UNDERWRITINGUNDERWRITING COMMUNICATING WITH PRODUCERS Session 40: February 28, 2006 Session...

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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

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

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?

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!

• # 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?

# 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!

Can’t you get the

company to make a

business

decision?

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?

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

• A pre-screened applicant does not equal an approval

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

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

• 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

• 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

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

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

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

What are some causes of COPD?

• Smoking• Prolonged exposure to second hand

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

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

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?

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?

• 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?

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

• What medications are you taking and why?

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.

If your applicant is using any of the following:

DON’T TAKE AN APPLICATION!!!!

Thank You

Karen, Tom, Barry & Beth

UNDERWRITINGUNDERWRITING COMMUNICATING WITH PRODUCERS Session 40: February 28, 2006 Session...

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