Field Underwriting Manual (revised 12/18)

Page #
Underwriting Flash Sheet - Automatic Declines 4-5
Underwriting Guidelines and Procedures 6-10
Miscellaneous Information 11
Impairments
Acquired Immunodeficiency Syndrome (AIDS)/HIV 12
Alcoholic Cirrhosis 36
Alcoholism 13-14
Angina (Angina Pectoris) 39
Anxiety - Minor Affective Disorder 46
Arrest History (Felony Arrests, Misdemeanors) 15-16
Arteriosclerosis - Peripheral Vascular Disease (PVD) 67
Artery Disease, Legs - Peripheral Vascular Disease (PVD) 67
Arthritis, Osteoarthritis (Degenerative Joint Disease – DJD) 17
Arthritis, Rheumatoid 18
Asbestosis 19
Asthma 20
Back Disorder - Herniated Disc 21
Back Disorder - Spinal 22
Blood Pressure - Hypertension 58
Breast Cancer 24
Bronchitis, Chronic - COPD 35
Bypass Surgery - Coronary Artery Bypass Graft (CABG) 40
CABG (Coronary Artery Bypass Graft) 40
COPD (Chronic Obstructive Pulmonary Disease) 35
Cancer - General, Others 23
Cancer, Breast 24
Cancer, Cervical 25
Cancer, Colon 26
Cancer, Lung 27
Cancer, Melanoma - (see Skin Cancer also) 28
Cancer, Prostate 29
Cancer, Skin - (see Melanoma also) 30
Cancer, Uterine 31
Carpal Tunnel Syndrome 32
Cerebral Palsy 33
Cerebrovascular Disease (CVA)/Stroke 34
Cervical Cancer 25
Chest Pain - Angina 39
Chronic Fatigue Syndrome/Fibromyalgia 53
Chronic Obstructive Pulmonary Disease (COPD) 35
Cirrhosis, Alcoholic 36
Colitis, Spastic Colitis/Irritable Bowel Syndrome 37
Colitis, Ulcerative 38
AG-2735 (R12-18) 1
Colon Cancer 26
Coronary Artery Disease - Angina Pectoris 39
Coronary Artery Disease - Coronary Artery Bypass Graft (CABG) 40
Coronary Artery Disease (Heart Attack/Myocardial Infarction) 41
Crohn's Disease (Digestive Disorder) 42
Cystic Fibrosis 43
Degenerative Joint Disease (DJD) - Osteoarthritis 17
Depression, Major 44
Depression, Manic - Bipolar Disorder 45
Depression - Minor Affective Disorder (Anxiety) 46
Diabetes - Diabetes Mellitus (DM/IDDM/NIDDM) 47
Digestive Disorder - Crohn's Disease 42
Digestive Disorder - Spastic Colitis/Irritable Bowel Syndrome 37
Digestive Disorder - Ulcerative Colitis 38
Diverticulitis/Diverticulosis 48
Drinking/Alcoholism 13-14
Drinking & Driving - DWI/DUI 51
Driving Violations 49-50
Driving While Intoxicated (DWI/DUI) 51
Drug Abuse - Marijuana 61
Drug Abuse - other than Marijuana 52
Duodenal Ulcer 75
Emphysema - COPD 35
Epilepsy, Grand Mal (Seizures) 71
Epilepsy, Petit Mal (Seizures) 72
Fibromyalgia/Chronic Fatigue Syndrome 53
Gastric Ulcer 75
Glomerulonephritis - Chronic Kidney Disease 54
Grand Mal Epilepsy 71
HIV (AIDS) 12
Heart - Angina 39
Heart Attack - Myocardial Infarction 41
Heart Bypass - Coronary Artery Bypass Graft (CABG) 40
Heart Valve Replacement 55
Height & Weight - Overweight also see Build Chart 65
Hepatitis - A, B & C 56-57
Herniated Disc (Back Disorder) 21
High Blood Pressure (HBP) - Hypertension 58
Hypertension - High Blood Pressure (HBP) 58
Irritable Bowel Syndrome/Spastic Colitis 37
Kidney, Chronic Disease - Glomerulonephritis 54
Kidney Stone 59
Lung Cancer 27
Lupus 60
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Major Depression 44
Manic Depression (Bipolar Disorder) 45
Marijuana 61
Melanoma 28
Mental Retardation 62
Minor Affective Disorder - Anxiety 46
Motor Vehicle Record - Driving Criticism 49-50
Motor Vehicle Record - DWI/DUI 51
Multiple Sclerosis (MS) 63
Muscular Dystrophy 64
Myocardial Infarction - Heart Attack 41
Osteoarthritis (Degenerative Joint Disease - DJD) 17
Overweight also see Build Chart 65
PVD (Peripheral Vascular Disease) - Arteriosclerosis 67
Parkinson's Disease 66
Peptic Ulcer 75
Peripheral Vascular Disease (PVD) - Arteriosclerosis 67
Petit Mal Epilepsy 72
Phlebitis/Thrombophlebitis 68
Prostate Cancer 29
Psychosis - Schizophrenia 69
Residency 70
Respiratory Disease - Asbestosis 19
Respiratory Disease - Asthma 20
Respiratory Disease -Chronic Bronchitis/COPD/Emphysema 35
Rheumatoid Arthritis 18
Schizophrenia - Psychosis 69
Seizure Disorder - Grand Mal Epilepsy 71
Seizure Disorder - Petit Mal Epilepsy 72
Skin Cancer 30
Sleep Apnea 73
Spastic Colitis/Irritable Bowel Syndrome 37
Spinal (Back) Disorders 22
Stroke/Cerebrovascular Disease (CVA) 34
Thrombophlebitis/Phlebitis 68
Tuberculosis (TB) 74
Tumors - see Cancer (there are several cancers listed)
Ulcerative Colitis (Digestive Disorder) 38
Ulcers - (Duodenal/Gastric/Peptic) 75
Uterine Cancer 31
Valve Replacement, Heart 55
Weight, Overweight also see Build Chart 65
Weight Loss Surgery 76

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4
5
 UNDERWRITING GUIDELINES AND PROCEDURES

AGE AND AMOUNT (A&A) REQUIREMENTS

For APS’s (Attending Physician Statements), oral tests, medical Exams, EKG’s (electrocardiograms), blood profiles, phone calls,
Inspections and MVR’s (Motor Vehicle Reports), the age and amount guidelines can be found on the Agency Resource Center
(ARC) and should be reviewed regularly for updates and current information.

ATTENDING PHYSICIAN STATEMENTS (APS)

An APS is required for applicants age 70 and up and for certain health histories. Always complete a HIPAA form for all
applications taken in the United States because they are required when ordering an APS.

HOW REQUESTED
APS’s are requested through service providers – AI Records for US and Canada and Konnect for New Zealand.

FOLLOW UPS
If the Underwriting Department has not received the APS within 20 days, a status request is sent to the service provider. When a
status is received, your agency will be advised through CAS and the Pending Underwriting Requirements Bulletin as to the status
and what action your agency needs to take. Be sure to check the vendor web site for updates – websites are listed on the ARC.

SUGGESTED ACTION BY THE AGENCY OFFICE

1) Contact the service provider with any additional information – i.e. Dr. name, phone #, maiden name, etc.
2) Follow up and assist them until you know the information has been received.
3) Sometimes it is necessary to have the applicant contact the physician to have the information released.

HELPFUL HINTS
Always provide the complete and correct name of the physician or medical facility. This includes the full name, street address,
city, state, zip code and, most importantly, the telephone number. It is also important to give the name of the clinic if that is
where the physician has their practice.
Always provide the medical identification number when applicable. This is especially important at medical facilities like Kaiser
and Cleveland Clinic.
Always submit the special authorization when called for by the facility having the medical records (i.e. Kaiser, Cleveland Clinic,
Veterans (VA) Hospitals, etc.).
Be sure to collect the HIPAA in the US.

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ORAL TEST GUIDELINES
These guidelines are as follows:
1. All ages on Non-Smoker plans up to $249,999
2. Ages 18-50 for face amounts from $100,000 to $249,999.
3. Any age with no dependents (spouse, fiancé, children) for face amounts $25,000 and up.

Applications requiring an oral test must have the bar code number provided to eApp. For Paper applications, affix the barcode
sticker to the application and the “Collectors Copy” or the “Insurance Company Copy” of the consent form submitted with the
application together with any state required Consent Form. See the AIL web site for the states that require an additional state
specific Consent form.
If an oral test is not received with the application, correspondence is sent to the agency with a message through CAS advising that
the agent needs to collect an oral test. Cases without an oral will be NO ADV’d, if not received by the bulletin date.

EXAMS
Requested for certain ages and face amounts and for certain health histories.

HOW REQUESTED
Exams are requested through service providers – APPS, EMSI, ExamOne, or Superior Mobile Medics in the U.S. In Canada the
exam vendor is ExamOne.
Know who your service provider is. Each Agency chooses their exam company from the above choices. Know their 800#,
website and local contact person. This information is on the Agent Resource Center (ARC), but if you do not know who your
exam company is, email the Underwriting Department at [email protected]. .

FOLLOW UPS
If the Underwriting Department has not received a status report from the service provider within 15 days, a status request is sent
to your exam company. When a status is received, your agency will be advised through CAS and the Pending Underwriting
Requirements as to the status and/or problem. If the exam is not received, a decision will be made to Incomplete the case or issue
it without the exam. Be sure to check the vendor web site for updates – websites are listed on the ARC.

SUGGESTED ACTION BY THE AGENCY OFFICE

1) Advise all applicants at the time of application that an exam with blood/urine could be requested.
2) When you are aware that an exam has been requested, contact the applicant to help make sure the exam gets scheduled.
3) Follow up with the exam service provider until you know the exam has been completed.

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MOTOR VEHICLE REPORTS (MVR)
MVR’s are automatically requested on male applicants ages 16-29 or amounts of insurance of $100,000 and up. The $100,000
includes base amount of insurance plus any ADB (accidental death benefit) and accident coverage (A71, A74).

MVR’s will be requested by Underwriting on any applicant with a history of a DWI/DUI. A Drug/Alcohol Qair should also be
completed for these applicants.

HELPFUL HINT
A driver’s license number should be provided on all proposed insureds that are of driving age (16 in most locations) having or
having had a driver’s license. If the proposed insured does not have a driver’s license, a reason should be given on the
application, and a Drivers License Qair completed. If the license is suspended, a reason should be given and the license number
given (most individuals with a suspended license know what the license number was).
If a MVR is needed and a license number is not provided, a call will be made to the applicant for the information. If we are
unable to contact the applicant by phone, a letter will be sent for the driver’s license information with a Pending Underwriting
Requirements message to the agency.

INSPECTIONS
Inspections are usually only required on cases of $500,000 or more, or for D50000 applications. The inspection report will
include questions to acquire information about the applicant’s financial condition.

HOW REQUESTED
Inspections are requested through EMSI

FOLLOW UP
If not received within 21 days a status is requested from EMSI and the application is held until status/problem is determined. If
assistance is needed from the agency, you will be advised on the Pending Underwriting Requirements.

SUGGESTED ACTION BY THE AGENCY OFFICE

When you are aware an inspection has been requested, contact the proposed insured and advise them that the inspection company
will contact them, usually by phone, for additional information.

LETTERS TO APPLICANTS
Letters to the applicant are necessary when information has been omitted from the application and we have been unable to contact
by phone to secure the necessary information, or sometimes for additional medical information. A Pending Underwriting
Requirements message is sent to the agency office explaining what is needed.

FOLLOW UP
The Pending Underwriting Requirements message is the only follow up.

SUGGESTED ACTION BY THE AGENCY OFFICE

When you receive the Pending UW Requirement message, contact the applicant and assist the applicant in returning the requested
information.

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CORRESPONDENCE TO THE AGENTS
Correspondence is sent to the agency office when Underwriting needs additional information or assistance with an application.
Example: an explanation of the need for the amount of the insurance applied for.

FOLLOW UP
The correspondence will include a deadline for receipt of the required information to give you time to gather answers before UW
takes further action.

SUGGESTED ACTION BY THE AGENCY OFFICE

Handle as soon as the correspondence is received in the office.

