Succeeding With Me In The Application & Underwriting Process For Long-Term Care Insurance

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We have discussed your personal situation for long-term care financial protection
and we’re ready to submit your application for a long-term care insured solution.  

DIFFERENT

Types of Underwriting Are Used Depending On The Long-Term Care Solution Selected

Long-term care insurance applications are underwritten differently depending on the insured solution you are considering.  HERE IS A BRIEF OVERVIEW.

Traditional Stand-Alone Long-Term Care:  Health based no life insurance involved.  They require an application, pharmaceutical check, telephone interview or face-to-face depending on age, and review of medical records.  Medical tests may be required based on one’s personal situation or at the discretion of the underwriter

Underwriting for stand-alone long-term care has evolved and changed due to fewer companies, industry product pricing errors over the years, and the increased number of claims.  Thus prompting the insurers to look more closely at underwriting standards and tighten them up with a more involved evaluation process than in prior years.

Linked Long-Term Care:  These policies provide a minimal amount of life insurance.   They require an application with approval, POSSIBLY, subject only to a pharmaceutical check and telephone interview.  More underwriting may be involved and require a review of medical records depending on your personal situation.   A face-to-face interview may also occur depending on the company, product, age and underwriting circumstances.

Certain criteria must be met where acceptance by a telephone interview occurs:

The applicant is under age 80.    

The applicant’s height / weight meets the build chart guidelines.

The applicant’s health is favorable with no listed medical impairments or conditions.   

The applicant has not been declined for other insurance (life, health, disability or LTC).

The applicant sees his or her physician regularly every 12 to 24 months depending on age.

The applicant must be knowledgeable about his or her health and able to answer questions about physicians, medical history, and medications during the telephone interview without assistance.

The applicant must be able to pass any cognitive recall testing if required.

An expedited underwriting decision can be obtained in 7 to 10 days if you qualify.  Otherwise, more underwriting may be required before a decision can be determined.

Life (Hybrid and Combination) Long-Term Care:  These policies are for those with a primary need for life insurance.  They require an application and follow more traditional life insurance underwriting guidelines and may also use some of the other products underwriting procedures depending on the face amount, and company.

I will always advise you in advance of what type of underwriting will be involved and prepare you appropriately.  My goal is to help you understand the following details of underwriting a long-term care application and doing it right!   

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What Is Involved In The Underwriting Of The Long-Term Care Insurance Application?

HEALTH IS EVERYTHING in underwriting long-term care insurance
and is used to determine the degree of risk to the insurance company and ultimately your eligibility.

AGE & GENDER:  Your long-term care premium is based on your age and gender.  The younger you are, the less your premium and the greater likelihood of being approved.  Females pay more for traditional stand-alone long-term care insurance than males because they live longer and are more likely than men to require long-term care, therefore, resulting in a higher frequency of claims.  Women account for two-thirds of all long-term care insurance claim benefits paid.   

On the other hand, women pay less than men for life insurance because they live longer.  The same logic applies to why smokers pay more for life insurance or why drivers with bad driving records pay more for auto insurance.     

HEIGHT & WEIGHT / MINIMUM & MAXIMUMS:  Your height / weight must be in a range of company established guidelines.

MEDICAL TESTS:  Companies may want a head-to-toe physical examination and complete lab tests within the past 24 months of your application for underwriting purposes.  Depending on the company and long-term care product considered some will pay and others won’t pay for these medical test costs.  The company always reserves the right to ask for more detailed medical testing if needed or required to complete the underwriting process.

The long-term care insurance application is designed to collect lots of information to determine RISK FACTORS and help the underwriter make an informed decision based on disclosed health history, prescription drugs including over-the-count, height / weight, the ability to perform and maintain activities of daily living (ADLs) as well as instrumental activities of daily living (IADLs), and cognitive evaluation.

Activities of Daily Living:  include (eating, toileting, transferring, bathing, dressing, continence)

Instrumental Activities of Daily Living:  include (shopping, meal preparation, housework, laundry, managing money, taking medications, using the telephone, walking outdoors, climbing stairs, reading / writing, transportation, etc.).

