How to anticipate a life insurance rating for cancer

Posted by Jack Cotlar, M.D. on Sat, Aug 17, 2013 @ 11:56 PM

Cancer is one of the more coshutterstock 142163296 resized 600ncrete medical underwriting problems that underwriters see. In order for the producer to have some idea of what a rating might be for the client, he or she can ask the underwriter by phone call or email. So what specifics does the underwriter need to know? They are the same ones that underwriters must discover in order to use their company’s reinsurance manual:
1.    Type of cancer (breast, prostate, colon, etc)
2.    What the pathology report says about the cancer
   a.    Stage, for example, “T1N0M0”
   b.    Grade, for example “well-differentiated” or grade 2 or, for prostate cancer, “Gleason      3+3=6”
   c.    Margins of the specimen removed: free of cancer or not free of cancer
3.    How was the cancer treated? Generally it would be by radiation, chemotherapy, surgery or some combination of these.
4.    What was the date of the last form of therapy? For example: if radiation follows surgery, then it would be the date of the last dose of radiation.
5.    What type of surveillance testing is being done?
a.    Type of test (colonoscopy for colon cancer, PSA for prostate cancer or mammogram for breast cancer, etc)
b.    Date of most recent test and its result
6.    Has there been a recurrence of the cancer, if so, when?
7.    Is the client currently in remission (is free of cancer)?

This information can be found in the medical records, often included in the most recent pages of the physician following the client for cancer and from the client himself or herself. If you are able to relate as much of this information as possible to the underwriter, he or she will be able to give you an accurate rating for this condition from which you can plan your strategy with confidence.

Contact me if you have any questions or comments.

Dr. Jack Cotlar

Topics: medical underwriting, Cancer, communicating to the underwriter

Why Experienced Producers Sell Their Cases to the Underwriter

Posted by Jack Cotlar, M.D. on Thu, Apr 05, 2012 @ 06:20 PM

PartneringConventional wisdom is that the process of selling life insurance involves only the interaction between producer and client; it is only the client who needs to be “sold” in making the transaction. This is not correct. Who is the other “decision maker” in the sales process? It is the carrier’s underwriter. Why? The answer lies in their job descriptions.

The underwriter’s job is to determine whether or not the case makes financial sense and whether or not the premium is in sync with the applicant’s health status, i.e. they determine whether or not the carrier is able to make an offer, and if so, at what rating (price). So the producer needs to “sell” the underwriter the idea that the contract will be profitable for the carrier.  A forward thinking and experienced producer understands that he or she should interact with the underwriter as business partner and not as an adversary. So how is this done?


The experienced producer will …

The inexperienced producer might …

  • provide the carrier the necessary underwriting information in a timely manner,
  • fail to meet deadlines and will give push back for any requested information,
  • avoid errors that create work for the underwriter,
  • carelessly complete forms and create problems that cause the underwriter to do additional work, needlessly,
  • provide an accurate and informative cover letter that provides relevant financial and medical information, succinctly and …
  • not bother to create a cover letter, of if he or she does, it contains little more than “fluff”, and …
  • communicate in a fashion appropriate for a business partner relationship


  • interact with the underwriter in a non-professional manner, then he or she will wonder why there appears not to be a good working relationship

 My point? Building sound relationships with both your client and the carrier’s underwriter evaluating your client’s case and providing the underwriter with tangible reasons to prove that a case is worthy of consideration are critical to the success of your placing your cases.

How do you define the role between you and your carrier’s underwriter? What do you do to make this happen?

Topics: Underwriter, experienced producer, medical underwriting, Insurance medical underwriting

The Producer’s Participation in Medical Underwriting

Posted by Jack Cotlar on Tue, Jan 17, 2012 @ 04:57 AM

istockphoto 6131779 the main part of mechanismSuccessful entrepreneurs know that what separates them from the competition is doing a few things of value really well. Often, one of these is a task that others ignore. In the life insurance industry, some producers either ignore the field underwriting piece of the case development, i.e. they simply don’t do it, or they delegate this task to staff that are not trained in this area. Life insurance company carriers have well trained professionals, underwriters, who make a risk assessment based upon the financial and medical data they see and this determines how much your client will be asked to pay for the product you sell. This simple concept should provide incentive to apply some of the sales energy into case management. What do I mean “case management”? This in part means to gather the necessary financial and medical data, ask the questions and record the answers on the insurance application (to gain first-hand knowledge and to cement the producer-client relationship), anticipate what the underwriting issues are or might be and take necessary steps to preempt underwriting problems. Any underwriter would say, “the devil is in the details”. This characteristic as it relates to medical underwriting is often outside the producer’s comfort zone. Because it is, any producer has an opportunity do standout from the others and to provide the kind of expertise your clients expect.

Jack Cotlar, M.D.
Strategic Medical Consulting, Inc.
Phone: 317-536-2603

Topics: Dr. Cotlar, Life insurance medical underwriting, case management, medical underwriting, Straegic Medical Consulting

A Proactive Way to Avoid a Possible Medical Underwriting Glitch

Posted by Jack Cotlar, M.D. on Mon, Sep 05, 2011 @ 10:19 AM

dreamstimefree 168394 resized 600Question: You have a client who is applying for a large amount of life insurance coverage and he sees a therapist for anxiety. The “APS” or attending physician’s statement you receive from the therapist is a one-page document that cites a diagnostic code for “anxiety” or only a diagnosis and no other useful descriptive information. You are concerned that the carrier’s underwriter will want more information given the size of the case, and you cannot afford a time delay. How would you manage this situation?

The most simple and direct way is to go to the client explaining the underwriting dilemma and to do so before the case is submitted. Providing the carrier up front what he or she will need to do their work properly is likely to greatly expedite the case being issued. There will be occasions when providing answers to key questions in a cover letter will allow the underwriter to make a decision about this issue without needing another APS. To see a brief case example, go HERE.

Topics: attending physician statement, underwriting glitch, underwriting dilemma, Dr. Cotlar, Life insurance medical underwriting, medical underwriting, Strategic Medical Consulting, medical records