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Case Placement: Standard Rates After Hepatitis C and Two Carrier Setbacks

September 25, 2026February 11, 2022 by Tim Fuller

Underwriter reviewing medical and financial data with a client during risk assessment

The same impaired-risk case can get wildly different answers from different carriers. This Hepatitis C file went from a decline to Standard, and the only thing that changed was where it was submitted.

Key takeaways

Underwriting for Hepatitis C depends heavily on liver damage (fibrosis stage) and whether treatment achieved a cure.
Sustained virologic response (SVR) after treatment and normal liver function are the strongest positives in the file.
Four carriers produced four outcomes on the same case: decline, Table E, Table B, and Standard Non-Tobacco.

Same client, same file, four carriers: a decline, Table E, Table B — and Standard Non-Tobacco.

The case

58-year-old male seeking $1 million of term coverage
Non-smoker, 5’11” and 230 lbs; takes medication for cholesterol and blood pressure
Diagnosed with Hepatitis C in his late teens from a contaminated blood transfusion
Liver biopsy showed stage 2 fibrosis, no cirrhosis
Curative treatment with Harvoni in 2015; post-treatment testing showed sustained virologic response
Current liver function tests normal

The results, carrier by carrier

Carrier 1: declined
Carrier 2: tentative Table E Non-Tobacco
Carrier 3: Table B Non-Tobacco, even with its credit program
Carrier 4: Standard Non-Tobacco

What made the difference

Modern Hepatitis C treatments can cure the infection, but carriers haven’t all updated their guidelines at the same pace. Some still weight the original diagnosis heavily; others focus on the cure and current liver health. Knowing which carriers take the second view is what turned this case around. It’s the same pattern we saw in a case that was declined three times before a Standard offer.

How to present a Hepatitis C case

Include treatment dates, the medication used, post-treatment viral load results showing SVR, the most recent liver function tests, and any biopsy or imaging on fibrosis. Send the details to our Underwriting Team first so the case goes to the right carrier the first time.

Frequently asked questions

Can someone with a history of Hepatitis C get life insurance?

Yes. Clients who have been cured, with sustained virologic response and normal liver function, can qualify for Standard or better with the right carrier.

What is sustained virologic response (SVR)?

SVR means the virus is undetectable in the blood months after treatment ends. It’s considered a cure and is the most important positive in a Hepatitis C file.

Why did carriers disagree so much on this case?

Carriers update impairment guidelines at different speeds. Some still rate the original diagnosis heavily, while others focus on the cure and current liver health.

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Reviewed by Tim Fuller on 2026-09-25

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.

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Life Insurance Underwriting for Diabetes: Type 1, Type 2, and Pre-Diabetes

September 25, 2026February 4, 2022 by Tim Fuller

Diabetes is one of the most common impairments on a life application, and one of the most misunderstood. A diagnosis alone rarely decides the offer. How well it’s controlled, how long the client has had it, and whether there are complications decide it.

Key takeaways

Type 2 diabetes with good control and no complications may qualify for Standard rates.
Type 1 diabetes is usually table-rated, but best-case clients over age 50 may see ratings as favorable as Table 2.
Pre-diabetes and gestational diabetes history may qualify for Standard Plus, and A1C history is the single most important document in the file.

With good control and no complications, a Type 2 diabetic may qualify for Standard rates — not the automatic table rating many advisors expect.

What underwriters look at

Underwriters build a picture of long-term control, not a single snapshot. The main factors are:

Type of diabetes and age at diagnosis.
A1C history, the average blood sugar over roughly three months, both at diagnosis and over time.
Complications, including neuropathy (nerve damage), kidney disease, retinopathy, stroke, and cardiovascular disease.
Treatment, whether diet, oral medication, or insulin, and how consistently the client follows up with their doctor.
Other risk factors, such as build, blood pressure, cholesterol, and tobacco use.

