The Life Insurance Medical Exam

Life insurance protects the consumer from financial loss at the point of death. It might not be something you want to think about, but it is necessary if you don’t want to leave behind a legacy of debt to your loved ones. Anyone with a dependent should purchase life insurance; otherwise, their spouses, children, or even business could wind up financially unstable after their death. Depending on your age and the amount of insurance you’re looking for, most life insurance companies require you to take a medical exam so that they can identify risks. Those under the age of 40 and applying for less than $100,000 worth of life insurance may be exempt from the exam, as will those who get life insurance through their employer, but everyone else should expect to be medically evaluated. If you live an unhealthy lifestyle or fall into a high-risk category — such as an obese person, a smoker, or someone who is already ill — you will have to pay higher premiums for your insurance. While there is a written component to the exam, the medical underwriting should not be overlooked as a strong indicator for the insurance company’s risk and a way of estimating your insurance rate.

What the Test Looks For

Part I or part A of the medical exam is a written portion with medical questions to be completed by your insurance agent in your presence. The second part is the physical medical exam, referred to as part II or part B. Collectively, the medical exam is referred to as the insurance exam underwriting. Nearly all medical exams will include a basic physical exam, urinalysis, a saliva sample, blood work, an EKG, and an X-ray. Higher life insurance policies may also include a treadmill EKG, in which the electrical activity of the heart is monitored. Issues with heart rhythm or blood supply to the heart may not be deduced on a regular EKG, but may show up on a treadmill EKG because you are enduring physical activity at the same time.

A chest X-ray may be required for higher insurance policies. Simple things like height, weight, blood pressure, current medications, and medical history are also recorded. The insurance company will want to know if you smoke, if you have pre-existing conditions, and if you’re overweight. They may also require an attending physician’s statement (or APS) from your doctor, which is an additional source of medical background information. The higher the amount of insurance you’re applying for, the more extensive the medical exam becomes. Thus, if you’re applying for a policy in the $1,000,00 to $5,000,000 range, the exam may be significantly more aggressive than a policy that amounts to $50,000.

The insurance medical exams are usually done by a paramedical who is contract-hired by the insurance company. They are also certified in administering drug tests. You cannot use your regular doctor to complete the exam, as it is a conflict of interest. The insurance company wants to make sure that the blood and urine tests are indeed yours, and that your relationship with your personal doctor doesn’t result in a biased exam. Likewise, regular doctors may not be equipped to screen for nicotine, alcohol, and other drugs. You won’t have to pay for the exam and the paramedical is usually able to conduct the exam from virtually any location, with centrifuges for blood samples and mobile equipment. Your entire exam should take about half an hour, with the results kept confidential. Any tests will be sent to a lab for evaluation, with the results sent exclusively to the insurance company. It is not out of line to send a written request for a copy of the results and many insurance underwriters will usually comply.

Ultimately, the insurance company is looking for any health conditions or habits that could eventually lead to death or higher risk for the insurance company. The test will confirm things like spikes in cholesterol or lipid functioning, any potential problems with your liver or kidneys, signs that would point to the onset of diabetes, the presence of HIV antibodies and other immune disorders, and prostate antigens. Drug screening tests will show whether or not you have traces of drugs in your system via your urine sample. The urine sample will also gauge protein, glucose, and creatinine. Glycohemoglobin tests check for high blood sugar and diabetes. When blood is taken, it can be anywhere from a finger prick to a full blood profile, depending on the amount of insurance you’re applying for.

If any of the tests conducted cause the insurance provider to raise medical questions, they are fully allowed to conduct additional tests in order to answer those questions. In the event that the insurance company finds the state of your health too questionable, they may turn you down. Your only option from that point forward would be to consider a high-risk carrier or a life insurance policy that guarantees all applicants. In most cases, they will accept you, although your premiums will be higher depending on the risk. After risk has been evaluated, the insurance company will assign you a rating. Keep in mind that the rating is not permanent, and risk can be lowered if you take necessary means to get your health in order. Losing weight, quitting smoking, and addressing other health problems can lower your rate for health insurance.

How to Prepare

The medical exam can be scheduled at your convenience, providing you at least a little time to prepare. If you’re concerned about the exam, lying about your health won’t do you any favors. Insurance companies will contact the Medical Information Bureau to track down the accuracy of your results. Instead, you can better prepare yourself by improving your health and wellness as best as you can before applying for insurance. Obviously, if you have more time to prepare, you can work on your diet and exercise regimen. However, most people will only have time for short-term preparation. In the week leading up to the exam, it can be helpful to get a decent amount of sleep per night, ranging between seven to nine hours. You should avoid alcoholic beverages and tobacco products for at least eight hours before the exam. Likewise, it will likely be required that you fast for four to eight hours prior to the exam, which will help the paramedical detect proper glucose levels. For females, it is preferable that you schedule your exam at a time when you are not menstruating.

Consuming caffeine within an hour of the exam can botch your blood pressure results, and thus should be avoided. For the same reason, you should avoid any stressful situations and practice things like deep breathing and meditation if the impending exam is worrying you. You may also want to be frugal with your sodium intake and high-cholesterol food. Oatmeal and a glass of red wine per day may help lower your cholesterol. You can adjust your diet accordingly the week prior to your exam to keep cholesterol levels in check. Keep hydrated by drinking plenty of water, which will make it easier for the paramedical to draw blood, given that your veins shrink when you’re dehydrated. Although exercise is good for your physique, you’ll want to keep strenuous exercise to a minimum within 24 hours of the exam. Strenuous exercise would likely be difficult already, assuming you have fasted properly. You should also come prepared with a list of all of the medications you take and their strengths, if you have trouble remembering them. Part of the exam will cover your current medication and you will be required to detail how much you take and how many times per day you administer the medication. You will also need to remember any treatment you’ve received, the dates of treatment, and the names of your physicians.

