Top Reasons Why a Life Application May Be Declined and How to Address Being Declined : Catherine Giles, An Independent Insurance Agent, Blog
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Catherine Giles, Independent Insurance Agent

Top Reasons Why a Life Application May Be Declined and How to Address Being Declined

by Catherine Giles on 11/23/15

Have you ever wondered some of the reasons why someone who applied for life insurance may have been declined coverage with an insurance company?  Life insurance coverage options as well as underwriting guidelines differ among insurance carriers.  Underwriting guidelines are the guidelines in which investigation of the facts contained in life applications are used to determine if coverage will be offered or declined.

 

Below is a list, in no particular order, of some reasons why an applicant might be declined for life insurance with some insurance carriers:

1. Previous Declines on Life Insurance Applications

Insurance carriers can utilize the Medical Information Bureau, a not-for-profit company through which life insurance companies can assess an individual’s risk and eligibility during the underwriting of life insurance.

Often, depending on insurance carrier, if an applicant was declined life coverage within the past five years and if the reason was due to a serious medical condition that it still in existence, it can make it more difficult to qualify for life insurance with some carriers.  However, just because an applicant has been declined life insurance coverage in the past doesn’t mean he or she can’t qualify for life insurance coverage now or in the future

2. Your Driving Record

A history of driving offenses, accidents, and claims can indicate that you live a dangerous lifestyle, as auto accidents are one of the leading causes of death, and especially prevalent among young adults.  Some carriers may charge an increased rate if coverage is offered.

A history of multiple accidents or tickets, or DUI/DWI episodes cause concern for insurance carriers. You may find it impossible to get life insurance until you can demonstrate a history of safe driving.

3.  Height and Weight Ratios

When applicants are obese or morbidly obese, some insurance carriers may decline life insurance coverage because often obesity or morbidity obesity lead to severe health complications, such as cardiovascular disease, diabetes, and can increase cancer risks.


If an applicant is obese without many other health issues, some carriers may charge an increased rate if coverage is offered.


4. Elevated Cholesterol, Lipids and Triglycerides

Research has shown that the relationship between high LDL cholesterol, and low HDL cholesterol puts a person at higher risk for heart disease and stroke. If a life insurance applicant has high cholesterol, lipids, and triglycerides without many other health issues, some carriers may charge an increased rate if coverage is offered.

 

5.  Elevated Liver Function

 

Elevated liver function can indicate inflammation or damage to the liver cells. This can cause the cells to leak above-normal levels of certain chemicals into the bloodstream. Typically, the elevation is mild, and the condition is temporary. But sometimes it can be an indication of more serious liver problems, and that's a concern to life insurance companies.

One of the challenges for an applicant, is that they may become aware of the elevated liver function only after taking a life insurance medical exam. However, there is no medical documentation to indicate if the condition is temporary or something more serious, since you haven't had the opportunity to get follow-up medical attention. A life insurance company however may assume the worst and deny your application.


6. High Levels of Glucose or Blood Sugar

 

High levels of glucose or blood sugar can be an indication of diabetes, and that opens up the possibility for a host of other medical consequences, such as increased risk of heart attack, stroke, cancer, kidney damage, and circulatory issues that many life insurance companies prefer to avoid.  Some carriers, if coverage is offered, may charge an increased rate if there is medical documentation that currently and for an extended period of time glucose levels are well-controlled by diet and/or medication.

 


7. Blood or Protein in the Urine

 

The existence of blood or protein in the urine could be an indication of kidney disease. It can also be caused by extreme physical exercise. One of the challenges for an applicant, is that they may become aware of blood or protein in the urine only after taking a life insurance medical exam. However, there is no medical documentation to indicate if the condition is temporary or something more serious, since you haven't had the opportunity to get follow-up medical attention. A life insurance company however may assume the worst and deny your application or may decide to gather additional medical information and may charge an increased rate, if coverage is offered.

 

 

8. Alcoholism

 

If alcohol use is indicated on the application, in medical records, and also if regular alcohol abuse is indicated when liver functions are high, most insurance companies will deny coverage; the reasons being liver function, along with damage to health that occurs from alcoholism, as well as the potential for engaging in life-threatening activity.

If alcoholism is a current problem, a denial of coverage would most likely occur, but the best strategy if applying for life insurance would be to delay your application until you have ceased drinking completely, and enough time has passed that medical evidence of sobriety can be substantiated.


9. Drug Use

 

Confirmed use of illicit drugs are typically an automatic decline when you apply for life insurance.

Just as is the case with alcoholism, if you have a drug habit or drug use disorder, the best strategy is to completely get off the drugs under a physician’s care and to document a medical history of being drug-free for an extended period of time.


10. Hepatitis

 

Hepatitis B or C already diagnosed and treated is typically not a reason for denial once treatment is complete. But it can be a problem with a life insurance application if the condition has only been recently diagnosed, or if it is revealed by the life insurance medical exam itself.

In order to get life insurance, you'll first need to begin and complete medical treatment. 


11. AIDS or HIV

 

Even though AIDS and HIV are better understood and treated now than in the past, and even though survival rates have improved dramatically, most insurance carriers will deny coverage.

 

 

12.  Occupation

 

Some occupations carry a higher degree of danger than others. This can make life insurance companies reluctant to approve policies if you are working in an occupation that is considered hazardous.

Some of the most hazardous occupations are:

  • Logging workers

  • Fishers and related fishing workers

  • Airline pilots and flight engineers

  • Roofers

  • Structural iron and steel workers

  • Refuse and recyclable material collectors

  • Electrical power-line installers and repairers

  • Drivers/sales workers and truck drivers

  • Farmers, ranchers, and other agricultural managers

  • Construction laborers                  



13. Hazardous Extra-Curricular Activities

For some people, it's not what they do for a living that causes increased risks, but rather what they do when not working. Some extracurricular activities are considered hazardous, and carry a higher risk of premature death. If you participate in any the following activities, many insurance carriers will decline coverage:

Skydiving

Scuba diving

Flying Aircraft (recreational pilot)

Base jumping.

Bungee Jumping

Mountain Climbing



14. A History or Family History of Heart Attack, Stroke, and/or Cancer

Even though cardiovascular and cancer outcomes have been improving dramatically in recent years, heart attack, stroke, and cancer are high risk medical events and the cause of many premature deaths.

Less serious forms of cardiovascular disease or cancer, such as hypertension or murmur that is well-controlled or skin cancer, may be approved by insurance carriers with an increased rate.


Steps to Take if You Have Been Denied Life Insurance Coverage:

1. Write the insurance company and request that they disclose to you in a written explanation all of the specific reasons why you were denied life coverage and request any medical information that was used in determining the denial.



2.  Order copies of any medical records that were used by the life insurance company in declining your application.

 

3.  Get copies of your complete medical records.

 

4.  Carefully check the medical records used in determining that your life application would be declined to make sure that they do not contain false or questionable information. Should you come across any, you'll need to make sure that the information is corrected, as it will appear in the database that virtually all insurance companies have access to.

5.  Work with an Independent Insurance Agent or Broker appointed with many insurance carriers.  One life insurance carrier may decline coverage, but another carrier may approve your life application as is or with an increased rate. 


Life insurance coverage options vary among insurance carriers as well as underwriting guidelines differ among carriers.  The best advice is to utilize an independent insurance agent appointed with many insurance carriers and who is also experienced in order to receive the best advice, recommendations, and options for coverage.

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