The four types, and how each is viewed

Type 2 is the most common form. The body is resistant to insulin and can’t use it effectively. Type 1 is an autoimmune condition where the body produces little or no insulin, usually diagnosed early in life; latent autoimmune diabetes in adults (LADA) is a slower-progressing form. Pre-diabetes, also called impaired fasting glucose or impaired glucose tolerance, means glucose is above normal but below the diabetes threshold. Gestational diabetes occurs during pregnancy and usually resolves after delivery, though it raises the chance of Type 2 later.

Typical underwriting outcomes

Type 2: may qualify for Standard with good control and no complications.
Type 1: best case around Table 2 for clients over age 50; higher table ratings are common at younger ages, depending on control and complications.
Pre-diabetes and gestational diabetes: may qualify for Standard Plus, and in some cases better. See how one client with a borderline blood sugar reading reached Super Standard Non-Tobacco.

These are illustrative ranges. Carriers differ widely on diabetes, so the same file can produce very different offers depending on where it goes.

How to prepare a diabetes case

Gather the client’s recent A1C results (several readings over time are better than one), a full medication list, and any eye, kidney, or cardiac screening results. Then let our Underwriting Team pre-screen the case informally before you apply, so it goes first to the carrier most likely to give the best offer.

Frequently asked questions

Can a Type 1 diabetic get life insurance?

Yes. Type 1 diabetes is usually table-rated, but clients with good control and no complications can get coverage, and best-case clients over 50 may see ratings around Table 2.

What A1C do life insurance underwriters want to see?

Carriers set their own thresholds, but the closer A1C readings are to normal and the more stable they are over time, the better the offer. Send us the client’s history and we’ll tell you which carriers are most favorable for it.

Does gestational diabetes affect life insurance rates?

Usually only modestly. A history of gestational diabetes that resolved after pregnancy may qualify for Standard Plus or better, depending on the carrier and current blood sugar results.

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Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

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Upgrade Programs in Life Underwriting: One-Class and One-Table Improvements

September 25, 2026November 5, 2021 by Tim Fuller

Sometimes a single factor, like a slightly high cholesterol reading, keeps an otherwise healthy client out of the best rate class. Some carriers have programs designed to fix exactly that.

Key takeaways

One carrier offers a one-class upgrade when only one of build, cholesterol, blood pressure, or family history holds a client back.
A one-table reduction program can improve substandard offers, for example from Table B to Standard, through age 70.
Some carriers also treat occasional pipe or cigar use and recreational scuba diving more favorably than others.

A one-table reduction can turn a Table B offer into Standard — on both term and permanent products, through age 70.

The one-class upgrade

One of our carriers allows a one-class upgrade when the less favorable class is caused by just one of four factors: build, cholesterol, blood pressure, or family history. If the other three all meet the better class’s guidelines, the upgrade applies. It’s available on term and permanent products, up to age 70, and includes smoker classes.

Example: a 60-year-old male whose build puts him in Preferred, but whose blood pressure, cholesterol, and family history all meet Preferred Best guidelines, is improved to Preferred Best. Family history is a common culprit; here’s how family history of cancer is handled.

The one-table reduction

For substandard cases, the same carrier offers a one-table improvement through age 70 on term and permanent products. A Table B offer, for example, becomes Standard.

Other underwriting strengths

Pipe and cigar use: occasional use (no more than once a month) with a negative nicotine test may be considered for Preferred non-tobacco rates.
Scuba diving: may be considered for Preferred Best for resort diving to 35 feet and up to 6 dives a year, or certified divers to 75 feet using the buddy system and up to 10 dives a year.

Carrier programs change, so confirm current availability with our team before quoting.

Frequently asked questions

What is a one-class underwriting upgrade?

A carrier program that moves a client up one rate class when only one factor, such as build or cholesterol, keeps them from the better class and everything else qualifies.

Can a table rating be improved?

Some carriers offer a one-table reduction program that improves substandard offers by one table, for example from Table B to Standard.

Can occasional cigar smokers get non-tobacco rates?

