You’re interested in life Insurance, but the first agent you spoke to said an exam is required.

Is it mandatory?  

Will the company you apply with cover the cost of the life insurance test?  

Will an exam save you money?

Since so many clients ask about this exam, we’re going to take a few minutes to cover the following 5 important questions:

• How much does it cost?
• Can they use my recent physical from my doctor?
• What exactly does a life insurance exam test for?
• Do I have to take an exam?
• How much more expensive are No Exam Policies?

With this information, you’ll be able to determine whether taking an exam is worth the effort or if you want to consider a policy with no exam.

Don’t want to take an exam? Learn How You Can Avoid the Medical Exam.

The Life Insurance Exam Requirement

I know what you’re thinking…

“Can’t they just use my recent physical done with my own doctor?”  Unfortunately, the answer is no. The life insurance medical exam is required and besides, they want to be sure the exam is 100% unbiased.

For all the insurance company knows, your doctor could be related to you, or have some vested interest in you obtaining a policy.  There’s always those bad apples who’ve ruined things for the vast majority of people who’d never think of committing insurance fraud. Besides, they’ll likely obtain your last five years medical records in addition to an exam.

There are life insurance policies out there that do not require a life insurance test which I’ll get to later in this article. However, I’d like to first discuss the process of approval.

Introduction to the Life Insurance Underwriting (Approval) Process

For some, especially those with an interesting health history, the process of the initial exam and subsequent underwriting process can be a grueling one.

The normal turnaround is 4-6 weeks for a final approval if you’re relatively healthy. Throw in some colorful health history like cancer, stroke or heart disease and the process can takes several months. The longest underwriting turnaround I’ve seen was just over 15 months. This was due to my client’s long history of ulcerative colitis. In the insurance company’s defense, the client had his colon removed 12 years ago, but had no follow-up with his doctor since. The underwriter wasn’t willing to offer a policy until they could review a current evaluation to assess health. They did end up approving his policy and I’m happy to say it’s in force today.

Insurance companies have their own underwriters who assess the risk of insuring an individual by reviewing their lab results along with their medical records. Some of the most expensive health conditions to insure are heart disease, diabetes, cancer, obesity, inflammatory bowel disease, and lung disorders. There’s a saying that states, “if you want to find out what’s wrong with you, apply for a life insurance policy.” This is likely because a decent percentage of people who were initially diagnosed with a health condition like diabetes found out while applying for a life insurance policy. When this happens, it can range from an offer (a higher rate than originally applied for), a decline or a postponed decision.

Insurance companies have 16 possible rate classes when applying for coverage.  Unfortunately, not everyone will be offered a policy. Many people get declined for various reasons. Sometimes, it’s a decline forever, meaning you’re uninsurable.  This is a sad situation, especially for people with small children, who really need life insurance. Other times, they’ll postpone offering a policy. While not the most favorable outcome, a postpone decision at least suggests an offer may be made after some action is completed. This could be completing a recommended colonoscopy you’ve been putting off, or not enough years transpired since your treatment for cancer ended. There’s countless reasons life insurance companies will make a postpone decision.

What is the Cost?

Most people erroneously think they have to go do a physical exam at their own doctor’s office. This is not true!

The insurance company will pay for a medical examiner to come to your home or office (whichever is most convenient) and perform your medical exam.

It costs nothing to you, even if you ultimately get declined, or even decide not to take the policy. It is considered a cost of doing business to the insurance company.

What to Life Insurance Exams Test for?

Many of my clients have asked me, “what are they looking for?”

This is a great question! The short answer is, everything.

First off, let’s discuss what’s involved during the exam. The insurance company will send an examiner who is a licensed phlebotomist, nurse, or in rare cases a medical doctor.

They will check your height, weight and Blood pressure.  They will also obtain blood and urine specimens. Depending on your age and amount applied for, they may do an EKG on your heart.

