Why does a life insurer need an attending physician statement (APS)?
Insurance companies might request an APS from your doctor to get additional medical information as part of the underwriting process.
When you apply for life insurance, the insurance company needs to know how healthy you are when you sign the policy. They figure this out through a process called underwriting, during which you take a medical exam and submit information about your current health and medical history, lifestyle, and your family medical history.
As part of underwriting, some insurance companies request an attending physician statement (APS) from your doctor for additional information about your health. The more health or lifestyle risks you pose, the higher your premiums will be. In some cases, people with very serious health risks may not qualify for life insurance coverage.
An APS isn’t always required, but if you’re asked to provide one, here’s what you need to know.
Key takeaways
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An attending physician statement helps your insurance company learn more about your history with a pre-existing condition.
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An APS request can prolong the underwriting period but ensures you get accurate policy rates.
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The cost of the life insurance medical exam and APS (if required) are covered by your insurer.
What is an attending physician statement?
An APS is your doctor’s detailed evaluation of your current health, from their point of view.
If an issue pops up during your medical exam, an APS can let the insurer know if it’s due to a side effect of some medication you’re taking or if the cause is an underlying medical issue. Insurers must know exactly what they’re covering with a policy, and an APS sheds light on any ambiguities.
If you’ve ever visited the doctor to treat a chronic medical condition, you’ll be required to submit an attending physician statement. The APS helps the insurer decide how much risk your diagnosis poses to your health. Such conditions include asthma, diabetes, and sleep apnea, among other types of health issues.
What is included in an attending physician statement?
A standard attending physician statement contains the following questions for your doctor to answer:
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What is the history of the condition? The doctor will explain how long they have been treating you for your illness, including when symptoms began, dates of treatment, and what treatments you’ve tried.
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What is the prognosis? This section goes into how you’re managing your illness and whether you’ve seen any improvements since beginning treatment.
If you’re being treated by different doctors for different conditions, there’s a chance the insurance company will ask for an attending physician statement from each doctor treating each condition. The APS is also a standard part of disability insurance claims, for which you’ll need to provide information like how long you’ve been out of work and the capacity of your physical abilities.
How does HIPAA apply to an APS?
The same HIPAA rules that apply to your other health information also apply to your APS. You need to sign a waiver so that your provider can share your medical history with your insurance provider. Your insurer can only use APS information to determine your eligibility for coverage and set your rates and cannot sell or share those details.
ow does the APS relate to the medical exam?
The medical exam provides initial information about your health and medical history. During the physical portion of the exam, the medical technician conducts a standard medical checkup. But they may not be qualified to speak on more complex health issues, which is when you need to get an APS.
The APS not only backs up the conclusions of the medical exam, but it also gives a picture of your health to your insurer that goes beyond simple blood draws, urine tests, and heart rate measurements.
The APS and medical exam provide a more accurate look into your health history, and if it turns out the insurer will have to take on more risk to insure you than it first estimated, then it will adjust your premiums accordingly.
How long does it take to get an APS?
Applying for life insurance takes minutes, but it can take between five to six weeks (on average) before a policy is in force. Part of that time is spent on the underwriting process, which includes scheduling and taking your medical exam. The process takes longer if you need to wait on your doctor to fill out an APS.
After your doctor fills out the APS, it goes back to the underwriter. Many underwriters use a template or script to make sure they get all of the important information down as quickly and efficiently as possible.
But the wait will be worth it. Not only will you get life insurance coverage; you’ll also get peace of mind that your application is accurate. All life insurance policies have a contestability period, a two-year length of time after your policy is in force during which the life insurance company can contest your beneficiaries’ claim. A misrepresentation on your life insurance application can cause a delay or even a denial of the claim. The attending physician statement is a way to ensure that you represented yourself to the life insurance company as accurately as possible.
Temporary life insurance
If you want life insurance coverage in case something happens while you’re waiting for your policy to go in force, most companies offer temporary life insurance. This type of coverage is designed specifically for the period between your application and approval and can secure peace of mind for yourself and your family while you go through underwriting.
An attending physician statement can make your life insurance application process take a little longer, but it’s a simple step to getting a policy with the most accurate rates possible.
article from:https://www.policygenius.com/life-insurance/why-does-a-life-insurer-need-an-attending-physician-statement-aps/ -