Coronary Angioplasty

A History of Coronary Angioplasty?


	Denotes a question that is critical to the underwriting outcome.

1) Does the client currently smoke?

Underwriting Comment: Clients who have had coronary angioplasty and continue to smoke may not be insurable. Smoking is a major risk factor for heart disease and one that can have a dramatic impact on outcome (i.e. life expectancy). The good news is that clients who have had coronary angioplasty and quit smoking have better survival rates and better pricing for life insurance.

2) When did the client have the coronary angioplasty?

Underwriting Comment: Clients with an uncomplicated coronary angioplasty are insurable 6 months after the procedure. The "failure rate" (i.e. the reclosing of the opened coronary artery) can be as high as 30% in the first 6 months following the original procedure.

3) How many blockages were opened via angioplasty?

Underwriting Comment: It is important to know whether the underlying disease of the coronary arteries involves one or more arteries. Clients may not know the exact nature of their coronary disease (i.e. single vessel versus multiple vessel). They may know how many blockages were treated. There is a marked pricing difference between single vessel coronary disease and multiple vessel coronary disease.

4) Did the client have a heart attack before the angioplasty?

Underwriting Comment: It is important to know if the client had a heart attack before the angioplasty procedure. Clients who have not had a heart attack are priced different than clients who have sustained some form of damage to the heart muscle. Both clients may prove insurable, but the pricing will be higher for the prior heart attack clients.

5) Has the client had any chest pain since the coronary angioplasty procedure?

Underwriting Comment: Any reoccurrence of chest pain signals a return of the original problem (i.e. significant blockage of a coronary artery). Clients who experience chest pain in the post-angioplasty period, regardless of the time since the procedure, are uninsurable.

6) Has the client had any follow-up cardiac tests since his or her coronary angioplasty (i.e. treadmill ECG, thallium treadmill, stress-echo treadmill)? If yes, was he or she told the results were “normal?”

Underwriting Comment: Follow-up cardiac testing provides objective evidence that the coronary angioplasty was successful. Thallium treadmills and stress-echo treadmills provide more useful information than a basic treadmill ECG. Any follow-up cardiac testing that is abnormal will result in the client being highly rated or declined for individual coverage.

7) What medications is the client currently taking?

Underwriting Comment: An uncomplicated coronary angioplasty is usually managed with minimal medications following the procedure (i.e. aspirin). A complicated angioplasty is managed with more potent medications such as Lanoxin, Imdur, Isordil or nitroglycerin. The medications will provide a very important pricing insight into not only the insurability of the client, but the actual pricing costs.

8) Is the client currently involved in any form of cardiac rehabilitation or undergone any lifestyle changes (i.e. quit smoking, began an exercise program, changed diet, etc.)?

Underwriting Comment: Lifestyle changes can have an enormous impact on the underwriting outcome for a cardiac case. There are excellent medical studies that verify that mortality outcome is greatly improved with positive lifestyle changes such as quiting smoking or beginning an exercise program. It is important that you document all lifestyle changes that would indicate a decrease in any cardiac risk factors.