PHONE CALLS TO THE APPLICANT

Phone call requests are sent to the Underwriting Phone Team when missing and/or additional information is needed. The Phone
Team makes several attempts to contact the applicant as well as leaving an 800 number (800-411-8808) in order to secure the
information. If the telephone number is incorrect, has been disconnected or the applicant has not returned the call, the file is
returned to Underwriting and they will either request the information by email, the Pending UW Requirements, or order a
requirement – usually an APS or exam.

SUGGESTED ACTION BY THE AGENCY OFFICE

Always be sure all questions on the application are answered, details are given for all “YES” answers. Be sure to advise the
applicant at the time the application is taken, that someone from the Home Office may be contacting them.

PENDING UNDERWRITING REQUIREMENTS (Underwriting Bulletin)

The agency office needs to handle all requests as soon as they are received. If there is no response to the Pending Underwriting
Requirements then the application may be incompleted and the premium returned. A Pending Underwriting Requirements
message will be entered for APS, exam, inspection, application problems and miscellaneous information needed.

FOLLOW UPS
There is no follow up to a Pending Underwriting Requirements item.

HELPFUL INFORMATION
1) The “Incomplete Date” is determined based on giving the agency a full 2 weeks to handle each case that is listed.
2) An extension may be requested for a pending requirement only if there is a good reason for needing the extension. A
reason must always be given when requesting an extension.
Example: You have determined that the information has been sent to a service provider 2 days prior to the INC date, or the
applicant has completed the exam the day of the INC date.

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QUESTIONNAIRES
There are medical and non-medical questionnaires that should be completed and submitted when applicable to a “yes” answer on
the application. If the questionnaires are not submitted with the application, then the file may still be referred to the Phone Team
for a phone call, need an APS or an exam. All questions on the questionnaires should be answered.
A completed questionnaire does not mean that an APS or exam will not be requested. But, for some impairments, with a
complete questionnaire, Underwriting is able to consider that application when other requested information is not received.
Copies of all the Questionnaires are on the Agency Resource Center. Please be sure you are only using the most recent
version of all Questionnaires.

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 MISCELLANEOUS INFORMATION
REOPENS
An INCOMPLETE cannot be reopened until the requested information has been received and reviewed. If an application is
incompleted because underwriting information was not received, and that information is received at a later date by the Underwriting
Department, the information will be reviewed and the agency office advised if the application couldn’t be reopened. If UW can
reopen the case, the policy will be issued and Policy Issue will advise the agent what is needed to put the policy in force (COD
amount, “Statement of Good Health,” currently dated application, etc.).
A DECLINED application cannot be reopened.
An application that has been NTO’d (not taken) may be reopened if the needed requirement is received within a reasonable amount of
time. Depending on the amount of time since the application was taken, Underwriting will advise if only the requirements are needed
(COD, amendment, etc.) or if a “Statement of Good Health” or a currently dated application is needed.
A WITHDRAWN application may be reopened depending on the reason for the withdrawal.

REINSTATEMENTS
These are handled by Policy Owner Service and referred to Underwriting when necessary. Underwriting reviews the request and
approves or denies the reinstatement or may request additional information (APS, exam, phone call, etc).

CONVERSIONS
CHILDREN’S RIDER (TLCR) – Most TLCR’s may be converted at the 5 times option on the policy anniversary date nearest the
child’s 21st birthday. 2001 CSO child riders use the policy anniversary AFTER the 21st birthday. Child Riders written after September
2006 are considered 2001 CSO. An application submitted prior to the policy anniversary date is only allowed for the amount of the
children’s coverage and is not considered a conversion, but additional coverage. Any additional coverage or benefits (WP, ADB, etc)
applied for on a “TLCR conversion” will require a properly completed application and will be underwritten.
SPOUSE RIDER (TLSR) - May be converted at any time prior to the expiration date of the rider for the amount of the spouse rider.
Any additional coverage or benefits applied for (WP, ADB, etc) will require a properly completed application and will be
underwritten.
TEN YEAR R&C RIDERS - May be converted at any time prior to the conversion date in accordance with the terms of the rider (2
years prior to age 65) for the amount of the rider. Any additional coverage or benefits applied for (WP, ADB, etc) will require a
properly completed application and will be underwritten.
DECREASING TERM RIDERS - May be converted prior to the conversion date of the rider in accordance with the terms of the rider
for the amount to which the rider has decreased. Any additional coverage or benefits applied for (WP, ADB, etc) will require a
properly completed application and will be underwritten.

NOTE: If applying for Non-Tobacco rates on a term conversion, an oral specimen should be collected. This is necessary to verify the
applicant is not a user of tobacco products.

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Acquired Immunodeficiency Syndrome (AIDS)/Human Immunodeficiency
Virus (HIV)

An immune function disorder caused by an infection with the Human Immunodeficiency Virus (HIV). Until
very recently AIDS was universally fatal. New methods of treatment are reducing symptoms and prolonging
life. As yet, there is no known cure. Of those individuals who have been infected with HIV, a substantial
portion will eventually develop AIDS. All persons who are diagnosed with AIDS or those who test positive for
the HIV virus, even though they are asymptomatic, are uninsurable.

LIFE A&H DISABILITY

H34000 A71000 A74000/D50000

UNDERWRITING ACTION: Uninsurable Uninsurable Uninsurable

Uninsurable

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Alcoholism
An alcoholic is an individual who is addicted to the use of alcohol and many have a long history of heavy
drinking. The non-addicted heavy drinker will have the capacity to curtail drinking when it begins to affect
health, job or family relationships. The fact that the alcoholic cannot curtail their drinking is evidence of
alcoholism. Most experts agree that alcoholism is a disease and the best method of treatment is complete
abstinence. Alcoholics Anonymous (AA), the most successful organization for the treatment of alcoholism,
teaches that complete abstinence is the only way to maintain long term sobriety. AA teaches that alcoholics
who are maintaining sobriety are recovering.

LIFE A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete See Life See Life See Life
an Alcohol Questionnaire and
Alcohol Exclusion Rider if
appropriate. An MVR is required.
An APS may be required in some
cases. An exam with blood profile
may also be requested.

OTHER FACTORS:
Abstinence from the use of alcohol Abstinence from the Abstinence for 1 A74000 - See A71000
for one year is required for use of alcohol for 5 year is required. D50000 - See H34000
consideration of life coverage. The years is required.
rate-up is determined by the number There must be no
of years of sobriety and whether associated medical
there is any associated medical problems or organ
problem or organ damage. damage.

A history of drug and See Life See Life See Life

alcoholism/alcohol abuse requires
the applicant to abstain from both
for at least 5 years before coverage
can be considered.

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UNDERWRITING ACTION:
Applicants who are recovering This policy excludes An Alcohol A74000 - See A71000
alcoholics can be considered for loss due to alcohol or Exclusion Rider D50000 - can only
coverage if they have been dry for 1 drugs. If the life can will be required on consider if Life can be
year. Range of rating may be T-8 be issued and there is applicants who approved standard.
(one year of sobriety) to possibly abstinence for 5 years have achieved 1-5
standard (5-8) years of sobriety. then usually the years of sobriety
Applicants with multiple DWI’s, 2 policy can be issued
within the last 5 years, the last standard.
within 2 years will not be
considered for coverage.

Recovering alcoholics who drink in

any amount are uninsurable.

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Arrest History – Felony / Misdemeanor
Felony – Any of several crimes, such as murder, rape, burglary, domestic violence, assault & battery,
aggravated assault, drug convictions, considered more serious than a misdemeanor and punishable by a more
stringent sentence.

Misdemeanor – An offense of lesser gravity than a felony, for which punishment may be a fine, probation or
confinement, in a local rather than a state or federal institution.

Depending on the charge, we may choose to Postpone coverage if the proposed insured is still “making
restitution”. When in doubt, a “trial app” is advisable.

When taking an application on a proposed insured with an arrest history, all questions on the Arrest
Questionnaire must be completed, providing as much detail as can be obtained. The exact charge should be
recorded. Some misdemeanor charges can be confused easily with more serious ones, e.g. “assault”. Given just
that word we could be dealing with “aggravated assault”, “assault to kill” or “assault and battery”, all much
more serious offenses. Always provide full details and circumstances of the arrest!!

LIFE A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete See Life See Life See Life
both the Arrest and Alcohol/Drug
Questionnaires. In some cases a
blood profile may be required.

OTHER FACTORS: See Life See Life See Life

In addition to the charge, other
factors are taken into consideration:
whether the offense was a single
episode or if there have been other
similar offenses (multiple episodes);
whether or not the proposed insured
is on probation, has received a
suspended sentence, has been
confined and released, or is on
parole; and the length of time since
the offense occurred.

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UNDERWRITING ACTION: If life can be See H34000 See H34000
Applicants with felony convictions approved at standard,
that required probation or parole then H34000 can be
must be declined if sentencing is approved at standard.
initiated for parole or probation If life requires a
within 5 years of the application rating, the proposed
date. Most applicants can be insured is uninsurable
approved at standard after for H34000.
completion of 5 years of parole or
probation.

Misdemeanor convictions require a

decline if initiation of parole is
within 1 year of the application
date. After 1 year, most
applications can be approved at
standard.

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Arthritis, Osteo (Degenerative Joint Disease - DJD)
Osteoarthritis occurs because of a “wear and tear” type of damage to the joints. This common impairment
usually begins after age 40 and causes little or no symptoms for years. Severe joint deformity may occur in
some cases.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete An APS may be See Underwriting A74000 - See Life
an Arthritis Questionnaire. An APS required. Action Below D50000 - See H34000
is not usually required. Information
from the applicant regarding the
degree of impairment, which joints
are involved and type of medication
prescribed, is usually sufficient for
Underwriting to make a decision
from the application.

UNDERWRITING ACTION:
Most cases will be issued standard. Cases with Approved unless A74000 - Most cases can be
Those with severe crippling may minor currently disabled. approved. More severe cases
require a rate up. symptoms can may require an Exclusion Rider
be approved on the affected joints. Very
standard. severe cases are usually
uninsurable.
Moderate and D50000 - Mild cases can be
severe cases approved. Moderate to severe
will require an cases are uninsurable.
Exclusion Rider
on the affected
joints.

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Arthritis, Rheumatoid
Rheumatoid arthritis is a systemic inflammatory disease of unknown cause that primarily involves the joints.
Still’s disease and juvenile rheumatoid arthritis are variants of rheumatoid arthritis. Significant systemic
complications, such as heart or lung disease and peptic ulcer disease, may accompany the inflammatory joint
symptoms. Treatment includes physical therapy, surgery, aspirin and other non-steroidal anti-inflammatory
medications, gold compounds, oral and intra-articular steroids such as prednisone, and immunosuppressants
(methotrexate). Oral steroids and immunosuppressants are reserved for more severe disease. The course of this
disease is highly variable. It can range from a single, brief episode, with little or no residual joint damage, to
chronic unremitting disease that leads to permanent, severe deformities and internal organ damage over a period
of years.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete See Life See Underwriting See Life
an Arthritis Questionnaire. An APS Action Below
is always required. Information
needed is the degree of impairment,
which joints are involved and the
type medication prescribed.

UNDERWRITING ACTION: Cases with minimal Approved unless A74000 - Cases with
Standard issue can be considered symptoms can be currently minimal symptoms can
for those cases with minimal joint considered standard 2 disabled. be approved. Moderate
involvement and no significant years after response to and severe cases are
systemic complications treatment. Others will uninsurable.
require a 75% increase in D50000 - See H34000
Mild to moderate cases usually premium and possible
range from T2 to T8. Severe cases Exclusion Rider on
are usually a high rating from T10 affected joints. Moderate
and up and could be uninsurable. and severe cases are
uninsurable.

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Asbestosis
There are several types of pneumoconiosis, which produce significant extra mortality. Pneumoconiosis is a
disease caused by the accumulation of dust in the lungs. Asbestosis is one type of pneumoconiosis. Asbestosis
is caused by exposure to the dust from asbestos. Before the use of asbestos was outlawed as an insulating
material, occupations such as boilermakers and heating and air conditioning workers were at risk to develop
asbestosis. The diagnosis of asbestosis is generally made with a chest x-ray, which may reveal diffuse fibrosis
(scarring), plural plaques or pleural thickening. Bronchogenic cancer of the pleura (lining of the lungs) and
peritoneum are cancers associated with asbestos exposure. Individuals with asbestosis who also smoke
cigarettes are particularly prone to the development of bronchogenic cancer.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS will always be required. See Life See A74000 - See Underwriting
Severity is determined by results of Underwriting Action Below
chest x-rays and timed vital Action Below D50000 - See Life
capacity (TVC) tests.