Some carriers allow Preferred non-tobacco rates for occasional cigar or pipe use, typically no more than once a month with a negative nicotine test.

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Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

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Life Insurance After Breast Cancer: What Underwriters Look For

September 25, 2026October 22, 2021 by Tim Fuller

About 1 in 8 women in the U.S. will develop invasive breast cancer in her lifetime, so it’s a history advisors see often. Many assume it means a decline or a long postponement. With the right carrier, many survivors can get favorable rates.

Key takeaways

Underwriters weigh stage, grade, tumor size, lymph node involvement, receptor status, and time since treatment.
Early-stage, low-grade cancer with no lymph node involvement may qualify for Preferred-level rates with no postponement at some carriers.
More advanced cases may be offered a table rating plus a temporary flat extra that drops off after a set number of years.

A 60-year-old diagnosed with low-grade, node-negative breast cancer at 58 could qualify for Non-Smoker Plus with no postponement.

What underwriters weigh

Cancer underwriting depends on the details in the pathology report and treatment records: tumor size, stage, grade, estrogen receptor status, whether lymph nodes were involved, what treatment was completed, and how long ago. Carriers vary a lot here, so the same history can get very different offers.

Case study 1: early stage, no postponement

60-year-old female, diagnosed at age 58
Low-grade cancer, estrogen receptor positive
Tumor 1.1 mm, no lymph node involvement (T1aN0)

Could qualify for: Non-Smoker Plus, with no postponement.

Case study 2: one positive lymph node

47-year-old female, diagnosed at age 40; treatment ended at 42
Tumor 1.5 cm, one positive lymph node (T1N1)

Could qualify for: Table B with a temporary flat extra of $10 per thousand for six years. If the positive node showed only microscopic disease (under 2 mm), the flat extra could drop to as little as one year.

How temporary flat extras work

A temporary flat extra is an added charge per $1,000 of coverage for a set period. It reflects the higher risk in the years after cancer treatment and then falls away, so the client’s long-term cost can be much closer to standard than the first-year premium suggests. For clients who also want protection if cancer occurs again, critical illness coverage is worth discussing.

How to prepare the case

Gather the pathology report, treatment summary, and date of last treatment. Send them to our Underwriting Team for an informal pre-screen so the case goes to the carrier most likely to make the best offer.

Frequently asked questions

Can a breast cancer survivor get life insurance?

Yes. Many survivors qualify, and early-stage, low-grade cancer with no lymph node involvement can receive Preferred-level offers from some carriers without waiting.

What is a temporary flat extra?

An additional charge per $1,000 of coverage for a fixed number of years after cancer treatment. Once the period ends, the charge drops off and the premium falls.

How long after breast cancer treatment can a client apply?

It depends on the stage and the carrier. Some early-stage cases have no postponement at all, while others require a waiting period after treatment ends. We can tell you where your client’s case stands.

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Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

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How Life Insurers Treat Family History for Older Applicants and Gender-Specific Cancers

September 25, 2026September 24, 2021 by Tim Fuller

Adverse family history can cap a client’s rate class, but not always. Two carrier rules often surprise advisors: family history may be ignored for older applicants, and gender-specific cancers in a parent of the opposite sex may not count.

Key takeaways

Some carriers don’t consider family history at all once the applicant is over 65.
Gender-specific cancers, such as prostate cancer in a father, may not count against an applicant of the opposite sex.
Two applicants with significant family history both received Preferred Best.

Both parents died of heart disease and cancer by 60 — and at 67, the client still got Preferred Best.

Rule 1: family history after 65

Some carriers stop considering family history once the proposed insured is older than 65, since the client has already outlived the risk period.

67-year-old male, 5’10”, 190 lbs
Blood pressure averaging 140/84; total cholesterol 218, ratio 4.6
Father died at 45 of a heart attack; mother died at 60 of breast cancer
No other adverse history

Decision: Preferred Best. Family history had no bearing because of his age.

