What Is Left Ventricular Hypertrophy?
Left Ventricular Hypertrophy is defined as a thickening of the ventricular muscle, or enlarged heart. It’s primarily caused by high blood pressure, and life insurance companies don’t like to see it, because people who have left ventricular hypertrophy have hearts that have to work harder, and are at higher risk of heart attack and cardiac death.
So it’s no wonder that a client who recently came to me with LVH had been declined by Genworth.
We put the policy out to bid, and while we got mostly declines and substandard rating quotes, we did have one company offer a quick quote of standard!
Here is a copy of the detailed letter I wrote on behalf of my client. I poured hours into reviewing my client’s medical records, as well as reviewing his case with my medical director, in order to come up with our “angle”. We wanted to admit up front that, yes, he has an enlarged heart, but tell a story of why they don’t need to be as concerned about it as other people with LVH.
In my client’s case, we pointed out his recent control of blood pressure, stress free life, and recent dietary changes. While you read the trial offer request, ask yourself how many agents would go through this trouble for their client. Do you think a Select Quote Agent with their sales quotas would be able to dedicate this sort of time to one client? No way! Here is the email I sent out to over 2 dozen companies on his behalf:
I have a male, age 65, 5’10 ½ 237 lbs, non smoker. My client lives a stress-free life. He’s a Canadian citizen who owns a home in FL, and stays here with his wife 6 months out of the year. Between them, they earn 130K per year (US dollars), and have a net worth of between 1.5M-2.0M. He is happily enjoying his retirement.
He rides his bike and plays tennis 5 days per week. Very active.
However, my client was declined by Genworth on 12/16/2011 for Left Ventricular Hypertrophy, even though his APS describes it as “mild left ventricular hypertrophy”.
His echo results from 2009 show:
RVIDd – 3.21 cm
IVSd – 1.69 cm
LVIDd – 4.44 cm
LVIDs – 2.9 cm
LVPWd – 1.68 cm
Ao Root Diam – 3.8 cm
LA Diam – 3.7 cm
EF – 60%
LVFS – 34.7%
All other values within normal range. (many of the values above are normal too)
Echo exam comments included “normal left ventricular chamber size”, “mild concentric left ventricular hypertrophy”, “normal left vent. systolic function”. “The right vent chamber size and systolic function are within normal limits. The right ventricular cavity size is mildly enlarged.” “mild mitral regurgitation”, “mild tricuspid regurgitation”, “mild annular calcification on mitral valve”. Right atrial cavity and left atrial chamber are normal.
My client’s primary problem over the past 3 years has been getting his blood pressure controlled. In May of 2011 he began seeing a nutritionist who taught him about portion control and adding 2 veggies to each lunch/dinner, and since implementing her suggestions , my client has lost 8 lbs, and his bp #’s have been under good control, with great results in his Oct. 2011 checkup, and again in his insurance exam in Nov. 2011, his readings were 112/66, 114/66, 116/68.
He’s really excited about his dietary changes, says he feels a lot better, and feels he’s finally turned the corner on getting his BP under control. He also has been taking Altace to control bp for many years, a very low dose. We argue that with BP being the primary risk factor for LVH, that since he now has this under control, that he is not at high risk for the LVH to worsen.
We also argue that he’s on a super low dose of bp medication, just 2.5 mg of Altace. If his dr was truly concerned, he would increase the dose.
Other pertinent details:
– In April 2009, was hospitalized for viral pneumonia, and had an episode of atrial fib. It was transient and immediately resolved, and records show it was resolved. In June 2009 in an exam, no atrial fib or murmur was detected.
– Father died of heart disease at age 55. Mother lived to 90, died of natural causes. 1 sibling is 69 in excellent health.
– Dx with fatty liver in 2009. Labs from 6/2009 show Hgb: 138, MCV: 90, ROW: N, AST: 68, ACT: 246, GGT 149, ALK phos: N
– Cholesterol under good control, Chol/HDL ratio was 4.82 as of Sept 2010, and 4.67 in Oct 2011.
– Drinks on average 2 alcoholic beverages per day
– Uses inhaler for asthma as needed – needs it approximately once every 1 to 2 years on average.
– His other rx is Novo-Naprox for daily tennis aches and pains
– He’ll be in FL for the next 5 months, so there won’t be any issues taking his app in the US or having it delivered in U.S.
– He wants a Canadian corporation to be beneficiary for tax reasons (corp. is his family business)
– Right bundle branch block on ekg from 2009. Doesn’t have a bundle branch block in current ekg taken for life ins. exam.
– Please remember lots of his results looked screwed up in April 2009, because he was in critical condition with viral pneumonia. He has been stable in all regards since recovering.
He’s looking for a $200,000 policy guar. UL, either 10, 15, or 20 pay policy. We are in competition with an offer he has from a company in Canada, and we’ll need to get a Standard or better offer to win the business. Total premium for this case will be around 6K to 7K per year.
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