The dreaded elevated PSA! Life insurance underwriters treat a PSA out of the normal 0-4.0 range or a PSA that is higher than your last PSA with the life insurance equivalent of shutting all the hatches on a sinking ship. Even though there are no less than half a dozen reasons other than prostate cancer for elevated PSA, most underwriters won’t budge unless you have a needle biopsy of your prostate.
This is one of many situations where underwriter meets physician and you can tell right away that those two minds aren’t going to meet on this subject. Not here, not now, not anywhere and likely not anytime. The underwriter wants irrefutable needle biopsy proof that there is no cancer even when the doctor, looking at the same test results says that a needle biopsy, at least at that point, would be more dangerous than helpful.
It is especially troubling in cases where the patient has no risk factors for prostate cancer. I had an inquiry from a client who had a 4.25 PSA on an insurance exam. His PSA on his annual physical last year was 3.25 and a followup PSA after the insurance exam was 2.91. The underwriter is not convinced and won’t reconsider without a biopsy and a year waiting period where the PSA stays at or below the 2.91. Temporary spikes, especially relatively low spikes as described above are not considered by most in the medical community as worthy of a lot of worry and certainly nothing as invasive as a biopsy.
So what’s a guy to do? You want life insurance and 1. Your doctor says a biopsy is unnecessary and dangerous and 2. Waiting a year is stupid because life insurance is for the unexpected occurrence and 3. There are underwriters out there who are interested in the parameters of your individual case and not the subject of elevated PSA of the masses to make their decision. There are underwriters out there who don’t make knee jerk decisions and dig their heels in for no good reason. It is for that reason that people like the client above, declined by the first company he went to, need to step back, gather their information and seek out the right agent who will use the right companies with the right underwriters and turn things around.
Let’s say the numbers from the client above were in a different order with the PSA over a six month period going from 2.91 to 3.25 to 4.25. That might lead to a different take by your physician which might lead to a biopsy, which might lead to a diagnosis of prostate cancer. That subject has been on the tip of my blog the last few weeks with one of our better underwriting companies announcing new guidelines for prostate cancer. Probably the biggest part of their huge announcement was their willingness to approve cases under watchful waiting for men over 70. That breakthrough has been so long coming that I can’t even begin to tell you how many times I’ve written about it. I would like to see it drop back to age 60, but that’s just my greedy side. The other huge change is immediate approval on successful completion of treatment with radiation for those men over age 60. Successful treatment would be measured by a PSA that has dropped to .5. And the final piece of the puzzle was for men over age 50 who have a radical prostatectomy, immediate approval upon successful treatment. Successful treatment in this case would be a PSA of zero.
Bottom line. So, while one company beats up on a fluctuating PSA, another company opens the door and says come on in. As with all impaired risk life insurance, when you get declined, it pays to take a deep breath, get your facts together and seek an agent with successful experience in working with your issue. If you’ve been declined or rated for any of the issues described in this post, call or email me directly. Let’s talk.