Rule 2: gender-specific cancers

Some carriers don’t count gender-specific cancers against an applicant of the opposite sex.

42-year-old female, 5’3”, 154 lbs
Blood pressure 130/80 and cholesterol 220 (ratio 4.2), both treated with medication
Father died at 59 of prostate cancer

Decision: Preferred Best. Her father’s prostate cancer didn’t affect her rating.

Know the rules by carrier

Family history rules vary widely. Our Underwriting Team can match clients to the carriers whose rules favor them. See also family history of heart disease and family history of cancer.

Frequently asked questions

Does family history matter for life insurance after 65?

At some carriers, no. They stop considering family history once the applicant is over 65.

Does my father’s prostate cancer affect my life insurance?

For female applicants, some carriers don’t count gender-specific cancers of the opposite sex.

How much does family history affect life insurance rates?

It can limit the best rate classes, but rules vary widely by carrier, age, and the specific conditions.

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Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

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Underwriting Niches: Conditions That Can Still Qualify for Preferred

September 25, 2026September 10, 2021 by Tim Fuller

Many advisors assume any health condition knocks a client out of the top rate classes. With the right carrier, a surprising number of common conditions can still qualify for Preferred or even Preferred Plus.

Key takeaways

Mild, resolved, or well-controlled conditions often have far less effect than clients expect.
Preferred Plus may be possible with a single resolved episode of anxiety or depression, mild asthma, uncomplicated osteoporosis, or some non-melanoma skin cancers.
Preferred may be possible with well-controlled anxiety or depression on one medication, or epilepsy with no seizures in five years and no medication.

A single, resolved episode of anxiety or depression, with no current medication, may still qualify for Preferred Plus.

Conditions that may still qualify for Preferred Plus

Anxiety, depression, or mood disorder: one episode lasting under a year, recovered, no current medication.
Asthma: mild exercise-induced or seasonal asthma. More on asthma underwriting.
Osteoporosis: with no complications.
Some skin cancers: basal cell, superficial squamous cell carcinoma, or a single atypical or dysplastic mole, with no family history of melanoma and well-documented dermatology follow-up.

Conditions that may still qualify for Preferred

Anxiety, depression, or mood disorder: current, well controlled on a single medication.
Epilepsy: no seizures for more than five years and no medication. See two epilepsy case studies.
Moles: up to three atypical or dysplastic moles, no personal or family history of melanoma, with favorable dermatology follow-up.

Why the carrier matters

These are niche guidelines at specific carriers, not industry-wide rules. The same history might be Standard at one company and Preferred Plus at another. Our Underwriting Team tracks these niches so you can place each case where it’s treated best.

Frequently asked questions

Can someone on antidepressants get Preferred life insurance?

Possibly. Some carriers may offer Preferred for well-controlled anxiety or depression treated with a single medication.

Does a basal cell skin cancer affect life insurance rates?

Often very little. Some carriers may still offer Preferred Plus with documented dermatology follow-up and no family history of melanoma.

Can a person with epilepsy get Preferred rates?

With some carriers, yes, if there have been no seizures for more than five years and no current medication.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

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Improving a Substandard Rating: Table D to Table B After Heart Valve Replacement

September 25, 2026August 20, 2021 by Tim Fuller

A table rating isn’t always final. Carriers with crediting programs can improve substandard offers when the rest of the client’s profile is strong.

Key takeaways

Crediting programs can apply to substandard (table-rated) cases, not just Preferred classes.
A 31-year-old with a prior aortic valve replacement had excellent cholesterol, build, and blood pressure.
His rating improved from Table D to Table B, a significant premium reduction.

Initial assessment: Table D. With credits for favorable cholesterol, build, and blood pressure: Table B.

The case

31-year-old male, non-tobacco, seeking universal life
Bicuspid aortic valve, replaced 12 years earlier
Cholesterol 139, ratio 4.0
6’6”, 222 lbs (BMI 25.7)
Blood pressure 117/70

The result

The initial assessment was Table D. Applying the carrier’s crediting program for his favorable risk factors improved the offer to Table B.

