Two-vessel coronary artery disease and an abnormal EKG finding would send most $3 million applications straight to a heavy table rating, if not a decline. This one came back Standard. Here’s how.
Key takeaways
- Cardiac impaired-risk cases vary enormously by condition, severity, compliance, and follow-up history.
- Strong compliance with cardiac follow-up and testing can outweigh the diagnosis codes alone.
- Matching the case to a carrier willing to evaluate the full picture produced the best possible outcome.
Two-vessel coronary artery disease and an abnormal EKG finding came back Standard — not a decline — once a carrier weighed the full clinical picture and cardiac follow-up compliance.
The situation
The client was a 72-year-old male, a lifelong non-smoker, applying for $3 million of permanent life coverage. His medical history included two-vessel coronary artery disease and an abnormal EKG finding of Right Bundle Branch Block (a form of heart block). On the positive side, he showed good compliance with recommended cardiac follow-up and testing.
Why this case was hard to place
Cardiac impaired-risk cases are some of the most challenging to underwrite, precisely because there’s no single “heart condition” — coronary artery disease, arrhythmias, congestive heart failure, and conduction abnormalities like this client’s Right Bundle Branch Block each carry their own underwriting criteria, and carriers weigh them very differently depending on severity, compliance, and follow-up history.
The solution
We know what underwriters are actually looking for in cardiac cases like this one, and which carriers are positioned to give credit for strong follow-up compliance rather than underwriting purely off the diagnosis codes. We matched this case to a carrier willing to weigh the full clinical picture, not just the surface-level findings.
The result
The carrier came back with a Standard rating — the best possible outcome for a case with this profile, and a result that would have been unlikely with a less experienced underwriting approach or the wrong carrier.
If you have a client with a cardiac history that’s making it hard to get a fair offer, that’s exactly the kind of case our underwriting team is built to place. Send it our way — we’ll get to the heart of the matter and find the carrier that gives your client the offer they deserve.
Frequently asked questions
Why do cardiac cases vary so much in how they’re underwritten?
Because “heart condition” covers a wide range of diagnoses — coronary artery disease, arrhythmias, congestive heart failure, conduction abnormalities, and more — each with different risk profiles. Carriers also vary widely in how much credit they give for strong follow-up compliance and stable test results.
Can a client with coronary artery disease still get a Standard rating?
Yes, in the right circumstances. This case involved two-vessel coronary artery disease and an abnormal EKG finding, but strong compliance with cardiac follow-up and testing, combined with placing the case with the right carrier, resulted in a Standard offer on $3 million of coverage.
Reviewed by Tim Fuller on 2026-09-23
Tim Fuller
President, SRS Inc.
Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency) connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners — with the impaired-risk and complex-case expertise to place business other IMOs and BGAs turn away.
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