If you have more time to prepare for the exam, you may consider athletic training to get your body in prime shape. Weight training will help raise your metabolism and can aid you on your journey for weight loss. Even losing just a few pounds before your medical exam can put you in a lower risk category, ensuring lower premiums. You may also take vitamins and other dietary supplements, although these need to be reported when you take your medical exam just like any other medication.

Tips for Smokers

When you’re applying for life insurance, there will be a check mark box on the form next to the question, “Do you smoke?” You might consider lying about your smoker status, and for good reason. Most insurance companies have three different ratings for policy-holders that do well on the exam: standard, preferred, or preferred plus. That doesn’t even touch on those that do poorly. Rates for smokers are significantly higher than those for non-smokers, because insurance companies consider smokers to be high-risk for mortality. Insurance companies are not being judgmental, but facts and statistics simply show smokers to be higher-risk policy-holders. According to a 2004 Surgeon General’s Report, smoking and other tobacco use results in more than five million deaths per year. To be classified as even standard, you must not have smoked nicotine within the past year. If you have nicotine in your system during the time of your exam, you will automatically be labeled a smoker, even if the nicotine came from a cigar instead of a cigarette. Once that nicotine has been detected, you will be subjected to smoker rates. These higher premiums can be substantial.

If you’re a known smoker, you have two options. You can lie on your medical exam, abstain from smoking for at least 72 hours, and complete your evaluation undetected. Otherwise, you can be honest about your smoker status and accept higher premiums. If you manage to complete the medical evaluation without raising any suspicions, with no traces of nicotine in your body, you may be off the hook. That is, unless you die within two years of obtaining your insurance policy from smoking-related complications. Insurance companies have what is called an incontestable clause that is viable for two years and withholds that they may contest a death claim. If your insurance provider has good reason to suspect that your death was as a result of smoking after you were dishonest on your medical exam, they may be able to pull your coverage posthumously.

Under no circumstance should you decline taking the medical exam, as insurance companies will simply red flag you. Your hesitation to comply will only identify you as high-risk and you will wind up paying more for insurance than if you had otherwise simply submitted to the test. Likewise, your medical exam becomes permanently attached to your record held by the Medical Information Bureau, so even if you decline the offer made by the insurance company that conducted the medical exam, other insurance companies will still see the test results. Some insurance companies offer insurance without a medical exam, but these will wind up costing you more in the long run. The premiums are much higher because the company is blindly accepting people without evaluating future risk.

Online Life Insurance

One of the pros about purchasing life insurance through an online insurance company is the fact that you can easily shop around for good rates without the hassle of visiting separate brick-and-mortar establishments and feeling pressured by a sales representative to choose their insurance over another. Most online insurance companies should have reviews, and you can take any customer feedback into consideration before determining whether or not you want to use their service. Sometimes online insurance premiums are lower as well because there are very few overhead costs in running an online business, which allows them to charge you less. Finally, the most obvious advantage to purchasing life insurance online is the fact that there is typically no medical exam. In most cases, you simply answer a few questions about your health, input your credit card information, and you’re on your way.

On the other hand, it can sometimes pay off to have a more personal relationship with your insurance provider than what the internet has to offer. If your provider knows you, you may feel a sense of security that an actual human is addressing your concerns, not a computer. You can’t simply call up your insurance provider if you have a question about your coverage when your insurance is utilized through an online source. Face-to-face interaction is invaluable and without being able to interact personally with your insurance agent, you may hand your money over to a fraudulent insurance company. Although rates may be lower as previously mentioned due to low overhead cost, they could just as easily be higher or level out because the company has to charge for the unknown risk factor. Lastly, life insurance providers with no medical exam often have to limit the amount of insurance available to $500,000 to cover their backs.

The Cost of a Lie

The consequences of lying about smoking were already covered, but that isn’t the only topic that policy-holders lie about to their insurance agents. Policy-holders may also lie about their recreational drug use. If an insurance agent suspects something, they can request a lock of hair for testing, which can hold traces of drugs for up to a year. They may also be able to dig up a past of drug use if the policy-holder has admitted it to any of their personal doctors. DUIs and moving violations are also commonly lied about, especially if the policy-holder has had several. Policy-holders may not want to admit to any history of cancer in their family, as it will result in higher premiums. Additionally, they may lie about how much money they make, which can be an obvious lie if the policy-holder reports making some $100,000 per year and works as a plumber. Insurance companies will take no issue in obtaining a credit report to contest such a lie.

You may think you’ve beaten the system by lying on your application, especially if your lies have made it past the underwriting. However, your insurance application is a contract, and is an official legal document. Lies on a legal document are considered fraud. Aside from legal problems, the insurance company is able to rescind your policy if lies are discovered within two years of the application process. If lies are discovered in the middle of the application process, your rate will be adjusted such that your discrepancies affect your rating. Your insurance provider will also have reason to assume that your lies trace further back, possibly prompting them to enact further testing.