Other ways to improve a rating

Shop carriers with crediting or table-reduction programs; see one-table reductions.
Request reconsideration after a period of stability or new favorable tests; see reconsideration success.
Consider carriers that price tables off better base rates; see Standard Plus-based tables.

Frequently asked questions

Can a table rating be reduced?

Yes. Some carriers apply credits or table-reduction programs, and ratings can sometimes be reconsidered after issue.

Can you get life insurance after heart valve replacement?

Yes. Many clients qualify, often with a table rating that depends on the valve type, heart function, and time since surgery.

What is Table D in life insurance?

A substandard rating typically about 100% above standard premium, depending on the carrier’s table scale.

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Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

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Income Replacement Multiples: How Carriers Decide How Much Life Insurance a Client Can Buy

September 25, 2026August 17, 2021 by Tim Fuller

Clients often underestimate how much life insurance they can buy. Carriers’ own financial underwriting guidelines usually allow far more coverage than clients assume, and they’re a useful tool for showing what survivors would really need.

Key takeaways

Carriers use a multiple of annual earned income, based on age, to set the maximum coverage for income replacement.
Multiples fall with age: a conservative carrier might allow 20–25x in a client’s 20s and 2–5x over age 65.
Non-working spouses can usually get at least half the coverage of the working spouse.

Even a conservative carrier may allow 15–20 times annual income for a client in their 30s.

Why carriers limit coverage

Financial underwriting exists to prevent over-insurance, not to grow the sale. Carriers standardize what they consider a reasonable amount of coverage based on the applicant’s situation. For income replacement, the most common need, that starts with a multiple of current annual compensation.

Income multiples by age (conservative example)

20–29: 20–25x
30–39: 15–20x
40–49: 12–15x
50–54: 10–12x
55–59: 8–10x
60–65: 5–8x
Over 65: 2–5x

Multiples decrease with age because fewer income-earning years remain. They vary by carrier, and many are more generous than these.

What income counts

Carriers generally use pre-tax earned income, which works in the client’s favor because the death benefit is usually paid income-tax-free. Unearned income typically isn’t counted unless the insured’s death would directly affect it. Non-working spouses can usually be covered for at least half the working spouse’s amount. For business owners, see how coverage above normal limits can be justified in a sweat equity case.

Using the multiples in a client conversation

Showing a client the carrier’s own maximum helps them see how large a pool of money their family would need. For young, healthy clients, competitive term pricing makes adequate coverage affordable even at high multiples. Call us with any financial underwriting question before you quote.

Frequently asked questions

How much life insurance can I get based on income?

Carriers typically allow a multiple of annual earned income that depends on age, from roughly 20–25 times income in your 20s down to 2–5 times over 65, though limits vary by carrier.

Can a stay-at-home spouse get life insurance?

Yes. Non-working spouses can usually be covered for at least half the working spouse’s coverage amount.

Do carriers use gross or net income?

Usually gross (pre-tax) earned income, which works in the client’s favor since death benefits are generally income-tax-free.

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Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

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Never Say Never: How Our Underwriting Team Gets Declined Cases Placed

September 25, 2026August 6, 2021 by Tim Fuller

A decline isn’t always the final word. Sometimes the carrier simply didn’t have the full picture, and the difference between a lost case and a placed one is an underwriting team willing to go back and ask.

Key takeaways

Declines often happen because records are incomplete or out of date, not because the risk is unacceptable.
Asking the carrier for reconsideration with updated information can reverse a decision.
In this case, a declined LTC rider on a $1 million UL policy was approved after interim details were provided.

The LTC rider was declined. We went back with updated details — and it was approved. The case was placed.

The case

A 60-year-old applied for $1 million of universal life with a long-term care rider. His medical records showed inflammatory arthritis, and the carrier declined the LTC rider.