OTHER FACTORS: See Life See A74000 - See Underwriting

Cigarette smoking within 1 year of Underwriting Action Below
application date requires a decline Action Below D50000 - See Life

UNDERWRITING ACTION: Mild to moderate Approved unless A74000 - See A71000

Most cases would require a rating cases may require currently D50000 - See H34000
from T-2 to T-12. Severe or an exclusion rider. disabled.
extreme cases are uninsurable. Severe cases are
Occasionally a best case (minimal) uninsurable.
could be approved standard.

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Asthma
Asthma is a common respiratory disorder caused by an increased responsiveness of the bronchial passages to a
variety of stimuli. Airways are narrowed by bronchospasms, thick mucus and swelling of the bronchial walls.
This causes wheezing, coughing, and shortness of breath. Chronic obstructive pulmonary disease (COPD) may
also be present in asthmatics who have had this disease for many years. The agent should always complete a
Respiratory Questionnaire.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
A Respiratory Questionnaire should See Life See Underwriting A74000 - See Underwriting
always be completed by the agent. Action Below Action Below
Severity, date of last attack, and if D50000 - See Life
hospitalized will determine whether
an APS is required.

OTHER FACTORS: See Life See Underwriting A74000 – See Underwriting

Complicating factors are the Action Below Action Below
presence of COPD and smoking. D50000 – See Life
Status asthmaticus is the term for a
severe asthma attack that does not
respond to conventional therapy.
Hospitalizations for asthma are
usually due to status asthmaticus or
an uncontrolled attack.

UNDERWRITING ACTION: Mild/Moderate Approved unless A74000 - See A71000

Mild cases can be approved cases may be currently disabled. D50000 - See H34000
standard. approved
Moderate cases may be rated T-4 to standard.
T-6. Severe cases require a decline. Severe
Hospitalization within 1 year of the asthmatics are
application requires a postponement uninsurable.
for 1 year.

Status asthmaticus or
hospitalization for uncontrolled
asthma requires a decline if within 1
year of the application date.

20
Back - Herniated Disc
Herniation (protrusion or rupture) of the intervertebral disc may occur as a result of degeneration or trauma
(often unrecognized). This allows some disc fragments to extrude and press upon the nerve roots or peripheral
nerves. Most herniations occur in the lumbar region causing low back pain, often with radiation down the legs.
If prolonged, conservative measures fail, surgical intervention may be required.

LIFE A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
Musculoskeletal disorders usually The agent should always See H34000 See H34000
have little effect on mortality. complete a Back/Joint
Questionnaire. With details
provided a decision can, in
many cases, be made from the
application and questionnaire.
(See example in “Spinal (Back)
Disorder”)

If surgery has been performed,

the date is needed and whether
there is complete recovery and
no recurrence of symptoms.

UNDERWRITING ACTION: If no surgery was performed Standard unless A74000 - See

Most cases are approved standard. and injury was within 1 year of currently H34000
Waiver of Premium is excluded if application date or surgery was disabled, then D50000 - If no
currently disabled. performed within the past 1 will require an surgery was
year an Exclusion Rider is Exclusion Rider. performed or
required. After 1 year and full surgery was
recovery a Rider may not be performed in the
required. past 3 years, an
Exclusion Rider is
required. After 3
years and full
recovery a Rider
may not be
required.

21
Back (Spinal) Disorders
Sprain or strain of the spine is often the result of an acute musculoskeletal injury which may effect any portion
of the spine (cervical, thoracic, or lumbosacral). While painful and possibly disabling, recovery is usually rapid
with rest and conservative treatment. Low back pain is often attributed to strain of the lumbosacral spine and
occurs more often than cervical or thoracic injuries. If episodes of pain are recurrent, the possibility of disc
disease or other significant disorders increase.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION
NEEDED/
REQUIREMENTS: The agent should always fully complete a See H34000 See H34000
Musculoskeletal disorders Back/Joint Questionnaire. A decision
usually have little effect on can usually be made from the application
mortality. However when and questionnaire.
chronic pain is present
requiring pain medication Example: An agent can cause an
adverse underwriting action unnecessary exclusion rider by not
may be required. furnishing details. An example is an
answer such as “back trouble”, “back
pain” or hurt back”. In the absence of
additional details, this answer causes a
rider. An example of complete details is,
“Pulled muscle in back 1-3-98. Treated
with muscle relaxant and rest. Lost two
days from work but no problem since
January”. With this description, no rider
is necessary.

UNDERWRITING
ACTION: A single episode of sprain or strain of the Standard See H34000
Most cases are approved back will require an Exclusion Rider unless
standard. Some severe case within six months of the application date. currently
may receive a decline. A single episode more than six months disabled, then
Usage of a pain pump to ago probably can be approved standard. will require
deliver medication would an Exclusion
require a decline. Waiver Rider.
of Premium is usually
approved unless currently
disabled.

22
Cancer
We have provided specific guidelines for several of the most commonly encountered cancers. As the
definition below indicates, there are many types of cancers. We have made no attempt to list them all;
however, the below guidelines can be utilized for other cancers.

It is generally appreciated that “cancer” is not one disease but rather a diverse group of disorders. Within this
group, the prognosis is highly variable depending on the type of cancer, location in the body, the extent of
invasion of the tumor into normal tissues (stage) and the degree of malignancy (grade).

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See See Underwriting A74000 - See Underwriting
Cancer Questionnaire. An APS is Underwriting Action Below Action Below
always required and it must contain Action Below D50000 - See Life
a pathology report.

UNDERWRITING ACTION:
Most Cancers will require a 2 year Uninsurable Approved unless A74000 - See A71000
waiting period after surgical currently disabled. D50000 - Uninsurable
removal and/or completion of all
therapy before coverage can be
offered - others may require a
longer waiting period. Range of
rating may be from $5 to $15 per
thousand. The amount of extra
rating depends on the type, stage,
grade and location of the tumor.

Tumors which have metastasized

(spread to lymph nodes or other
parts of the body) generally are not
insurable for the first 10 years.

23
Breast Cancer
It is generally appreciated that “cancer” is not one disease but rather a diverse group of disorders. Within this
group, the prognosis is highly variable depending on the type of cancer, location in the body, the extent of
invasion of the tumor into normal tissues (stage) and the degree of malignancy (grade).

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See Life See Underwriting A74000 - See Underwriting
Cancer Questionnaire. An APS is Action Below Action Below
also required and it must contain a D50000 - See Life
pathology report.

UNDERWRITING ACTION:
Most Breast Cancers require a 2 Most cases of Approved unless A74000 - See A71000
year waiting period from the time of Breast Cancer currently disabled. D50000 - See H34000
surgical removal and/or completion are uninsurable
of all therapy before coverage can for a minimum
be offered. Applicants taking of 10 years.
Tamoxifin may be considered for
coverage. Range of rating may be
from $5 to $15 per thousand. The
amount of extra rating depends on
the type, stage, and grade of the
tumor.

Tumors which have metastasized

(spread to lymph nodes or other
parts of the body) generally are not
insurable for the first 10 years.

24
Cancer – Cervical (Cervix)
A PAP (Papanicolaou) smear is a routine diagnostic procedure performed to detect cervical cancer or its
precursor, cervical dysplasia. Cells are scraped from the surface of the cervix and examined under a
microscope. The results are expressed as "grades" or "classes". As the grade or class increases, the likelihood of
having or developing carcinoma of the cervix increases.

An important abnormality that may be discovered by a Pap smear is Cervical Dysplasia (cervical intraepithelial
neoplasia or CIN). This disorder is a precursor to invasive carcinoma of the cervix. Cervical dysplasia is
characterized by the replacement of normal cervical cells by abnormal cells. The extent of involvement is
graded as: grade 1 (mild), grade 2 (moderate), and grade 3 (severe). Treatment for cervical cancer may include
total abdominal hysterectomy.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See See Underwriting A74000 - See Underwriting
Cancer Questionnaire. An APS is Underwriting Action Below Action Below
always required and it must contain Action Below D50000 - See Life
a pathology report.

UNDERWRITING ACTION:
Some early cancers can be rated Most cases of Approved unless A74000 - See A71000
$5.00 for 3 years in the 1st year Cervical Cancer currently disabled. D50000 - Uninsurable
following the date of last treatment are uninsurable
or surgery. All treatment must have for a minimum
been completed and the applicant of 10 years.
thought to be cured. Others will
require a waiting period of 1-3
years. The range of ratings may be
$5 to $15 per thousand.

Tumors which have metastasized

(spread to lymph nodes or other
parts of the body) generally are not
insurable for the first 10 years.

25
Cancer – Colon
It is generally appreciated that “cancer” is not one disease but rather a diverse group of disorders. Within this
group, the prognosis is highly variable depending on the type of cancer, location in the body, the extent of
invasion of the tumor into normal tissues (stage) and the degree of malignancy (grade).

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See See Underwriting A74000 - See Underwriting
Cancer Questionnaire. An APS is Underwriting Action Below Action Below
always required and it must contain Action Below D50000 - See Life
a pathology report.

UNDERWRITING ACTION:
Most Colon Cancers will require a 3 Uninsurable Approved unless A74000 - See A71000
year waiting period after surgical currently disabled. D50000 - Uninsurable
removal and/or completion of all
therapy before coverage can be
offered. Range of rating may be
from $5 to $15 per thousand. The
amount of extra rating depends on
the type, stage, grade and location
of the tumor.

Tumors which have metastasized

(spread to lymph nodes or other
parts of the body) generally are not
insurable for the first 10 years.

26
Cancer - Lung
It is generally appreciated that “cancer” is not one disease but rather a diverse group of disorders. Within this
group, the prognosis is highly variable depending on the type of cancer, location in the body, the extent of
invasion of the tumor into normal tissues (stage) and the degree of malignancy (grade).

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a
Cancer Questionnaire. An APS is See See Underwriting A74000 - See Underwriting
also required and it must contain a Underwriting Action Below Action Below
pathology report. Action Below D50000 - See Life

UNDERWRITING ACTION:
Most Lung Cancers will require a 5 Uninsurable Approved unless A74000 - See A71000
year waiting period after surgical currently disabled. D50000 - Uninsurable
removal and completion of
treatment before coverage can be
offered. Ratings will usually be $15
per thousand. Smokers are
uninsurable.

Tumors which have metastasized

(spread to lymph nodes or other
parts of the body) are not insurable
for the first 10 years.

27
Cancer - Melanoma
Malignant melanoma is a cancer derived from pigment containing cells called melanocytes. Since the majority
of these cells are contained in the skin, this tumor is considered primarily a dermatologic malignancy. In these
cutaneous skin lesions, the cancer develops primarily in preexisting moles (although not always). However,
melanocytes can be found in a variety of tissues and, thus, melanomas can be diagnosed anywhere in the body.
All of these lesions tend to metastasize (spread to other locations) widely, resulting in substantial mortality risk.
Since surgical removal is the only effective therapy, early diagnosis and treatment is paramount to a good
outcome. Lesions not originating on the skin (non-cutaneous) are difficult to detect and generally produce very
high mortality.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a
Cancer Questionnaire. An APS is See See Underwriting See Underwriting Action Below
also required in all cases and it must Underwriting Action Below
contain a pathology report. Action Below

OTHER FACTORS:
The depth of invasion and overall See See Underwriting See Underwriting Action Below
size of the tumor will determine Underwriting Action Below
underwriting action. Action Below

UNDERWRITING ACTION:
Range of rating is a temporary Uninsurable Approved unless A74000 - See A71000
rating from $5 to $20 per thousand. currently disabled. D50000 - Uninsurable
Many melanomas will require a 1 to
2 year waiting period following
surgery. The overall size and depth
of invasion determines the waiting
period. Some cases will require a
decline.

28
Cancer - Prostate
It is generally appreciated that “cancer” is not one disease but rather a diverse group of disorders. Within this
group, the prognosis is highly variable depending on the type of cancer, location in the body, the extent of
invasion of the tumor into normal tissues (stage) and the degree of malignancy (grade).

