Saturday, September 13, 2014

Weekly Whine: Insurance

Recently my husband and I bought life insurance. It was a huge saga, which I may post about in the future if I am motivated.

One thing that struck me about the whole process of applying for insurance is how it punishes both honesty and self-improvement.

For example, my husband has sleep apnea. Obviously, this is not something that would be picked up by a clinician during a routine exam like high blood pressure or high cholesterol. However, in order to improve his health, he opted to get diagnosed and treated. And he has faithfully used a CPAP machine every night for the last six years.

Unfortunately, a person who never bothered to get treated for severe sleep apnea and presumably has higher health risks would probably have a much lower insurance rate than my husband. Ditto for people who seek treatment for mental health issues like depression or anxiety, which probably wouldn't be caught during a routine exam.

I understand that insurance companies need to use some sort of model to assess risk. But I do feel like that model shouldn't punish people who try to help themselves.


  1. I agree, it's really obnoxious. I do understand why it is the way it is, but still. I recently went through this process also, and at some point I was talking to a friend who went to the cardiologist because of palpitations that she'd been having for years. It turned out she has an arrhythmia. My first thought, having just been through this process myself, was shit -- now you're going to be uninsurable. And... their plan is for her husband to be the SAHF.

    Have you purchased long term disability too? That was even more annoying.

  2. Hubby tried to put extra insurance on a tiny car loan. (under $5K) He is in his 50's and they asked if he was dx with diabetes, High BP or High Chol in the last two years. YES - which made him un-insurable. No follow up asking if the problem was under control / dr care and certainly no question that said, 'if not, have you had a physical in the last two years?'

    The kicker? it was less than 3 months until the two-year mark.


  3. So you are just confirming that insurance companies ultimately control the health care system in this country. Why do we keep allowing it?

  4. Now with the insurance companies dictating the rules, doctors are scrambling, joining
    groups run by mega corporations which offer "protection" in exchange for loss of autonomy. Medicine is not the profession it once was but then, what is?

  5. I have an idea: Why don't you form your own group, incorporate it and allow me to deal with the insurance companies. It would allow me to channel some of my
    underlying anger issues in a positive way. Ya know, sublimation?

  6. I think I'm going to shave one side of my face and leave the other side unshaved.
    Maybe it will start a trend! ....I need to get a hobby.

  7. I am 39 and uninsurable due to health problems that are not of my own doing, or so my doctor says. Be glad you could even get life insurance. And I'm glad the hubby finally saw how important it is to have some.

  8. My colleague had some major limits placed on her disability insurance due to seeking some brief counseling during a stressful life event. The agent reminded her that disability insurance is a privilege, not a right. The companies can do whatever they want.

    In a similar vein, I recently got health insurance on my own. A phone rep pulled up my (minimal) health records and demanded I explain each part in excruciating detail so that she could document details. One might argue that they have a right to know my health history b/c they're insuring me, but I'd prefer to pay cash and keep my health records confidential. However, the government mandates that I get health insurance, which means I can't opt for privacy.

    I asked her to document an episode of "bronchitis" as "acute," so that those who see the records later won't assume I, a never-smoker, have COPD, but she said her system "doesn't allow me to specify." I hate the whole damned insurance system.

  9. Let me see if I understand correctly: An actuary calculates the risk and it's the
    rep's duty to "cross examine" you to make certain the company is not assuming
    any undue risk. Lastly, in the event you do need to put in a claim, another careful
    evaluation is undertaken to make certain they are the responsible party. Did I miss

    1. The question is: why is hubby being punished for being proactive and ensuring that he will not suffer adverse health issues due to apnea. If he's faithfully using a CPAP - problem is essentially solved, is it not? So now how is he a risk? On the other hand, every time I visit my dad, I hear his snoring throughout the house every single night, and the number of times he stops breathing while he sleeps is shocking. I'm talking hundreds of times a night, for far more than a few seconds each time. Yet he refuses to do anything about it and won't mention it to his doctors. I love my dad, but why should he be more insurable than Fizzy's husband?

  10. Yes, it seems honesty has consequences too. However, look it this way. If you're not honest, and they discover your omission, they will be more than too happy to refuse your claim. So, you're going to get in the end either way(excuse the pun), but with
    full disclosure, your end is at least covered.

    1. This is only partially true. If they deny someone coverage because of a pre-existing condition, then that person's beneficiaries get nothing even if they die from a totally unrelated issue. A person with apnea could very well die in a car accident, and his family is denied any life insurance proceeds because of the fact that he went for treatment for his apnea. On the other hand, the guy who hides his apnea can die in the same car crash, and his family gets $500K in life insurance benefits. Seems a bit inequitable.

    2. Sorry if I confused the issue. I was referring to health, not life insurance.
      To the best of my understanding, you can no longer refuse someone health insurance due to a preexisting condition. As for life insurance, I'm assuming they can put in "qualifiers" to get around that issue. If that is
      the case, you may very well be right.

    3. The only line of insurance that cannot discriminate for pre-existing conditions is health insurance. All other lines of insurance can take your health into consideration for underwriting purposes.

  11. There is an answer to some of life's difficulties. I't's called "The Chocolate Fetish"
    located in Asheville, NC The good news: They ship!

  12. I work in the insurance industry & FIzzy you are correct. It is absolutely certain that a person who has something wrong which is undocumented AND not causing such serious issues as to affect lab values will get a better rate offer for life insurance than someone who is treating a chronic condition- anxiety, depression, apnea, etc.

    It does vary somewhat company to company as to how they treat health issues, some give their best discount even with an Rx for cholesterol and some even allow an Rx for HBP, others don't.

    Reading medical records over the last 20+ years has convinced me to be very circumspect about what I say in the doctor's office, not wanting an offhand extraneous comment documented and potentially being misleading to a 3rd party.

  13. So, this begs the question. Does it count as having HBP or High Cholesterol, if the values are in normal range due to medicine, exercise and/or diet?

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  15. If the company allows Rx for chol/HBP and if you are within their normal range, yes you get the good rate.
    And the company's cholesterol guidelines are fairly high for normal (compared to what a PCP wants to see), traditionally 220 or lower for the best rate, some companies are going more by the ratio, so 300 or lower for overall cholesterol is okay IF your ratio is below 4.5 for one company.
    Each company is different and a person can get a different offer (preferred best, preferred, standard plus, standard) from different companies based on the same labs!
    Example 1:
    HDL ratio, total
    If ratio <5.0, 205
    If ratio <4.5, 260
    EXAMPLE 2:
    Total Cholesterol may not be lower than 130 untreated and may
    not exceed 275 with or without treatment.
    Cholesterol/HDL Ratio may not exceed 4.5.