Client Visit:

The ability to accurately predict and price the health care needs of an individual has always been challenging. In addition, many carriers are concerned about rising claim costs and product management. The Producer has an important role in this analysis of the client’s eligibility for LTCi.
If an underwriter lacks a complete understanding of a client’s health, the client may be declined.

No amount of money will purchase long-term care insurance once the applicant is uninsurable due to a significant physical or mental health problem.

Field underwriting means the Producer has an in-person interview with the client. During this interview the client is assessed based on:

• Eligible age – over 18 and below the top age limit of carrier(s)
• Not residing in a nursing home, assisted living facility or receiving home care or attending adult day care
• Not currently on Medicaid – ability to pay premiums
• Height and weight – observe and use build charts
• Smoker or non-smoker – current and recent tobacco use
• Health status – when was last physician exam, recent major surgeries or planned treatments, medical statement on application and discussion with client about history
• Prescription drugs – review Underwriting Guide for impairments
• Disability or worker’s compensation – current or recent history
• Functionality – without assistance from another individual or mechanical device (e.g. walker, quad cane, wheelchair, oxygen, dialysis)
• Cognition – no signs of memory loss, confusion or forgetfulness
• Social support – spouse or family in the household
• Social activities – out of the house, participating with others
• Exercise tolerance – mobility, transportation, shopping, housework

Always ask, “Is there anything else?”

Remember, field- or pre-underwriting is not an exact science. It is just a rough estimate of your client’s situation. Final decisions are always based on medical records and what the underwriter feels is acceptable.

The combination of observation of the client, assessment of abilities, and completion of the application by the Field Underwriter (Producer) will provide the underwriter with the tools to successfully make a determination.