Sarcoidosis- What is it?
Sarcoidosis is predominately a lung disorder, characterized by rounded microscopic, tumor-like masses of inflammatory cells in the lungs or lymph nodes.
It is a chronic disorder of unknown cause. Patients may exhibit signs of cough, difficulty breathing, or skin lesions called erythema nodosa. Frequently they are asymptomatic and present when an abnormal chest x-ray is taken for another reason. Besides the lungs and lymph nodes, sarcoidosis may involve the skin, liver, spleen, salivary glands, eyes, heart and nervous system.
Sarcoidosis most commonly affects indivdiuals between the ages of 20 and 30 and affects men twice as often as women.
Sarcoidosis and Life insurance underwriting
When an insurance company evaluates an individual for life insurance who has a history of sarcoidosis that will want to review the medical records of the applicant.
The medical records will help the underwriter evaluate the risk class to place the applicant. Most often these records will contain information regarding the staging of the sarcodosis. The staging is usually represented by stage 1, stage 2, stage 3 or stage 4. Typically, the lower the stage of the sarcoidsis the better chance of a favorable rating.
As mentioned earlier the staging of the disease is made by history, chest x-ray and mircroscopic findings of non-caseating granulomas (round masses). A biopsy will establish the diagnosis in 90% of those with stage 2 or stage 3 disease. If that biopsy is negative, a mediastinal node biopsy will establish the diagnosis in 95% to 100% of patients.
In regards to remission of sarcoidosis, the staging of the disease typically helps identify the remission rate 2 years after diagnosis. Stage 1 is 75% remission rate, stage 2 is 50% remission rate and stage 3 is 33% remission rate.
Unfortunately, any stage 4 diagnosis of sarcoidosis will be a declination from most all life insurance carriers.
Often times low dose corticosteroid is the standard treatment for symptomatic sarcoidosis. With the high rate of spontaneous remission, asymptomatic patients even with positive x-rays are often not treated with steroids. The prognosis is good for 85-90% of patients who only have a 10-15% progression of the disease.
From a life insurance underwriting standpoint, the progression of the disease is vital to final risk evaluation.
Table ratings on life insurance applicants with sarcoidosis
A table rating is a classification that insurance companies use to identify an individual’s risk. If someone applying for life insurance protection is evaluating at higher than the standard underwriting risk class a table rating is typically assigned. Table ratings generally add 25% additional premium above the standard risk class for each table assigned.
As an example, lets say you apply for coverage and the underwriting company comes back with a Table B rating on your policy. This would indicate that you are going to pay approximately 50% above the company’s standard printed rates for your age and sex. A Table C risk class would indicate a 75% rating above the company’s standard risk class.
Most life insurance companies will underwrite up to a Table H (200%) before declining an application for coverage.
But, it is important to remember that not all life insurance carriers underwriting sarcoidosis the same. In fact, it is the underwriting of this condition that makes finding the right company the most important factor.
One company may decline any or all applicants with sarcoidosis. While another company may offer a Table B for someone with sarcoidosis. This makes it vital to only use a broker who specializes in the companies that underwriter this condition the best.
Examples of Underwriting sarcoidosis
Stage 2 and Stage 3 applicants who have gone into remission will have their mortality affected by the extent of their residual impairment evaluated by pulmonary function test.
- Stage 1– 6 months to 2 years typically rated Table B. After 2 years could be standard.
- Stage 2– 6 months to 2 years typically rated Table E. After 2 years rated by pulmonary funtion test results.
- Stage 3– 6 months to 2 years typically declined. After 2 years rated by pulmonary funtion tests.
- Stage 4– Declination
Also, it is important to remember that if still currently on steroid medication, one or two tables is typically added to the the above rates. Involvement of other than lung, nodes, eye, skin or liver will be individually considered.
Who are the best life carriers for sarcoidosis?
As mentioned earlier there are specific companies that underwrite the risk of sarcoidosis better than others. These companies are known in the insurance world as “special risk” life insurance carriers. This means not only do they underwrite preferred risks but also have a speciality in the market for individuals with pre-existing medical condition’s, high risk hobbies or foreign travel.
Here are a few of the carriers that often times do the best job underwriting this particular risks:
- American General Life
- Banner Life
- Prudential Life
- United Of Omaha
- Lincoln National
- North American Company for life & health
- Phoenix Life
- Principal National Life
- Protective Life
Questions for underwriting sarcoidosis
Getting preliminary questions answered up front can help speed along the process and pinpoint the best carrier for underwriting sarcoidosis.
Here are some of the questions that are typically asked:
- Date of birth?
- Date of first diagnosis?
- Was a biopsy done?
- How was sarcoid treated?
- Date treatment was completed?
- Use of steroid?
- Taking any medication including inhalers?
- What organs are involved? I.E. lungs, heart, liver, eyes, etc.
- Results of recent pulmonary function test? FEV1 or FVC test
- Any evidence of recurrence or progression?
- Have you used tobacco in last 5 years?
- Any other major health conditions such as diabetes, heart disease, cancer?
In addition to the above information it will also be important to know the amount of coverage needed and the type of plan considering? (Term or whole life)
We are experts in the field of special risk underwriting. Thank you for reading this blog. If we can assist you in finding affordable coverage, please don’t hesitate to contact us at 1-888-393-9003 or firstname.lastname@example.org