By Renee | Underwriting Corner
Underwriting Tip:
Declines aren’t always black and white.
Sometimes they’re a miscommunication.
Sometimes it’s missing information.
And sometimes? They’re just wrong.
That’s where a sharp agent-and a strong underwriting partner-can make all the difference.
Ever submitted an app that looked great on paper-only to get a decline you didn’t see coming?
You’re not alone. And here’s the truth:
Most declines aren’t caused by the big, obvious stuff.
They’re caused by missing context, vague answers, or unchecked assumptions.
Not All Red Flags Are Created Equal
Some conditions raise eyebrows but aren’t auto-declines:
Red Flag That Looks Worse Than It Is:
Prednisone
Shows up as a steroid, which screams “inflammation, neuromuscular disorders, mobility issues, flare-ups!”
But:
- Taken short-term for a sinus infection? No problem.
- Used PRN for asthma or allergies? Probably fine.
- Long-term daily use? Now that’s a true red flag.
Trazodone
Often flagged as an antidepressant, but more than half the time it’s prescribed for sleep.
If the applicant’s stable, not seeing a therapist, and has no history of mood disorders-this is not a decline.
Metformin
We see “diabetes” and everyone panics.
But Metformin alone with a controlled A1c and no complications?
That’s a manageable, not melt-down, moment.
Propranolol
Yes, it’s a beta blocker.
But it’s also used for stage fright, migraines, or mild BP.
If there’s no heart history, this one may be a non-issue.
What Actually Causes a Decline (That Agents Often Miss)
- Vague answers like “recent changes” with no dates
- Multiple fall-related injuries or ER visits that weren’t disclosed as part of the health question
- Therapy or mental health meds without clarification on why they’re being used
- Ongoing use of home health or PT that the client forgot to mention
- Pending tests to diagnose symptoms
- Diabetes + circulatory or renal complications (especially if not stable)
Agent Tip: Clients often forget things. You need to ask:
“Has your doctor mentioned any tests, treatment, or surgery they would like to do?”
“Was that ER visit because of a fall or illness?” “Are you using this medication daily or just as needed?”
When to Push Back on a Decline
Yes, you can fight a decline-but only when the file has been misunderstood or under-documented.
When to push back:
- The flagged med was for something benign.
- A fall was from a clumsy moment, not frailty.
- The condition does not fall within the criteria listed on the application.
When to leave it alone:
- The condition is a true knockout (like Parkinson’s or late-stage diabetes complications).
- The lookback window hasn’t passed.
- The info on the app doesn’t match the interview-and it’s not defensible
Bottom Line
Declines aren’t always black and white.
Sometimes they’re a miscommunication.
Sometimes it’s missing information.
And sometimes? They’re just wrong.
That’s where a sharp agent-and a strong underwriting partner-can make all the difference.
Renee Stutes