Ask an Underwriter: What is Cognitive Impairment?


Ask an Underwriter: What is Cognitive Impairment?

One of the first questions you’ll see on most life insurance applications is whether or not the applicant has Alzheimer’s disease, dementia or any form of cognitive impairment. In most cases, a “Yes” response is often the precursor to declining your policy. However, understanding these impairments will help get your client full consideration – and potentially a policy in hand.  

 

The word dementia is really just a general term used in describing symptoms caused by disorders of the brain. Symptoms are things like memory loss, or difficulties with thinking, problem solving or language.1 The most common type of dementia is Alzheimer’s disease. Typically, if you have been diagnosed with end-stage dementia or Alzheimer’s disease, the condition has progressed enough that it interferes with activities of daily living. This decline in cognition is severe enough to generally exclude consideration for traditional life insurance plans.

 

Get the Facts

Mild Cognitive impairment or MCI is a decline in memory and personality that could produce alterations in judgment, behavior and language. Mild cognitive impairment is a disorder that presents with measurable memory decline, but the client is able to independently perform all usual activities of daily living successfully. This is not to be confused with basic forgetfulness or not being able to recall a name on occasion. However, it’s important to understand the signs and symptoms. In fact, there are several causes of mild cognitive impairment that are actually reversible. To name just a few: thyroid dysfunction, vitamin deficiency, medication side effects, sleep disorders and even stress.
 

In general, a medical workup for cognitive impairment will include:

  • A thorough review of medical history, where the physician documents current symptoms, previous illnesses and medical conditions, and any family history of significant memory problems or dementia.
  • Assessment of independent function and daily activities, which focuses on any changes from a person's usual level of function.
  • In-office neurological examination to assess the function of nerves and reflexes, movement, coordination, balance and senses.
  • Evaluation of mood to detect depression; symptoms may include problems with memory or feeling "foggy." Depression is widespread and may be especially common in older adults.
  • Laboratory tests, including blood tests and imaging of the brain's structure.

 

If the workup doesn't create a clear clinical picture, the doctor may recommend neuropsychological testing, which involves a series of written or computerized tests to evaluate specific thinking skills.2

 

Underwriting Assessment

To help best negotiate a life insurance offer, we must work together to determine the actual diagnosis and how it was made. We must understand the severity of the client’s symptoms or lack even lack thereof.

 

It’s important to highlight all of the favorable factors. This would include having regular preventative health care and immunizations, as well as compliance with any prescribed medications. You should also make note of a routine that involves gainful employment, regular exercise, hobbies, participation in social activities and the ability to travel or take vacations. It also helps to point out if there are any family members with longevity as well. 

 

What does this all mean for your clients’ chances of securing life insurance? Carriers are continually re-evaluating their manuals when it comes to older age underwriting and cognitive impairment, giving more opportunity to secure affordable life insurance.  

 

Clearly, many factors need to be taken into consideration for underwriting, and Ash Brokerage is here to help. To help assist you in gathering the needed information, we have developed a Cognitive Impairment Questionnaire. Give our experienced underwriting staff a call to discuss your case.  

 

About the Author

Dianne Leidigh has earned an unwavering reputation, among customers and constituents alike, as a respected partner and trusted resource. Through her personal commitment to continuous professional growth, she’s become an Associate of the Life Management Institute, Associate of Customer Service with LOMA, and an Associate of the Academy of Life Underwriting. As Dianne approaches her second decade in the brokerage life insurance industry, much of which dedicated to advocating risk, her passion for helping others, commitment to personal growth, and perseverance continues to yield truly winning solutions!  

 

Learn More

Ash Brokerage Cognitive Impairment Questionnaire: https://ashcmsstorage.blob.core.windows.net/media//Docs/uw/impairment/Mild_Cognitive_Impairment.pdf

1Alzheimer Society Canada, “What is dementia?”: http://www.alzheimer.ca/en/About-dementia/What-is-dementia

2Alzheimer’s Association, “Mild Cognitive Impairment”: https://www.alz.org/dementia/mild-cognitive-impairment-mci.asp