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The devil is in the detailsBlog added by Andrea Caruso on October 23, 2012
Andrea Caruso

Andrea Caruso

Harrisburg, PA

Joined: April 18, 2012

The Hidden Truth About the Affordable Care Act
Today, I would like to tell you about a case involving an older couple who, on the surface, looked like they had health issues that may have prevented the case from placing. A male age 70 and female age 69 recently applied for over $4 million of survivorship universal life (SUL) coverage.

A formal application was sent to the carrier underwriter who assessed both clients at table two. The male had a history of an elevated cardiac calcium score and sleep apnea. In addition, his insurance EKG was abnormal per the carrier underwriter. The female had a history of rheumatoid arthritis requiring steroid treatment. The producer needed a standard offer on both in order to make the sale work and place the policies in force.

We pointed out to the carrier underwriter that the client’s most recent treadmill stress test in the last year was not only normal, but showed an above average exercise capacity. We argued these results should offset any worries about the calcium score. We also pointed out that while the medical records did not contain an actual copy of the sleep study, the client’s sleep apnea was being treated successfully with a mouthpiece only, and the client did not require the use of a continuous positive airway pressure (CPAP) machine. A CPAP device is used to treat more severe cases of sleep apnea. As the records indicated that the sleep apnea was well controlled with the mouthpiece only, we concluded the condition was no worse than mild. Finally, we read the electrocardiogram (EKG) and felt the abnormalities were caused by lead placement versus an underlying cardiac abnormality.

The carrier underwriter’s main concern on the female was her regular use of steroids to treat her rheumatoid arthritis. Long-term treatment with steroids can increase the risk of osteoporosis, hypertension, diabetes and other serious medical conditions. We alleviated these concerns by highlighting the fact that the steroid doses used to treat her rheumatoid arthritis were tapering and her steroid use was not chronic, but occasional only.

We took this additional information to the carrier’s medical director, who agreed with our assessment and re-approved both files at standard.

The underwriter’s attention to detail helped place the case for a premium of over $110,000.
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