If it hasn't happened to you yet, it is only a matter of time!

What am I talking about?  The pro BNP is a simple blood test that can indicate the presence of congestive heart failure (CHF).  An elevated level can result in a rating or even a declination for your client.  The challenge it presents is the proposed insured can be completely asymptomatic and still come up with elevated levels on this test.  As in most cases, the lab tests trump just about everything, so the fact that the client is asymptomatic is not enough to counter the negative impact of an elevated pro BNP.

What to do about this?  First and foremost, it's time to arm ourselves with a little education, and Quest Diagnostics can help us do just that.  They have a nice write up on their web site - pro BNP - but there is probably no need for you to read beyond the first two sections.  Here's the bottom line:

• A normal pro BNP has a strong predictive value (at least 98%) in ruling out congestive heart failure
• 50% of CHF patients are asymptomatic
• CHF is a/the leading cause of hospitalization in the elderly

Anyone who has been in the life insurance business can see why a carrier, or more importantly, a reinsurer, would be interested in the results of this test.  So interested in fact, that the majority of carriers are now including it as part of the normal panel for older clients.  Great for them, not so great for us or our clients (At least from a pricing perspective.  The more thoughtful client may appreciate the early heads up on something like this.).  So now what?

The critical step is to know which carriers use this test, and which don't.  If the pricing is close, maybe go ahead and use the carrier that does not run this test.  That's the obvious path, and there are cases that will not follow it.  The result if the subsequent test is elevated is either a significantly different price for the client, or a lost sale.  There are a couple other possibilities:  move the case to a carrier that will ignore the test completely (this becomes more challenging by the day), or map out a strategy to offset the elevated pro BNP with other testing.

That last choice is going to vary from case to case, and we are here to guide you through that process when the inevitable surprise confronts one of your cases.

While we are on the subject of lab results today, you can also take a look at this summary of routine underwriting lab tests. 

Lab Tests Explained

Hopefully it will help you explain what it all means the next time a client comes back with an abnormal result.

Until next week,