An abnormal electrocardiogram (EKG or ECG) in life insurance underwriting is common but may be costly to you if it is mishandled. This guide shows you what to do.
Finding affordable life insurance with any heart condition depends on understanding your health history, and working with the right life insurance companies.
Abnormal EKG Overview
The following article provides you with the information you need to make an informed decision about your life insurance – these links take you right to the info.
- How Does an Abnormal EKG Affect Life Insurance?
- Abnormal EKG Underwriting Questions
- Abnormal EKG FAQ
- EKG Test Requirements by Life Insurance Company
How Does an abnormal EKG Affect Life Insurance?
Life insurance companies always assume the worst when they see an abnormal electrocardiogram (EKG)…which leads us to the most important underwriting tip.
Here’s Why – Electrocardiogram abnormalities range from minor T-wave changes that have little impact on underwriting, to major heart conditions that may get you declined!
Some companies will tell you that a better rate may be available if you have a favorable cardiac workup completed first…don’t do it.
Instead, you should accept the current offer first (you can pay monthly) and then let us shop the market for you.
This way, you will have coverage in effect if it turns out your heart condition is significant and that prior offer was the best available.
Abnormal EKG Underwriting Questions
Underwriters want to know:
- When were you first diagnosed with an abnormal EKG?
- What tests were performed to diagnose this condition?
- What is your specific diagnosis? (it’s important to have the exact condition)
- Do you see a cardiologist for this condition?
- Has your cardiologist recommended surgery?
- If yes, has the surgery been completed? If not, why?
- What medications and dosages do you take?
- Do you have any current symptoms – palpitations, chest discomfort, dizziness, etc?
- Have you had any other health conditions? If yes, what?
- Is there any family history of your parents/siblings having heart conditions?
- If yes, who was it and what did they have?
- Which life insurance companies have you previously applied to?
- What was the underwriting outcome with these companies?
With the information you provide us, we’ll shop the life insurance companies that specialize in heart conditions for underwriting feedback (takes about 3 days).
Once we have all underwriting feedback, we’ll tell you what to expect from each company in terms of underwriting and price.
Abnormal EKG FAQ
An EKG measures the electrical activity of your heart and graphs it to paper. The EKG (or ECG) measures your heart’s rhythm, heart rate, P Wave, PR interval, QRS interval, T wave, QT interval, and ST-segment.
No. In fact, more and more companies have eliminated the EKG from their underwriting requirements. Click here for the rules by the company or ask us and we’ll tell you which companies require the EKG.
It depends on the EKG abnormality. Abnormal EKG results are classified from minor to major. Minor changes may have no impact on life insurance, while major T-wave and ST-segment changes may result in a table rating or postpone until it is further evaluated by your physician.
An EKG measures the electrical activity of your heart and graphs it to paper that looks like this.
Abnormal EKG readings take many shapes depending on the underlying heart issue.
The Mayo Clinic has a great article about EKG tests that you may find interesting.
Abnormal EKG causes may include heart problems such as:
- Atrial Fibrillation
- Atrial Flutter
- AV Blocks
- Bundle Branch Blocks
- Congestive Heart Failure
- Coronary Artery Disease
- Electrolyte Imbalance
- Heart Attack
- Heart Rate Abnormalities
- Hypertension
- Mitral Valve Prolapse
- Premature Ventricular Contractions (PVC)
- Ventricular Tachycardia
- Ventricular Fibrillation
The impact on life insurance underwriting depends on what type of abnormal heart rhythm you have and your overall cardiac history.
Abnormal EKG from Life Insurance Exams
You may first learn that you have an abnormal EKG from your paramed exam…although this is less likely to happen as many companies have recently updated their guidelines to do away with EKG tests.
We can tell you upfront whether an EKG test will be required as each life insurer has its own set of underwriting guidelines that determine if and when an electrocardiogram is required.
The ECG requirement is based on your age and the amount of life insurance.
If required, the examiner will bring a portable EKG machine with them. The ECG is painless and takes a few minutes to complete.
Once complete, the ECG is sent to underwriting where the underwriter will review and interpret the EKG.
If it appears abnormal, it is sent to a medical director at the insurance company for further review. A medical director is a physician who specializes in insurance medicine.