They check for illicit drugs and if you test positive for something like cocaine, you’ll be banned from getting life insurance from most all carriers for five years. Many carriers will offer you a policy if they find marijuana in your system, but depending on the carrier your rates will likely go way up. Tobacco is a huge one they test for because not everyone who says they don’t smoke is being 100% honest. As an agent, it’s never a fun call to tell someone they tested positive for any of these.

Cholesterol is always tested. They look at your HDL ratio to be sure your good cholesterol is high and bad cholesterol low. An excellent HDL ratio is anything below 4.5 in men and 4.0 in women. Some people have a harder time controlling their cholesterol due to heredity. It’s widely known that sustained elevated cholesterol and especially high LDL (bad cholesterol) in combination with low HDL (good cholesterol) are linked to higher risk of developing heart disease. Heart disease is the leading cause of death in the United States. Insurance companies know this first hand, so no wonder they are so critical on elevated cholesterol.

• High-density lipoprotein (HDL) cholesterol: This is sometimes called the “good” cholesterol because it helps carry away LDL cholesterol, thus keeping arteries open and your blood flowing more freely.
• Low-density lipoprotein (LDL) cholesterol: This is sometimes called the “bad” cholesterol. Too much of it in your blood causes the buildup of fatty deposits (plaques) in your arteries (atherosclerosis), which reduces blood flow. These plaques sometimes rupture and can lead to a heart attack or stroke.

When it comes to diabetes, sometimes life companies will only test glucose. Other times, they’ll perform a more thorough test called hemoglobin A1c. The hemoglobin A1c is a three month average of your blood sugar. The A1c test is considered a far more comprehensive test than just testing glucose which is more of a snapshot of your sugar level at a moment in time.

How does the A1C test work?

The A1C test is based on the attachment of glucose to hemoglobin, the protein in red blood cells that carries oxygen. In the body, red blood cells are constantly forming and dying, but typically they live for about 3 months. Thus, the A1C test reflects the average of a person’s blood glucose levels over the past 3 months. The A1C test result is reported as a percentage; the higher the percentage, the higher a person’s blood glucose levels have been. A normal A1C level is below 5.7 percent.

A small percentage of my clients have found out they were diabetic during their insurance exam.  If your A1c is only slightly elevated, say between 6.2-8.5, you’ll likely still qualify for a policy, but at a different rate than applied for. If your A1c is above 10.0, most carriers will decline or postpone coverage until you can get be officially diagnosed and maintain an A1c under 9.0 for at least six months.

Liver Function Testing

Liver functions are another category of interest to insurance companies.  Elevated liver functions can mean almost anything so any elevations will raise a red flag with the carrier and will reduce your chance of being approved at a preferred rate, or at all. If you have Hepatitis, in most cases you’ll have elevated liver functions.  One liver function insurance companies run is called GGT, which is actually an alcohol marker. Most doctors never test this, but almost all insurance companies will. I’m not saying you can’t drink alcohol, but if you drink a six-pack of beer every night after work, don’t expect to get the best rate. The normal range is 0-45; anything above will be a concern to the underwriter. The other common liver functions are ALT, AST and alkaline phosphatase among others. They each are linked to numerous health problems and will expected to be in the normal range if you’re applying for a standard, or better rate class.

Kidney Functions

Kidney function tests are a real concern with insurance companies. Renal failure being the ultimate concern. There are a few tests insurance company look at to evaluate how well your kidneys are functioning. They will look for presence of blood in urine, called hematuria, which is not common in healthy individuals.  Many times it’s nothing, but due to the wide range of causes insurance companies won’t just assume it’s nothing. If you are a bodybuilder, it’s a good idea to avoid the gym for at least 24 hours prior to your exam. Lifting heavy weights overloads and breaks down muscle tissue, which will also put blood in your urine. They’ll either approve your application at a much higher rate, or require you to see a kidney specialist to rule out any potential diseases.

What causes Hematuria?