LIFE
A&H DISABILITY

H340000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See Life See Underwriting A74000 - See Underwriting
Cancer Questionnaire. An APS is Action Below Action Below
also required and it must contain a D50000 - See Life
pathology report.

UNDERWRITING ACTION:
Many Prostate Cancers will require Most cases of Approved unless A74000 - See A71000
a 2 year waiting period after surgery Prostate Cancer currently disabled. D50000 - See H34000
and/or completion of all therapy are uninsurable
before coverage can be offered. for a minimum
Range of rating depends on the of 10 years.
type, stage, grade, location of the
tumor, and length of time since
completion of treatment.

Tumors which have metastasized

(spread to lymph nodes or other
parts of the body) generally are not
insurable for the first 10 years.

29
Cancer – Skin (Note: For Melanoma types of skin cancer, see Melanoma section)
Malignant skin tumors can be caused by excessive exposure to sunlight or toxic chemicals. The vast majority of
skin cancer consists of squamous or basal cell carcinoma. The prognosis for these tumors is good unless they
have become deeply invasive.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See Life See Underwriting A74000 - See Underwriting
Cancer Questionnaire. An APS Action Below Action Below
may be required in some cases. D50000 - See Life

OTHER FACTORS:
Metastasis (spread to lymph nodes See Life See Life See Life
or other parts of the body) is rare in
this type cancer.

UNDERWRITING ACTION:
Most cases can be approved Many cases can Approved unless A74000 - See A71000
standard once the tumor is removed. be approved currently disabled. D50000 - See H34000
standard.

30
Cancer - Uterus
Uterine cancer is the most common of the female gynecologic cancers. Sarcomas are relatively rare, accounting
for only 3-5% of uterine malignancies. Both types more typically occur after age 50 but may be diagnosed at
younger ages.

Risk factors for the development of uterine cancer include: obesity, nulliparity, unopposed estrogen (i.e. without
progesterone) use, polycystic and estrogen secreting ovarian disease, diabetes, and hypertension. Pelvic
irradiation is a risk factor for the development of sarcoma of the uterus.

The most common presenting sign for all uterine cancers is abnormal vaginal bleeding. Diagnosis of
malignancy is by examination of endometrial tissue either by D&C or endometrial biopsy. Pap smears of the
cervix are not accurate for diagnosis of these tumors. Treatment for uterine cancer is total abdominal
hysterectomy.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See Life See Underwriting A74000 - See Underwriting
Cancer Questionnaire. An APS is Action Below Action Below
always required and it must contain D50000 - See Life
a pathology report.

UNDERWRITING ACTION:
Most Uterine Cancers will fall into Most cases of Approved unless A74000 - See A71000
a group requiring a waiting period Uterine Cancers currently disabled. D50000 - Uninsurable
of 2 years. Range of rating will are uninsurable
usually be $7.50 to $15.00 per for a minimum
thousand. of 10 years.

Tumors which have metastasized

(spread to lymph nodes or other
parts of the body) generally are not
insurable for the first 10 years.

31
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is caused by compression of the median nerve in the wrist between the forearm
muscle tendons and the carpal ligament. This compression produces symptoms of pain, weakness and burning
or tingling paresthesia in the fingers and hand, which may extend to the elbow. This syndrome is associated
with disease such as acromegaly, hypothyroidism, rheumatoid arthritis, and with occupations requiring constant
flexion of the wrist. Surgery may be required if rest and conservative measures are not effective.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
This disease has no effect on With sufficient details provided on See See H34000
mortality. the application, a decision to rider Underwriting
or not can in many cases be made Action Below
from the application.

If surgery has been performed, we

need to know the date and whether
there was complete recovery with
no recurrence of symptoms.

UNDERWRITING ACTION:
All cases are issued standard. If present, an Exclusion Rider is No Exclusion A74000 - An
required. Rider required Exclusion Rider may
unless currently be required.
No Exclusion Rider is required one disabled. D50000 - See H34000
year after successful surgery.

32
Cerebral Palsy
Cerebral Palsy (infantile spastic palsy) is a syndrome in which there are abnormalities of muscle movement due
to maldevelopment of or injury to the central nervous system in utero, at birth, or in infancy. The movement
disturbances are non-progressive. Mental retardation and epilepsy are sometimes present.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
List details to physical or mental See Life See Underwriting A74000 - See Underwriting
limitations. An APS will always be Action Below Action Below
required. D50000 - See Life

OTHER FACTORS:
Cannot consider if under age 10. See Life See Underwriting See Life
Action Below
Adults must be no more than mildly
impacted. They must be employable,
able to sign own application, and able
to live independently. Children 10 and
older may be considered if they can be
educated and are only mildly
impacted.

UNDERWRITING ACTION:
No more than mild neurologic Best case - normal Approved unless A74000 - Mild cases can be
impairment and/or mild mental mentality, little or currently approved standard. Severe
retardation and no other complications no impairment of disabled. cases are uninsurable.
can be present to consider for standard locomotion can be
to T-4. Cases not meeting the above considered D50000 - See H34000.
criteria will require a higher rate up or standard. More severe cases are
possible decline. uninsurable.

33
Cerebrovascular Disease (CVA)/Stroke
Stroke (CVA) is caused by interruption of the blood supply to a portion of the brain. Frequently the cause is a
cerebral thrombosis (blood clot) due to atherosclerotic narrowing of the carotid or cerebral arteries. The result
is death to a portion of the brain cells. Partial or complete loss of control of certain body functions or death may
result.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS is always required. The See See Underwriting See Underwriting Action Below
name and address of the physician Underwriting Action Below
who has treated the applicant since Action Below
the stroke is required and details of
any limitations.

Complicating/Unfavorable
Factors:
Factors are poorly controlled high
blood pressure, diabetes mellitus,
overweight, other atherosclerotic
diseases such a peripheral vascular
disease or heart attack and
continued cigarette smoking.
Multiple strokes will be declined.

UNDERWRITING ACTION:
Range of rating may be T-3 + $5x3 Uninsurable Most favorable A74000 - See A71000
years to decline. cases can be issued, D50000 – Uninsurable
i.e. those applicants
A 1 year waiting period is required who have little or
from the date of the stroke. no residuals from
the stroke.
A diagnosis of stroke along with
other atherosclerotic diseases such
as heart attack, coronary bypass or
angina is uninsurable.

34
Chronic Obstructive Pulmonary Disease (COPD)
Chronic obstructive pulmonary disease (COPD) or chronic obstructive lung disease (COLD) are terms used to
describe a variety of diseases that cause chronic or frequent airway obstruction. Two of the more common
forms of COPD are chronic bronchitis and emphysema. There are many possible causes for COPD, but the
most common cause is cigarette smoking.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See Life See Underwriting A74000 - See Underwriting
Respiratory Questionnaire. An APS Action Below Action Below
is also required. Large cases may D50000 - See Life
also require an exam with a “Timed
Vital Capacity Test” (TVC). This
test measures the capacity of the
lungs and is a useful tool to help
determine the severity of the
disease.

OTHER FACTORS:
Complicating factors include See Life See Underwriting A74000 – See Underwriting
asthma, other respiratory disorders Action Below Action Below
and continued cigarette smoking. D50000 – See Life

UNDERWRITING ACTION:
Range of rating may be from “Mild" cases Approved unless A74000 - See A71000
standard to decline. The degree of can be issued currently disabled. D50000 - See H34000
severity will determine the range of with an .
rating. Exclusion
Rider. Cases
Continued cigarette smoking and diagnosed as
severe COPD is uninsurable. moderate or
severe are
uninsurable.

35
Cirrhosis
Cirrhosis refers to disorganization of the internal architecture of the liver due to widespread fibrosis (scarring)
and the formation of nodules of liver tissue as a response to prior injury. Most cases are caused by chronic
alcohol abuse.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete See An Alcohol A74000 - See A71000
an Alcohol Questionnaire and Underwriting Questionnaire is D50000 - See Underwriting
include the date of diagnosis. An Action Below required. Action Below
APS is always required. A blood
profile may be required.

OTHER FACTORS:
Only best cases, 5 or more years See None A74000 - None
from date of diagnosis, can be Underwriting D50000 - See Underwriting
considered for coverage. These are Action Below Action Below
cases with only mild liver
enlargement, normal liver enzymes,
no evidence of liver failure or other
systemic complications and no
alcohol use in any form, and must
have been dry for 5 years.

UNDERWRITING ACTION:
Those cases as defined above and Uninsurable If insurable for A74000 - See A71000
five years since diagnosis may Life, Accident D50000 - Uninsurable
qualify for a T-10 rating. Cirrhosis coverage is
from causes other than alcohol approved. Alcohol
require a decline. Exclusion Rider
may be required.

36
Colitis - Spastic/Irritable Bowel Syndrome
Spastic colitis or irritable bowel syndrome is a disorder caused by an abnormality of the basic contractile pattern
of the bowel. Symptoms include intermittent abdominal pain, constipation and diarrhea. The diagnosis is
suggested by the chronic nature of the symptoms, the lack of any evidence of other serious underlying disease,
and the exclusion of other disorders, which could cause similar symptoms.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS may be required. See Life See A74000 - See
Information furnished on the Underwriting Underwriting Action
application or furnished by Action Below Below
telephone interview is usually D50000 - See Life
enough to make a decision.

UNDERWRITING ACTION:
With a definite diagnosis cases are Most cases can be Approved A74000 - Approved
approved standard. approved standard. D50000 - See H34000
Symptoms occurring at
time of application require
a postponement.

37
Colitis - Ulcerative
Ulcerative Colitis is a chronic inflammatory disease of the colon (large intestine) of unknown etiology, which
primarily affects the mucosal (innermost) layer of the bowel wall. Symptoms consist of rectal bleeding,
diarrhea, abdominal pain and fatigue. In more severe cases, fever, anemia, loss of appetite and weight loss
occur. Complications which are generally minor and not life threatening, include the development of
inflammatory pseudopolyps (swollen areas of mucosa) or inflammatory tissue located between ulcerations, anal
fissures, fistulas and perianal abscesses. Major complications include toxic megacolon, colonic perforation,
stricture formation, massive hemorrhage, and cancer.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
A Digestive Questionnaire and an See Life See A74000 - See
APS are always required. The Underwriting Underwriting Action
prognosis of this impairment is Action Below Below
highly variable. The more severe D50000 - See Life
cases sometimes require surgery,
which is usually curative if the
entire colon and the rectum are
removed.

UNDERWRITING ACTION:
Range of rating may be from T-2 Uninsurable if presently Approved A74000 - See A71000
to T-16. under treatment. Can unless currently D50000 - See H34000
consider approval with an disabled.
Must be one year after diagnosis or Exclusion Rider if only one
hospitalization. Some cases treated attack and full recovery and
with surgery may qualify standard. date of last symptom is
more than 2 years ago.
Applicants under age 20, or anyone Uninsurable if unoperated
disabled from this condition, are and symptoms have
uninsurable. occurred within the last two
years.

38
Coronary Artery Disease (Angina Pectoris)
Coronary Artery Disease and Coronary Heart Disease refer to the atherosclerotic narrowing (hardening) of the
arteries that supply the heart with blood. Angina Pectoris (angina) means chest pain caused by lack of adequate
blood supply to the heart muscle. The usual cause for “angina” is atherosclerotic narrowing of one or more of
the coronary arteries. The frequency and severity of the anginal pain will vary depending on several factors,
including the amount of coronary disease and the amount of stress (exercise, pain, anxiety, fear, etc.) placed
upon the heart. The diagnosis of angina is usually made as a result of the description of the chest pain.
Ischemic changes on an EKG may help confirm the diagnosis. Stenting in the affected artery is now more
common than bypass procedures.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS: See See See Underwriting Action
The agent should always complete a Chest Underwriting Underwriting Below
Pain Questionnaire. An APS is also Action Below Action Below
required.

Complicating/Unfavorable factors are

poorly controlled high blood pressure,
diabetes mellitus, overweight, other
atherosclerotic disease such as peripheral
vascular disease, cerebrovascular disease and
continued cigarette smoking.

UNDERWRITING ACTION: Uninsurable Approved A74000 - See A71000

Ratings range from T-2 to decline. unless D50000 – Uninsurable
currently
A six-month waiting period is required from disabled.
the date of the bypass. A one month waiting
period is required for angioplasty or stenting
IF no heart attack occurred.

