Heart septal defects and life insurance

Can I get life insurance with a septal defects?

Septal defects are looked at differently by each life insurance carrier. In fact, all life insurance carriers have certain criteria that they use to evaluate health and lifestyle when underwriting coverage.

But, while all life insurance companies do underwrite differently, only a handful actually specialize in underwriting heart septal defects. So, the main question is not can I get life insurance with a septal defect, but who is the best company to go to if I have a septal defect?

Fortunately, you landed on this page. We know the top carriers specializing in underwriting septal defects along with other conditions such as heart by-pass history, heart attack history and stroke history.

Atrial and Ventricular Septal Defects- What are they?

The heart has four chambers: two atria and two ventricles. A wall, known as the septum, separates the two atria and the two ventricles. Cogenital holes in this septum allow blood to flow between the right and left sides of the heart. This abnormal flow of blood causes heart enlargement and failure. If left unchecked, it can lead to permanent heart and lung damage.

An atrial septal defect is a hole in the atrial septum. It is a common congenial defect that sometimes is not diagnosed until adult life. There are three sub-types of atrial septal defects, depending on the location of the opening:

  • Ostium secundum defects- midseptal location
  • Sinus venosus defects- high septum
  • Ostium primum defects- low septum

Secundum is most common. Primum defects are usually associated with other congenital heart lesions and have a poorer prognosis, than the secundum or sinus venosus type defects. In general, the smaller the hole, the better the prognosis is for all sub-types. Many small atrial septal defects do not need intervention.

Moderate to large  atrial septal defects may need surgical closure, which is ideally done in childhood. If the repair is completed before pulmonary hypertension or heart enlargement has developed, the prognosis is excellent. The risk of later complications, such as irregular heart rhythms, increases with repairs beyond age 20.

Ventricular septal defect is a hole in the septum between the two ventricles. It is a common congenital heart defect, too, and can occur alone or in association with other congenital heart lesions.

Many small and moderate size ventricular septal defects close spontaneously in childhood. Large ventricular septal defects are closed surgically to prevent complications.

Underwriting atrial and ventricular defects Heart Septal defects and life insurance

When underwriting life insurance for individuals with atrial or ventricular defects it is important to remember that defects associated with complications, such as heart enlargement, arrhytimias, or pulmonary hypertension, or other congenital heart lesions can often complicate they process and result in declination of coverage.

But, for the purposes of this article let’s look at the typical rating schedule for both atrial septal defects and ventricular septal defects:

Atrial septal defects rating schedule for ostium secundum or sinus venosus type, unoperated-

  • Small, asymptomatic typically non-rated
  • Moderate and large is typically postoponed until after age 25, then rated Table E. ( We will discuss below what the particualar table ratings indicate)


  • Ostium primum, unoperated is typically a declination

Operated atrial septal defects, no residual impairment-

  • Ostium secundum or sinsuvensosus typically non-rated to Table C, depending on age at repair.
  • Ostium primum typically postponed for one year from date of surgery, then Table B to Table C, depending on age at repair.

Ventricular Septal Defects rating schedule unoperated-

  • Small- non-rated
  • Moderate- Table C
  • Large- Typically declination 

Operated ventricular septal defects, operated, no residual impairment-

  • Non-ratable to Table C, depending on preoperative size. 

What are Table ratings?

Life insurance companies use something called a table rating to assign risk to a medical condition or conditions. Most life insurance companies use the alphabet to designate what their table ratings are for a particular cases. Some using a numerical number to designate their rating.

Here is an example of what an insurance companies ratings mean.

All individuals who apply for coverage are approved at a certain rating. For someone in excellent health they might receive a preferred best rating class. Someone in good health might get a preferred rating class, while someone in average health might receive a standard rating.

Now, the Table rating classes begin after the standard class. Each table rating issued above the standard rate class usually adds a 25% surcharge to the base standard rate for that particular company. So, if you received a Table rating A you would be paying 25% more than the standard rate charged for someone your age and sex.

Someone who receives a Table B rating would be getting a 50% surcharge added to the standard rate for someone of their age and sex. This table rating system or numerical rating system (Table 1, Table 2, etc.) will usually go as high as a Table 8 before you are just flat out declined an offer for coverage.  Table 8 would be a 200% rating above the standard rate class.

So, as you can see from this  and using the information from above most atrial and septal defects would come in somewhere around the Table B to Table E if small to moderate size.

Now, in regards to what this means as far as actual premium dollars you would have to get a quote from the particular carrier to find out the exact rates for your risk class.

Best way to get a quote-

Underwriting a life insurance policy for someone with some medical history such as atrial or ventricular septal defects is a bit different than underwriting someone with no medical history.

You see, you do not want to just apply to a half a dozen carriers and see which one sticks, if any. The reason is if you apply to 5 or 6 carries and those particular carries do not specialize in underwriting atrial and ventricular defects you will just end up with a bunch of declination’s in your Medical Information Bureau file.

This actually hurt’s your chances of getting a viable offer from a company that might make an offer. Why? Well, life insurance companies are not in the business of spending money on underwriting a policy if they see you have applied to many different insurance companies and been declined.

Each company has access to the medical information bureau and can see what action has taken place on other applications. It cost them money to pay an underwriter, order medical records, lab reports, etc. and then not get a policy completed.

The better way to apply for this coverage is to use a broker who has access to multiple companies. Then let your broker gather your medical information and speak independently by phone to the underwriter to find out if they would even be interested in giving a quote on your case.

If your broker finds a carrier willing to make a tentative offer, then and only then should you formally apply and complete medical requirements. This also saves you alot of time and aggravation on being declined by other companies.

Questions needed to quote coverage-

Here are some basic questions that your broker would need to provide you with tenative quotes of protection:

  • Date of first diagnosis?
  • Type of septal defect?(I.E. atrial, ventricular, primum, large, small)
  • Has surgical repair been completed? If so, when?
  • Any other congenital defects present?
  • Any other heart issues apply? (I.E. heart enlargement, pulmonary hypertenison, arrythmias, etc.)
  • Any medications?
  • Used in tobacco in last 5 years?
  • Amount of protection needed?


If you are in the market for life insurance protection and have medical issues such as atrial or ventricular septal defects then give us a  call at 1-888-393-9003 or e-mail mike@specialriskterm.com






About SpecialRiskTerm.com
About SpecialRiskTerm.com

We work with individuals across the nation to secure the best life insurance rates.

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