Did you know that atrial fibrillation (or AFib) is the MOST common heart arrhythmia? It is estimated that up to 6.1 million people in the United States have this condition. Therefore, it should come as no surprise that we are underwriting AFib on a frequent basis; at least weekly! The AgencyONE Underwriting Team has amassed an impressive knowledge of the condition including, but not limited to, the symptoms, risk factors, treatment, and prognosis of AFib.
In this ONE Idea we will discuss this condition and how it is underwritten and demonstrate why carrier choice is imperative to securing the most favorable offer and pricing for your clients.
Atrial fibrillation (AFib) is an irregular, sometimes rapid heart rate that results from a “mis-fire” within the natural pacemaker of your heart (sinoatrial node). During atrial fibrillation, the two upper chambers of the heart (atria) beat chaotically, or out of sync with the two lower chambers of the heart (ventricles). AFib can be caused by chronic conditions such as ischemic heart disease and/or high blood pressure. It can also result from temporary conditions such as hyperthyroidism, pericarditis, thoracic surgery and acute alcohol intoxication (aka “holiday heart”). Symptoms may include palpitations and shortness of breath, although some individuals experience no symptoms at all. Episodes of atrial fibrillation can be paroxysmal (comes and goes) or chronic. Treatment can vary from oral medication to surgical ablation. The risks associated with this cardiac arrhythmia include stroke and heart failure.
When clients report a history of atrial fibrillation, the following information will be scrutinized during underwriting:
- Age at onset – younger is better in most cases;
- Frequency of attacks – 4 episodes or less annually is classified as paroxysmal;
- Associated symptoms and complications;
- Risk factors for stroke;
Let’s look at a case study that illustrates this point.
Mr. Hart is a 60-year-old successful attorney seeking $1,000,000 of Universal Life (UL) insurance coverage. He has a history of paroxysmal atrial fibrillation but has experienced only a few episodes of “mis-fire” since his original diagnosis in 1996. He is currently treated with a daily antiarrhythmic. However, Mr. Hart’s medical history is further complicated by a diagnosis of bicuspid aortic valve and thoracic ascending aortic aneurysm (4.3cm). All things considered, AgencyONE’s team expected this case to be an underwriting challenge but knew we could deliver a favorable offer to suit the case requirements. AgencyONE directed Mr. Hart’s case to four carrier partners based on expected underwriting offers/pricing, established carrier underwriter relationships, and proposed insured /advisor preference.
- Exercise tolerance;
- Underlying cardiac and non-cardiac disease;
- Treatment including use of anticoagulant (blood-thinning) medication; and
- Results of full cardiac evaluation, if completed.
As with all conditions, carriers sometimes view the same medical history very differently.
Carrier A was far and away the winner. AgencyONE impressively negotiated a Table 3 non-tobacco offer on this medically complex case! Not only did AgencyONE save the proposed insured nearly $7,000 of annual premium but we increased the agent’s target premium by almost $2,000!
AgencyONE has the underwriting knowledge and expertise, along with well-established relationships with carrier underwriters, to successfully place even your most challenging cases.
Please call AgencyONE’s Underwriting Department at 301.803.7500 for more information or to discuss a case.
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