Health History Guidelines

Health insurance underwriting varies dramatically by state
and insurance company. These are general guidelines only.

In some states, exclusion riders allow more pre-existing
condition cases to get placed, usually with little or no impact
on premiums. Even in those states, not all conditions will be
excluded -- many conditions are actually being covered under
current underwriting schemes, although sometimes with an
additional premium charge.

In a few states, exclusions are severely limited by law
(examples include California, Minnesota, Michigan, Illinois, etc.).
In these states, if a sufficient premium increase is not allowed or
justified, then a decline may be more likely.

Permanent Declines by Health Condition
The following conditions are considered permanent
declines with most insurance companies.

Common conditions are BOLDED for your convenience.

Please feel free to contact our offices with any questions about health history.

_ Addison’s disease

_ Adult respiratory distress syndrome (ARDS) with severe

respiratory impairment, greater than one month steroid use

_ AIDS

_ Alcohol abuser (diagnosed; associated with other drug abuse,

medical disease, three or more DWIs or more than one detox

hospitalization)

_ Alzheimer’s disease

_ Amphetamine usage (current history of usage)

_ Amyotropic lateral sclerosis (ALS)

_ Aneurysms

_ Angina (unstable, variant, prinzmetal, vasospastic)

_ Ankylosing spondylitis

_ Anorexia nervosa (up to 5 years decline; individual

consideration thereafter)

_ Aortic arch arteritis

_ Aortic insufficiency

_ Aortic stenosis

_ Aortitis

_ Aplastic anemia

_ Aregenerative anemia

_ Arterial embolism (clot)

_ Arterial occlusion

_ Arteriosclerosis obliterans (ASO)

_ Arteriovenous malformation

_ Arteritis

_ Ataxia telangiectasia

_ Atherosclerosis obliterans

_ Atherosclerosis thrombotic disease

_ Atrial fibrillation – chronic

_ Atrial septal defect (if surgically corrected with complications)

_ Autism

_ Banti’s syndrome (spleen disorder)

_ Bronchiectasis

_ Bladder extropy (congenital malformation of the bladder wall)

_ Cancer (see melonama or skin cancer)

_Cardiac decompensation

_ Cardiomyopathy

_ Cerebral palsy

_ Charcot’s syndrome

_ Charcot-Marie tooth disease (if present)

_ Christmas disease

_ Chronic obstructive pulmonary disease (COPD) (less than 45

years old, smoker, underweight with associated respiratory

disorders or older than 45 and severe form)

_ Cirrhosis of the liver

_ Coarctation of the aorta

_ Cocaine abuser

_ Congenital lymphedema

_ Congestive heart failure (CHF)

_ Cor pulmonale

_ Coronary artery disease (CAD)

_ Coronary heart disease (CHD)

_ Crohn’s disease

_ Curvature of the spine (with pulmonary, cardiac

or spinal cord involvement)

_ Cushing syndrome (caused by bilateral adrenal hyperplasia

or administration of steroids to treat another disorder)

_ Cystic fibrosis

_ Cystic medical necrosis

_ Dejerine type sclerosis

_ Dementia

_ Depressant addiction (current history of addiction

with current usage)

_ Dermatitis herpetiformis (with evidence of significant

immunological compromise)

_ Diabetes mellitus

_ Down’s syndrome

_ Ebstein’s malformation

_ Eisenmenger’s complex

_ Electroconvulsive therapy (ECT administered for a

manic episode resulting in a life-threatening situation)

_ Eosinophilic granuloma

_ Eosinophilic granuloma of bone

_ Esophageal varices (varicose veins in the esophagus)

_ Ehlers-Danlos syndrome

_ Fabry disease

_ Factor VIII or IX deficiency (clotting disorder)

_ Fatty liver

_ Fragilitas ossium

_ Gargoylism

_ Gastric bypass/stapling

_ Gilles de la tourette’s syndrome

_ Glycogen storage disease

_ Hand-Schuller-Christian disease

_ Heart-lung transplants

_ Heavy chain disease

_ Hemiplegia

_ Hemochromotosis

_ Hemophilia A or B

_ Histocytosis X

_ Hodgkin’s disease

_ Hydrocephalus (older than age 20, surgically corrected

with complications or shunt procedure)

_ Hydronephrosis (bilateral or under age 20)

_ Hypersplenism

_ Huntington’s chorea

_ Hypoplastic anemia

_ Idiopathic thrombocytopenia purpura (ITP)

_ Ischemic heart disease

_ Ischemic / ulcerative colitis

_ Kahler’s disease

_ Kartagener’s syndrome (heart is twisted and

in the right chest area)

_ Kidney injury (major injury with history of dialysis)

_ Kidney transplant recipient (donor may be insurable with some companies)

_ Letterer-Siwe disease

_ Leukemia

_ Liver abscess (with residuals)

