When would an attending physicians statement be appropriate for life insurance purposes?

When applying for life insurance, the company that issues your life insurance policy needs to know how healthy you are before a policy is issued. Life insurance company often evaluates your health status by requesting an attending physician statement (APS). Before your insurance policy is finalized, you will have to submit information about your health, medical history, lifestyles, and take a medical exam. The health information you provide to the insurance company issuing the life insurance policy will be used to determine your risk. The risk score is used to judge your likelihood of developing illness or other medical conditions. Higher risk scores will mean a higher premium since you pose a higher risk. If your risk is too high, the insurance company may not issue a life insurance policy. Part of the APS is to get documents from your physician or healthcare providers. Your healthcare provider will be best suited to provide a comprehensive review of your health. The APS is a standard summary of your overall health, medical history, and any known medical conditions the insurer will need to know. The APS servers as a means to document and assess your risk to the insurance company.

What is in an APS statement, and what are the typical form look like?

The insurance underwriting process starts when the insurer begins to determine how much insurance you need and generate a premium quote. The accuracy of an insurance policy, and the premium is partly based on the APS. Since the APS will contain sensitive patient health information (PHI), it must adhere to all HIPPA regulations and guidelines to safeguard patient medical data. Your healthcare provider will submit paperwork that describes your condition, any medication use, and any health-related issues.

A typical APS will contain history of any medical conditions and prognosis. The doctor will explain your medical history by noting how long you have been treated, what are the symptoms, and what other treatments you might have had. Along with your medical history, APS will contain the prognosis of your condition detailing your health status if you’ve made any improvements or not since treatment began. If you have multiple healthcare providers, the insurer will likely request your medical information from all healthcare providers you have had in the past that have treated you.

Collating APS is a lengthy process

Applying for life insurance can be a lengthy process. One reason for this is because the process to obtained APS can be extensive. The insurer will have to process and extract APS from multiple healthcare providers before they can start the underwriting process. Doctors are very busy people and will take time to fill out paperwork that your insurer requested. The request can take two to four weeks to process and can hold the application until the request is completed. Not all medical practices use a standardized form. After your doctor does fill out the APS, it goes to the underwriter. The insurer will summarize and issue a report which can add more time before an insurance policy is issued.

Datafied specializes in APS retrieval by utilizing our extensive network of Certified Field Agents to retrieve medical records. Our extensive network and experience can help you reduce the amount of paperwork you need to chase down allowing your company to focus on customer service. Give our specialist a call at 800-765-7510 to learn how we can help.

UPDATED: Jun 24, 2022Fact Checked

When applying for life insurance, there is an underwriting process and sometimes that requires life insurance attending physician statement (APS). APS underwriting in life insurance begins after you’ve gathered quotes and applied for the insurance and is meant to explain the level of risk you are to the insurance company.

You probably have many life insurance underwriting questions, PPT, and policy issue questions including What does APS stand for in life insurance? What is APS summarization? What is the process of insurance underwriting? What do underwriters do? Can you underwrite your own insurance? (You can’t, by the way.)

If you’re curious about final expense insurance, APS BHCS, Chaucer underwriting APS/APS underwriting in general, or if buying term life insurance is the right option, an overview of the APS process is exactly what you need. When APS underwriting is required, it could help you get rates as low as $13.71/month.

What is an attending physician statement?

An attending physician statement is a testament by a hospital, physician, or medical facility that has treated or is currently treating an individual for their current or past health conditions. An attending physician statement PDF can be found on most insurance sites.

The APS underwriting is probably the biggest hurdle, time-wise, to the life insurance underwriting process as it must be completed and signed by your treating doctor, an already busy individual. Additionally, once the underwriter receives the report back, they need to prepare an accurate summary of the attending physician’s statement, which calls for a skilled underwriter in the first place.

APS underwriting can take anywhere from four to six weeks.

As of lately, with COVID-19 dominating the news cycle, some insurance carriers are shifting how they approve policies. Some have postponed the approval of insurance policies for those 70 and over, and those 60–69 are being carefully reviewed.

What does the attending physician statement reveal?

Each insurance company has its own APS insurance underwriting requirements and forms. However, you should expect a four-part, in-depth examination of your health conditions. When underwriting insurance for clients, underwriters need to know the following:

• History – questions about the time when the condition first developed
• Diagnosis – dates of examination by the physician, including any complications
• Treatment – the type of remedy, frequency, and first and last visit
• Progress – Are any of the medications or treatments working?