These risk factors are determined and clarified by the underwriter using the following:
(1) Medical Information Bureau (check previous insurance application activity if any).
(2) Pharmaceutical Check (searches a national database on prescription drug usage, dosage, frequency, length of use and date of use).
(3) Medical records may be requested by an underwriter for review of office notes, lab and test results.
(4) Telephone or face-to-face Interview (to verify all entries on the application, obtain additional details, review cognitive evaluation, or determine if more underwriting is required).
(5) Medical Tests (para-medical exam, blood or urine, etc.) if required.

My Cover Letter

It helps the underwriter answer questions and read between the lines on your application.  More importantly, it clarifies issues (medical and nonmedical) and solves questions that the underwriter may have regarding the applicant.  I might reference a conversation or emails previously with the underwriter regarding your application.  I may even at times ask for special considerations I feel are appropriate for your personal situation.

The Underwriting Process 

I will provide you with an email or cover letter asking you to review your application carefully and make sure all answers are correct and complete.   If not, notify me immediately so I can communicate any changes to the insurance company.

Once your application has been submitted and received in the long-term care underwriting department.  You can expect within a couple of days, a phone call from a representative of the insurance company to complete the required telephone interview.  The sooner this is taken care of, the quicker your application can be reviewed for additional underwriting requirements or a request to review medical records will be initiated by the underwriter.    

I normally submit an application for consideration only.  You are not obligated during the processing of your application and the insurance company is not on the hook until your application is formally approved, you have accepted the offer for coverage and the company has received your initial premium to put the policy in-force.  

A conditional receipt is issued to the insured (you) when a premium is paid at the time of application, which provides you with temporary coverage during the processing of your application.  A conditional receipt will be determined on a case by case basis.

I recommend premiums are paid via monthly bank withdrawal.  I suggest these automatic payments so no need to worry about a premium notice being lost in the mail, and it’s easier to budget and pay premiums on a monthly basis.  Premium modes of quarterly, semiannual or annual are also available.  I can discuss with you the premium payment that best meets your personal situation at the time of application or policy delivery.  The premium method can also be changed at any time.

I will advise you once your application is submitted it normally takes 4 to 8 weeks to receive an offer from the insurance company regarding your application for long-term care insurance.  However, there are situations when it can take less time depending on the product, risk factors, and underwriting involved, and other times due to unforeseen delays when it can take longer.

I will follow your application closely and contact you with the ongoing status of your application.  The insurance company must be notified if you have any change in health or visit a doctor during the underwriting of your application or subsequent to the delivery of a policy.  Try to hold off on going to the doctor for any other reason if you can.  A life-threatening emergency is obviously an exception.

Regarding The Purpose Of The Interview

(1) Translation services are available and will be arranged if you need the interview to be conducted in a language other than English. 

(2) Plan for 60 minutes.  It may be shorter.

(3) You want to be in a place free of distractions.

(4) Only the applicant may be on the phone during the interview.

(5) Using a speakerphone is not permitted.  Any indication of coaching or participation by another party will affect the applicant’s ability to be approved for coverage.

(6) IMPORTANT!  TAKE THE INTERVIEW SERIOUSLY AND GIVE THIS YOUR FULL ATTENTION. 

The OBJECTIVE of the telephone interview is to confirm, collect and clarify information disclosed on your application.  This helps the underwriter determine the appropriate course of action and offer we can anticipate from the insurance company. 

Experience tells me being knowledgeable about the telephone interview and prepared increases the chances for better results.

Preparation Is The Key Plan Be Prepared Concept Just Prepare To

Preparing For The Interview

List any medical conditions you have been diagnosed with depending on the time frame.  It may be within 5 years or 10 years.  Indicate if medical conditions are well controlled and stabilized.

Name of attending physician(s), addresses, and phone numbers.

