Why do life insurers need an attending physician statement (APS)?

Insurance companies might request an APS from your doctor to get additional medical information as part of the underwriting process.

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Rebecca ShoenthalEditor & Licensed Life Insurance ExpertRebecca Shoenthal is a licensed life, disability, and health insurance expert and a former editor at Policygenius. Her insights about life insurance and finance have appeared in The Wall Street Journal, Fox Business, The Balance, HerMoney, SBLI, and John Hancock.&Tory CrowleyAssociate Editor & Licensed Life Insurance AgentTory Crowley is an associate editor and a former licensed insurance agent at Policygenius. Previously, she worked directly with clients at Policygenius, advising nearly 3,000 of them on life insurance options. She has also worked at the Daily News and various nonprofit organizations.

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Ian Bloom, CFP®, RLP®Ian Bloom, CFP®, RLP®Certified Financial PlannerIan Bloom, CFP®, RLP®, is a certified financial planner and a member of the Financial Review Council at Policygenius. Previously, he was a financial advisor at MetLife and MassMutual.

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When you apply for life insurance, the insurance company needs to have an accurate view of your health before they can offer you coverage.

Insurance companies assess this through a process called underwriting, during which you take a medical exam and submit information about your current health and medical history, your lifestyle, and your family medical history.

As part of underwriting, some insurance companies request an attending physician statement (APS) from your doctor for additional information about your health.

The more health or lifestyle risks you pose, the higher your premiums will be. In some cases, people with very serious health risks may not qualify for term life insurance coverage.

An APS isn’t always required, but if you’re asked to provide one, here’s what you need to know.

Key takeaways

  • An attending physician statement helps the insurance company learn more about your history with a pre-existing condition.

  • An APS request can lengthen the underwriting period, but it ensures you get accurate policy rates.

  • The cost of the life insurance medical exam and APS (if required) are covered by your insurer.

What is an attending physician statement?

An APS is your doctor’s detailed evaluation of your current health, from their point of view.

If an issue pops up during your medical exam, an APS can let the insurer know if it’s due to a side effect of some medication you’re taking, or if the cause is an underlying medical issue. Insurers must know exactly what they’re covering with a policy, and an APS sheds light on any ambiguities.

If a doctor has ever treated you for a chronic medical condition, you may be required to submit an attending physician statement. Such conditions include asthma, diabetes, and sleep apnea, among other types of health issues.

If the insurance company needs to order an APS, this doesn’t mean that you’re not eligible for a competitive rate. The APS helps the insurer understand the details of your medical history so they can accurately assess how much risk your diagnosis poses to your health.

What’s included in an attending physician statement?

A standard attending physician statement contains the following questions for your doctor to answer:

  • What is the history of the condition? The doctor will explain how long they’ve been treating you for your illness, including when symptoms began, dates of treatment, and what treatments you’ve tried.

  • What is the prognosis? This section goes into how you’re managing your illness and whether you’ve seen any improvements since beginning treatment.

If you’re being treated by different doctors for different conditions, there’s a chance the insurance company will ask for an attending physician statement from each doctor treating each condition.

How does HIPAA apply to an APS?

The same rules based on the Health Insurance Portability and Accountability Act (HIPAA) that apply to your other health details also apply to your APS. You need to sign a waiver so your provider can share your medical history with your insurance provider.

Your insurer may only use APS information to determine your eligibility for coverage and set your rates. They cannot sell or share those details.

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How does the APS relate to the medical exam?

The medical exam provides initial information about your health and medical history. During the physical portion of the exam, the medical technician conducts a standard medical checkup.

But if you have more complex health issues, this information will not be enough. The insurance company will order an APS.

The APS not only backs up the conclusions of the medical exam, but it also gives a picture of your health to your insurer that goes beyond simple blood draws, urine tests, and heart rate measurements.

The APS and medical exam provide a thorough look into your health history. And if the insurer determines it’s more risky to insure you, then you may pay higher premiums than you were first quoted.

How long does it take to get an APS?

Applying for life insurance takes minutes, but it can take between five to six weeks (on average) before your policy goes in force.

Part of that time is spent on the underwriting process, which includes scheduling and taking your medical exam. The process takes longer if the insurance company needs an APS.

After your doctor fills out the APS, it goes back to the underwriter. Many underwriters use a template or script to make sure they get all of the important information down as quickly and efficiently as possible.

While an APS may add a few weeks to underwriting, it will ensure that the offer you get from the insurance company is fair and accurate.

Temporary life insurance

Most insurance companies offer temporary life insurance, which provides life insurance coverage for you right when you apply. This offers you coverage while your application goes through formal underwriting.

This type of coverage is designed specifically for the period between your application and approval. It can secure peace of mind for yourself and your family while you wait for your offer.

As long as you’re honest and provide accurate information on your life insurance application, if you choose temporary coverage and die during underwriting, the insurance company will honor your policy and pay the death benefit to your beneficiary.

An attending physician statement can make your life insurance application process take a little longer, but it’s a simple step to getting a policy with the most accurate rates possible.

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Frequently asked questions

What is an attending physician statement (APS)?

An APS is a summary of your medical history from your doctor.

Why do I need an attending physician statement?

Insurance companies may request an APS if they need to clarify details of your medical history before they make you a formal offer of coverage. This is expected if you have a chronic or more complicated medical condition. The statement helps insurers better understand your medical history and evaluate your health. Not everyone who applies for life insurance will have an APS requested.

Does an APS cost money?

An APS will not cost you any money. If there’s a fee associated with obtaining your APS, the insurance company will cover it.

Authors

Rebecca Shoenthal is a licensed life, disability, and health insurance expert and a former editor at Policygenius. Her insights about life insurance and finance have appeared in The Wall Street Journal, Fox Business, The Balance, HerMoney, SBLI, and John Hancock.

Tory Crowley is an associate editor and a former licensed insurance agent at Policygenius. Previously, she worked directly with clients at Policygenius, advising nearly 3,000 of them on life insurance options. She has also worked at the Daily News and various nonprofit organizations.

Expert reviewer

Ian Bloom, CFP®, RLP®, is a certified financial planner and a member of the Financial Review Council at Policygenius. Previously, he was a financial advisor at MetLife and MassMutual.

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