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Congestive Heart Failure and its Impact on Life Insurance Premiums

I Have Congestive Heart Failure. Now What?

Because congestive heart failure affects the heart, it is often a frightening condition. Indeed, it is a concern to life insurance companies. The good news is that congestive heart failure is often due to underlying causes which can sometimes be treated. Therefore, a life insurance company will not automatically turn down an individual just because he or she has congestive heart failure. In order to offer life underwriting, however, the insurance company will need to see as much information as possible. As a general rule, the more information you provide, the better the underwriting since ambiguity is never rewarded with good risk assessment. The life insurance company will want to see results for EKGs, Echocardiogram (with ejection fraction ), and current stress tests. If your case was recently diagnosed, a full cardiovascular work up is also essential.

Note that congestive heart failure is evaluated primarily on the underlying cause. In other words your rating will be based on what underlying condition has brought about your congestive heart failure, how you have treated this underlying condition, and how successful the treatment has been. Be prepared for an extended review period as the underwriters evaluate your case and be prepared for higher rates than you would receive as a normal, healthy individual.

Congestive Heart Failure's Effect on Insurance Rates

This table depicts a general outline of what ratings to expect for several different scenarios of congestive heart failure. ejection fraction is an indication of your heart's effectiveness and is an important indicator of the likely outcome of your heart disease. 

Scenario

Expected Rating

Newly Diagnosed Case

Postponement pending evaluation of full cardiovascular work up

Older individual; mild heart disease; heart's effectiveness is stable and near normal

Standard

ejection fraction (EF) measures of 55% or higher; condition is stable

Standard

Congestive heart failure began prior to age 60; EF measures of 50% or less

Low table ratings

EF measures of 40% to 50%

Moderate table ratings

EF measures of less than 40%

Severe table rating through decline

More Information on Congestive Heart Failure

Congestive heart failure is a condition where the heart does not supply the body with ample oxygenated blood. A tell-tale symptom of this condition is shortness of breath after very mild activity, sometimes after something as simple as walking within one's home. 

As indicated above, congestive heart failure is often a symptom of some other underlying heart disease or condition. Thus it is often possible to reduce or eliminate the congestive heart failure by treating the underlying condition. 

Congestive heart failure has many potential causes which includes high blood pressure for extended periods of time, heart muscle disease, heart valve abnormalities, heart rhythm abnormalities, numerous forms of coronary heart disease, and hyperthyroidism. Possible treatments range from medication to the installation of a pacemaker and from surgical procedures (such as a heart valve replacement) to something as simple as improved diet and regular exercise. 

Important Things to Know for Those with Congestive Heart Failure

What are some of the issues that interest underwriters?

  • What are your test results (e.g., EKG, Echocardiogram, etc)?

  • What is your ejection fraction?

  • What is the underlying cause of your condition?

  • What treatments have been used?

  • How successful have these treatments been?

What can I do to help the underwriting process?

It is very important that you provide as much information as possible since this condition is assessed on a case by case basis. Any documentation of positive information will be valuable since it could lead to improvements in your rating. Also, please include the contact information for all doctors who have helped treat you.

Complete the following form, or call us toll-free at 888-854-7526 if you would like to speak with someone or get more information.

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