Abnormal electrocardiograms are common in life insurance underwriting. We show you how to get approved.
Abnormal EKG Overview
- How Does an Abnormal EKG Affect Life Insurance?
- Abnormal EKG Underwriting Questions
- Abnormal EKG FAQ
- EKG Test Requirements by Life Insurance Company
Finding affordable life insurance with any heart condition starts with understanding your health condition.
How Does an abnormal EKG Affect Life Insurance?
Life insurance companies always assume the worst when they see an abnormal electrocardiogram (EKG).
Electrocardiogram abnormalities range from minor T-wave changes that have little impact on underwriting,
To major heart conditions that may get you declined!
Some life insurers may tell you that a better rate is available if you first complete a favorable cardiac workup.
Don’t do it. (yet)
Instead, you should accept the current offer first (you can pay monthly) and then let us shop the market for you.
The reason why is that if it turns out your heart condition is significant, the original offer may be lost for good.
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? (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 companies have you previously applied to?
- What was the underwriting outcome with them?
With the above information,
We’ll shop the life insurers that specialize in heart conditions.
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 underwriting. See below for individual company rules.
Abnormal EKG results are classified from minor to major. Minor changes may have no impact, while major T-wave and ST-segment changes may result in a negative outcome.
Abnormal EKG Causes
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.
- Atrial Fibrillation
- Atrial Flutter
- AV Blocks
- Bundle Branch Blocks
- Congestive Heart Failure
- Coronary Artery Disease
- Electrolyte Imbalance
- Heart Attack
- Heart Rate Abnormalities
- 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.
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 today as many companies 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.
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.
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.
As much as you may be upset about the approval,
You should probably 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.
We can then re-shop the market to see if a better offer exists.
Postponed until cardiac testing is complete
When you are postponed until further testing is complete,
Underwriters have a 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 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.
Once the issue has been resolved with your physician, we can look for coverage.
EKG Test Requirements by Life Insurance Company
When the EKG is required, it is based on your age and the amount of life insurance you apply for.
EKG requirements by company, age and face amount:
- AIG-American General
- Age 71 or older or anyone applying for $10 million+
- American National
- Age 18 – 40 for amounts over $1.5 million
- 41 – 50 for amounts over $1 million
- 51+ for amounts over $500,000
- Applicants aged 51 or older and are applying for $500,000+
- Banner Life
- Age 41 or older if applying for $1,000,000+
- 61 or older if applying for $250,000+
- Age 18+ When applying for $10 million+
- 41+ When applying for $2.5 million+
- 51+ When applying for $500,000+
- 56 or older – When applying for $250,000+
- 61 or older – When applying for $100,000+
- Cincinnati Life
- Age 18 or older and $1,000,000+
- 51 or older and $500,001+
- 70 or older and $100,000+
- Columbus Life
- Age 41 or older and $1,000,000+
- 61 or older – All amounts
- Lincoln National
- No EKG required up to $60 million, all ages.
- Age 18 – 39 for amounts greater than $5 million
- 40 – 50 for amounts greater than $1 million
- 51 – 70 for amounts greater than $500,000
- 71+ for amounts greater than $50,000
- North American for Life & Health
- Age 16 – 45 for amounts greater than $2 million
- 46 – 55 for amounts greater than $500,000
- 56 – 75 for amounts greater than $250,000
- 76+ for amounts greater than $100,000
Additional companies include
- Protective Life
- Age 16 or older and $5,000,001+
- 41 or older and $1,000,001+
- 51 or older and $500,001+
- 61 or older and $250,001+
- 71 or older and $150,001+
- Age 41 or older and $10 million+
- Age 41 – 50 for amounts greater than $1 million
- 51 – 60 for amounts greater than $500,000
- 61 – 69 for amounts greater than $250,000
- 70 – 80 EKG required for all cases.
- Age 0 – 49 for amounts greater than $10 million
- 50 – 59 for amounts greater than $500,000
- 60 – 80 for all amounts
- Age 18 – 40 for amounts greater than $10 million
- 41 – 70 for amounts greater than $2 million
- 71+ for amounts greater than $500,000
- United of Omaha
- Age 61 – 65 for amounts greater than $5 million
- 66 – 70 for amounts greater than $2 million
We work for you, not the insurance company.
We’ll do everything we can to get you the best rate possible.
Please take a few minutes to complete our quote request.
Michael J Horbal
I’m the owner of RiskQuoter. We specialize in life insurance underwriting, helping you get the best rates whether you have perfect health or a history of medical problems.
Last Updated – January 27, 2021