Applicants diagnosed with Angina Pectoris,

or requiring a bypass, prior to age 40 cannot
be considered for coverage.

A diagnosis of angina along with other

atherosclerotic disease such as stroke, IDDM,
or peripheral vascular disease is uninsurable.

39
Coronary Artery Disease - Coronary Artery Bypass Graft (CABG)
Coronary Artery Disease and coronary heart disease refer to the atherosclerotic narrowing (hardening) of the
arteries that supply the heart with blood. Coronary artery bypass grafts are used to re-establish good blood flow
to sections of the coronary arteries (and the areas of the heart muscle served by the arteries) obstructed by
atherosclerotic lesions. The surgical procedure involves splicing a segment of vein (usually the saphenous vein)
from the ascending aorta to an area in the coronary artery beyond the obstruction.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS: See Underwriting See See Underwriting Action
A Heart/Circulatory Questionnaire should Action Below Underwriting Below
always be obtained by the agent. An APS Action Below
with a copy of the heart catherization report
is always required. Needed is the name,
address and phone number of the physician
who can furnish the operative report as well
as follow-up care. Also needed is the name,
address and phone number of the hospital
where surgery was performed. The operative
report must be obtained either from the
physician or the hospital.

Complicating/Unfavorable Factors:
Factors are progression of disease, poorly
controlled high blood pressure, diabetes
mellitus, overweight, other atherosclerotic
disease such as stroke or peripheral vascular
disease and continued cigarette smoking. If
heart catherization demonstrates extensive
damage to the left ventricle such as CHF,
coverage cannot be offered.

UNDERWRITING ACTION:
Ratings range from T-2 to decline Uninsurable Approved A74000 - See A71000
unless D50000 - Uninsurable
A six-month waiting period is required from currently
the date of the surgery. disabled.

Applicants requiring a CABG prior to age 40

cannot be considered for coverage.

A history of multiple CABG and a diagnosis

of stroke, IDDM, or peripheral vascular
disease is uninsurable.

40
Coronary Artery Disease - Heart Attack/Myocardial Infarction (MI)
Coronary Artery Disease and Coronary Heart Disease refer to the atherosclerotic narrowing (hardening) of the
arteries that supply the heart with blood. Myocardial infarction (MI) is the scientific term meaning heart attack.
Heart attack refers to the death of a portion of the heart muscle. Heart attack occurs as the blood supply to an
area of the heart becomes totally blocked, usually as a result of atherosclerotic disease. A blood clot may form
on an uneven plaque, obstructing that site or moving to a smaller area in the coronary artery, totally blocking
the vessel. The diagnosis of heart attack (MI) is usually made by the presence of severe chest pain.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS: See See Underwriting See Underwriting
A Heart/Circulatory Questionnaire should always Underwritin Action Below Action Below
be completed by the agent. An APS is always g Action
required. Needed is the name, address and phone Below
number of the physician who can furnish the initial
history as well as follow-up treatment. Current and
old EKG tracings are valuable in estimating the
extent of the disease and progression.

Complicating/Unfavorable Factors:
Factors are progression of disease, poorly
controlled high blood pressure, diabetes mellitus,
overweight, other atherosclerotic disease such as
stroke or peripheral vascular disease and continued
cigarette smoking.

OTHER FACTORS:
With recovery, a six-month waiting period is See See Underwriting See Underwriting
required from the date of the heart attack. Underwritin Action Below Action Below
g Action
Applicants who have suffered a heart attack prior Below
to
age 40 cannot be considered for coverage.

UNDERWRITING ACTION:
Ratings range from T-2 to decline. Uninsurable Approved unless A74000 - See A71000
currently D50000 – Uninsurable
A diagnosis of multiple heart attacks or a heart disabled.
attack with IDDM along with other atherosclerotic
diseases such as stroke or peripheral vascular
disease is uninsurable.

41
Crohn's Disease
Regional enteritis (Crohn’s disease) is a chronic inflammatory disorder of unknown etiology. All layers of
bowel wall are affected and the inflammatory process may even extend beyond the bowel wall to involve
adjacent structures. In most cases, both the small bowel and colon are involved. Less commonly, the disease
may be confined to the small bowel, colon, anorectal area, or other sites within the digestive tract.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS and a Digestive See Life See Underwriting A74000 - See Underwriting
Questionnaire with current doctor Action Below Action Below
information will always be required. D50000 - See Life

OTHER FACTORS:
Applicants who have needed See Life See Underwriting A74000 – See Underwriting
surgery or multiple hospitalizations Action Below Action Below
will be rated higher than those who D50000 – See Life
have not.

UNDERWRITING ACTION: Uninsurable

Must decline within 1 yr. of Approved unless A74000 - See A71000
diagnosis. Mild to moderate cases currently disabled. D50000 - See H34000
may be considered at T-3 to T-6,
and higher if they have had surgery.
Severe cases will require a decline.

42
Cystic Fibrosis
Cystic fibrosis is an inherited disease in which the overproduction of mucus causes obstruction of the pancreatic
and bile ducts, intestines, and bronchi. It is diagnosed by measuring the amount of salt in sweat, with quantities
in excess of 60 mEq/L generally considered to be diagnostic. Manifestations of the disease include
bronchiectasis, hemoptysis, declining pulmonary function, pancreatic insufficiency, and digestive problems.
Most of those afflicted have respiratory symptoms at a very early age, and the prognosis is generally poor.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

UNDERWRITING ACTION:
Uninsurable Uninsurable Approved unless A74000 - Uninsurable
currently disabled. D50000 - Uninsurable

43
Depression - Major
Major depression causes difficulty in sleeping and eating as well as feelings of dejection. It may be the result of
a stressful life event (death, divorce, major illness). In other cases, it may arise “endogenously” (from within)
i.e., without apparent life stress. Antidepressant medication is often prescribed as well as psychotherapy.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a Depression See Life See Life See Life
Questionnaire. An APS may be required.
Needed information is the degree of impairment
(severity) and duration of “effective control.”

OTHER FACTORS:
“Effective control” means the individual has See Life See Life See Life
adjusted well to the impairment and is currently
not experiencing any significant interference
with the activities of daily living.

UNDERWRITING ACTION:
Range of rating for mild cases with effective Cases with a Cases that can A74000 - See
control is T-4 within the first year and possibly history of be rated T-4 or A71000
standard from 1-2 years. After two years and a complete less for Life can D50000 - See
complete recovery, a standard offer may be recovery for five be approved. H34000
considered. years, no Those that
continuing require a higher
Severe cases within 2 years of the date of psychotherapy or rating are
application are uninsurable. medication may uninsurable.
be considered at a
75% to 100%
increase in
premium. All
others are
uninsurable.

44
Depression – Manic (Bipolar Disorder)
Manic depression psychosis is characterized by episodes of manic (hyperactivity) as well as major depression.
Bipolar disorders usually begin in the teens, 20’s and 30’s. Treatment is usually with lithium.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See Life See Life See Life
Depression Questionnaire. An APS
is also required.

The degree of impairment (severity)

and the duration of “effective
control” is the information needed.

OTHER FACTORS:
“Effective control” means the See Life See Life See Life
individual has adjusted well to the
impairment and is currently not
experiencing any significant
interference with the activities of
daily living.

UNDERWRITING ACTION:
Range of rating for mild cases with Cases with a history of Cases that can be A74000 - See A71000
effective control is T-4 to possibly complete recovery for five rated T4 or less D50000 - See H34000
standard after 2 years. Moderate to years, no continuing for Life can be
severe cases with effective control psychotherapy or approved. Those
will range from T-4 to T-10. medication may be that require a
considered at a 75% to higher rating are
100% increase in uninsurable.
premium.

All others are uninsurable.

45
Depression/Anxiety - (Minor)
Minor depression or anxiety can cause problems similar to those caused by major depression but are typically
much less serious. Minor depression can occur as a result of a life experience and is common to most people.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See Life See Life See Life
Depression Questionnaire. If there is a
life experience causing this condition
the agent should list this information.
An APS is generally not required but
may be necessary if we cannot assess
the severity from information
furnished on the application and
questionnaire.

OTHER FACTORS:
“Effective control” means the See Life See Life See Life
individual has adjusted well to the
impairment and is currently not
experiencing any significant
interference with the activities of daily
living. "Effective control" is usually
not a factor in minor depression or
anxiety, but if symptoms are more
than minor, then effective control
becomes more critical.

UNDERWRITING ACTION:
Most cases can be approved standard. Most cases can be Cases that can be A74000 - See A71000
If the severity appears more than approved standard. rated T-4 or less D50000 - See H34000
minor or effective control has not been Cases in which for Life can be
achieved a rating of T-2 to T-6 may be there is a question approved. Those
required. of effective control that require a
or the severity higher rating are
seems more than uninsurable.
minor are
uninsurable.

46
Diabetes Mellitus
Diabetes Mellitus is a chronic disease of carbohydrate (sugar and starch) metabolism where either the pancreas
does not produce enough insulin or where insulin, although produced in sufficient quantity, cannot be fully
utilized. Because of this metabolic disorder, blood glucose (sugar) levels are elevated (hyperglycemia). This
leads to spilling of sugar into the urine (glycosuria) and symptoms such as fatigue, increase in thirst, appetite or
urination and in some cases weight loss. Insulin-dependent diabetes mellitus (IDDM) was formerly called
juvenile onset diabetes. These individuals cannot produce sufficient insulin and are dependent for the
remainder of their lifetime upon injected insulin for both survival and prevention of systemic complications.
Non-insulin dependent diabetes mellitus (NIDDM) was formerly called maturity onset diabetes. These
individuals may produce normal quantities of insulin but it is relatively ineffective because body cells are
resistant to its effects. Most of these individuals can control their sugar through diet or oral medication.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
A Diabetic Questionnaire should See Life See A74000 - See
always be completed by the agent. Underwriting Underwriting Action
An APS is always required. An Action Below Below
exam with a blood profile may be D50000 - See Life
required.

OTHER FACTORS: See Life See A74000 - See

Hypertension and overweight are Underwriting Underwriting Action
two common impairments, which, if Action Below Below
associated with diabetes, may D50000 – See Life
require an additional rating.
Arteriosclerosis (angina, heart
attack, or coronary bypass) or
peripheral vascular disease
associated with IDDM are
uninsurable.

UNDERWRITING ACTION: Applicants diagnosed at age IDDM’s are A74000 - See A71000
Range of rating may be from T-2 to 40 or older whose blood sugar not issued. D50000 – Applicants
T-8. Best case applicants diagnosed is well controlled by diet or NIDDM’s are diagnosed at age 40 or
at age 50 and with excellent control oral medication may be insurable if older whose blood
may qualify standard. Diabetics considered standard. Those they are sugar is well controlled
who are uncontrolled are diagnosed under 40 will insurable for by diet or oral
uninsurable. Also, diabetes in require a rating or possible Life. medication may be
combination with Table 6 more decline. All IDDM’s and any considered at a 50-
overweight is uninsurable. NIDDM’s who are not under 100% increase in
good control are uninsurable. premium. All IDDM’s
and any NIDDM’s who
are not under good
control are uninsurable.

47
Diverticulitis/Diverticulosis
Diverticula are herniations (closed pouches or saclike protrusions) which extend outward from the inner surface
of the esophagus or bowel wall. Diverticula of the intestine may be either congenital or acquired. Diverticula
of the colon are very common at older ages. The major complications of Diverticula are hemorrhage and
Diverticulitis. Diverticulitis of the bowel is characterized by abdominal pain, fever, constipation, and in severe
cases, perforation of the bowel wall.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS may be required. Needed is See Life See A74000 - See
the date of attack(s), medication(s), Underwriting Underwriting Action
severity, and if any surgery or Action Below Below
hospitalization has been required. D50000 - See Life

UNDERWRITING ACTION: A history of Approved A74000 - See A71000

Mild symptoms usually require no Diverticulitis will unless D50000 - See H34000
rate up. usually require an currently
Exclusion Rider. Those disabled.
More severe cases may be rated from cases, which are
T-2 to T-4. asymptomatic more than
2 years may be,
considered standard.

