Ask an Underwriter: Is coverage available for clients with prostate cancer?


Ask an Underwriter: Is coverage available for clients with prostate cancer?

Do you know the top two leading causes of death among men in the United States? If you answered heart disease and cancer, you are correct!1 What you may not know is that prostate cancer is the most prevalent type of cancer among men. Currently, nearly 2.9 million American men are living with the disease, and the American Cancer Society estimates that in 2017, 161,360 men will be told they have prostate cancer.2 With these statistics, there is a high probability you will encounter the opportunity to protect a prostate cancer survivor, if you haven’t already.  

 

As a result of increased preventative screening to include Prostate Specific Antigen (PSA) – normal values between zero and four – digital rectal exam (DRE), and advancement in treatments, early detection is naturally higher. 

 

Diagnosis

When Prostate Cancer is diagnosed, usually through a biopsy procedure, a specific stage will be assigned. The staging refers to the extent of the cancer (how much cancer is present and how far it has spread), stage I-IV. Staging is a big piece of the puzzle in underwriting, along with a Gleason Score, which is based on the tumor pattern the pathologist sees.     

 

Key Information 

All of these factors have improved many life insurance carriers’ underwriting guidelines, leading to decreased postponement periods and more favorable ratings. The key to successfully insuring your prostate cancer survivor is understanding what information is important to find the very best solution. 

  • Stage of cancer
  • Gleason Score
  • Date of diagnosis
  • Type of treatment(s)
  • Date of last treatment  

 

Additional Questions That Could Be Helpful 

  • Any lymph node involvement?
  • Any metastasis (spreading of the cancer to other areas in the body)?   
  • Any relapses?
  • Date and result of most recent PSA?
  • Any current medications being taken? 
  • Family history of prostate cancer?  

 

Two important pieces of information will be whether or not they are in full remission/cancer free and for how long (month/year the remission was established). The longer your client has been cancer free, with regular follow-up and testing, the more favorable their offer may be.   

 

For most life insurance carriers to give consideration of someone who has a history of prostate cancer, the client must fully complete treatment (surgery, radiation, chemo) and often the carrier will require a waiting period, referred to as a postponement period. The extent of the rating and duration of postponement varies depending heavily on the stage of the prostate cancer, type of treatment, and date of last treatment. Risk philosophy also varies from carrier to carrier based on the reinsurance manual used or the carrier’s own proprietary guidelines. 

 

Active Surveillance/Biochemical Recurrence

With increased early detection, we are seeing more and more cases with these considerations. Active surveillance or watchful waiting means the client’s physician is treating them by regularly monitoring the client’s lab markers (PSA, CEA, etc.) on an interval basis and closely monitoring PSA velocity. 

 

This treatment option may be elected with a first-time diagnosis or biochemical recurrence. A biochemical recurrence happens when the PSA levels transition from undetectable to detectable, generally increasing, and may occur among men treated with radical prostatectomy or radiation for localized prostate cancer. These clients require careful consideration on an individual basis with the most favorable being age 65 or older, initial diagnosis Gleason Score of six or less, availability of favorable PSA trending documented over several years, and being three or more years out if previously treated. 

 

Get Started

Let Ash Brokerage assist you with your next Prostate Cancer case. To simplify fact-finding, use our Prostate Cancer Questionnaire. We leverage our experience, carrier relationships and resources to identify viable solutions based on your client’s individual circumstances and insurance needs. Reach out to your underwriting team for information or assistance. 

 

Learn More

1Centers for Disease Control: https://www.cdc.gov/healthequity/lcod/men/2014/index.htm

2Zero: https://zerocancer.org/learn/about-prostate-cancer/facts-statistics/

Ash Brokerage Underwriting Questionnaire:http://go.ashbrokerage.com/rs/535-YRX-827/images/Cancer-Prostate.pdf

 

 

About the Author

Julie’s unwavering passion and dedication for risk advocacy promotes lasting partnerships while driving impactful results for all stakeholders, from our agents to our carriers. She leverages her 20 years of industry experience with her relational approach to ensure you experience the Ash difference.