Condition date of diagnosis symptoms.

Type and date of treatment.

Tests that were done and results.

Date of last doctor visit.

For example, a client with a history of diabetes should be prepared to state the date of onset, current treatment, any complications, lab results indicating the level of control and the treating physician’s name, address, and specialty.

I will provide you with an appropriate form to help the interview proceed without delay and go smoothly. The form is used only to assist you in providing medical information during the interview and does not need to be returned to the insurance company.

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More About The Telephone Interview

IMPORTANT!  The information and answers you provide should not be any different than what was disclosed on your application.  It should be consistent with no discrepancies between what the underwriter is reviewing on your application and the transcribed telephone interview.

Be ready to provide the following details:

(1) Your name, gender, birth date, height / weight, tobacco usage, marital status, Social Security number (SSN), citizenship, and source of paying premiums.

(2) Employment, residence and living arrangements, hobbies, activities and social habits.

(3) Your existing life insurance policy, annuity and long-term care contract information including company names, coverage amounts, issue dates, policy numbers, and if you’re replacing the policies.  This includes any previous coverage for which you applied and may have been postponed, rated or declined.

(4) About your current health including recent doctor visits, diagnoses, symptoms, and conditions for which you are or have been tested or treated in the last 5 to 10 years depending on the company.  You want to provide your doctor’s name(s), specialty, address, and phone number.

5) You will be asked the names and dosages of any medications you are currently taking and for how long.  You may want to have your prescription bottles handy to make it easier for you.

(6) This interview may require you to participate in memory recall exercises depending on your age.  It’s not about tricking you but ruling out any cognitive issues, which is of great concern to the insurance company as long-term care insurance covers Alzheimer’s / Dementia and these claims can run for many years.

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The Face-To-Face Interview (Based On Age)

(1) A face-to-face interview is required based on age. It must be conducted In the applicant’s home where he or she resides. It cannot be completed at their place of work, a relative’s home or in a public place, such as a restaurant.

(2) A face-to-face interview can be arranged if hearing loss prevents an applicant from completing a telephone interview. The underwriter would want to know if the applicant can read lips or communicate using sign language.

(3) The face-to-face interview will observe and include your ability to perform the activities of daily living and brief cognitive exercises.

As stated above, this is not about tricking you.  It’s just about ruling out any cognitive issues.  

What Happens When The Telephone Or Face-To-Face Interview Has Been Completed, And All Underwriting Requirements Have Been Reviewed?

An underwriter will evaluate all of the details and information regarding your application and will provide us with a premium offer for long-term care insurance coverage.

My ultimate goal together with you is matching an anticipated offer with the final underwriting decision while managing your expectations throughout the entire underwriting process.  This adds up to an underwriting success when an offer is accepted by you and the policy is put in-force.

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The Long-Term Care Insurance Policy Is Issued

Your policy can be delivered traditionally with a face-to-face meeting, via mail or online depending on the company.  

We want to review the policy carefully and make sure you understand the benefits, provisions, and limitations as well as make sure it was properly issued with all of the benefits approved and applied for with the insurance company.  Your policy will be tracked for an annual review or any anticipated follow-up changes in your personal situation.  Should a claim arise I will contact the insurance company and request the appropriate forms for you.

You will never hear me tell you underwriting is simple or easy.  However, I will always tell you that it is worth your time and effort to follow me and let me take you through the entire process, and after all the steps have been completed.  You will have acquired a valuable long-term care insurance policy that adds a pool of money for future care services to your retirement assets and provides you, your spouse and children with financial security and peace-of-mind.

Let me help you put the pieces of your underwriting puzzle together.   

It’s about you winning and me helping you to win!

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Marc Maretsky Personal Insurance Services based in Beverly Hills, serves all of California and the United States.  I help my clients acquire life, disability, long-term care, and critical illness insured solutions, as well as enroll them into Medicare when eligible.

“No matter how fast technology changes our world and everything around us.  I believe the personal touch and a human voice are more important than ever.”

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