Jenilee Wirtz

Life Insurance Medical Examination

In New York Life on December 8, 2010 at 1:58 am

“I made the decision to purchase a New York Life Insurance policy to protect my family…what’s the next step?”

To gain as complete a picture of the potential risk an individual presents to the insurance company, the evaluation of the application and the relevant information about an individual’s activities and general health are important.

The life insurance application is usually completed in two parts, known simply as Part I and Part II.

Part I consists of general information about the individual as well as personal information about such things as driving history, criminal history, other life insurance coverage, recreational sports activities and finances.. There is also an authorization to sign which grants permission for the company to request medical information from physicians and other medical record keepers if it becomes needed.

Part II is the medical questionnaire. Depending upon the amount of insurance this portion of the application will be completed by either your life insurance agent, a paramedical professional or a doctor.

Once completed, the Part I and Part II provide the insurer with a fairly comprehensive picture of the exposure to risk the proposed insured represents. Each company has its own standards of what it considers to be acceptable insurable risks and will offer a policy based on those guidelines.

What kind of medical exam will I have to take?

The short answer is – that depends. Generally speaking, if you are under 40 years of age and are applying for less than $100,000 of coverage, there’s a good chance the company will not have an actual exam completed but will have some lab studies completed such as an oral fluid test, blood test or urinalysis. If you are over 40 for and/or applying for more than $100,000, you may be required to have either a paramedical or full medical exam. In addition to the exam any of the following studies could be included with the exam: oral fluid test; blood test; urinalysis; EKG tracing; X-ray and possibly a Treadmill Stress test. If any of these exams or tests becomes required and they are not completed, the company will not accept your application for insurance.

  • a. Paramedical Exam

A trained technician will complete the paramedical exam. The paramedic asks medical history questions and measures height, weight, blood pressure and pulse. Depending upon your age and the amount of insurance being applied for, the paramedic may also perform an oral fluid test or a blood and urine test and possibly an electrocardiogram as well. In most cases a paramedic will call you to find a convenient time to schedule the exam and come out to your house to perform it. You also have the option of going to a clinic for the exam. The exam takes approximately 30 minutes.

  • b. Full Medical Exam

A physician will complete the full medical exam. The exam consists of the same elements of the paramedical exam, plus listening to the heart, and a review of other bodily systems. Some companies specify that the physician must be a board certified internist or heart specialist rather than a general practitioner.

What do the tests show?
The insurance company wants to check for any unknown conditions that could adversely impact an individual’s normal life expectancy and could increase the company’s risk. The urinalysis screens for a number of things including diabetes, the presence of medications and nicotine as well as general kidney function. The blood profile can reveal the functioning of organs of the body and specific testing for things such as diabetes, liver impairments and kidney impairments as well as HIV testing. An oral fluid test can indicate the presence of HIV antibodies, as well as cocaine and nicotine.

What other information does an insurance company gather?
In addition, to Parts I &II the company may want to review your medical records or obtain a phone interview with you. Medical records can be obtained for a few reasons with one being a way to check how your personal physician is treating you or has treated you for a medical condition.

At times a phone interview is conducted to verify the information on the application and to obtain a few additional details to clarify this information. In the case of New York Life, if an interview is needed a company representative will contact you directly to maintain a high level of customer satisfaction and confidentiality.

Can proposed insureds access all the results of exams and other requested information?
Yes. People can and frequently do request to receive copies of test results. They can also request to have them sent to their personal physician.

Who else has access to these results?
Exam results and medical records are sent directly to the company’s underwriters and handled in strict confidence.

How are the results used?
The information gathered on both parts of the application and from the other requirements is used to classify the risk a person represents. Based on the level of risk a proposed insured is placed into one of four general categories, preferred, standard, special class or declined. Every company has its own rating and based on this they determine the premium structures for the policy.

What if an exam reveals an unknown medical problem?
Remember most people that undergo medical exams qualify for insurance without any concerns. In the unlikely event a problem is discovered, you may be offered a policy with a higher premium as a special class or we may postpone the application until the findings are evaluated by your personal physician.

What is role of the agent in this process?
The agent can act as your advocate in the process and with the insurance company. The agent can explain the underwriting and exam process to make sure the proposed insured understands why certain tests may be needed.

While a medical exam can seem like a hassle at first, let me assure you that it is very quick process done by professionally trained examiners.  Do not let a medical exam stop you from making a very important decision for you and your family.  Please read the full article here.


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