Q

Q

Why does a life insurer need an attending physician statement (APS)?

A

A

If you have certain medical conditions, an insurer might request an attending physician statement from your doctor as part of the underwriting process in addition to the medical exam.

Rebecca Shoenthal author photo

Rebecca Shoenthal

Published September 17, 2020

KEY TAKEAWAYS

  • If you have a chronic health condition, an attending physician statement (APS) is sometimes requested during the underwriting process so an insurer can learn more about your medical history

  • If an APS is requested, it can prolong the underwriting time period by several weeks and delay your policy’s activation

  • The life insurance medical exam and attending physician statement (if required) are covered by the insurer and add no cost for you

When you apply for life insurance, the life insurance company needs to know how healthy you are at the time you sign the policy. They figure this out through a process called underwriting, during which you take a medical exam and submit information about your current health and medical history, any dangerous lifestyle choices, and your family medical history.

Insurance companies use the underwriting results to calculate your risk. That is, how likely it is that you’ll die from a given illness, medical condition or hobby. The higher risk you pose, the higher your premiums will be, compared to a healthier or younger person receiving the same amount of coverage. In some cases, your health will indicate too high of a risk and you may not be eligible for life insurance coverage.

As part of the underwriting process, some insurance companies may request an attending physician statement (APS) from your doctor for additional information about your health. As a medical professional, your doctor is best positioned to document your health to the insurer,including what medications you take and the severity of certain illnesses. The aps is a standard summary of your medical history, including descriptions of your health and a checklist of medical conditions the insurer will want to know about.

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

IN THIS ARTICLE

What is an attending physician statement?

Underwriting officially begins after you figure out how much coverage you need, get quotes, and submit an application. At that point, the insurer determines whether your quote is accurate and they might increase or decrease the initial quoted premiums depending on the data obtained during underwriting.

If you’ve ever visited the doctor to treat a chronic medical condition, you’ll be required to submit an attending physician statement. It’s a standard part of virtually every life insurance application, with some exceptions of life insurance coverage types like simplified issue life insurance or no medical exam life insurance. The APS helps the insurer decide how much risk the treated condition poses to your health. Such conditions include asthma, diabetes, cancer, sleep apnea, lupus, and dementia, among many other types of health issues.

The APS must adhere to the same HIPAA rules as your health history. If an issue pops up during your paramedical exam, an APS will 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 that might have been missed on your application or interview. Insurers must know exactly what they’re covering with a policy, and an APS sheds light on any ambiguities.

An insurer will only request an APS if they absolutely have to since it adds an extra step to the underwriting process and costs the insurance company money. A standard attending physician statement contains the following questions for the doctor to answer:

  • What is the history of the condition? The doctor will explain how long they have 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 per condition. The APS is also a standard part of disability insurance claims, for which you’ll need to provide info like how long you’ve been out of work and the capacity of your physical abilities.

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How does the APS relate to the paramedical exam?

The medical exam, also called the paramedical exam, provides initial information about your health and medical history. The life insurance company sends a medical technician to your home or work, or you can visit the technician’s lab. As with other components in underwriting, the medical exam doesn’t cost you anything, and you keep the results and even reuse them when applying for other types of insurance coverage or for life insurance coverage from a different provider.

During the physical portion of the exam, the medical tech draws blood, checks your weight and height, and performs many of the other tasks associated with a regular checkup. But they may not be qualified to speak on more complex health issues, which is why you’ll need to get an APS. The APS not only backs up the conclusions of the paramedical exam but also gives a picture of your health to the insurer beyond simple blood draws, urine tests, and heart ratex measurements.

The combination of the medical exam and the APS will result in your final premium quote, once the underwriter has finished reviewing your information. The point of the APS and medical exam is to provide a more accurate look into your health history, and if it turns out the insurer will have to take on more risk to insure you than it first estimated, then it will adjust the policy accordingly.

How long does it take to get an APS?

Applying for life insurance takes minutes, but it can take between four to six weeks (on average) before a policy is in force. Part of that time is for the underwriting process, which includes finding time to schedule your medical exam. The process takes longer if you need to wait on your doctor to fill out the attending physician statement.

Doctors are generally very busy people. If your insurer requests an APS, the doctor must take time out of their day to fill out the paperwork. Because of this, the underwriting process that usually takes four to six weeks will probably be extended by at least a couple more weeks, sometimes longer.

After your doctor does fill out the APS, it goes back to the underwriter. They’ll summarize the report, which has its own timeline attached to it. Many underwriters use a template or script to make sure they get all of the important information down as quickly and efficiently as possible.

But the wait will be worth it. Not only will you get life coverage; you’ll also get peace of mind that your coverage is solid. All life insurance policies have a contestability period, a two-year length of time after your policy is active during which the life insurance company can contest your beneficiaries’ claim if you die. A mistake or misrepresentation on your life insurance application can cause a delay or even a denial of the claim. Thus, the attending physician statement is a way to help ensure that you represented yourself to the life insurance company as accurately as possible.

Temporary life insurance

If you’re looking for life insurance coverage in the interim in case something happens while you’re waiting for your policy to go in force, most companies offer temporary life insurance. This type of coverage is a great way to secure peace of mind for yourself and your family during the underwriting process.

Attending Physician Statement (APS) FAQs

What is an attending physician statement (APS)?

An APS is a summary of your medical history from your doctor’s point of view.

Why do I need an attending physician statement?

If you have a chronic or more complicated medical condition, an insurance company may request an APS from your doctor in addition to a general paramedical exam. The attending physician statement helps insurers better understand your medical history so they can evaluate you accurately.

Does an APS cost money?

No, not for you. An APS, like the rest of the underwriting process, doesn’t cost you anything and is covered by the insurance company.

How long does the underwriting process take?

It depends, but the average time is between four to six weeks. If the insurance company requires any additional information, like an APS, the process can take longer. Depending on the doctor’s schedule, obtaining an attending physician statement can take anywhere from a few weeks to a few months.

About the author

Insurance Expert

Rebecca Shoenthal

Insurance Expert

Rebecca Shoenthal is an insurance editor at Policygenius in New York City. Previously, she worked as a nonfiction book editor. She has a B.A. in Media and Journalism from the University of North Carolina at Chapel Hill.

Policygenius’ editorial content is not written by an insurance agent. It’s intended for informational purposes and should not be considered legal or financial advice. Consult a professional to learn what financial products are right for you.

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