48
Driving Criticism
Motor vehicle accidents are the single most common cause of violent death among all individuals and are the
leading cause of death among those ages 16-24. Drivers with several traffic violations are at increased risk of
having a fatal motor vehicle accident. The kinds or types of violations, as well as number, can also be
indicators of added risk. Statistics demonstrate that males are at greater risk of having fatal accidents than
females. Young males, as a group, are at especially high risk of dying in a motor vehicle accident, compared to
other causes of death. Alcohol abuse is the leading cause of fatal, single vehicle accidents among drivers below
age 25.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An MVR is required on every male See Life See Life See Life
applicant ages 16-29. A driver’s
license number is needed from
every applicant who is of driving
age. If the applicant does not drive,
it is essential for the agent to obtain
a Drivers License questionnaire and
include the reason for no license.
The agent should always complete
an Alcohol Use Questionnaire if the
applicant has ever had a DWI.
An MVR is required on every
applicant who has ever had a DWI.

UNDERWRITING ACTION: If the Life can be approved See Life – Except no 6 or more points
A point system is utilized to with a rating or an Alcohol rate-up is assigned. for violations
determine underwriting action. Exclusion Rider the Points for violations requires a decline.
Violations are assigned points based H34000 can be approved totaling less than 10 See Classification
on the type of violation and date of standard. can be issued Table.
occurrence. See Classification standard. 10 or more
Table. points are
uninsurable. See
If a rate-up is required, the extra Classification Table.
premium ranges from $3 - $10 per
thousand.

Only moving violations are

assigned points.

49
 MOTOR VEHICLE VIOLATIONS – CLASSIFICATION TABLE
UNDERWRITING ACTION

Violations such as DWI, Reckless Driving, Speeding, etc. will generate points that may result in ratings.

CLASSIFICATION TABLE
Total Points Males under age 30 Others
1-5 0 (1) 0 (1)
6-9 0 (2) 0 (2)
10-12 $5x2 (3) $3x2 * (3)
13-15 $7.50x3 (4) $5x2 (4)
16-18 $10.00x5 (4) $7.50x3 (4)
19 - up U DCL U DCL

(1) WP Std, ADB Std

(2) WP Std, ADB No
(3) WP 2X, ADB No
(4) WP No, ADB No

* if the points are due to a DWI/DUI, the rating will be $5x2

50
Driving While Intoxicated (DWI)
In most major studies of motor vehicle accidents, alcohol abuse consistently has been one of the primary causes.
Individuals cited for accidents or other traffic violations while driving under the influence require special
underwriting. It has been suggested that the majority of DWI violations involve “problem” drinkers rather than
“social” drinkers. In either case, the risk of having a fatal accident is high – the combination of drinking and
driving is extremely hazardous.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
A motor vehicle report (MVR) and an See Life See Life See Life
Alcohol Use Questionnaire regarding the
applicant’s drinking habits is required if the
applicant has ever had a DWI. We must have
the driver’s license number in order to obtain
the MVR.

A complicating factor is if the applicant has

moving violations other than the DWI. See Life - except the See A71000
Alcohol Exclusion
In those locations allowed (see below) an Rider is the AG-2070
agent should obtain the Alcohol Exclusion and the AG-2070 is
Rider (PI-347) whenever an applicant has had approved in all
a DWI within the last 5 years. locations.

UNDERWRITING ACTION: A single DWI A single DWI within See A71000

A single DWI within 2 years of the date of without criticism 5 years of the date of
application requires a rate up of $5 per of drink habits the application
thousand for 2 years. This assumes no other requires no requires an Alcohol
criticism. In those locations where allowed, adverse Exclusion Rider (AG-
an Alcohol Exclusion Rider (PI-347 ) is underwriting 2070). This assumes
assigned in lieu of the rating. The locations action. Language no other criticism.
allowing an Alcohol Exclusion Rider are AK, in the policy Applicant’s who have
AL, AZ, CA, DC, DE, HI, IA, ID, IN, LA, excludes coverage had 2 DWI’s and still
ME, , MT, NC, , NE, NV, RI, VA, VT, WV, for alcohol and drink are uninsurable.
WY, all Canada except AB, and New drugs.
Zealand. Applicants who
have had 2 DWI's
Applicants who have had 2 DWI’s within the within the past 5
past 5 years and the last DWI within 2 years years and the last
are uninsurable. Anyone with 2 DWI’s ever within 2 years are
and still drinking has only a 30% chance of uninsurable.
being insured.
Applicant's who have had 3 DWI's and
continue to use alcohol in any amount are
uninsurable.

51
Drug Abuse (See Separate Guide for Marijuana)
Dangers inherent in the use of illicit drugs are very familiar to the public. There is an increased incidence of
violent death, including drug overdose. Accidents and homicides account for a large proportion of drug-related
deaths. Because of the mind-altering effects of drug usage, there is an increased incidence of suicide. IV
injections may lead to serious or fatal infections (e.g. septicemia, hepatitis, AIDS). Also, long term use of many
drugs has been indicated as a cause of kidney and liver damage, hypertension, heart disease and occasionally,
seizures and psychosis.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete See Life See Life See Life
Drug and Alcohol Use
Questionnaires. An MVR is
required. An APS, exam with a
blood profile, and a drug screen
may be required on some cases.

OTHER FACTORS
Abstinence from the use of drugs Abstinence from Abstinence for 5 A74000 - See A71000
for 2 years is required for the use of drugs years is required. D50000 - See H34000
consideration. The rate up is for 5 years is
determined by the number of years required. There
of abstinence. must be no
associated
medical
problems or
A history of drug and alcoholism organ damage.
requires the applicant to abstain
from both for at least 5 years before
coverage can be considered. See Life See Life See Life

UNDERWRITING ACTION:
Range of rating may be $7.50 to Abstinence of 5 Abstinence of 5 A74000 - See A71000
$10 per thousand. Applicants who years is required years is required. D50000 - See H34000
have abstained for 7 years can be for consideration. After 5 years, may
considered standard. 5 to 7 years be approved
require a 75% standard.
A history of drug and alcoholism increase in
requires the applicant to abstain premium. 7
from both for at least 5 years before years and up can
coverage can be considered. be considered
Previous drug use (hard drugs) in standard.
addition to current marijuana is
uninsurable.

52
Fibromyalgia (FM)
Fibromyalgia is a generalized form of soft tissue rheumatism marked by chronic, widespread pain and by the
presence of tender points. It has been know as fibrositis, tension myalgia, chronic pain (fatigue) syndrome,
musculoskeletal pain syndrome, and generalized nonarticular rheumatism. It is not associated with extra
mortality, but is strongly correlated with long periods of disability. The principal symptoms of "FM" are
diffuse, widespread musculoskeletal pain and tenderness.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
Information furnished on the An APS may be See Underwriting A74000 - See Underwriting
application including any current required if the Action Below Action Below
medications is generally sufficient. severity is not D50000 - See H34000
apparent from
info furnished
on the
application.

OTHER FACTORS: Severity of See H34000 See H34000

None symptoms is of
principal
concern.

UNDERWRITING ACTION:
Usually approved standard. More Mild to Approved unless A74000 - Most cases are
severe cases may require a rating. moderate FM currently disabled. approved standard.
Very few cases require a decline. may be D50000 – Only mild cases are
approved insurable.
standard.
Severe FM
requires a
decline.

53
Glomerulonephritis – Chronic Kidney Disease
Glomerulonephritis is sometimes an acute, isolated event that resolves completely with no residual impairment.
Most other types of glomerulonephritis are chronic, ongoing diseases characterized by chronic inflammation of
the kidney glomerulus. The exact causes usually cannot be determined although a specific underlying disease is
occasionally identified such as diabetes mellitus, rheumatoid arthritis or some other systemic disease.
Symptoms include albumin and blood in the urine and a gradual deterioration in kidney function. Treatment
with steroids or immunosuppressants is sometimes helpful. Long term prognosis is usually related to the
specific type of glomerulonephritis that is present (as determined by kidney biopsy and sophisticated tests of the
kidney and immune systems).

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS is always required. An See Life See Underwriting See Underwriting Action Below
exam with a blood profile may be Action Below
required.

OTHER FACTORS:
Continuing consultation with a See Life See Underwriting See Underwriting Action Below
physician and successive renal Action Below
function tests are required to
determine the rate of progression of
the disease.

UNDERWRITING ACTION:
Range of Rating may be T-4 to T- In most cases - Approved unless A74000 - See A71000
16. Uninsurable currently disabled. D50000 - Uninsurable

Current age less than 15 is

uninsurable.

54
Heart Valve Replacement
Valve replacement is the surgical implantation of a prosthetic device, which takes over the function of a
damaged heart valve. This procedure is considered to be palliative and not curative. Often the patient has other
underlying conditions, and has not experienced success with medical treatment.

Some hazards are presented by these prosthetic devices. Valves made of metal or plastic tend to generate blood
clots (thrombi), causing stroke and pulmonary emboli. Patients with metal or plastic valves usually take
anticoagulants for the remainder of their lives and then are at risk for the development of a fatal hemorrhage.
Any prosthetic valve increases the risk of endocarditis.

The prognosis depends on the overall condition of the patient. Applicants with any other significant impairment
will be declined.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS is always required. See See Underwriting See Underwriting Action Below
Underwriting Action Below
Action Below

OTHER FACTORS: See See Underwriting See Underwriting Action Below

Best cases - stable since surgery Underwriting Action Below
with little or no symptoms Action Below
(dyspnea, chest pain, etc.) or
physical limitations - not currently
disabled – no more than slight heart
enlargement.

UNDERWRITING ACTION: Uninsurable Approved unless A74000 - See A71000

A 1 year waiting period is required currently disabled. D50000 – Uninsurable
after surgery.

Uninsurable age 19 and under.

Range of rating for a best case is T-

8 plus $5 to $7.50 per thousand.

55
Hepatitis (Type A & B & C)
Hepatitis A is usually due to infection with a virus. It is acquired by intimate (including sexual) person-to-
person contact. Hepatitis A is usually a benign disease in previously healthy individuals; death during the acute
infection is rare and chronic hepatitis never develops as a late diagnosis. Those applicants who are no longer in
the acute phase of Hepatitis A can be approved standard.

Hepatitis B, or serum hepatitis is caused by the Hepatitis B virus. It can cause serious illness and death during
the acute infection, and chronic active hepatitis occurs in 5-8% of acute cases. Transmission usually occurs as a
result of intimate (including sexual) person to person contact or from using needles previously contaminated by
an individual who was infected with the virus (usually a drug abuser). It can also be contracted by receiving
contaminated blood. Hepatitis B may cause serious illness including massive liver infection or death during the
acute infection. If symptoms and signs persist after an acute infection, this is probably indicative of Chronic
Active Hepatitis. Hepatitis B is usually treated with interferon. Only those applicants who are no longer taking
interferon can be considered for coverage. The diagnosis of Chronic Active Hepatitis is confirmed by the
presence of elevated liver enzymes or a positive liver biopsy.

Hepatitis C is a more serious infection than B. Unlike B, Hepatitis C rarely produces symptoms at time of
infection, but becomes chronic in 85% of cases. Chronic Active C ultimately produces liver failure or cancer of
the liver. Interferon is also commonly used to treat Hepatitis C. Unfortunately the success rate is low and in
most cases the medication is unable to clear the virus. Only those applicants who are no longer taking
interferon can be considered for coverage. Diagnosis is generally made by detection of antibodies to the
Hepatitis C virus.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/ REQUIREMENTS:
The agent should always complete a Hepatitis See Life See A74000 – See
Questionnaire. An APS and a blood profile are required Underwriting Underwriting Action
for Hepatitis C. A blood profile may be required in Action Below Below
those cases where the APS does not furnish enough D50000 - See Life
information. Chronic Hepatitis B may require an APS
and a blood profile.

56
UNDERWRITING ACTION: See Life A, B and C A74000 - See
Hepatitis A can be issued standard upon recovery from can be A71000
the acute illness. approved D50000 - See
unless H34000
Current treatment for Hepatitis B is uninsurable. See Life. currently
Hepatitis B can be underwritten 6 months after full Chronic disabled.
recovery from an acute infection. If liver enzyme tests Hepatitis B
demonstrate no abnormalities, the applicant can be is
approved standard. If they have not returned to normal uninsurable.
then our ability to offer coverage is dependent on the
degree of abnormality in the liver enzyme tests. New
statistical information allows us to make rated up offers
on some cases.

