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Ask an Underwriter: Why should clients be screened for diabetes?


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November is American Diabetes Month and, ironically, the month for pumpkin pie! But … diabetes is about far more than skipping or modifying dessert. It’s a common condition affecting millions of Americans with potential life-threatening complications.

In fact, according to the American Diabetes Association, 29.1 million Americans, or 9.3 percent of our population, had diabetes in 2012, and 1.4 million Americans are diagnosed with diabetes every year.

So, even if your clients haven’t been diagnosed as diabetic or pre-diabetic, it’s important to understand the disease and its risk factors. One simple screening could save a life or a lifetime of complications! Unfortunately (or fortunately), their lab results can come back with surprising results.

 

Types of Diabetes

Type 1 diabetes

usually develops in childhood or adolescence (prior to age 30) and accounts for 10-15 percent of all cases. In Type 1, the cells in the pancreas responsible for producing insulin have either been destroyed or produce no insulin. Since no natural insulin is available, treatment involves injection of laboratory-manufactured insulin for effective control of glucose metabolism. Risk factors for Type 1 include autoimmune disease and a family history of diabetes.

Type 2 diabetes

is commonly associated with obesity and onset after age 30. A family history of diabetes is common, and sufferers probably inherit a predisposition to glucose intolerance, which is exacerbated by obesity. 

Gestational diabetes

starts or is first recognized in pregnancy, in a previously non-diabetic woman. It usually becomes apparent during the 24th to 28th week of pregnancy. Risk factors include family history of diabetes, obesity, birth weight over 9 pounds in a previous infant, unexplained death in a previous infant, congenital malformation in a previous child and recurrent infections. Thirty to 50 percent of women with a history of gestational diabetes develop non-insulin dependent diabetes within 10 years. 

 

Potential Complications

  • Diabetes Mellitus

    is a group of metabolic disorders characterized by chronic hyperglycemia from insulin deficiency or resistance, or both. It is usually irreversible and, although a reasonable lifestyle can be enjoyed, the late complications result in reduced life expectancy. Macrovascular disease leads to an increased prevalence of coronary artery disease, peripheral vascular disease and stroke. 

  • Neuropathy

    is damage to the small blood vessels that supply all nerves, causing numbness and tingling in the extremities, abnormal sensations and muscle weakness.

  • Nephropathy

    is a progressive kidney disease caused by damage to the capillaries due to longstanding uncontrolled diabetes.

  • Retinopathy

    is damage to the retina in the eye from microvascular changes which can cause blurry vision and, in extreme cases, blindness.

  • Proteinuria

    is the presence of excess levels of protein in the urine due to damage to the kidneys.

 

Testing – Hemoglobin A1C

The industry gold standard for identifying applicants with, and those at risk for, diabetes is an A1C screen. This test measures a person’s average levels of blood glucose, or blood sugar, for the past two to three months. It is measured as a percentage, and the ideal range is less than 5.7.

A hemoglobin A1C screen is stable, is not affected by glycolysis and does not require fasting, making it more reliable and accurate that a glucose test. These screenings can empower applicants to take control of their health, especially those who are pre-diabetic and have the chance to make life-saving changes.

So let’s all become aware – about diabetes or any disease. Ask questions. Educate yourself. Be an advocate for yourself and your clients. More importantly, know your number!

 

Learn More

Statistics About Diabetes, American Diabetes Association: http://www.diabetes.org/diabetes-basics/statistics/

 

About the Author

Debra Misko is passionate about her work and gratified to help clients find security for their family’s future. She has worked in underwriting for 21 years and has been with Ash Brokerage for more than eight years. A graduate of Schoolcraft College, she has a business degree and has also completed two of the Academy of Life Insurance Underwriting exams. 

 

UW Underwriting Diabetes

Why You Can’t Afford to Avoid Long-Term Care Planning


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Personally, I’ve seen two family members require long-term care, and those care events were emotionally, physically and financially draining for everyone involved. Planning ahead could have made a world of difference.

Professionally, I’ve seen an advisor’s relationship with his clients negatively impacted when he avoided discussing LTC. Again, a little planning could have made a world of difference …

A Missed Opportunity

About two years ago, I received a call from an advisor whom I’d been trying to connect with for months. He apologized for not returning my calls and emails, and he said he needed my help, which made my day.

The advisor, who focused primarily on investments, explained that recently, one of his top clients came into the office and laid down two linked benefit policies – one for him and one for his wife. The client said he was at the bank when the bank’s advisor pitched the policies to cover their future potential LTC expenses, in return protecting the rest of their assets. This made sense to the client and his wife, so they moved forward, using excess cash they had sitting at the bank.

The client brought the policies back to the investment advisor to see how they would fit into the couple’s existing retirement plans. The client said, “We purchased these from the bank advisor because we know you don’t deal on the insurance side.”

Not only was the investment advisor upset because he lost business, but he also felt he let his clients down by not helping them prepare for potential LTC expenses. He also told me these same clients starting moving their money away … to the bank advisor. He said, “I need to be brought up to speed about LTC planning and available solutions before this happens again.”

Moral of the story: If you aren’t having LTC discussions with your clients, someone else will.

 

Your Chance at Redemption

The concept of a three-legged stool is used a lot in our industry. We usually position three needs and point out that any two will have a hard time standing without the third.

This is a simple way to position LTC planning with clients. You may have done a great job of planning their retirement income and wealth transfer plans … But what happens if their health becomes compromised? Their income and estate plans could be ruined. Tell your clients, “This is why I would like to discuss a plan that addresses potential long-term care expenses.”

By positioning an LTC plan as protection for your clients’ assets and income, you’re showing them you care about protect everything they have worked so hard to accumulate over their working years. You’re showing them how to support all three legs of their stool.
Your LTC team at Ash Brokerage is here to help you in any way we can. We understand you’re busy with many other aspects of the financial planning process, and LTC planning may not be your main focus. Let us help you streamline the process and grow your business along the way.

When you’re proactively discussing LTC planning with clients, you’re a step ahead of your competition. Want to get started? Check out last month’s post on opportunities within your existing book of business [LINK] or give us a call.


About the Author

Mickey Belt has been in the insurance industry for about four years and has been able to assist many advisors with incorporating LTC planning in their practices. He views LTC planning as a value-added service that advisors can provide to their clients to protect their assets. Mickey is currently working his way through the Financial Services Certified Professional® designation through The American College.