The executive received the policy offer with a rating attached.
The rating was a 25 percent premium load triggered by a cardiac workup his doctor had ordered as a precaution two years earlier. The workup itself was clean. The carrier read the act of investigating cardiac health as a risk signal regardless of the result.
The offer carried a non-cancellable contract he could keep for the rest of his career. He had a choice. Accept the rated offer and carry the load for thirty years, or decline and apply somewhere else with the same workup on his record.
He accepted the offer.
Twelve months later, the same broker filed an adjustment application that reopened the medical questions on his individual disability insurance for executives policy. The reconsideration produced an unrated offer at standard terms.
Adjustment Application Reverses the Executive Disability Insurance Rating
The adjustment application is a formal request to the carrier’s medical underwriter to revisit a rated or excluded policy. The carrier reopens the medical questions only. Premium age, occupational class, benefit amount, definitions, and riders all stay locked at the original issue terms.
The applicant must demonstrate 12 months of clean medical documentation. No new symptoms, no new diagnoses, no new prescriptions, no new physician visits beyond routine annual care. A short letter from the prescribing or attending physician summarizing the clean period is usually attached to the request.
The medical underwriter at the carrier reviews the documentation and may remove the rating, reduce the rating, retain the rating, or in rare cases attach an additional exclusion. The first three are the common outcomes. The fourth happens only when the new medical records surface an unrelated condition.
The reconsideration submission is built like the original underwriting argument, only with cleaner facts.
“Underwriting is rarely black and white. It’s often very subjective. And the more subjective that it is, the more that you can put together an argument for why the rate class should be better.”
Steve Eskoz, senior executive account manager at Eugene Cohen Insurance Agency, on the Income Protection Journal Podcast
Eskoz’s frame applies to the reconsideration cycle directly. The clean year and the physician’s letter give the broker the material to make the case that the original rating no longer reflects the risk.
The reconsideration is broker-led. An executive who accepts a rated offer and never raises the question with the broker stays rated for the life of the policy. The carrier does not initiate the reconsideration.
The mentality is consistent across high-income professionals.
“I think we just have this mentality that we’ve gotten this far, just sort of taking care of business. Why do we need to? We’re going to continue to probably be fine because we work really hard every day.”
Michelle Custead, DVM, DACVIM (Oncology), owner of Ally Veterinary Specialty Center, on the Income Protection Journal Podcast
Custead’s framing names the executive’s posture on a rated offer. The rating gets accepted as the cost of being insured and the question of removing it never comes up.
The first submission resolves the majority of reconsiderations. If the first submission does not move the rating, the broker can request a second-level review or escalate to the carrier’s medical director.
Clean Medical Documentation Frees Executive Income Protection
The clean year runs from the policy issue date forward, not from the date of the original underwriting event. An executive whose underwriting happened in March and whose policy issued in June begins the clean year counter in June.
The carrier requires the documentation in a specific structure. The physician’s letter typically states the date of the original event, the resolution status, the absence of symptoms or recurrence, and the physician’s clinical statement about ongoing risk. A well-written letter pre-empts the questions the underwriter would otherwise ask.
The clean year window is strict. A single physician visit for an unrelated condition can interrupt the window if the visit generates documentation the underwriter reads as a new flag. Routine annual care does not interrupt the window. An executive who needs a chiropractor visit, an emergency room visit for an unrelated injury, or a specialist consult during the clean year should consult the broker before scheduling the visit.
The rate that locks at issue does not reset during reconsideration. The premium, the occupational class, and the rider package all stay at the original issue terms. Only the rating is up for review.
Executive Long Term Disability Reconsideration by Carrier
Carriers handle reconsideration differently in practice even though the contract mechanic is the same. Principal’s reconsideration process runs through the broker to the underwriter directly. The Standard routes through an agency case manager with carrier underwriting visibility. Guardian, MassMutual, and Ameritas use intermediary case managers.
The carrier with the direct broker-underwriter relationship typically resolves reconsiderations faster. Sixty days is the practical floor, ninety days is more common.
Outcomes vary by the nature of the original rating. Cardiac ratings issued on a clean workup with no follow-up issues are the most likely to clear on reconsideration. Ratings issued on chronic conditions like diabetes, Crohn’s, or autoimmune disorders rarely clear on a single reconsideration cycle because the underlying condition has not resolved.
Mental-health ratings sit in a separate category. A rating issued for an SSRI prescription clears more readily when the prescribing physician confirms the prescription was preventive and the executive has discontinued the medication without recurrence. A rating issued for documented psychotherapy or counseling treatment clears more slowly and may require multiple reconsideration cycles.
The executive who accepts a rated offer and files for reconsideration on the broker’s recommendation typically pays less in total premium across thirty years than the executive who declines the rated offer and shops elsewhere with the same medical record. The shop-elsewhere path resets the underwriting clock at the new carrier and resurfaces the same record under a different review.