To ensure fairness in insurance pricing, companies select and classify insurance applicants according to degrees of risk. They rely on studies of large groups with similar characteristics to make that determination. Factors such as age, health and functional capacity, among others, all affect claims and ultimately influence the premiums charged.

While the application is the basic source of information, we may request additional information before completing the underwriting (eligibility) process. Be assured that only information having a direct bearing on your eligibility for long-term care insurance will be requested. If a cost is involved, the company will normally cover that expense.

For example, they may ask for the following:

Medical records from your doctor,
or perhaps from a specialist you may have seen or are seeing
We would ask for copies of your physician’s office records for the last five years. This report also provides us with a physician’s insight, which can help us greatly in our assessment of your medical history. In order to ensure a more timely underwriting decision, please encourage your doctor to provide this information as quickly as possible.

Face-to-Face Interview
If required, a specially trained health care professional will conduct a face-to-face interview in your home. The interview will include questions about your daily activities and all medications taken. Names of doctors you have recently seen, and your vital statistics (height, weight, blood pressure), will be verified. A short-term memory evaluation designed to determine cognitive abilities will be administered.

If this interview is requested, an approved examiner will call you to schedule an appointment at your convenience.

Here’s how to prepare for the interview, which will usually take about 30 minutes:

• Have the names, addresses, and phone numbers available for doctors/specialists you have seen

• Have details ready about hospitals or facilities in which you may have been confined

• Have the name, dosage and reason for taking each of your medications available. (Having the containers nearby will be helpful)

Note: To avoid distractions, family and friends should NOT be in the same room during the interview.

The company will then review all the information to determine your eligibility for coverage.

If the medical information we receive results in a higher premium, modified benefits, or if we decline to issue you coverage, you or your physician may question the appropriateness of our decision. Please keep in mind that your physician and our medical underwriters perform assessments with different perspectives in mind.

We are concerned about the long-term implications of all medical factors. Your physician focuses on your present health status, while the company focuses on future medical implications. Your physician can follow your medical conditions over time, change the diagnosis, or adjust treatment accordingly. However, the medical underwriters will not change the risk classification if your health deteriorates over time.

The same price for similar risks is what underwriting process is all about. The company is committed to making informed, accurate, and fair decisions on all applications. In addition, we strive to complete the underwriting process as quickly and with as little inconvenience to you as possible. After all, the goal is to keep the cost of insurance as affordable and available to as many people as possible.