Case study: Kidney Disease & Pruco
We recently obtained a life insurance approval from Pruco Life Insurance for a client of mine in AZ with a very unique case. While this client had been declined by West Coast Life, Lincoln Benefit, and every other insurance company we brought the case to refused to offer, Pruco Life came through with an offer. Here are the details of the case. Of course, I will not include any names or identifying remarks for confidentiality, but all medical details are accurate.
Below I’ve pasted a copy of the trail offer request I sent out on behalf of my client to over 30 carriers to find an offer. As you read the details, ask yourself if any agents you know would go to such great lengths to obtain life insurance for an individual who has already been declined by two other companies.
I have a male PI, nearest age 69, non smoker. He is 5’6, 165 lbs. He was postponed by West Coast Life in Feb. 2011 due to elevated creatinine in exam results. We believe we have a good story to tell as it relates to his kidney disease, since disease was caused by cardiac bypass surgery as explained below, rather than a progressive, chronic kidney disease, so his prognosis is stable. Please indicate whether an offer is possible. Needs $1,000,000 10 year term for an SBA loan. Thank you.
In Feb 2007 had a coronary artery bypass graft done, 4 vessels, for angina, although he did not have a heart attack. No recurrent symptoms of angina. Original cath showed left anterior descending artery of 95% blockage, circumflex of 100%, and RCA of 90% distal stenosis. Adenosine nuclear scan 2008 was negative and showed left ventricular ejection fraction of 55%. No evidence of ischemia or infarction. EKG done annually.
During the bypass surgery, my client’s kidneys were damaged and have been operating under GFRs in a range indicative of stage 3 kidney disease since the surgery, with his two most recent levels at 42 and then 47 in Jan 2011. BUN has also been elevated with most recent readings at 26 in Jan 2011 and 39 in Feb 2011. Creatinine ratio has been elevated but stable at 1.81 in Aug 2009 and most recently at 1.78 in July 2011. Most recent UA also showed protein – negative, blood – negative, urine protein/creat – .05 mg/mg. Nephrologist states that the disease is stable and will remain so as he has controlled his risk factors of build, hypertension and hyperlipidemia. In one quote, he states, “Given absence of proteinuria, stable GFR and BP control, would anticipate slow progression of CKD.”
There is mention in his hospital discharge notes in March 2007 of new onset of Diabetes type II with a1c at 6.7, but this may have been an anomaly, as he isn’t on any diabetes meds, and most recent a1c was 5.3. In July 2011, primary dr indicates there is “no evidence of diabetes”.
Other notes from Primary Physician from July 2011 include:
“Following the surgery, my client has done remarkably well addressing risk factors of hyperglycemia, exercise, and hyperlipidemia”… In summary Mr. XX is doing exceptionally well exercising, maintaining his weight, and is in compliance with his present medications. The problems noted should not present a problem in the years ahead and I anticipate a long and fruitful life.” His primary physician also notes the bypass surgery as the likely cause for creatinine elevation.
Coumadin 4.5 mg, Fenofibrate Micronized 134 mg 1X day, Simvastatin, and Lisinopril.
No tobacco for 35+ years.
Great family history – no deaths from any disease prior to age 70. Mother lived to 94; father lived to 95; has a 75 year old sibling in good health
Lifts weights and cardiovascular exercise 3X per week
Excellent driving history
High income earner, high net worth, 30+ year experience as a skilled nursing facility administrator and business executive
Minimal to no alcohol use. Very conscious of diet in last 3 years.
Excellent Cholesterol: Total 113, Chol/HDL ratio: 2.9
I realize stage 3 kidney disease is very serious and grounds for some companies to decline, but I think we have a good story to tell here. Dr. David Miller, an MD and close friend of mine, explained to me that since the kidney disease was caused by the surgery as a one-time event rather than due to chronic kidney failure, the likelihood is much greater that they will remain functioning at current levels. Given my client’s excellent control of risk factors, his doctors all indicate he has a great prognosis.”
We ended up getting a substandard offer from Pruco Life Insurance, but we were thrilled that they were willing to offer at all based on the stage 3 kidney disease and elevated kidney function levels. Please understand that I am in no way implying that Pruco Life routinely approves applicants with kidney disease, but I would like to publicly thank them for coming through for my client.
If you need life insurance and have a health risk such as kidney disease, call us at 877-443-9467.*Huntley Wealth Insurance and its representatives do not give legal or tax advice. Please consult your own legal or tax adviser.