by Bernice Casey, Senior Underwriting Consultant, Creative Life
As you grow your business and work to place policies on clients of all ethnicities, backgrounds, ages and lifestyle habits, you will become increasingly familiar with just how varied underwriting challenges can be. Sometimes, you may work with clients who have health issues that aren’t so obvious, resulting from a cause that isn’t easily identifiable. For example, what should you do when a client receives test results suggesting he or she has some variation of abnormal liver function?
"Abnormal liver function" means that a predetermined amount – or more – of elevated liver enzymes were found in the bloodstream. With an increased number and magnitude of these abnormalities, the likelihood of significant liver disease and/or organ damage also increases. The elevations signify injury to the liver or biliary tree, thus releasing dead cells into circulation. These cells are not exclusively found in the liver, but are also located in the tissue of the skeletal and cardiac muscle, bone, and intestines. In order to move forward with a case of this nature, you’ll need to inquire further about the client’s blood screening results.
First, it’s important to note that liver dysfunction is most commonly indicated by increases in aspartate transaminase (AST) and/or alanine transaminase (ALT). Some of the primary causes of abnormal liver function include hepatitis, fatty liver due to alcohol consumption, drugs, obesity, diabetes and high cholesterol. Underwriters will also look at levels of gamma glutamyl transpeptidase (GGT) to indicate alcohol abuse or the possibility of liver disease. Keep in mind that clients of varied ages will have different upper limits of AST, ALT and GGT to signify normal function.
In some cases, individuals who receive test results indicating an abnormality may not exhibit any symptoms or have any apparent history of liver disease. In fact, your client’s liver could be functioning abnormally simply because he or she is taking certain medications or has a specific skin or allergy condition, rather than something more serious.
Fortunately, the labs that conduct these screenings automatically run reflex testing to determine the significance of the test abnormalities, asking the question: "Is this result actually a significant indicator of a high-risk individual?" Underwriters will take all of these test results into consideration to determine the significance of the abnormalities and provide the best possible offer.
It’s important to remember that when you’re in the field gathering information, crafting cover letters and working tirelessly to offer your clients a best-class rating, you don’t need to go it alone. Instead, partner with your Creative Life team, including our in-house and concierge underwriters, to evaluate each case in-depth. The results of that choice will always show elevated opportunities of success in field underwriting.
FOR AGENT USE ONLY. NOT FOR USE WITH THE GENERAL PUBLIC. 12145 – 2012/1/18