & Mobic

Medical Records

6” 260#

HTN - stable

RA in hands with joint deformities in his fingers and right knee

Meds prescribed:

Mobic, Methotrexate Remicade

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• Know the Underwriting requirements• Prepare your client for the underwriting

process• Agents should know that failure to follow-up

with doctor does not always mean full recovery, it could be a sign of neglected health

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• Looks can be deceiving – How about the client who is actively at work fulltime and we still can’t issue due to anti-psychotic drug usage

• Note that an applicant who has not seen a physician in years does not necessarily indicate the applicant is in good health

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What are the LTC Risk Factors for Uncontrolled Diabetes

• Stroke• PVD/Foot Ulcers• Claudication• Atherosclerosis• Neuropathy• Nephropathy• Retinopathy• Seizures/ Coma

Co-morbid Factors• Obesity• Heart disease• Non-compliance• Excessive alcohol use• Duration of the disease

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Why would someone use NH or HC with a condition of diabetes?

• Renal failure• Inability to ambulate due to severe PVD• Visual loss • Stroke residuals• Heart failure• Diabetic Coma• Amputation

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What are the risk factors for COPD? (Chronic Obstructive Pulmonary Disease)

• Progressive DOE & SOB

• Weakness • Limitations in ADLs• Respiratory failure• Heart failure• Altered mental status

Co-morbid factors• Smoking• Obesity• Other related

respiratory disorders

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What are some causes of COPD?

• Smoking• Prolonged exposure to second hand

smoke• Repeated infections• Industrial exposures• Alpha –1 antitrypsin deficiency• Cystic fibrosis• Bronchiectasis

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Why would someone use NH or HC with a condition of COPD?

• Inability to perform ADL’s due to SOB, DOE and weakness

• Altered mental status• Worsening dyspnea requiring oxygen• Congestive heart failure• Respiratory failure

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Best Pre-screen Questions• Arthritis

– What type of arthritis do you have?– Where is the arthritis? (fingers, hands, knees or back)

– What medications are you taking?– Do you take steroids? – Do you use any type of walking aids?– Are there any joint deformities or

replacements?

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Best Pre-screen Questions

• Date of Last physical exam?• Best time to call for Telephone interviews or

FTF assessments? If appropriate, a work phone number.

• Language barriers – do you need an interpreter for the FTF?

• Is there a work up in progress or upcoming surgery?

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• Balance Problems or Falls– What was the cause of the balance problem?– How often do you experience the imbalance

or falls?– Has there been a work up? If so, what were

the results?– Is the problem interfering with your ADL?

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• Recent hospitalizations, nursing home or home care services? – If so, for what?

• What medications are you taking and why?

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Helpful Underwriting Tips

• Look for an oxygen tank; follow the tube, if it is attached to the applicant don’t take an application.

• If your applicant is seated throughout the entire interview with a lovely knitted afghan over his legs, ask for a glass of water and see if he stands up.

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If your applicant is using any of the following:

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DON’T TAKE AN APPLICATION!!!!

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Thank You

Karen, Tom, Barry & Beth

underwritingunderwriting communicating with producers session 40: february 28, 2006 session...

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