Microsoft word - understanding the resource brokerage.doc

Long-Term Care Underwriting
Simple issues to note:
Age – Coverage is often limited at age 80 and above.
Saving age can be done 30 days from date of birth.
Height and Weight – an imbalanced height to weight ratio may be all you
need to take your client out of the “preferred” ball park.
Medical Records are helpful if you can obtain them in a trial situation.
Cognitive Ability – carriers will assess basic common sense through a variety
of questions that may seem redundant or juvenile. It is important for your
clients to be aware that this is a part of the process.
Vendors – Paramedic companies and Phone interviewing entities represent
our reputation but often forget this important face. One wrong turn with a
examiner or an interviewer can set your client running. Resource Brokerage,
LTC has the “liaison of requirement” program that reduces the chance of a
challenge such as this occurring on your business.
Medical Conditions
a. When diagnosed? b. Date of last treatment? Key question c. Current physical therapy? d. At the very least list of medications? e. Surgeries recommended but not yet performed? f. Have they had history with any of the below conditions? If so contact Have you ever been on disability or receive any disability benefits? Have you ever needed at home care or faculty care?
Cancer Heart
bones/fracture
Kidney disease
Memory Loss
Liver disease
Depression
Psychiatric
disorders Arthritis
Stroke/TIA
Neurological disease Seizures
damage HIV
Diabetes
Osteoporosis

Unacceptable Medications:

Aricept Morphine
Chlorpromazine
Navane Olanzapine
Clozaril Perphenazine
Phenothiazine DDI
Quetiapine
Drgoloid
Mesylate
Risperdal
Fluphenazine
Rispiridone
Foscavir
Serentil Seroquel
Stelazine
Haloperidol
Tacrine Hydergine
Tjoprodazome
Lithium Thiothixene
Loxitane
Mesoridazine
Trifluoperazine
Mellaril Trilafon
Molindone

Long Term Care Conditions and what to ask your clients.


COPD/Emphysema
Any hospitalizations for the condition with the past 6 months. Daily or intermittent use of oxygen. IPPB therapy or home respiratory with the past 12 months Have you been to the ER within the past 12 months for respiratory symptoms? History of Congestive Heart Failure or Cardiomyopathy? Are activates restricted to shortness of breath?
Depression

Is it situational? (i.e. divorce, death, ) Diabetes

If you are taking insulin – how and how much? If not, how are you treating the diabetes? Any ancillary issues such as blindness or amputation due to the condition? What is the A1C level and how long as it been level?
Hypertension


Osteoporosis

Does client have full range of motion in all limbs?
Arthritis

Does client have full range of motion in all limbs? Active progression of symptoms within the last 24 months?

Stroke or TIA
•
What if any residuals is client experiencing?
Coronary Artery Disease

History of heart attack/angioplasty/stent/ or any a symptomatic issues?
Fractures/broken bones
Fully recovery with normal range of motions History of other conditions such as arthritis or osteoporosis? History of other conditions such as arthritis or osteoporosis?

Hip, knee replacements
Due to other medical conditions such as arthritis or osteoporosis?

Source: http://www.resourcebrokerage.com/pdfs/ltci/training_tools/underwriting_LTC.pdf