Part of our guide: Long-Term Care Insurance: Costs, Options and Planning →
Long-term care underwriting has become stricter. Declines on one spouse, and offers at worse rate classes than quoted, lead to policies that are never placed and clients who lose confidence. The fix starts before the first quote.
Key takeaways
- Stricter LTC underwriting has increased declines and not-taken policies, especially for couples.
- Four questions predict most outcomes: height and weight, tobacco use, recent or pending health issues, and current medications.
- Pre-screening lets us recommend the carrier most likely to approve the client at the quoted rate class.
Medications tell you more than almost any other answer. Ask for the full list before you quote.
Why placement rates suffer
When a proposal is built without knowing the client’s health, the underwriting decision often doesn’t match the quote. Couples are especially vulnerable: if one spouse is declined, the other often walks away too. The result is wasted time and frustrated clients.
The 4 things to know first
- Height and weight
- Tobacco use
- Recent major health issues or pending surgeries
- Current prescription medications, which often reveal conditions clients forget to mention
With this information we can estimate insurability and rate class, and point you to the carrier most likely to view the client favorably.
Tools to make it easy
We offer a one-page LTC health questionnaire covering the issues that drive underwriting decisions. Reviewing a carrier’s underwriting guide once or twice also helps you learn what matters. The same approach works for life insurance; see field underwriting that gets the rate class right.
When one spouse is declined
Even with good field underwriting, it happens. Here’s how to handle the couple rejection objection.
Frequently asked questions
What health questions affect long-term care insurance approval?
Build, tobacco use, recent or pending health issues and surgeries, and current medications are the biggest factors.
Why are LTC insurance applications declined?
Common reasons include cognitive issues, recent major illnesses, mobility problems, and certain medications. LTC underwriting focuses heavily on future care needs.
How can I avoid LTC declines?
Pre-screen clients with a health questionnaire before quoting, and submit to the carrier most favorable to their health profile.
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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