Demystifying Attending Physician Statements for Life and Disability Insurance
Apr 8, 2024
Jamie Fleischner

Jamie Fleischner

8 Apr, 2024

When applying for life or disability insurance, you may encounter the term “Attending Physician Statement” (APS). Approximately 60% of the time, an APS is ordered, meaning the underwriters need medical records to asses your risk. This document plays a crucial role in the underwriting process, providing insurers with valuable medical information about the applicant’s health.

What is an Attending Physician Statement?

An Attending Physician Statement is a detailed report provided by the applicant’s healthcare provider(s) to the insurance company. It contains comprehensive information about the applicant’s medical history, current health status, treatments received, medications prescribed, and any ongoing medical conditions. Essentially, it offers insurers a clearer picture of the applicant’s health beyond what is disclosed in the initial application. APS is another term for medical records request.

How Long Does it Take?

The time it takes to obtain an APS can vary depending on several factors, including the complexity of the applicant’s medical history, the responsiveness of healthcare providers, and the specific requirements of the insurance company. On average, it may take anywhere from a few days to a few weeks to obtain an APS. In some cases, if there are delays in receiving medical records or if additional information is required, the process may take longer. This is the part of the process that can cause the process to drag on for weeks.

What is Involved?

  1. Authorization Form: When you apply for life or disability insurance,  you will sign an authorization form allowing the insurance company to request medical information from their healthcare providers. Sometimes your doctor’s office or hospital will require their own HIPAA form to be signed to release the records.
  2. Request Submission: The insurance company sends a request to the applicant’s attending physician(s) for the APS.
  3. Physician’s Response: The physician completes the APS, providing detailed information about the applicant’s medical history, current health status, and any relevant medical conditions or treatments.
  4. Review and Underwriting: Once the APS is received, the insurance company reviews the information provided to assess the applicant’s risk. This may involve comparing the information with the applicant’s disclosed medical history and any other relevant documents.
  5. Decision Making: Based on the information gathered from the APS and other underwriting factors, the insurance company makes a decision regarding the applicant’s eligibility for coverage and determines the appropriate premium rates. For life insurance, this will determine if your risk classification. This can be anywhere from preferred plus (best rates), preferred, select, standard, substandard or decline you altogether. For disability insurance, the APS may result in an exclusion on some type of pre-existing condition. Common exclusions are back, neck, spine or mental illness.

Tips for a Smooth APS Process:

  1. Provide Accurate Information: Be thorough and accurate when completing the initial insurance application to minimize the need for additional medical information later on.
  2. Communicate with Healthcare Providers: Inform your healthcare providers that you are applying for insurance and that they may receive requests for medical information. This can help expedite the process.
  3. Follow Up: Stay in touch with the insurance company to ensure that the APS request is processed promptly and to address any delays or issues that may arise.
  4. Be Patient: While waiting for the APS to be completed, be patient and understand that obtaining comprehensive medical information takes time.

For more information about attending physician statements or to review your life or disability insurance, contact Set for Life Insurance today!

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