Protection Products

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


Protection

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

Ask an Underwriter: Are Breast Cancer Survivors Able To Get Life Insurance?


Protection

With an estimated 2.8 million women with a history of breast cancer in the United States and 246,660 new cases of invasive breast cancer to be diagnosed in 2016 alone, there is a very high probability you will be faced with protecting a breast cancer survivor in the future if you haven’t already.  

 

As a result of increased preventative screening – including regularly performed breast self-exams, routine mammograms, discovery of genetic predisposition testing and advancement in treatments – early detection is naturally higher. For that reason, many life insurance carriers have improved underwriting guidelines, leading to decreased postponement periods and more favorable ratings for clients with a history of breast cancer.

 

Underwriting Breast Cancer 

The key to successfully insuring your breast cancer survivor is understanding what information is important to enable your underwriting team to find the very best solution. 

  • Stage of the breast cancer
  • Date the cancer was diagnosed
  • Type(s) of treatment
  • Date of last treatment  

 

Additional questions that may help in your assessment: 

  • What was specific type of breast cancer? (Ductal Carcinoma In Situ/DCIS or Lobular Carcinoma In Situ/LCIS)
  • Any lymph node involvement?
  • Any metastasis (spreading of the cancer to other areas in the body)?   
  • Any relapses?
  • Any medications currently being taken? 
  • Family history of breast cancer? If so, any genetic testing? 

 

Additionally, one of the most important pieces of information will be whether or not the client is in full remission/cancer-free and when (month/year). The longer they have been cancer free, with regular follow-up and testing, the more favorable their offer may be.   

 

Postponement Period

For life insurance carriers to give consideration of someone who has a history of breast cancer, they must fully complete treatment (surgery, radiation, chemo) and often undergo a specific waiting period referred to as a postponement period (which varies based on stage of breast cancer). If they are past the initial waiting period, and they are taking hormonal therapy, such as Tamoxifen, Arimidex, etc., as part of their treatment plan, there would not be an additional postponement/waiting period for consideration. Everything will still depend on the stage of the breast cancer, type of treatment, and date of last treatment.   

 

Let Ash Brokerage assist you with your next breast cancer case – to simplify your fact-finding process, use our Breast Cancer Client Questionnaire and reach out to us for help. We leverage our experience, carrier relationships and resources to identify viable solutions based on your client’s individual circumstances and insurance needs.  

 

Dedication

On March 11, 2016, Kristina Alderdice lost her 10-year battle with breast cancer and we lost a sister of our Ash Brokerage Family. Kristina’s legacy lives on in all of our cherished memories and through her mission at Hope in a Handbag . The organization supports mastectomy patients with a necessities bag, which gives supplies and information to aid in their recovery, and also provides a resource for surgeons and nurses to improve communication with patients about the challenges of major surgery. To date, Hope in a Handbag has distributed more than 2,000 bags to women in northeast Indiana.

 

Learn More

 

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.

 

UW underwriting breast cancer cancer