Current treatment for Hepatitis C is uninsurable. Some Hepatitis C

cases of Hepatitis C can be considered for coverage. Our is
ability to offer coverage is dependent on their age at uninsurable
diagnosis, age at the time of the application and the
results of liver function tests. New statistical data enables
us to insure some applicants whose liver function values
remain in an abnormal range.

57
Hypertension (High Blood Pressure - HBP)
A sustained elevation of blood pressure above the range considered normal for a given age and gender. If left
untreated, individuals with hypertension will generally experience significantly greater mortality than those who
have normal blood pressure.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See Life See A74000 - See
High Blood Pressure Questionnaire. Underwriting Underwriting Action
An APS may be required. Some Action Below Below
cases may also require an exam. D50000 - See Life

OTHER FACTORS:
Applicants who are under treatment See Life See A74000 - See
for hypertension and whose blood Underwriting Underwriting Action
pressure has been maintained at a Action Below Below
normal level generally qualify D50000 - See Life
standard. An average of the blood
pressure readings for the past year or
lesser period of time determines
whether the applicant can qualify for
standard rates.

UNDERWRITING ACTION:
Range of rating will be determined Most cases of treated high If insurable A74000 - See A71000
by the average of blood pressure blood pressure can be for life, D50000 - Treated high
readings over the last year or lesser approved standard if accident blood pressure that
period. Many cases can be issued insurable for Life. In a few coverage is does not qualify
standard. cases an increased premium approved. standard for Life will
may be required. require a rating.

58
Kidney Stone
Genitourinary stones (calculi nephrolithiasis) are abnormal mineral collections (usually calcium) which form in
the kidney, ureter or bladder. Stones form because of infections, structural abnormalities, metabolic imbalances
or for unknown reasons. They may occur only once or be recurrent. Some are asymptomatic and discovered
with a routine x-ray performed for another purpose; others are associated with severe pain or a urinary tract
infection. Small stones can pass through the genitourinary tract but large stones sometimes become lodged and
obstruct urine flow. In these cases, the stone must be removed before permanent kidney damage occurs. Stones
may be removed via a catheter passed through the urethra or skin, surgically or with lithotripsy (a procedure in
which stones are broken into smaller pieces with sound waves.)

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
Information requested will depend See Life See A74000 – See
on information furnished on the Underwriting Underwriting Action
application. A single stone without Action Below Below
recurrence may not require D50000 – See Life
additional information. A more
extensive history may require an
APS.

OTHER FACTORS: See Life See A74000 – See

The number of stones and whether Underwriting Underwriting Action
one or both kidneys are affected Action Below Below
influence the rating. A history of D50000 – See Life
complications (multiple surgeries,
hospitalizations, or periods of
disability) require an additional rate
up.

UNDERWRITING ACTION: A single stone passed Approved A74000 – See A71000

Most cases where the stone or spontaneously or by unless D50000 – A single stone
stones have passed can be approved endoscopic manipulation currently passed spontaneously or
standard. Less favorable cases may or lithotripsy may be disabled. by endoscopic
require a rate up of T-2 to T-4. considered standard after manipulation or lithotripsy
one year. may be considered
A few chronic stone formers who standard after two years. A
are not well controlled are A history of multiple history of multiple stones
uninsurable. stones may require an may require an Exclusion
Exclusion Rider, or may be Rider. Chronic stone
uninsurable. formers are uninsurable.

59
Lupus - Systemic Lupus Erythematosus (SLE)
Systemic (disseminated) Lupus Erythematosus (SLE) is a chronic inflammatory disease of the connective
tissues. It develops because the immune system incorrectly perceives the connective tissue cells of the body as
foreign and attempts to destroy them. The cause of this disorder is unknown. SLE occurs predominantly in
young and middle aged women. Any area of the body can be affected. The most common symptoms consist of
arthritis, arthralgia (joint pain), skin rashes including a "butterfly" rash on the cheeks and bridge of the nose and
a discoid rash (which may also be referred to as discoid lupus or cutaneous lupus erythematosus), systemic
symptoms such as fever and fatigue, and lymphadenopathy (lymph node enlargement). Vasculitis, pericarditis,
glomerulonephritis, central nervous system disorders, anemia, leukopenia, thrombocytopenia, and hepatitis
(lupoid hepatitis) are a few of the diverse clinical manifestations that may also be present with SLE. Treatment
consists of aspirin and other nonsteroidal anti-inflammatory medications, antimalarials (hydroxychloroquine
/plaquenil, chloroquine), steroids (prednisone), immunosuppressants (azathioprine/imuran,
cyclophosphamide/cytoxan), and plasmapheresis. The latter three forms of treatment are reserved for more
severe cases. Because the severity of this impairment can vary over a span of many years, the prognosis is
difficult to predict. The best prognosis may be anticipated for those individuals who have not experienced any
of the significant complications listed below:
Circulatory -- myocarditis, endocarditis, vasculitis
Gastrointestinal -- hepatitis (lupoid hepatitis)
Genitourinary -- glomerulonephritis (lupus nephritis)
Nervous -- all manifestations except peripheral neuropathy

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS is always required. Full See Life See A74000 - See
details should be provided which Underwriting Underwriting Action
include the date of diagnosis, current Action Below Below
medications, and any disabilities D50000 - See Life
resulting from the disease.

UNDERWRITING ACTION: Many cases are Approved A74000 - See A71000

Best case: mild, no progression, no uninsurable. Some mild unless currently D50000 - See H34000
use of steroids and no major organ cases can be approved disabled.
involvement can be considered for standard.
coverage. To be considered,
applicants must be over age 19 at
diagnosis and diagnosed more than 2
years ago. Range of rating varies
from T-2 to T-12 depending on age,
date of diagnosis and severity. Some
cases are uninsurable.

60
Marijuana
Ratings listed below are for best case scenarios. Applicants must have no current physical or mental problems,
any criticism of other habits or associates, no aviation or other avocations that may be considered hazardous.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete See Life See Life See Life
Drug and Alcohol Use
Questionnaires. An APS, MVR and
exam with blood profile and drug
screen may be required.

A complicating factor is a history of

treatment for alcoholism and current
use of marijuana.

UNDERWRITING ACTION:
Current Marijuana use in Infrequent users See Life A74000 - See A71000
conjunction with previous drug may qualify D50000 - See H34000
use (hard drugs), drug related or standard.
felony arrest, or voluntary alcohol
treatment is uninsurable. Applicants who
Infrequent uses of marijuana may use marijuana
qualify as standard, non-smoker more often than
rates. More frequent users require monthly are
T2 and up depending on use, uninsurable.
smoker rates apply.

Medical Marijuana use – Must

have a valid prescription and
cannot be smoked. If smoked then
treat as Marijuana use. Medical
Marijuana use requires a T2 rating
plus any additional ratings for the
medical condition.

61
Mental Retardation
Mental retardation refers to significantly below average intellectual functioning associated with an inability to
effectively meet the usual standards of personal independence and social responsibility. Its onset occurs before
the age of 18. Some individuals with mental retardation have seizures or other neurologic abnormalities,
psychiatric impairments, or congenital disorders.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS will usually be required. A See Underwriting See Underwriting A74000 - See Life
telephone interview may also be Action Below Action Below D50000 - See
needed. Underwriting Action
Below

OTHER FACTORS: See Underwriting See Underwriting See Underwriting Action

Adults must be no more than mildly Action Below Action Below Below
retarded. They must be employable,
able to sign application, and able to
live independently.

UNDERWRITING ACTION: Uninsurable. If insurable for Life, A74000 - See A71000

Mild mental retardation without Accident coverage is D50000 – Uninsurable
additional impairments may be approved.
considered standard. Some cases may
require a T-4 rating. More than mild
mental retardation is uninsurable.

62
Multiple Sclerosis (MS)
Multiple Sclerosis is a disorder that is characterized by degeneration of the myelin that lines or “insulates” the
outside of the nerves. As a result of the degenerative process, the myelin becomes hardened (sclerotic) in
multiple sclerosis. Symptoms occur because damaged nerves are unable to transmit their electrical impulses
normally. The cause is not known, but it is thought to be either a viral infection or an autoimmune process in
which the body’s immune system goes awry and attacks its own nerves. The prognosis of this impairment is
variable and often unpredictable.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS is always required. “Best See See Life A74000 - See Life
case” situations are those in which Underwriting D50000 - See Underwriting
there is a history of only one or two Action Below Action Below
episodes of active disease, no residual
neurological impairment and the
disease is in remission. The degree of
impairment and duration of remission
determine ratings for those which do
have neurological impairment, but are
in remission.

UNDERWRITING ACTION:
“Best cases” may be considered at T- Uninsurable Approved unless A74000 - Mild cases can be
2 to T-4. For those not qualifying for currently disabled. approved. More severe cases are
“best case” consideration, ratings uninsurable.
range from T-4 to T-12. D50000 – Uninsurable

Severe or rapidly progressive disease

is uninsurable. Unlikely to qualify
for coverage if medically disabled.

63
Muscular Dystrophy
Muscular dystrophy is a group of inherited disorders that are characterized by progressive muscle degeneration.
The exact origin of the degenerative process is not known; it may be associated with some component of the
muscle itself or the blood vessels that supply it. There is no effective therapy to stop or prevent the progression
of this disorder. The goal of treatment is to enable the individual to function independently with the aid of
physical therapy, splints, and braces. Drugs, such as quinine and phenytoin (Dilantin), are sometimes
administered in order to decrease muscle spasms. Prognosis is dependent upon the type of muscular dystrophy
and the rate of progression. A pattern of steadily progressive deterioration and disability is indicative of an
unfavorable case.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS is always required. See See Underwriting See Underwriting Action Below
Underwriting Action Below
Action Below

OTHER FACTORS: See See Underwriting See Underwriting Action Below

The type of muscular dystrophy and Underwriting Action Below
degree of progression determines Action Below
insurability

UNDERWRITING ACTION: Uninsurable Approved unless Uninsurable

Most types are uninsurable. Those currently disabled.
that can be issued will require a
rating of T-6 to T-8. One type,
"myotonia congenita of Thomsen,"
in its mild form and if over age 19
at diagnosis can be considered
standard.

64
Overweight
The relationship between overweight and mortality is well established. It does not matter if the weight is due to
muscle or fat. Significant overweight is commonly associated with cardiovascular problems.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
Ratings for overweight are generally Ratings for overweight See A74000 - See
determined from the application. Ratings for are not assigned until Underwritin Underwriting Action
overweight are not assigned for less than they equal T5 on the life g Action Below
(Table 2). If the amount of overweight build chart. Below D50000 - See Life
requires a rate up in excess of T-4, an APS or Cases rated T-5 to T-8
exam is required. for overweight will be
assigned a 100% increase
Example: (See Life build chart) in premium.
A 5’0” 185 lbs. (female) is issued standard.
At 186 lbs., A Table 2 is assigned. Example: (See Life build
chart) An applicant who
is 5’6” 268 lbs. is rated
Complications/Unfavorable Factors T-5 for Life. The
are poorly controlled high blood H34000 is assigned a
pressure, diabetes mellitus and heart 100% increase in
disease premium.

UNDERWRITING ACTION: See height and weight Approved A74000 - See

See height and weight chart on the flash sheet chart for Life and above unless Life A71000
for Life. requirements. coverage is D50000 - See Life
uninsurable.

65
Parkinson’s Disease
Parkinson’s disease is a chronic syndrome consisting of tremor, muscular rigidity, and extreme slowness of
movement. It is due to the loss of certain nerve cells in the brain. Most cases are idiopathic; i.e., there is no
known cause. The degree of impairment is generally progressive over many years. With advancing disease,
symptoms become incapacitating with marked depression, recurrent pneumonia, or dementia. Treatment
usually consists of medications that lessen the severity of symptoms.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS is always required. Most See See Underwriting See Underwriting Action
cases will require a rate up. Cases Underwriting Action Below Below
diagnosed after age 50 have a more Action Below
favorable prognosis than at younger
ages.

