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An attending physician’s statemtent is a request sent by an insurance company for more detailed medical information about an applicant who is applying for insurance. The request can come from either life or a health insurance company, but we will deal with the life insurance aspect here.
Medical science is very detailed, and sometimes the smallest things can cause the life underwriter and life insurance company doctors to either rate up a policy, give a standard rating, or decline an application.
With more details available from the applicant’s attending physician, or regular doctor, it is easier to make an underwriting decision.
If a home office underwriter needs more clarification or detail about an applicant’s health history, many times he or she will send an attending physician’s statement to the applicant’s physician.
With the help of the paramedical companies and a good electronic and digital format, the time lapse can be cut down to more than half the time illustrated here.
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Life insurance agents and brokers, as well as applicants, tend to become frustrated with attending physician’s statements, or APS’s as they are called.
It has a lot to do with the speed of processing, or the lack thereof. Requests have to come from busy doctor’s offices, and they cannot happen fast enough for anxiously awaiting brokers and applicants.
There has been some relief with the seemingly slow delivery of an APS, which can sometimes take up to two to three weeks and longer to receive back a reply from the doctor.
It also seems to add insult to injury when the agent or applicant calls the doctor’s office, only to learn that the request has been received, but they are waiting on the doctor’s fee before they can send back the information.
The relief comes from the paramedical companies who come to perform your insurance physical at your home or your office.
Most of these companies now have an APS service where they order and follow up on the collection of the APS document.
The reason that timing is so important with these documents is that the more time that elapses, the foggier the facts become around the reason for the insurance in the mind of the applicant.
What does and attending physician’s statement contain?
Most APS reports simply contain the applicant’s medical chart or a summary of the same. A simple as that sounds, it still takes the time to get everything out the door and back to the insurance company.
Think of this scenario:
- The insurance company underwriter sends a request to Dr. Jones, the personal doctor of Andrew Smith by US Mail. (time elapsed: 3 days)
- APS letter gets to Dr. Smith’s office and is put in his mailbox where it sits until the next morning. (Time elapsed: 1 day)
- Doctor Jones opens the APS request and sees that there is information requested about Andrew Smith’s recent history on a heart murmur. Dr. Jones will have to get the file, so he sets the letter aside and calls for the file. (Time elapsed: 1 day)
- Dr. Jones tends to his paperwork the next day after rounds. He sees in the file that the heart murmur was not organic, but functional which means that there is no physical damage to the heart valve, it just sounds like it. He dictates a reply and sends the file back to the filing area. (Time elapsed: 1 day)
- The billing clerk gets a notice that the APS was completed by Dr. Jones, but the office has had trouble lately by slow payment from some insurance companies, so their policy is to hold the return of the APS to the insurance company. She sends a memo to the insurance company and a bill for $55. (Time elapsed: 3 days)
- The insurance company runs the bill through its accounts payable process and puts a check in the mail in 2 days. (Time elapsed: 2 days)
- Mail time back to the doctor is 3 days.
- APS is received by Dr. Jones’s office, and it takes one day to process and get into the next day’s mail. (Time elapsed: 1 Day)
- Letter is received by the insurance company and takes one day to get to the desk of the underwriter who is handling Andrew Smith’s application. (Time elapsed: 1 day)
- The underwriter reads the APS from the doctor, sees that the heart murmur is functional and not organic, and authorizes a standard rating, which then causes the policy to be issued and place in force.
This scenario is a worse case scenario because much of this is handled electronically, but just a few years ago, an APS could take as long as the 16 day period illustrated in this example.
With the assistance of the paramedical companies, this time-frame of APS travel can be cut in half or better.
The Technology of it All
The essence of the job of the home office underwriter is to make a judgment regarding the suitability of applicants for life insurance.
Life insurance judgments at this point have lots of statistics, trends and final on-the-spot decisions that need to be made before a policy is issued. Reports like the APS become a part of the mosaic that creates the final tally of many factors.
The more recent any data received by the insurance company, the better.
If the report about Mr. Smith had contained new information that was negative rather than positive, it would be acted on accordingly.
The decision had better be the right one because of the long-term risk that the life insurance company has to be responsible for.
The final underwriting decisions do come about more rapidly than they used to, largely due to the digital capabilities we have.
This is true of the APS where technology can get the informational underwriting decisions back to the insurance company in just a few days, rather than weeks.
At first glance, the details of the underwriting process seem chaotic and time-consuming, but in recent years the introduction of technology and digital processes have changed the world of underwriting.
Now everything moves much faster, including APS documents and that is good for business. Better decisions are made when better information that is more timely accessed and processed more quickly.
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