Hematuria can be caused by menstruation, vigorous exercise, sexual activity, viral illness, trauma, or infection, such as a urinary tract infection (UTI). More serious causes of hematuria include:

• Cancer of the kidney or bladder
• Inflammation of the kidney, urethra, bladder, or prostate—a walnut-shaped gland in men that surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen
• Polycystic kidney disease—an inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time, taking over and destroying working kidney tissue
• Blood clots or blood clotting disorders, such as hemophilia
• Sickle cell disease—an inherited disorder in which RBCs form an abnormal crescent shape, resulting in less oxygen delivered to the body’s tissues, clogging of small blood vessels, and disruption of healthy blood flow

Your body produces a chemical waste product called creatinine. If your kidneys are healthy, they’ll filter most of the creatinine from your blood. Normal creatinine levels are between 0.6-1.2mg. Anything above 1.2mg, usually results in a decline. BUN, or blood area nitrogen, shows how well your kidneys and liver are working.  Normal range is 6-20mg/dL.  Elevated BUN is often due to diabetes, hypertension and some autoimmune diseases.  In some cases, it’s due to antibiotics, anti-inflammatory and gout medications.  This is why it’s important to schedule your exam when you’re not sick and not on any pain medications, or supplements within the last 24 hours.  Only prescription medications should be taken.

Some of the other more commonly known tests are complete blood count to make sure your red and white blood cell count are in good order.  A full drug panel is done to see if any amphetamine, cocaine, phencyclidines (PCP), marijuana and opiates are in your system. Testing positive for any of these will result in a higher premium at the bare minimum with a decline being the most likely result. For men, the PSA will be tested (depending on age) to evaluate the risk of enlarged prostate and prostate cancer. They test everyone for the HIV virus, which if positive is an automatic decline.

Many people feel they’ll be on some “blacklist” once they’ve been declined for life insurance. The carrier will report the decline to the MIB, also known as the Medical Information Bureau. Insurance companies use the MIB to help prevent fraud. All companies run an MIB report to see if an applicant has tested positive for nicotine elsewhere, been declined, or has any reported information about a major health problem. However, being declined by a life insurance company doesn’t necessarily mean you’re uninsurable. Instead, based on your current situation with that carrier, no policies could be offered. About 50% of the time, I’ve been able to get my client who was declined by one carrier approved by another one!

Do I have to Take an Exam?

If you want a fully underwritten policy, which typically results in the lowest rates, then YES, you have to take an exam.  However, if you elect to forego the exam, and are willing to pay a few additional dollars per month, see the alternative to taking an exam below.

Alternative to Taking a Medical Exam

After reading this, you’re probably not exactly thrilled to schedule your life insurance physical right away.  Luckily, there are no exam life insurance policies out there as well.

There’s two basic categories of no medical exam life insurance policies.

If you’re in relatively good health, you can get a simplified issue term life policy up to about 350,000 depending on your age and the carrier.

Compare No Exam Rates vs. Fully Underwritten Policies Here

You’ll definitely pay more than a policy requiring a life insurance medical exam, but you won’t have to jump through all the hoops.  This is an ideal policy for someone with a busy schedule who’s not worried about paying a little more money.  For example, many of my over-the-road truckers like this option because they never know when they’ll be home.

The other type of no medical exam life insurance is called guaranteed issue, or graded death benefit life insurance.  As Jeff from Life Insurance by Jeff writes in his article, these are great options if you’re either not willing to complete a life insurance physical or cannot qualify for a regular fully-underwritten policy.

These are very expensive policies, but sometimes the only other option for someone in poor health other than accidental death insurance. There’s usually a waiting period before you’re actually covered, the most common waiting period being two years. If you die during waiting period from natural causes, the carrier will refund your premiums paid to-date plus interest to your beneficiary. Most plans also require you to be at least 45 years of age before you’re eligible. This is more of a last resort option for someone who has no savings to cover final expenses and doesn’t want to be a burden on the ones they leave behind. These are normally permanent life insurance plans with 25,000 being the maximum amount with most carriers.

There’s a lot of different options to choose from when shopping for the right life insurance policy. This is why it’s imperative you have a skilled agent with multiple companies to shop from in case a plan B is needed.  At JRC Insurance Group, we have over 45 carriers to choose from. Give us a call today at 855-247-9555, or submit a quote request in the box to the right for a no cost quote today.