Preferred best with a history of sleep apnea?

By Jeff Reed

Kestler Financial Group


Actually, yes, in some cases. We have pin-pointed a carrier that can offer up to preferred best on permanent products for clients with a history of sleep apnea. Obviously not all cases will qualify, so what makes the difference between a preferred best sleep apnea case and one that may end up standard or worse? Two words: compliance and control.

Like most impairments, the carrier's willingness and ability to make a great offer on a sleep apnea case will depend largely on the proposed insured's compliance with their physician's prescribed course of treatment, as well as the treatment's actual effectiveness. What could that look like?

Consider the following:

Fifty-year-old male qualifies for preferred best rates with the exception of an abnormal sleep study two years ago. A diagnosis of moderate obstructive sleep apnea was made at the time, and a CPAP was prescribed. Two subsequent studies (one six months post diagnosis, a second six months prior to the application) were normal. The documented compliance and control enabled the carrier to offer preferred best.

Before we all dust off old sleep apnea cases and get them ready to submit, there are some additional factors to consider:

The initial diagnosis was obstructive sleep apnea (OSA), rather than central or mixed apnea. OSA was categorized as no worse than "moderate". The prescribed treatment demonstrated resolution of the symptoms. The proposed insured was a nonsmoker.

Having underwritten an OSA case or two over the years, the big challenge here is the subsequent sleep studies. In the vast majority of cases, the proposed insured fails to return for the recommended follow ups that were the lynchpin of the case described above. The real issue is the documentation of compliance and control. It may not be enough that the proposed insured "uses their CPAP." Without the subsequent sleep studies to create the paper trail, the underwriter is left with very little choice but to assume that there is still a potential issue, resulting in standard or worse.

All of that said, I still think dusting off those old cases is a great idea. They may be a follow-up sleep study away from a really great offer on a new permanent life insurance contract.