By Dr. Bruce Empringham, BA, MD, FCFP, Diplomate Board of Insurance Medicine 
Medical Consultant, Canada Life | March 4, 2021

Dr. Empringham recently retired as head of the medical board at Canada Life to provide medical guidance for advisors with large cases for Canada Life.

For years, I’ve promoted field underwriting for all types of insurance. For small cases, it can mean getting the case issued without further evidence. In the large-case market, field underwriting can allow you to provide your clients with a more accurate pricing estimate of their insurance solutions upfront and help keep your relationship with your client positive.

I’ve been involved in insurance cases of all sizes, helping with preliminary reviews, for many years. What I’ve seen is that clients applying for large amounts of insurance, like all clients, really do benefit from the advisor investigating medical conditions ahead of time, for a variety of reasons.

You may be tempted to skip the field underwriting step on a large case. Sometimes an advisor won’t dive into the medical too deeply because the client is also going to have a nurse ask questions, and so the reasoning isn’t immediately apparent. Sometimes these clients are well known and more concerned than the average client about sharing medical details. Ironically, these are cases where the underwriter really does need to get a good understanding of the medical factors and where field underwriting can help the most.

Beyond that, many of the clients applying for large cases are over 50 and more likely to have medical conditions that will impact the underwriting decision.

It's important to remember that you’re the link between your client and the underwriting team. Your job through your interaction with the client, is to gather medical and financial information that will paint a picture for the underwriter. When you can gather information properly and get in front of the situation, you’re positioning the case for the best underwriting outcome. 

Avoid surprises 

It’s important for advisors to help set client expectations for the outcome early to avoid surprises. On the medical side, field underwriting is the way to do that. For most cases, asking some simple field medical questions is enough to get things moving in the right direction. If there is no pending paramedical examination, take the time to go through the detailed medical questionnaire with your client. If you know there may be an adverse underwriting decision ahead of time, you can prepare your client for the decision right from the start. Experience tells me that it’s much better for everyone when you set the expectation early in the process.

In the situation of a large case, let’s assume that a nurse will be involved to ask the medical questions in detail. You should still ask some general medical questions so the client has an idea whether there are medical issues that might impact underwriting. You’ll have your own style, but over the years, I’ve heard advisors simply ask about what medications are taken. Others ask if there are any major medical conditions, while others list a few common ones (i.e. “Do you have cancer, heart disease, diabetes, anything like that?”). 

However you approach it, it’s important that you develop a broad understanding of the medical issues, in the same way you develop an understanding of the financial situation. 

You’re not alone 

When you work with Canada Life^TM for your large-case business, I can partner with you through the field underwriting process. I can help you take a much deeper dive into a client’s medical factors to understand the risks on the case.

Already, I’ve had the opportunity to help out on quite a number of cases in my new position as Medical Consultant. Being aligned with the advisor puts me in a wonderful spot. When I can connect with a client by phone or email, I can get lots of detail on their medical situation and help understand the risk. Coming out of this process, the client understands from the beginning the likely pricing of their insurance solution. When they know what to expect, the entire underwriting process is smoother and often faster.