_ Liver transplant

_ Lobstein’s disease

_ Lou Gehrig’s disease

_ Lymphoblastoma

_ Lymphoma

_ Malaria (more than one occurrence, severe complications,

frequent disabling attacks)

_ Malignant melanoma (stage II or III, Clark level III, IV or V)

_ Marchiafava-Micheli syndrome

_ Marfan’s syndrome

_ Marijuana usage (current or past history in conjunction

with other drugs, relapse)

_ Medullary sponge kidney (unilateral with history

of infections, or bilateral)

_ Mental retardation (severe, emotionally unstable

seizures or psychiatric impairments)

_ Milroy’s disease

_ Mitral insufficiency

_ Mitral stenosis

_ Mixed connective tissue disease

_ Mongolism

_ Mucopolysaccaridosis

_ Multiple myeloma

_ Multiple sclerosis

_ Muscular dystrophy

_ Myocardial infarction (MI)

_ Myocardial ischemia

_ Narcotic use/addiction

_ Nephrocalcinosis

_ Nephrosclerosis

_ Neurofibromatosis (malignant, single or multiple)

_ Niemann-pick disease

_ Osteitis fibrosa cystica (multiple cysts or history)

_ Osteitis fibrosa cystica disseminate

_ Osteitis fibrosa cystica generalisata

_ Osteogenesis imperfecta

_ Pacemakers

_ Pancreatitis (chronic with enzymes and medications)

_ Pancytopenia

_ Paralysis

_ Paranoid disorder

_ Paraplegia

_ Parkinson’s disease

_ Paroxysmal noctural hemoglobinuria

_ Periarteritis nodosa

_ Permanent Declines by Disorder, continued

_ Peripheral occlusive arterial disease (POAD)

_ Pituitary dwarfism

_ Plasmacytoma

_ Pneumocystitis carinii pneumonia (PCP)

_ Polio myelitis (acute with loss of bladder or bowel control,

requiring wheelchair)

_ Polyarteritis

_ Polycystic kidney

_ Polycythemia vera

_ Porphyria (diagnosed less than 5 years prior to application)

_ Premature ventricular contractions (if symptomatic and treated

with encaid/encainide or tambocor)

_ Primary pulmonary hypertension

_ Primary sclerosing cholangitis

_ Pseudocysts (if multiple cysts are present)

_ Pseudohemophilia

_ Pseudotumor cerebri (if surgically corrected

with shunt present or residual complications)

_ Psittacosis (with extensive respiratory involvement)

_ Psoriatic arthritis (with spine involvement, gold injections)

_ Psychedelics usage (current or past history: LSD, PCP)

_ Pulmonary heart disease (chronic or acute)

_ Pulmonic insufficiency

_ Pulmonic stenosis

_ Pulseless disease

_ Quadraplegia

_ Renal agenesis (unilateral kidney absence) (if under age 20;

over age 20 and symptomatic or abnormal renal functions)

_ Rhabdomyosarcoma

_ Sarcoma

_ Scleroderma (systemic, diagnosed or suspected)

_ Sick sinus syndrome

_ Sickle cell anemia

_Skin cancer (usually insurable unless it has spread internally)

_ Sleep apnea (surgery suggested or advanced condition

with cardiac or pulmonary complications)

_ Spina bifida (older than age 20; surgically corrected

with recurrent symptoms or surgeries needed)

_ Splenomegaly (congestive)

_ Spurway’s disease

_ Stimulant usage (current or past history)

_ Stroke

_ Sturge-Weber syndrome

_ Sudden infant death syndrome (SIDS) (must be

off monitor two years before consideration)

_ Suicide attempt

_ Syndrome X

_ Systemic lupus erythematosis

_ Takaysu’s disease

_ Tetrology of fallot

_ Thalassemia major

_ Thrombocytopenia (if cause is known)

_ Total anomalous pulmonary venous connection

_ Tourette’s syndrome

_ Transient ischemic attack (TIA)

_ Transposition of the great vessels

_ Transsexualism

_ Tricuspid atresia

_ Tricuspid insufficiency (if surgically repaired,

annuloplasty or other valve repair)

_ Tricuspid stenosis

_ Trisomy 21 syndrome

_ Truncus arteriousus

_ Turner’s syndrome (less than age 25 or evidence

of cardiovascular disease)

_ Valve replacement

_ Vascular hemophilia

_ Ventricular arrhythmias

_ Ventricular septal defect (if surgically corrected

with complications)

_ Von Hipple-Lindau syndrome (malignant or evidence

of renal carcinoma)

_ Von Willebrand’s disease

_ Waldenstrom’s macroglobulinemia

_ Wegener’s granulomatosis

_ Wilson’s disease

_ Zollinger-Ellison syndrome (multiple tumors)