What is an Attending Physician Statement

Before an insurer agrees to write you a policy, they will assess your health (often with an attending physician statement) to accurately measure the risk of insuring you. This assessment helps the insurance company to determine your insurability and set your premium rate.

The process of assessing the risk an applicant presents is called underwriting.

This process typically involves a health questionnaire and a medical examination.

In certain situations, the insurance carrier may also request an Attending Physician Statement (APS) from a physician who is currently treating you or has treated you in the past.  

What is an Attending Physician Statement in Canada?

An Attending Physician Statement is a questionnaire form that the insurer asks your physician to complete. While the exact questions included in the APS may vary for each insurance company, its purpose is always the same: to obtain a summary of your health from your family doctor. Some insurers may call this questionnaire by different names, such as Functional Report, but the most common title is Attending Physician Statement.  

Typically, the insurance company will ask your doctor to provide information about your diagnosis and treatment. Common questions in an APS include:

• What is the primary diagnosis?  
• What are the symptoms you are currently experiencing?
• For how long have you had the condition?
• What is your prognosis?
• What treatments have you undergone?
• Has there been any improvement since the treatment began?
• How are you managing your condition?

In case you are receiving treatment from more than one attending physician, it is possible the insurer may ask each doctor to fill in an attending physician statement report. 

Who completes an APS?

An Attending Physician Statement is completed by a physician who is currently providing treatment to you or has treated you in the past. Sometimes, an insurer may contact a specialist instead, which will invariably increase the application processing time. For example, if you have mental health issues, the insurer may ask a psychiatrist, not your physician, to complete the APS.  

How long does it take to issue an APS?

The time it takes to get an APS can vary significantly, anywhere between one week and six weeks. However, the wait is worth it. All life insurance products include a contestability period, which is a short period — usually two years — during which your insurance company can contest the claim filed by your beneficiaries. False information on the application can delay the payout or even lead to a denial of claim. An APS, however, serves as a proof that you did not hide any key information from the insurer.  

How much does an APS cost?  

An attending physician statement can cost about $150 or more, however the insurance company pays the physician. This is why insurance carriers do not request an APS unless it is absolutely necessary.  

Why do insurance companies need an APS?  

Insurance carriers ask for an Attending Physician Statement to have a complete picture regarding your health. This helps them to set a premium rate that is appropriate for the level of risk you present. The healthier you are, the lower your premium. The more medical conditions you have, the higher the premium rate.  

Life insurance companies do not always ask for an APS. In most cases, the health questionnaire and the medical examination provide life insurance companies with enough information to be able to accurately set premium rates. However, in some situations, they may need additional information to fill in the gaps.  

For example, the insurance company may request an attending physician statement if they believe you present a higher risk than what the information shared on the application reveals. Likewise, if your medical test shows something unexpected, the provider may ask your doctor about it. Some health conditions also require supporting evidence from the attending physician. For example, if you have asthma, the insurer may want to ask your doctor about the level of risk your diagnosis poses to your health. Other health conditions that may flag the insurance carrier to request an APS include cancer, sleep apnea, rheumatoid arthritis, lupus, hepatitis, high blood pressure, diabetes, and mental illness. 

Which life insurance products may require an APS?  

If you are applying for a fully-underwritten life insurance policy, an APS may be required if:  

• the insurer thinks you may be a higher risk than your life insurance application reveals
• you have a chronic health condition
• some unexpected issue shows up in your life insurance medical examination.  

You may also need an attending physician statement when you apply for a disability insurance or critical illness insurance policy. With either of these products like disability insurance, the insurance company may ask for another APS a few years after you start collecting living benefits. While the first APS helps the insurance carrier decide whether to extend a disability insurance policy or critical illness insurance policy to you or not, the second helps it determine whether you still qualify for the benefits you are receiving.  

An APS is not required for no-medical life insurance policies, which are aimed at people who have underlying health issues or want a policy quickly.

Can my application be denied based on the APS?  

Yes, an insurance company can deny you coverage on the basis of information provided by your family doctor. However, since each insurance company follows a unique underwriting process and not all of them require an APS, there is a good chance you may find a provider that is willing to write you a policy. Another option is to consider a no-medical life insurance policy. Because the no-medical life insurance policy does not require a medical examination or an APS, you can buy it even if you have a health condition.  

Conclusion

Life insurance companies gather information about your health through various ways. These include a health questionnaire that is a part of the application process, a paramedical examination, and an Attending Physician Statement. The APS is not always required, but if the insurer feels they need more information regarding your health and medical history before they can approve your application, the insurance company may ask your family doctor to provide one. An Attending Physician Statement is a form with a series of questions that provide a summary of your health, from your physician’s point of view. You do not have to pay anything for it, but it can increase the application processing time by a couple of weeks or more with your insurance company.