• Provide agents with the most current medical information they need to package and present their cases

• Provide agents with the most current medical information that will be of interest to their clients

• Provide agents with the most current medical information to improve their own health awareness

All baby boomers need to read this book!
Robert W. Griffith, MD
Editor, HealthandAge.com 

This book is a great gift for a financial advisor to give to all clients with senior parents.
Dick Bell, CLU, ChFC, President 2004 Society of Financial Service Professionals

Rheumatoid arthritis (RA) affects over 2,000,000 Americans and two to three times more women than men. The average onset for RA is between the ages of 20 and 45. It decreases functional ability and leads to permanent disability; it is also associated with a decrease in life expectancy of 5 to 15 years secondary to damage to other organs of the body.

In the early stages, RA resembles other types of arthritic disorders (i.e. systemic lupus) and requires a “high index of suspicion” to insure the correct diagnosis.  Studies suggest that a critical window of opportunity for highly successful treatment exists within the first 3 months following diagnosis.

RA is diagnosed based on clinical, x-ray, and laboratory findings.  See this link for the current diagnostic criteria: RA Diagnosis

The current thinking in the treatment of RA is to change the course of the disease.  Current treatment options include:

1. Non-steroidial anti-inflammatory medications (NSAIDs) and COX-2 inhibitors. These agents can reduce inflammation and provide pain relief but they do not modify the course of the disease.  Medications in this group include Aleve, Motrin, Voltaren, and Celebrex.

2. Corticosteroids.  These medications are effective to a point in reducing inflammation but have serious side effects with long-term use.  In addition, they cannot modify the course of the disease.  Medications in this group of drugs include Deltasone and Medrol.

3. Disease-modifying anti-rheumatic drugs (DMARD). These medications not only control the symptoms of RA but they retard disease progression, improve function, and enhance quality of life.  Medications in this group of drugs include Plaquenil, Ridaura, Rheumatrex, Arava, Cytoxan, Enbrel, Remicade, and Humira.

Bottom Line:

Applicants for life insurance with RA are usually insurable in some cases at standard rates.  It is important to determine when the RA was diagnosed, the severity and progression of the disease, and the current treatment program. 

Applicants for long term care insurance with RA are usually uninsurable.  Given that arthritis is the number one cause of disability in the United States and RA is the most severe form of arthritis, long term care insurance carriers are unwilling to insure this risk.

The newest analysis of data from the ongoing Early Lung Cancer Action Project (I-ELCAP) indicates that lung cancers identified with baseline computed tomography (CT) have a cure rate of 76% to 78%, said lead investigator Claudia I. Henschke, MD, PhD.  That’s the good news.  Here is the bad news.  Data from I-ELCAP confirm previous reports about the latent lung cancer risk associated with smoking. Dr.Henschke explained that cancer risk does not immediately decline when a patient stops smoking.

"It takes at least 20 years for the risk to decrease — up until 19 years after smokers quit the risk stays steady and then it drops by half at

20 years," she said. Even when the risk drops, "former smokers always have a higher lifetime risk of lung cancer than never smokers," she added.

Bottom Line: Ex-smokers need to consider CT screening for lung cancer.  With an increased risk of malignancy for 20 years after they have stopped smoking combined with a cure rate of 76% to 78% when malignant lung tumors are discovered with CT scanning, the test offers ex-smokers new hope from the dismal statistics of lung cancer survival in which only 10% of 170,000 new cases of lung cancer diagnosed each year currently survive.

Byetta (exenatide injections) was approved in April 2005 as adjunctive therapy in the treatment of type-2-diabetes. Exenatide is self-administered as a fixed-dose 5- or 10-mg subcutaneous injection via prefilled pen device prior to morning and evening meals.

RiskTutor classification is Yellow (underwriting concerns).

Bottom Line: If an applicant is taking Byetta, you need to gather underwriting information about their type-2-diabetes.  This would include how long they have been a diabetic, their current medications, the degree of their glucose control (A1-C value), and the presence of any known diabetic complications.  In addition, the client’s weight, blood pressure and cholesterol values will impact the final assessment of the case. 

Male 48, Non-smoker, $4,000,000 Individual Coverage
Height 6’ 0””, Weight 234 lbs
Current Medications: Lipitor, Altace

The applicant was declined for life insurance based on “positive” urine finding for cocaine use.  When questioned by his agent, the applicant admitted to using cocaine at a friend’s birthday party the day before his insurance examination (“my friends talked me in to it after I had a few drinks”).  He denied previous drug use and insisted this was a one-time event.

Discussion: The “party story” has been around a long time in underwriting circles as has been used to explain the discovery of non-admitted substances in urine specimens.  All of these stories have the same structure, a party with friends, and a sudden impulse to try a new drug.  In almost every case, the applicant attests that this was the first time they had used the substance.  In addition, they always appear to wind up at parties the day before they are scheduled to take their insurance examination.  This applicant was not issued life insurance.