What is an Attending Physician Statement (APS)?
If you apply for life, critical illness, or disability insurance, your insurer may request an Attending Physician Statement (or APS for short). This is fairly straightforward; your physician provides any information about your health that the insurer requests. Analyzing an APS is part of the underwriting process and can determine your insurance eligibility, insurance rating, and premiums.
In this article, we explain the ins and outs of an Attending Physician Statement (APS), why insurers ask for it, when they’ll need it, and what to consider when you obtain and submit an APS.
How does an Attending Physician Statement work?
An APS is a report written by your doctor to detail your health. The information contained in an APS varies and depends on what your insurer is looking for. They generally want to understand any of your prior diagnosis, health history, treatments, and possible symptoms of an undiagnosed disease.
An APS can solidify your life insurance application so you can rest assured that your coverage won’t falter. If your questionnaire, paramedical exam, and APS paint the same picture about your health, your insurer will have a significantly harder time denying any coverage upon your death, critical illness, or disability claim.
Why do insurers need an Attending Physician Statement?
The APS ultimately helps an insurer better understand your medical history and current medical status. This lets them accurately evaluate your application and manage their own risks.
While insurance applications already ask you for this information, a medical professional can better document your health. They may see issues that you don’t or understand whether something is “normal” or “average”.
APS’s become especially important when complex illnesses like cancer are present. The APS helps the insurer understand the intricacies of your issue and how you and your doctor have managed it. Although paramedical exams can provide some information on complex illnesses, the technicians or nurses who perform these exams aren’t qualified to speak to the more complex health issues that doctors can.
When is an Attending Physician Statement required or not required?
Commonly, your life insurance questionnaire is enough for an underwriter to complete the process. Insurers aim not to request APS’s because they add another step to the underwriting process, which increases the insurer’s costs and the time to grant you coverage.
Requiring an APS increases the time it takes to approve an insurance policy. Generally, doctors don’t prioritize drafting an APS because their first focus is on their patients. They may, therefore, treat the request as an afterthought. After the APS is provided, an underwriter still has to examine it in contemplation with other documents such as any paramedical tests or completed surveys.
If you purchase simplified or non-medical life insurance, your insurer won’t require an APS. Often, the point of simplified and non-medical life insurance is to provide coverage to those with pre-existing conditions or speed up the application approval timeline. An APS is ultimately counter-intuitive to these goals.
Critical illness or disability insurance
Insurers usually require an APS with critical illness or disability insurance. An insurer may request an APS when you initially apply for a policy and further request an APS every few years if you’re collecting benefits. With the latter, they want to understand your condition and whether you still qualify for the insurance benefit due to disability.
Depending on your condition, an insurer may require multiple APS’s from different doctors treating your critical illness or disability. In such a scenario, these APS’s should be consistent.
What to consider when obtaining an Attending Physician Statement
Speaking with your doctors about the APS and reviewing the document before submitting it to your insurance company can mitigate many issues. Doctors are busy people and because drafting an APS isn’t a priority, it’s not uncommon to find errors in their statements. An error can lead to denial of benefits, termination of a policy, or delays in the overall approval process.
It’s also essential to have the proper doctor(s) complete the APS. A nurse practitioner, social worker, or other healthcare providers may be able to provide this information. Still, the insurer may deny an APS provided by anyone who’s not your attending doctor. Requiring anyone other than your doctor to provide the statement could cause delays and lengthen your application timeline.
Sometimes, insurers will request an APS from a specialist. For example, if mental health issues concern your insurer, they may request an APS from your psychiatrist (if you see one) instead of your physician. Again, submitting an APS from the wrong doctor can cause delays and other issues with your application or benefits.
An APS is one of many pieces of information that insurers use to determine your risk or eligibility for life or critical illness insurance. It’s not always required, but when it is, it’s a reasonably straightforward process.
If you’re looking for life, critical illness, or disability insurance, PolicyAdvisor works with over 20 of Canada’s top insurance providers to get you the best coverage. Our experts are happy to answer any questions you have regarding life or critical illness insurance.
The information provided herein is for general informational purposes only. It is not intended and should not be construed to constitute legal or financial advice.
- An Attending Physician Statement (APS) is a specific report requested by your potenital insurer.
- It is written by your doctor, and the information contained in the APS varies and depends on what your insurer is looking for.
- Your insurer my request an APS from a specialist you've seen as opposed to your family doctor.