Elevated Liver Enzymes Life Insurance (Here’s How You Get Approved!)

Elevated liver enzymes shouldn’t stop you from getting affordable life insurance. Here’s how we can help.

By Michael Horbal - Updated on 09/13/2023

Can You Get Life Insurance With Elevated Liver Enzymes?

Yes, you can get life insurance.

Many clients come to us after having elevated liver enzymes on a life insurance paramedical exam.

Underwriters look at your lab test results for AST, ALT, bilirubin, GGTP, and ALP. They also want to know if the elevations are from a known or unknown medical condition.

sample liver enzyme tests

The primary concerns underwriters look for are signs of liver disease or alcohol abuse.

Secondarily, they look for signs of illness, medications, or other unknown issues that may elevate liver enzymes.

In our experience underwriting elevated liver enzymes, most people can obtain life insurance. Still, you may have to pay more or complete tests (more about tests later) before coverage becomes available.

Underwriters look at:

Which tests are elevated
How many tests are elevated
How elevated the results are
Underlying medical conditions
Evidence of liver disease
Unknown causes

We work with life insurers specializing in high-risk life insurance to help you get the best rates.

How Do Liver Enzyme Lab Results Affect Life Insurance?

You’re probably wondering how far outside the normal range your labs are if you were rated or declined.

Single Liver Enzyme Elevation Guidelines When One Test Result is Elevated

Alkaline Phosphatase (ALP) – Normal is 44-147 (IU/L)

3-5x normal range = standard rates
Greater than 5x normal = postpone/decline

Alanine Aminotransferase (ALT) – Normal is 45 U/L

Less than 4x normal = Standard rates
4-5x normal = Table 2 rating
Greater than 5x normal = postpone/decline

Aspartate Aminotransferase (AST) – Normal is 45 U/L

Less than 5x normal = Standard rates
Greater than 5x normal = postpone/decline

Bilirubin – Normal range is 0.3 – 1.2 mg/dl

Less than 6.0 mg/dl = standard rates
Greater than 6.0 mg/dl = postpone/decline

Gamma Glutamyl Transferase (GGT) – Normal is 65 U/L

Less than 4x normal = standard rates
4-5x normal = Table 2 rating
Greater than 5x normal = postpone/decline

Underwriting becomes more complicated for multiple elevated results.

For example, underwriters look at how elevated above average the enzyme results were:

ALP greater than 1.5x normal
ALT and AST above 50 U/L
Bilirubin greater than 2 mg/dl
GGTP above 65 U/L

With 2 or more elevations:

Less than 2x normal = Standard rates
2-3x normal = Standard rates plus 50% (Table 2)
3-4x normal = Standard rates plus 100% (Table 4)
4-5x normal = Standard rates plus 150% (Table 6)
Greater than 5x normal = postpone/decline until evaluated.

Something to keep in mind is that these are general guidelines. Your outcome could be better or worse.

What to Do if You Were Declined Due to Elevated Liver Enzymes?

Have you been denied life insurance because of elevated liver enzymes?

Most life insurance companies do a poor job of underwriting elevated liver enzymes.

The good news is that several life insurance companies understand how to underwrite liver enzymes, and we should explore those options before you go through additional testing.

We can often simply move you to a better company using your existing lab results.

Once we have coverage in place, we can explore additional testing to see if it will help your life insurance rate.

We explain in the next section why you want to try and lock in coverage before going through additional testing.

What Should You Do If You Are Table Rated Due to Elevated Liver Enzymes?

You should contact us before you do anything.

Here’s why:

In 20+ years of high-risk underwriting for elevated liver enzymes, 99% of elevations are due to either having a liver problem or having absolutely nothing wrong!

The Underwriting Trap – Your life insurance company approves you but adds a table rating expense to your policy.

You’re pissed because the price is 50-150% more than your original quote.

Your current agent (who you will fire after reading this article) tells you that a better rate may be available if you repeat testing at your own expense.

The risk of taking this gamble is that if those tests confirm a liver health issue, the insurance company will rescind your original offer.

Here’s what you should do instead.

Accept the table-rated policy temporarily on a monthly basis, and contact us!

We’ll tell you if we think your current policy is the best available or if other better options exist.

Important Note About Repeat Testing – If elevations are believed to be temporary, simple lab testing with normal results may be enough to get you a better offer.