August 2016: joint pain in hands and feet, first treated as presumed gout without relief
Normal rheumatoid factor and uric acid tests
Rheumatology diagnosed inflammatory arthritis and prescribed meloxicam; pain improved within three months
Last visit October 2018: no joint pain, no medication

What we did

The records stopped in 2018, so the underwriter had no information on his current condition. We went back to the carrier and arranged to provide interim details. They showed no further joint pain and no medication since 2016. After reviewing the update, the carrier approved the LTC rider and the case was placed.

Why reconsideration works

Underwriters decide based on what’s in the file. If the file has gaps, they assume the worst. Filling those gaps with current, documented information often changes the answer. We take the same approach on every difficult case, including one that was declined by three carriers before a Standard offer.

Bring us your difficult cases

If you have a decline, a postponement, or an offer that doesn’t match your client’s health, contact our Underwriting Team. We’ll review the file and look for a path to a better outcome.

Frequently asked questions

Can a life insurance decline be reversed?

Sometimes. If the decline was based on incomplete or outdated records, a carrier may reconsider when given current, documented information.

What is an underwriting reconsideration?

A request for the carrier to review a decision again, usually with new information such as a doctor’s statement or updated test results.

How does an IMO/BGA underwriting team help?

We know each carrier’s guidelines, can pre-screen cases, and advocate with carrier underwriters to get the best possible decision.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

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Executive Underwriting: Life Insurance With No Exam Using an Executive Physical

September 25, 2026July 23, 2021 by Tim Fuller

Busy executives don’t want to schedule a paramedical exam, and many have already had a more thorough one. Some carriers will use a recent executive physical in place of insurance exams and labs.

Key takeaways

An executive physical completed in the past 18 months may replace the paramed exam and labs.
One program offers up to $20 million of indexed or variable UL, including survivorship, for ages 25–65.
Clients need at least $200,000 in annual income and an executive, professional, or white-collar occupation.

Up to $20 million of permanent coverage — no paramed exam, no insurance labs — using an executive physical from the past 18 months.

What an executive physical is

Many executives and professionals get an annual executive physical: a comprehensive health review with full lab panels and cardiovascular testing. These are done by a personal physician or through formal programs at major health systems such as Mayo Clinic or Cleveland Clinic.

Program guidelines

Ages 25–65
Up to $20 million of coverage
Indexed UL and variable UL, including survivorship (both spouses need an eligible physical in the past 18 months)
Preferred and Standard classes
Executive, professional, or white-collar occupations with at least $200,000 in annual income

What the physical must include

Medical records are still required and must show a physical meeting minimum criteria: height, weight, blood pressure, and pulse; a medical history review; full blood and urine panels; and cardiovascular testing.

Why it helps the sale

Removing the exam removes one of the biggest reasons high-net-worth clients delay or drop out of the process. Contact our Underwriting Team to confirm eligibility and current program details before you quote.

Frequently asked questions

Can an executive physical replace a life insurance exam?

With some carriers, yes. A comprehensive executive physical from the past 18 months may be used instead of a paramed exam and labs.

How much coverage is available without an exam through executive underwriting?

One program offers up to $20 million of indexed or variable universal life for ages 25–65.

Who qualifies for executive underwriting?

Typically executives, professionals, and white-collar workers earning at least $200,000 a year who have had a qualifying physical within 18 months.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

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Case Placement: Standard Rates After Hepatitis C and Two Carrier Setbacks

The case

The results, carrier by carrier

What made the difference

How to present a Hepatitis C case

Frequently asked questions

Tim Fuller

We’re Here to Help

What underwriters look at

The four types, and how each is viewed

Typical underwriting outcomes

How to prepare a diabetes case

Frequently asked questions

Tim Fuller

We’re Here to Help

Tim Fuller

We’re Here to Help

Tim Fuller

Tim Fuller

Tim Fuller

Tim Fuller

Tim Fuller

Tim Fuller

Tim Fuller