Merritt Personal Lines Manual: Medical Profile

A medical profile normally will consist of past medical history and current physical condition. Most disability insurance companies ask about medical history -- and the family history -- on a policy application. They also will ask a prospective insured to take a physical exam (usually at the company's expense).

If an applicant has to have a physical examination performed by a doctor in lieu of simply answering medical questions, the application is normally referred to as a medical application. If the company obtains medical information simply by reviewing answers to questions on the application, it is referred to as a non-medical application.

Depending on the medical problem, the personal physician may be requested to complete an attending physician's statement (APS). The purpose of this report is to provide more detailed information about medical history or current physical condition.

Past medical history refers to what was; current physical condition refers to what is. These two factors, plus any hereditary traits -- such as heart disease or diabetes -- would indicate what will be or provide a prognosis for the future.

Example: Ralph has just been given a clean bill of health following a physical exam. A week later, he has a severe heart attack and becomes totally disabled.

How can this happen? The family physician is normally looking at the patient today -- at a specific moment in time. It is entirely possible that at that precise moment, Ralph appeared to be in excellent condition. He came from a family with a history of heart problems, though. And for many years he had been overweight, with a high-cholesterol diet and a sedentary lifestyle. Even though he had trimmed down a bit before his physical, he was a candidate for heart problems.