Sometimes, though, a liver sonogram and liver biopsy may be the only tests that help improve your rate. These tests may also confirm a liver problem, so that’s why you should accept your initial policy before taking these steps.

Here’s what we do instead – We’ll shop the market using your existing lab results to see if we can get a better rate for you. If a better offer exists, you make the switch.

And then, we can decide together if additional favorable test results will give you even better rates. If it does, we can switch again. If not, you’ll know that your rate is the best available.

Elevated Liver Enzymes Underwriting

We use a quick quote process. Quick quotes allow us to contact all life insurers that underwrite elevated liver enzymes. We summarize your medical information and can get underwriting feedback in 3-5 days.

At that time, you’ll know what to expect regarding underwriting and price.

When you apply for life insurance, underwriting will check the MIB for prior application activity and review your medical history, including the possible reasons for the elevations.

If you have other health issues like heart disease or a history of prostate cancer, underwriting will consider those issues when making an offer.

Health Issues That May Elevate Liver Enzymes

The following health issues are known to cause problems.

Hepatitis – is a severe inflammation of your liver that may lead to liver cirrhosis if untreated.

Cirrhosis causes irreversible scarring and damage to your liver, and you will be uninsurable except for final expense types of policies.

Alcohol Abuse – This may cause significantly elevated liver enzymes.

Some health issues like ulcerative colitis or Crohn’s disease may also elevate liver functions.

Things That Elevate Enzymes

Exercise – Exercise temporarily elevates liver functions.

Liver enzymes stay elevated for hours after exercising. 

Do not exercise on the day of your paramed exam.

Make sure you read our paramedical exam tips for the best results.

Medications – Aspirin and Tylenol may elevate your liver enzymes.

Tell your paramed examiner about any medications taken,

Including over-the-counter medications.

Prescription medications may elevate liver enzymes.

Dilantin, Truvada, phenobarbital, antibiotics, acne treatment medications, and arthritis medications all elevate enzymes.

Some herbal remedies tend to elevate liver enzymes.  

Sickness – If you are sick or have an illness, postpone your exam.

Liver enzymes elevate when you’re sick.

Medical conditions like Crohn’s disease and HIV+ may elevate liver functions.

Alcohol and life insurance exams – Occasional glasses may elevate your liver enzymes.

It is best to avoid alcohol for a few days before your paramed exam.

We can always reschedule your paramed exam.

I Have Elevated Liver Enzymes; Now What?

A letter to the underwriter can resolve some temporary elevations.

In more severe liver enzyme elevation, underwriters will ask for additional testing before considering life insurance.

Whatever your situation is, we’ll review and decide the best steps to take moving forward.

Lab Tests for Liver Enzymes

Liver enzyme tests by life insurance companies include:

GGTP

Gamma Glutamyl Transferase – Also known as GGT test.

GGTP levels greater than 65 U/L are significant.

AST

Aspartate Aminotransferase – also known as Serum Glutamic Oxaloacetic Transferase (SGOT)

AST levels greater than 45 U/L are elevated.

ALT

Alanine Aminotransferase, aka Serum Glutamic Pyruvic Transferase (SGPT)

ALT levels greater than 45 U/L are considered elevated.

Bilirubin

Life insurers may decline Bilirubin levels greater than 6.0 mg/dl.

Fatty Liver

Fatty liver is diagnosed when more than 5% of the liver is made from fat and is traditionally classified as alcoholic or nonalcoholic fatty liver.

Non-Alcoholic Fatty Liver Disease (NAFLD) is the liver’s enlargement due to fat accumulation in the liver cells.

Some causes of fatty liver include obesity, diabetes, and excessive alcohol use.

If there is inflammation and cell death in the liver, that is a more serious condition called non-alcoholic steatohepatitis (NASH). Fibrosis (scarring) and cirrhosis are severe medical conditions and difficult to insure.

If the liver health issue is due to alcohol consumption, the only option available will be guaranteed issue-type policies.

Simple fatty liver with no additional inflammation or scarring is often insurable at “standard” to “Standard with a 50%” rating.

Final Thoughts

Each life insurer has its own set of guidelines regarding liver enzymes. 

Based on your medical history. We’ll know the best life insurance companies.

We’ll explain which companies are best and why.

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