Finding Coverage with Congestive Heart Failure

Jeff Root Jeff Root Posted in Heart
Last updated on April 23, 2019

Hearing the term “Congestive Heart Failure” induces a black cloud of anxiety, particularly in the life insurance world.

The prospect of “heart” failure automatically brings with it worries about mortality; however, “congestive heart failure” does not necessarily indicate that an applicant is going to pass away before he or she can even be given a rating.

Congestive Heart Failure refers to a condition in which the heart works insufficiently and is unable to supply the body with oxygenated blood, The condition can occur as a result of multiple causes, and typically only involves one side of the heart.

In fact, finding a life insurance policy with a history of Congestive Heart Failure (CHF) will depend on the amount of information your agent and underwriter have available to evaluate your risk.

A good rule of thumb for most high-risk insurance is “the more information you can provide, the better you can expect your rating to be, because your risk will be more accurately evaluated.

Let’s talk a little bit about what this means for those with Congestive Heart Failure.

Life Insurance With Congestive Heart Failure 

Before you begin searching for a life insurance policy, you will first want to talk to your agent and do some preliminary research on companies that will suit your coverage needs and your high-risk needs.

The first information you should always gather is how much insurance you need and what type of life insurance policy you are looking for. By calculating your needs and knowing what type of policy you want, you will be able to gather a baseline of price comparisons based on “standard” and “preferred” ratings for those without CHF or for those with other high-risk diseases.

Remember: the larger the policy, the more you can reasonably be expected to pay for coverage.

Additionally, some policies – like whole life insurance – promise protection for your whole life but will cost more. You should also take into consideration that the addition of any insurance riders will also raise your premium.

Once you and your agent have reviewed this information, you will need to gather the medical records and documents your underwriter will want to assess.

A key piece of information insurers use to assess your risk is the cause of your CHF. This is because CHF is treated for cause. The severity of the root source of your CHF and the symptoms you display will be heavily considered when underwriting you for coverage.

The more underwriters know about the cause of your CHF and the treatment options recommended for you, the more likely they will be able to assess the success of the treatments and your subsequent risk.

Before applying for life insurance, you should also undergo EKGs and stress test with Ejection Fractions. Underwriters will want the most up-to-date information possible for these documents, so be sure to get them done as close to your application date as possible.

This means you should also frequently provide your insurer with updates to these tests.

Ejection Fraction refers to the amount of blood volume squeezed out of your heart with each contraction. This measurement is heavily relied upon by underwriters to assess an individual’s CHF risk.

For example, an EF measurement of 55% or higher may mean a “standard” rating if the condition is otherwise stable. If these measurements drop below 55%, table ratings and flat extras are common.

If your Congestive Heart Failure is not otherwise being successfully treated and your EF measurement is below 50%, you can reasonably expect to be declined; however, for those who are undergoing treatment for the root cause of their CHF, table ratings are still possible, even for EF measurements around 40%.

Here are a few other important pieces of information your insurer will want to know:

  • The date you were diagnosed, and the presence of any symptoms that lead to your diagnosis.
  • The specifics of the symptoms or diseases that lead to your CHF, including high blood pressure, myocarditis, hyperthyroidism, atrial fibrillation, cardiomyopathy, and heart valve disease
  • Family history of heart disease
  • Additional health issues
  • What, if any, medications are you taking?
  • Treatments prescribed for your CHF
  • The approximate date and results of your last EKGs and chest x-rays, as well as your EF measurements.

Get The Right Information To Your Agent And Underwriters

It may seem tedious to report all of this information to both an agent and underwriters, but the first step is necessary because a life insurance agent might be able to find you underwriting credits. These refer to steps you are taking to proactively improve your overall health and lower your coverage risk.

These might include eating right, no family history of CHF or other heart diseases, abstaining from smoking, a regular exercise regimen, or following your treatment plan to the letter and making strides in improving your condition.

This information is crucial to providing you the best insurance premiums possible, and an agent can present it to underwriters so that they can assess you as a whole person, not just as a high-risk client. Our agents are experts in viewing you as a person, not just as a risk classification. We call this “finding a silver lining.”

We know that Congestive Heart Failure can be the result of a number of causes and we will take the time to get to know you and your unique situation. Then, we present you, the person, to insurers that will care about your well-being just as much as we do.

Don’t let CHF stand in the way of finding the right life insurance coverage option for you and your family. Because sometimes finding the right coverage is a matter of talking to the right people. Sit down today with an expert who can help you get started toward finding your life insurance silver lining.

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