Red Flag Medications in Underwriting: Part 3

The U. S. population is the most medicated population in the history of medicine. Over 2 billion legal prescriptions were written in 2001 and the number is expected to continue to increase. A significant portion of these medications (greater than 30%) is taken by persons 65 and older.

It is essential to ask every client about his or her medications. However, knowing the medications is only the first step. You also need to know what they mean in the specialized world of underwriting. Normal medical references (i.e. PDR) offer little insight into the underwriting implications of a given medication. Life insurance and LTC agents need to develop other resources that can help immediately clarify the impact of a medication on the underwriting outcome. In simple terms, an underwriting reference needs to answer the following question: does this medication mean preferred, standard, rated or decline?

The following groups of medications cause significant problems (potential declines) for both the life and LTC agent. This list offers both agents and support staff a key reference on drugs that are common to an aging population (we suggest you print it and keep it for future use).

Pharmacy Tutor is RiskTutor’s most used feature because it provides a color-coded system (red, yellow and green) for assessing the impact of any drug on underwriting. Click here to see a demo: http://www.risktutor.com/demo/pharm_tutor_new.html

Underwriting Comment: : Irregular heart rhythms can range from minor (i.e. essentially no underwriting consequence for both life and LTC insurance to life threatening (i.e. essentially uninsurable for individual life and LTC insurance). Significant irregular heart rhythms put a client at risk for a stroke and a potentially fatal heart event. It is important to find out why the client is taking a medication for an irregular heart rhythm (i.e. what led to the diagnosis and what type of work-up was done to evaluate the problem). Are there other medical problems (i.e. heart murmur, heart attack, etc.)?

*(These medications are beta-blockers. They can be used to treat irregular heart rhythms as well as high blood pressure, heart attacks and congestive heart failure (CHF). It is important to be very clear about why a client is taking a beta-blocker)

Reference: See this medical site for additional information on irregular heart rhythms:

Facts About Arrhythmia/Rhythm Disorders:
http://www.nhlbi.nih.gov/health/public/heart/other/arrhyth.htm

Underwriting Comment: Parkinson’s disease with older clients is generally a slowly progressive condition. However, it can also present with rapid deterioration pattern. It is important to find out the clincial pattern of the client’s conditon along with the type and degree of signs and symptoms (i.e. tremor, walking difficulty, etc.). With the addition of newer Parkinson’s medications (i.e. Mirapex, Requip) there may be a series of "drug adjustments" by the client’s physician to figure out the optimal treatment program.
Reference: See this medical site for an excellent "self-guided" tutorial on Parkinson’s disease:

http://www.nlm.nih.gov/medlineplus/tutorials/parkinsonsdisease.html