It’s also important that you are truthful on the applications that you fill out.

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Why does a life insurance company order an APS statement?

Many clients ask these questions. Some might even say, “I’ve had my interview for the APS life insurance underwriting. They did a background check and also took my blood and urine. What do life insurance underwriters look for? Why do they need this APS?”

They might have drawn your blood or analyzed your urine. What do life insurance companies test for in underwriting? What is the medical underwriting process? Well, the collected blood and urine samples are screened for blood lipids, blood sugar, liver and kidney function, nicotine, HIV, and illegal drugs. But, they aren’t a final picture of your health.

Adding an APS to the mix can support the results from your test or sometimes show abnormalities that aren’t evident via a blood test. The good news is, after the APS review, the underwriter will come back with a final offer. Think of an APS as the last requirement for a final resolution.

When does the life insurance company order an APS?

Note that most companies are not interested in ordering an APS due to the increased costs and underwriting processing time. Besides, in many cases, the medical exam results, along with the other reports (MIB, MVR, RX), are more than enough to assess your risk and determine your eligibility for coverage.

Some companies are actually considering obtaining records at the time of application rather than waiting for physicians’ reports in this case study.

A Few Cases for Which the Carrier Will Order the APS Regardless of the Exam:

• Medical impairments – Many times, regardless of face amount or age, an insurance company will order an APS if an applicant has had a history of or consulted with a physician about any of the following conditions (not limited to these conditions only) in the past 10 years:
  • Abnormal cardiac test
  • Blood disorder
  • Cancer
  • Crohn’s disease
  • Diabetes
  • Hepatitis
  • Lupus
  • Mental disorder
  • Rheumatoid arthritis
  • Sleep apnea
  • Stroke
  • Suicide attempt
• Age and amount limits – There are other times in which there are no present or past health impairments, but a combination of a large death benefit amount and older age (typically over the age of 50) will trigger the underwriter to order an APS. For instance, an applicant age 51 or older seeking $5 million in coverage will require an attending physician statement with some companies. Other applicants ages 66 and older will also require an APS for all face amounts.

An APS may be required in any case at the underwriter’s discretion. If you were seen by a physician in the past year. If you were seen by more than one physician, the life insurance company could order an APS from all treating physicians. If you’ve had general testing such as colonoscopy before age 50, mammogram before age 40, or MRI, the underwriter will request an attending physician statement.

How long does it take to get an APS?

Any time an insurer orders an APS, you should add another two to four weeks to the underwriting processing time. It’s a good idea to call the doctor’s office and ask them to fill out the report, especially if you have a good relationship with your doctor.

Lastly, many carriers use a service company such as EMSI. This is not only cost-effective but, by knowing what types of authorization providers require and how they prefer to receive requests, it can reduce the processing time tremendously.

Do companies still order an APS if I buy a no-exam policy?

If you apply for simplified issue life insurance like final expense insurance, for instance, your eligibility is determined by your answers on the application (which are yes or no), and the underwriter will not order an APS.

Nevertheless, if you buy term life insurance as no exam life insurance, which has a higher death amount than the final expense type of coverage, the underwriter will order an APS if some of the conditions such as medical impairments apply to you.

How common is the attending physician statement?

The attending physician statement, or APS, isn’t a requirement for going through underwriting in most cases. However, in some circumstances, it could be the final determination in issuing, declining, or rating up a policy such as short-term disability.

Perhaps you do have a disability. APS underwriting would take that into consideration with the proper documentation. The assessment is performed in various ways. The most notorious of which are the insurance medical exam, Department of Motor Vehicle reports (MVR), Medical Information Bureau reports (MIB), prescriptions database check (RX), phone interview (PHI), written inspections, and the most time consuming one: the APS.

You may also be curious as to which medical records life insurance companies check. How do life insurance companies check medical backgrounds? Life insurance companies check self-reported data and then the information you release from your doctor. Underwriters also have access to records from the Medical Information Bureau — or MIB reports.

What is an emergency physician statement?

An emergency physician is accredited to practice emergency medicine. It appears that an emergency physician’s statement is a bill or statement from the procedure.

Shopping for Life Insurance Quotes with an Attending Physician Statement

If you’re shopping for life insurance quotes, and you’re not sure where to start, it’s always good to begin with the top life insurance companies. The following insurance companies are in the top 10.

