Greetings!

Question: How would you manage this situation? You have a client who sees a therapist for anxiety and is applying for a large amount of life insurance. The APS you receive from the therapist is a one-page document that cites a diagnostic code and no other useful information. You are concerned that underwriting will want more information given the size of the case, and you cannot afford a time delay. Suggestions? 

SMC opinion: Get the client involved and inform him of the situation. Prior to the date of the insurance exam, consider having him write an "addendum" that he can attach to the insurance application. It could provide the details about his visits to the therapist. Some of what underwriting might want to know is why he is seeing a therapist, when he began seeing the therapist, and his treatment plan and results. The details your client provides may satisfy the carrier's need  for more information about this issue.

Jack Cotlar, M.D.

Stategic Medical Consulting, Inc.   

www.strategicmedconsulting.com 

Important Notice:

The opinions and examples contained in this e-mail are those of Strategic Medical Consulting, Inc. (SMC). As each case is fact sensitive, it would be ill-advised to take action on any given case based on the conclusions from examples that are included in this communication. Whether or not they are appropriate for a specific medical underwriting situation must be determined by the producer who will assume all responsibility should the outcome not be favorable. The examples illustrated herein are what SMC provides on a case-by-case basis for and to its clients. In addition, the opinions are not medical advice and they do not establish any physician-patient relationship.