Depending on what you read and who you follow, we are still in a pandemic phase or transitioning from the pandemic to the endemic phase of COVID-19. This has an ongoing impact on the life insurance industry.
The virus continues to mutate and, thus far, almost 90 million individuals in the U.S. have already reported being infected with the COVID-19 virus, according to the Johns Hopkins COVID Resource Center. No matter where we are in the phasing, COVID-19 and its ongoing mutations are with us to stay. The severity of a person’s COVID-19 infection can be wide-ranging, and residual symptoms are affecting a growing percentage of these people. This is referred to as long COVID-19. These post-infection symptoms can be a challenge to diagnose due to the wide range of symptoms, which can translate into additional challenges regarding the underwriting of insurance products.
Long COVID-19 symptoms can range from minimal to severe. The symptoms are broad and may include respiratory symptoms, muscle aches and pains, weakness, gastrointestinal symptoms, brain fogginess and general malaise. Because of ongoing viral inflammation, a person can be impacted in many different ways. Each person impacted can vary widely in their presentation and severity, making true long COVID-19 difficult for a clinician to diagnose.
When reviewing attending physician’s statements, the presentation can show that doctors are assessing the wide range of symptoms in multiple ways with an eye on the specific but also the broader potential of the chronic long COVID-19. This makes the clinician’s job extremely challenging. When considering that currently, there is no single specific long COVID-19 “test,” a series of protocols will ultimately result in the determination of long COVID-19.
In 2021, the International Classification of Diseases, Tenth Revision, Clinical Modification (aka ICD-10-CM) introduced a diagnosis code of U09.9 “Post COVID-19 condition, unspecified.” The medical claims codes are important data points for insurance carriers using automated decision engines in their analytic and screening underwriting. Now more than ever, it is vital for comprehensive field underwriting to understand the history of proposed insureds to best direct them in navigating the insurance marketplace today. AU09.9 ICD code could create an underwriting challenge for a client.
Case delay, on hold, ultimately placed
We are currently in a cautious, risk-averse versus a risk-aware insurance marketplace, especially in the over-age-70 demographic. The unknowns of acute COVID-19 infection and long COVID-19 symptoms that impact a patient/client long-term remain challenging. Investigation and diagnoses are significant and are definitely a cause for a diligent approach to risk assessment in the insurance marketplace today.
With the ongoing waxing and waning of COVID-19 mutation spike activity, protecting the insurability of the proposed insured is paramount. For example, an individual in the over-age 70 demographic recently received a Preferred underwriting classification. There was a delay for varying reasons in placing the contract in force, and due to the length of the delay, there was a change in health: The client contracted COVID-19. Due to the client’s older age, it presented a challenge, and the carrier needed to understand the severity as well as any suggestion of long COVID-19 concerns, thus creating further delay. Depending on the specifics, the Preferred pricing could have changed to a Postpone or even Decline. Fortunately, the interim information allowed for contract placement.
It’s important, particularly for clients over 70 years of age, to protect their insurability. If a policy is issued as applied, the goal should be to place it in force as quickly as possible to avoid any change-in-health scenario such as the above example.
COVID-19 will continue to be part of our lives. The potential for a client being infected, re-infected or diagnosed with long COVID-19 is real. Don’t miss the opportunity to protect clients with insurance coverage or be adversely impacted due to a change in health by delays in policy placement.
Chris Cook is senior vice president and head of underwriting at Crump Life Insurance Services. Chris may be contacted at [email protected].