Once reviewed, the insurance company will make one of the following decisions:
Approved as you applied
If you are approved as we applied, accept the offer and be done with it.
The carrier considers the abnormality to be minor enough to disregard.
We’ll get you a copy of the EKG and our advice is to have your doctor take a look at it.
Approved at a higher price than you applied for
You may get approved, but the rate is more expensive than expected due to the ECG result.
As much as you may be upset about a more expensive table rated offer, you should accept that offer at least on a temporary basis.
The reason why is that if further testing such as a stress test reveals a significant heart issue, the offer you have now may be the best available.
If not, we can re-shop the market and find a better policy after you follow-up with your doctor.
Postponed until cardiac testing is complete
When you are postponed until further testing is complete, underwriters have a significant concern about the underlying heart issue.
The best course of action is to take the EKG to a cardiologist and let them advise you of the next steps.
If you require surgery, a pacemaker or other treatment, we’ll revisit life insurance once you recover.
Your doctor may perform more extensive tests that are normal and we’ll use that information to get life insurance for you.
Declined for life insurance
When you’re declined for life insurance, it’s important that you visit with your physician as soon as possible.
This tells us that there is a significant concern that needs to be reviewed by a cardiologist.
The type of underlying heart issue will determine what type of life insurance will be available and when life insurance is available in the future.
Keep in mind that our life insurance service is free, and there is never any pressure or obligation.
We’ll show you which life insurance companies are best and what to expect in terms of price. We’ll help you determine how much life insurance to get and what type.
EKG Test Requirements by Life Insurance Company
EKG testing is no longer required by many companies. When the EKG is required, it is based on your age and the amount of life insurance you apply for.
The following guidelines tell you when an EKG will be required.
- AIG-American General
- Age 71 or older or anyone applying for $10 million+
- American National
- Age 18 – 40 for amounts over $1.5 million
- Age 41 – 50 for amounts over $1 million
- Age 51+ for amounts over $500,000
- AXA
- Applicants aged 51 or older and are applying for $500,000+
- Banner Life
- Age 41 or older if applying for $1,000,000+
- Age 61 or older if applying for $250,000+
- Brighthouse/Metlife
- Age 18 or older – When applying for $10 million+
- Age 41 or older – When applying for $2.5 million+
- Age 51 or older – When applying for $500,000+
- Age 56 or older – When applying for $250,000+
- Age 61 or older – When applying for $100,000+
- Cincinnati Life
- Age 18 or older and $1,000,000+
- Age 51 or older and $500,001+
- Age 70 or older and $100,000+
- Columbus Life
- Age 41 or older and $1,000,000+
- Age 61 or older – All amounts
- Lincoln National
- No EKG required up to $60 million, all ages.
- Nationwide
- Age 18 – 39 for amounts greater than $5 million
- Age 40 – 50 for amounts greater than $1 million
- Age 51 – 70 for amounts greater than $500,000
- Age 71+ for amounts greater than $50,000
- North American for Life & Health
- Age 16 – 45 for amounts greater than $2 million
- Age 46 – 55 for amounts greater than $500,000
- Age 56 – 75 for amounts greater than $250,000
- Age 76+ for amounts greater than $100,000
- Protective Life
- Age 16 or older and $5,000,001+
- Age 41 or older and $1,000,001+
- Age 51 or older and $500,001+
- Age 61 or older and $250,001+
- Age 71 or older and $150,001+
- Prudential
- Age 41 or older and $10 million+
- SBLI
- Age 41 – 50 for amounts greater than $1 million
- Age 51 – 60 for amounts greater than $500,000
- Age 61 – 69 for amounts greater than $250,000
- Age 70 – 80 EKG required for all cases.
- Symetra
- Age 0 – 49 for amounts greater than $10 million
- Age 50 – 50 for amounts greater than $500,000
- Age 60 – 80 for all amounts
- Transamerica
- Age 18 – 40 for amounts greater than $10 million
- Age 41 – 70 for amounts greater than $2 million
- Age 71+ for amounts greater than $500,000
- United of Omaha
- Age 61 – 65 for amounts greater than $5 million
- Age 66 – 70 for amounts greater than $2 million
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