Drug "Abuse" Case - Thoughts?

[JGold814]

I'm shopping around for a client and every carrier so far is a postponement for at least 2 years for this person. Anyone got any ideas on who could take him now? I think there may be a few options for graded policies, but ideally i'd like to find an immediate death benefit policy for him.

Here's a brief summary of the history:

29 year old male. Height/weight is fine, non-smoker. Had appendicitis in late 2013 so he had his appendix removed. Doctor who did the surgery prescribed Percocet for pain discomfort from procedure. He developed an addiction to the pain meds, but became self-aware of the issue and contacted his doctor. In mid-2014, doctor created a course of treatment for him - he put him on a minimum dosage of Suboxone to eliminate the urge to take pain medications. Treatment has worked very well and is scheduled to be completed next month, April 2015.

No legal issues and no driving issues. Job status unaffected - employed prior to surgery and is still employed at same job today. Alcohol usage is very rare (special occasions only such as birthdays or weddings - estimates about 5 drinks a year).

Wants up to $150k of term or permanent - pretty much whatever he can get. He applied with a carrier earlier this year and was declined as treatment was still ongoing.

Let me know if you all have any ideas. Thanks very much for your help in advance!

 

[Stevekobrin]

This is a tough case, but it could be a great case for you. People with this history have a lot of trouble getting coverage, as you have seen. Once you come through for them, you have a client for life.

I agree that the goal should be getting a policy with an immediate benefit. That is certainly better for the client and the beneficiary.

The fact that treatment is ongoing is a deal-breaker; however, the fact that treatment is due to end in month is a plus. If you can get a carrier to waive the two-year waiting period, they wouldn’t have too much of a problem looking at the case now. That month won’t make a difference.

I had a case once in which a person did cocaine less than a year before wanting to apply for coverage. I am sure you know that carriers tend to want to wait five years after the last usage. I was able to get an offer based on the extreme singularity of the incident in which he did that drug. It was very atypical for him.

Of course, a pretty hefty flat extra was assessed on the premium. The client gobbled it up because he really needed a policy. His willingness to buy now and pay a lot was an influential factor in getting an exception. But really what made the whole deal was that I got a hold of an underwriter who was willing to make an exception based on the extraordinary merits of the case.

So, if I was you, I would do the following:
1. Make sure the client understands that you are trying to get him an underwriting exception, and that if you succeed in doing so, the premium will be much higher than usual. He needs to commit to a budget here.

2. Work with your distributor on a mission to find an underwriter willing to make exceptions.

3. Make sure you know how to present this case as one worthy of an aggressive underwriter making an exception.

Good luck. Feel free to PM me if you need further assistance.

 

[UW Guy]

I'm shopping around for a client and every carrier so far is a postponement for at least 2 years for this person. Anyone got any ideas on who could take him now? I think there may be a few options for graded policies, but ideally i'd like to find an immediate death benefit policy for him.

Here's a brief summary of the history:

29 year old male. Height/weight is fine, non-smoker. Had appendicitis in late 2013 so he had his appendix removed. Doctor who did the surgery prescribed Percocet for pain discomfort from procedure. He developed an addiction to the pain meds, but became self-aware of the issue and contacted his doctor. In mid-2014, doctor created a course of treatment for him - he put him on a minimum dosage of Suboxone to eliminate the urge to take pain medications. Treatment has worked very well and is scheduled to be completed next month, April 2015.

No legal issues and no driving issues. Job status unaffected - employed prior to surgery and is still employed at same job today. Alcohol usage is very rare (special occasions only such as birthdays or weddings - estimates about 5 drinks a year).

Wants up to $150k of term or permanent - pretty much whatever he can get. He applied with a carrier earlier this year and was declined as treatment was still ongoing.

Let me know if you all have any ideas. Thanks very much for your help in advance!

Don't take this too lightly; Suboxone's a bad player in the prescription medication world. It's not like you're asking to flex a month on a build or tobacco rating, he could very well relapse and simply keep filling the Suboxone scripts.

Hopefully someone's willing to make you an offer of a few tables out (say 4-5, likely without benefits for the first year or two) and give you reconsideration in one to two years with his interim history. If all it took was his appendix getting popped out to get him addicted to Percocet it makes me wonder what would happen if he had a more substantial injury.

 

[senior-advisor-indiana]

Honestly, someone addicted to pain pills will be dead or in prison on the next 5 years. Pass....

 

[rousemark]

I'm shopping around for a client and every carrier so far is a postponement for at least 2 years for this person. Anyone got any ideas on who could take him now? I think there may be a few options for graded policies, but ideally i'd like to find an immediate death benefit policy for him.