• Northwestern Mutual
• New York Life
• Metlife
• Lincoln National
• Prudential
• MassMutual
• Aegon/Transamerica
• John Hancock
• State Farm
• Minnesota Mutual

These are the larger companies from which you probably see advertisements and can secure some of the most competitive rates even with an attending physician statement.

Sample Annual Life Insurance Rates

Now, let’s look at some rates for non-smokers from the top 10 companies:

Compare those rates with the higher rate smokers would pay.

Although these prices vary somewhat, they seem quite reasonable.

What is the underwriting process in life insurance?

So, you may be wondering what is the need for underwriting in insurance? According to Investopedia, APS insurance underwriting or APS for underwriting occurs when an institution takes on financial risk. This financial risk could be a loan (by a bank) or, in our case, life insurance. APS life insurance underwriting is a key component in the process of applying for a loan or for life insurance.

Some might wonder about the format of the APS. An attending physician statement life insurance template, sample, or PDF during underwriting might all look different. One APS from a doctor might look different from another.

A physician statement form or a generic attending physician statement form might be required during underwriting.

A popular Google request is “attending physician statement short term disability” which encouraged us to look into APS and short-term disability. According to a variety of short term disability claim processes, an APS is often required.

What is an underwriter?

Life insurance has risks. An underwriter is a member of a financial institution that evaluates the financial risk of the person applying for the loan, mortgage, or, in our case, insurance, and medical underwriting.

During the underwriting process, they evaluate the financial risk of the applicant and assess their application. There are all types of financial underwriters (loans, mortgages, etc.), but in our case, we’re discussing the insurance underwriter.

What is the life insurance underwriting process?

Life insurance underwriting is where your approvals, denials, and premiums are determined. The underwriter evaluates risks associated with your policy application and with you as an applicant. A healthier person poses less of a risk to a life insurance company. A life insurance company can include a medical exam. According to a sample from Legal & General America Companies, a health and life insurance exam is required for term insurance in the older demographics.

Here are some tips for passing the life insurance exam according to LifeInsurance.org as to what companies test for:

• Maintain a lower blood pressure by avoiding excessive exercise and getting plenty of sleep the night before.
• Avoid excessively salty or fatty foods to avoid a spike in cholesterol.
• Only drink plain water six to eight hours before the exam. Even consuming a slice of fruit might make your blood sugar spike.
• Stay away from over-the-counter drugs to avoid potential side effects, 24 hours in advance of testing.
• Completely avoid alcohol before testing, as alcohol can spike liver enzymes for testing.
• Schedule the exam for the least stressful part of the day.

Taking these steps into account can help you have a successful life insurance exam.

APS Underwriting in Life Insurance: The Bottom Line

Insurance companies will use every advantage in their arsenal to accurately evaluate an applicant’s overall risk and determine their eligibility for coverage. While it may take a little longer if they choose to order an attending physician statement, you actually should be glad they did.

Here is why: If they went through all the trouble of getting an APS, conducting the exam, reading all the reports from MIB, MVR, and issuing you a policy, it means your policy is robust and is less likely to be contested.

Want to know more information about life insurance quotes? Now that you’re up-to-date about APS underwriting in life insurance, you can start viewing companies that have cheap life insurance rates.

Frequently Asked Questions: APS Underwriting in Life Insurance

Here are a few FAQs that you can consider when learning about the APS underwriting process.

#1 – What are some life insurance exam questions?

Here are some sample questions underwriters might ask:

• What are your age and gender?
• Has your weight shifted by more than 10 pounds in the last year?
• Have you ever had an organ transplant?
• Do you smoke tobacco or use nicotine?
• How often do you skydive?

They take into account healthiness and your level of risk-taking.

#2 – Which of the following is an important underwriting principle of group life insurance?

In group life insurance, an important underwriting principle of group life insurance is that all individuals are covered.

#3 – What is the difference between a medical certificate & a physician statement?

A medical certificate is typically generated from a request from the patient and a physician statement is usually generated from the medical body investigating the patient, such as a life insurance company.

#4 – What is a fully underwritten life insurance policy?

A fully underwritten policy is when they do blood and urine sample checks, in addition to checking your height and weight. A no-exam policy is an alternative to a fully underwritten policy, where you wouldn’t have a physical exam.

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