Introduction

Clients have certain apprehension about taking a medical examination for life insurance. The process provokes both anxiety and hesitation. In addition, it is possible that improper client preparation could lead to avoidable poor underwriting outcome.

This guide provides strategies to assist life insurance agents to make the process easier and improve the chances of the best medical outcome.

Client Preparation

The following is a list of items that improve a client’s chance of having a successful medical examination.

1. Rest and Good Health Clients should have adequate rest and be in good health for their medical examination. If a client is sick (i.e. has a cold) or exhausted, reschedule the examination.
2. Nicotine Testing Clients will have their urine tested for nicotine. Clients do not have to be cigarette smokers to have nicotine discovered in their urine sample. Smoking cigars, chewing tobacco, snuff, the nicotine patch and nicotine gum can all cause nicotine to be detected in the urine.
   
   IMPORTANT NOTE: It is important that clients "disclose" any nicotine products they are y using to the medical examiner at the time of test. Failure to do so combined with a discovery of nicotine in the urine may suggest "lack of full disclosure."
   
   
3. Alcohol Consumption Clients should avoid all alcohol consumption preferably 48 hours before the examination. Alcohol consumption can increase blood pressure and adversely affect certain elements of the blood study.
4. Caffeine Consumption Clients should limit caffeine consumption 48 hours before the examination. They should have no caffeine the morning of the examination. Caffeine increases blood pressure and pulse rate. It can even provoke an irregular heart rate (arrhythmia). It is important to advise clients of the various sources of caffeine in the diet aside from coffee and tea (i.e. diet soft drinks, cold preparations, pain medications, etc.).
5. Medications Clients taking prescription medications should be taking the medications as directed by their physician. Clients who are not taking their prescription medication correctly (i.e. forgot to get a refill, taking the medications only occasionally) should not be examined until they return to the proper medication schedule.
   
   IMPORTANT NOTE: Failure to verify compliance with prescription medications may lead to adverse findings on the medical examination (i.e. elevated blood pressure, elevated cholesterol levels, elevated blood sugar levels, etc.).
   
   
6. Food and Drink Clients should not eat or drink four (4) hours before the medical examination. A small amount of water is permissible during this four-hour "fasting" period.
7. Exercise Clients should not exercise before they have their medical examination. Exercise, especially cardiovascular workouts, can cause inaccurate elevations of cholesterol levels.
8. Blood Pressure It is normal for clients to become anxious about having their blood pressure taken. It is helpful if clients are offered a few minutes to relax before their blood pressure is recorded. Elevated blood pressure readings need to be rechecked later on during the examination to insure that the examiner documents more than one reading.
9. Treadmill Testing Clients who are undergoing exercise treadmill testing should not eat or drink four (4) hours prior to the test.
   
   IMPORTANT NOTE: Clients should always have their life insurance blood sample drawn before they undergo an exercise treadmill test.
   
   
10. Pulmonary Function Testing Clients who are undergoing pulmonary function testing should realize that the quality of the test is determined by the effort (i.e. how much air is taken in the lungs and how hard and how long it is expelled) and the tightness of the seal on the mouth piece.

IMPORTANT NOTE: Clients who do not follow the above guidelines for pulmonary function testing may have their test interpreted incorrectly as abnormal.

Items That Need To Be Doubled Checked

The following are items that must be doubled checked either before or after the medical examination.

1. What are the exact prescription medications the client is currently taken from their physician?
   
   Underwriting Comment: Many times the examiner fails to list all of the client’s medications. This only complicates the underwriting process. Providing a complete and accurate list of the client’s medications at the outset of the underwriting process will prevent future surprises and provide important insight to potential underwriting problems.
2. When was the last visit to any physician?
   
   Underwriting Comment: Many times the examiner fails to list all of the client’s physicians or the correct date of the last visit. This only complicates the underwriting process. Providing a complete list of the client’s doctors and last date they were seen at the outset of the underwriting process will prevent future surprises and provide important insight to potential underwriting problems.
3. Is there any physician visit, medical test or medical procedure planned in the near future?
   
   Underwriting Comment: Many times the examiner fails to note that the client is planning to see a physician or undergo medical testing or a procedure. This only complicates the underwriting process. Providing a complete a correct list of any future medical care at the outset of the underwriting process will prevent future surprises and provide important insight to potential underwriting problems.

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