Here's a brief summary of the history:

29 year old male. Height/weight is fine, non-smoker. Had appendicitis in late 2013 so he had his appendix removed. Doctor who did the surgery prescribed Percocet for pain discomfort from procedure. He developed an addiction to the pain meds, but became self-aware of the issue and contacted his doctor. In mid-2014, doctor created a course of treatment for him - he put him on a minimum dosage of Suboxone to eliminate the urge to take pain medications. Treatment has worked very well and is scheduled to be completed next month, April 2015.

No legal issues and no driving issues. Job status unaffected - employed prior to surgery and is still employed at same job today. Alcohol usage is very rare (special occasions only such as birthdays or weddings - estimates about 5 drinks a year).

Wants up to $150k of term or permanent - pretty much whatever he can get. He applied with a carrier earlier this year and was declined as treatment was still ongoing.

Let me know if you all have any ideas. Thanks very much for your help in advance!

There is more to this than you are being told.. You would not develop an addition to pain meds based upon the few percocets you might receive after an appendectomy.

 

[JGold814]

There's no other medical history issues related issues for this person and he's basically looking at graded coverage if he can get anything at all - the main concern would be driven by whether there has been any usage of other illegal drugs, any legal issues, required therapy by a court, or something like narcotics anonymous.

Spoke with a few underwriters and apparently the usage of Suboxone is like a doctor's go-to drug for getting people off of pain med addiction so when that name is seen it's like an auto red-flag.

Just trying to see if there's any options at all for this guy. Fully underwritten programs are basically all saying a minimum of a 2 yr postponement for coverage consideration from the date treatment is completed.

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Can anyone think of a carrier that would take him? I'm willing to split the case if you can find coverage.

 

[goillini52]

There's no other medical history issues related issues for this person and he's basically looking at graded coverage if he can get anything at all - the main concern would be driven by whether there has been any usage of other illegal drugs, any legal issues, required therapy by a court, or something like narcotics anonymous.

Spoke with a few underwriters and apparently the usage of Suboxone is like a doctor's go-to drug for getting people off of pain med addiction so when that name is seen it's like an auto red-flag.

Just trying to see if there's any options at all for this guy. Fully underwritten programs are basically all saying a minimum of a 2 yr postponement for coverage consideration from the date treatment is completed.

----------

Can anyone think of a carrier that would take him? I'm willing to split the case if you can find coverage.

I'm not even seeing any FE carriers that'll take him. The ones that'll write a 29 year old don't go that young for ROP, which is what he'd be.

 

[VolAgent]

There's no other medical history issues related issues for this person and he's basically looking at graded coverage if he can get anything at all - the main concern would be driven by whether there has been any usage of other illegal drugs, any legal issues, required therapy by a court, or something like narcotics anonymous.

Spoke with a few underwriters and apparently the usage of Suboxone is like a doctor's go-to drug for getting people off of pain med addiction so when that name is seen it's like an auto red-flag.

Just trying to see if there's any options at all for this guy. Fully underwritten programs are basically all saying a minimum of a 2 yr postponement for coverage consideration from the date treatment is completed.

----------

Can anyone think of a carrier that would take him? I'm willing to split the case if you can find coverage.

The underwriter has spoken.

While he hasn't said who he works for, I'm pretty sure I know who. They aren't know as a generous underwriter, but I'd say it sounds like this guy is close to uninsurable at this point. As UW Guy mentioned, if all it takes is an appendectomy to get this guy addicted to percocet, imagine what some more serious would do. That or he needs to find a new doctor who isn't such a pill pusher.

 

[UW Guy]

There's no other medical history issues related issues for this person and he's basically looking at graded coverage if he can get anything at all - the main concern would be driven by whether there has been any usage of other illegal drugs, any legal issues, required therapy by a court, or something like narcotics anonymous.

Spoke with a few underwriters and apparently the usage of Suboxone is like a doctor's go-to drug for getting people off of pain med addiction so when that name is seen it's like an auto red-flag.

Just trying to see if there's any options at all for this guy. Fully underwritten programs are basically all saying a minimum of a 2 yr postponement for coverage consideration from the date treatment is completed.

----------

Can anyone think of a carrier that would take him? I'm willing to split the case if you can find coverage.

Even the most liberal reinsurers I've had to use on cases like this want 6-12 months clean because of the high relapse rates for either the Suboxone or the original narcotic. And then you're WAY out on the table ratings at that close out. Like I said with good build/BP/cholesterol you might buy your way back to table 4-5 or if there's table shaving involved.

 

[JGold814]

From my research, he's too young for the graded policies he could medically qualify for and the shortest postponement period is 1 year before any consideration - most being a 2 or 3 year postponement.

I think this guy is pretty much out of luck for life insurance and will need to wait a while before qualifying for coverage. :/