UNDERWRITING ACTION: Uninsurable Approved unless A74000 - Mild cases are

Ratings range from T-2 to T-6. Some currently disabled. insurable. Moderate to
severe cases are uninsurable. severe cases are
uninsurable.
D50000 - Uninsurable

66
Peripheral Vascular Disease (PVD)/ Arteriosclerosis
Hardening of the arteries, atherosclerotic narrowing of the arteries that supply blood to different parts of the
body.

Peripheral Vascular Disease is a disorder characterized by the formation of atherosclerotic plaques that form in
the large and medium size arteries of the legs or less commonly in the abdominal aorta.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS is always required. We need to See See Underwriting See Underwriting
know if unoperated or operated. Underwriting Action Below Action Below
Action Below

OTHER FACTORS: See See Underwriting See Underwriting

Complicating factors are continued Underwriting Action Below Action Below
cigarette smoking, diabetes, and Action Below
hypertension that is not controlled.

UNDERWRITING ACTION: Uninsurable Approved unless A74000 - See A71000

Most cases will require a rate-up. currently disabled. D50000 – Uninsurable

A diagnosis of coronary artery disease,

cerebrovascular disease and peripheral
vascular disease, or PVD requiring
surgery is uninsurable.

67
Phlebitis/Thrombophlebitis
Phlebitis is inflammation of a vein. Thrombophlebitis occurs when a blood clot (thrombus) is associated with
inflammation of a vein. Complications of phlebitis and occlusion are swelling, ulceration and the production of
clots, which may travel to vital organs. A clot that travels to the lungs is known as a pulmonary embolism.
Treatment may include the use of anticoagulants, anti-inflammatory agents and the application of heat to the
extremity involved.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION
NEEDED/
REQUIREMENTS: See Life See A74000 - See
Whether an APS is required Underwritin Underwriting Action
will depend on the severity of g Action Below
the disease and date of last Below D50000 - See Life
episode.

OTHER FACTORS: See Life See A74000 - See

Complicating factors are Underwritin Underwriting Action
pulmonary embolism, g Action Below
ulceration or swelling. Below D50000 - See Life

UNDERWRITING An Exclusion Rider is required if Approved A74000 - Most cases are

ACTION: an episode has occurred within 2 unless approved. Very severe
If hospitalized within last 6 years of the application date or currently cases and those who are
months is uninsurable. A there are continuing complications. disabled. disabled are uninsurable.
single episode with full A single episode without D50000 - See H34000
recovery is standard. complications and with full
Multiple episodes with recovery more than 2 years before
complications may require a application date can be approved
rating of T-2 to T-4. The standard.
most severe cases may
require a decline. Applicants who are continuing to
receive anti-coagulant treatment are
uninsurable.

68
Psychosis - Schizophrenia
If an individual's mental disease is such that the person cannot distinguish reality from their thoughts, then that
person has psychotic features. This is generally characterized by hallucinations (hearing voices, delusions,
irrational belief in false ideas and abnormal thinking patterns).

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See Life See Underwriting See Underwriting Action Below
Depression Questionnaire. An APS Action Below
is always required. The degree of
impairment, duration of effective
control and date of diagnosis is
information needed from the APS.
“Effective control” means the
individual has adjusted well to the
impairment and is currently not
experiencing any significant
interference with the activities of
daily living.

UNDERWRITING ACTION: Most cases are Uninsurable Uninsurable

Range of rating for two to five years uninsurable.
of recovery is T-8 to T-12. Some
cases with severe impairment can Some cases may
be considered after two years of be considered
recovery at T-10 to T-16. Those after ten years
who have not achieved "effective of “effective
control" are uninsurable. control”.

69
Residency - Citizenship
For Residency Guidelines, see the Residency Addendum Instructions document on the Underwriting page of
the Agency Resource Center.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
Residency Addendum should be See Life See Life See Life
completed for every application that
answers no to the citizenship
question.

UNDERWRITING ACTION: See Life See Life See Life

Follows Residency Guidelines as
outlined in the Residency
Addendum Instructions.

70
Seizures - Grand Mal Epilepsy
Epilepsy (seizure) is a disorder characterized by recurrent, brief episodes of uncontrollable activity produced by
abnormal electrical stimulation within the brain. A grand mal seizure involves the entire brain producing
convulsions of the whole body with loss of consciousness.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a Seizure See Life See Life See Life
Questionnaire. An APS may be required.
Information from the applicant regarding date
of diagnosis, type and amount of medication,
how many seizures per year and date of last
seizure is essential in evaluating the risk.

Much of the increased morbidity and mortality

come from the risk of an accident occurring
during a seizure.

UNDERWRITING ACTION:
Usual range of rating is from T-2 to T-10. An increase in Applicants who A74000 - See A71000
Those cases diagnosed more than 5 years ago premium of 75% have not had a D50000 - See H34000
and no seizures for more than 5 years may may be seizure for 2
qualify standard. considered for years can be
applicants who approved.
Those having more than 12 seizures per year have not had a
generally require a rating of T6 and up. seizure in 2 years.Applicants who
Waiting period of 6 months from the date of have had a
diagnosis before application can be considered. Applicants who grand mal
have had a seizure seizure within 2
within 2 years of years of the
the application application date
date are are uninsurable.
uninsurable.

71
Seizures - Petit Mal Epilepsy
Epilepsy (seizure) is a disorder characterized by recurrent, brief episodes of uncontrollable activity produced by
abnormal electrical stimulation within the brain. Petit Mal (generalized absence) seizures are characterized by
episodes of staring without any abnormal movements, but with loss of consciousness.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
The agent should always complete a See Life See Life See Life
Seizure Questionnaire. An APS is
usually required. Information
needed from the applicant is date of
diagnosis, type and amount of
medication, how many seizures per
year and date of last seizure.

OTHER FACTORS:
Cases requiring the highest ratings, See Life See Life See Life
apply to juveniles, frequent seizures
and a short time since the original
diagnosis.

UNDERWRITING ACTION:
Best cases may be issued standard. Applicants who have not Approved A74000 - See A71000
Those requiring a rating will range had a seizure in 2 years unless D50000 - See H34000
from T-2 to T-4. Waiting period of will be approved standard. currently
6 months from the date of diagnosis All who have experienced disabled.
before application can be a seizure within 2 years of
considered. the date of the application
are uninsurable.

72
Sleep Apnea
The sleep apnea syndromes are a group of disorders that are characterized by the presence of periodic pauses in
breathing during sleep. These pauses may be either complete, during which airflow totally ceases (apneas) or
partial, during which airflow is significantly diminished but does not entirely cease (hypopneas). They may be
the result of a brain stem failure to continue breathing efforts during sleep (central sleep apnea or Ondines
Curse) or may be due to obstruction to airflow at the level of the pharynx (obstructive sleep apnea). The
combination of central apneas followed by obstructive apneas is termed mixed sleep apnea. By far, the most
common form of sleep apnea is obstructive sleep apnea.

Obstructive sleep apnea is usually suspected when a history of loud snoring is present in addition to one or more
of the following features: (1) witnessed apneic episodes; (2) hypersomnolence; (3) change in personality or
ability to concentrate; (4) insomnia; and, (5) significant obesity. However, many persons may have sleep apnea
without being significantly overweight.

The consequences of sleep apnea include:

- repetitive drops in blood oxygen levels during sleep (oxygen desaturations)
- complete or partial arousals from sleep (sleep fragmentation)
- excessive daytime sleepiness (EDS or hypersomnolence)
- arrhythmias (sinus pauses, transient heart block, and atrial and ventricular arrhythmias during apnea)
- hypertension
- impaired neuropsychological functioning (including altered libido, impotence, irritability, personality
disturbances, inability to concentrate, fatigue, and an increased risk of driving and industrial accidents),
and sudden death.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
Agents should complete a Sleep See Life See A74000 - See
Questionnaire. An APS is sometimes Underwriting Underwriting Action
required. Action Below Below
D50000 - See Life

OTHER FACTORS: See Life See A74000 - See

The result of a polysomnogram is Underwriting Underwriting Action
useful information to assess severity. Action Below Below
Additional complicating factors are D50000 - See Life
overweight, COPD, CAD and
smoking.

UNDERWRITING ACTION: Best cases, i.e. mild cases If insurable for A74000 - See A71000
Cases, which have responded to requiring no therapy can Life, Accident D50000 - See H34000
therapy favorably, may be approved be considered at standard. coverage is
standard. Others will require a rate up Cases requiring therapy approved.
and some cases are uninsurable. (CPAP or surgery) may
be uninsurable.

73
Tuberculosis
Tuberculosis is an infectious disease caused by the bacillus, mycobacterium tuberculosis. This bacillus is
transmitted through the air and infects people with normally functioning immune systems as well as those who
are immunocompromised. The lungs are the most commonly affected organ, but the disease can also involve
other sites. Once a common health problem, tuberculosis in the United States and Canada had been steadily
decreasing in incidence until the mid 1980s. However, with the advent of the AIDS epidemic, the number of
new cases diagnosed in these countries has dramatically increased since 1985.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS may be required. See Life See Underwriting A74000 - See
Action Below Underwriting Action
Below
D50000 - See Life

OTHER FACTORS: See Life See Underwriting A74000 - See

The degree of lung impairment after Action Below Underwriting Action
full recovery will determine the Below
rating. If no lung impairment, then D50000 - See Life
the case is standard.

UNDERWRITING ACTION: Mild cases with full Approved unless A74000 - See A71000
A positive skin test and a negative recovery can be issued currently disabled. D50000 - See H34000
check X-Ray is usually approved standard. Cases worse
standard. Current treatment or than mild will require
significant complications may be an exclusion rider or
uninsurable. may be declined.

74
Ulcers (Duodenal, Gastric, Peptic)
Peptic ulcer disease is a common impairment in which ulcerations develop in the esophagus, stomach,
duodenum, and upper jejunum. In all cases, these ulcerations are associated with the secretions of acid and
pepsin (an enzyme secreted by the stomach that digests protein). Peptic ulcers occur if the protective
mechanisms, which normally guard the upper intestinal tract against the deleterious effects of acid, pepsin and
other digestive enzymes, are overwhelmed. Peptic ulcers are most common in the duodenum (duodenal ulcers)
and stomach (gastric or stomach ulcers). There is a broad spectrum of severity with this disorder. Some
individuals recover quickly after one or two brief episodes. Others experience multiple recurrences of active
ulceration and pain lasting days to a few weeks, eventually subsiding with medical therapy. Finally, a small
group experience almost constant pain with the eventual development of complications necessitating surgery.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS is not usually required – if See Life See Underwriting A74000 - See
the ulcer was more than 6 months Action Below Underwriting Action
ago and completely healed, an APS Below
is not needed. D50000 - See Life

OTHER FACTORS:
Complicating factors are recurrence, See Life See Underwriting A74000 - See
history of hemorrhage and surgery. Action Below Underwriting Action
Below
D50000 - See Life

UNDERWRITING ACTION:
Most cases are issued standard. A single episode of Approved if A74000 - See A71000
duodenal ulcer with no insurable for Life. D50000 - see H34000
complications diagnosed
more than 1 year ago
may be issued standard.
Others will require an
Exclusion Rider.

75
Weight Loss Surgery
Bariatric surgery treats obesity by altering the digestive process. It has been shown to produce effective weight
loss for clinically severe obesity, with a reversal or reduction in associated diabetes mellitus, hypertension,
hyperlipidemia, and obstructive sleep apnea. Surgery is divided into two categories:
Restrictive surgeries – Laparoscopic adjustable gastric band, laparoscopic sleeve gastrectomy, and vertical
banded gastroplasty.
Malabsorptive surgery – a more extensive operation. Roux-en-Y gastric bypass, jejunoileal bypass.

LIFE
A&H DISABILITY

H34000 A71000 A74000/D50000

INFORMATION NEEDED/
REQUIREMENTS:
An APS is usually required. See Life See Underwriting A74000 - See
Action Below Underwriting Action
Below
D50000 - See Life

OTHER FACTORS:
If weight has not normalized, a rate See Life See Underwriting A74000 - See
up or decline may be necessary. Action Below Underwriting Action
Below
D50000 - See Life

UNDERWRITING ACTION:
A waiting period of 3 months from May consider after a 2 Approved if A74000 - See A71000
the date of a lap band is required. 6 year waiting period for insurable for Life. D50000 - see H34000
months wait is required for a lap band surgery.
bypass. Bypass surgery is a
decline.

76