Case study: Looking beyond the application

Micheline Varas is a Senior Partner, VP of Living benefits and International Risk Management specialist, with Customplan Financial Advisors Inc. A Top of the Table member with MDRT, she specializes in complex cases and frequently acts as an advisor resource. Insurance Portal asked her about the most challenging cases of her career.

Questions by Donna Glasgow (DG), Insurance Portal & Answers by Micheline Varas (MV)

DG Describe one of the most complex or challenging client situations you've handled, or helped another advisor with.

MV One of the most memorable and challenging cases I have worked on came through another advisor who was seeking assistance in obtaining life insurance for his brother.

At first glance, the case appeared extremely difficult from an underwriting perspective. However, as I spent time speaking with the client and understanding his history, it became clear that this was far more than an insurance application, it was the story of an individual who had overcome extraordinary adversity and was determined to build a different future for his own family.

DG What made this situation particularly difficult?

MV The client had experienced significant trauma throughout his life. After losing his father at a young age, an individual who was welcomed into the family home became a trusted figure in the household. Tragically, that trust was violated, and the client endured years of abuse before leaving home as a teenager.

Like many individuals coping with unresolved trauma, he turned to drugs and alcohol. Although he eventually entered a rehabilitation program and achieved sobriety, the legal proceedings surrounding the arrest and prosecution of his abuser forced him to relive much of that trauma. The lengthy court process, combined with the emotional toll of facing both family members and his abuser, led to a relapse.

From an underwriting perspective, the history of substance abuse, rehabilitation, relapse, and extensive use of hard drugs and alcohol presented significant challenges. Cases involving multiple risk factors often receive highly rated offers, postponements, or outright declines.

DG What were the client's main concerns at the time? What were yours?

MV The client's primary concern was simple and deeply personal: he wanted to ensure that his wife and child would be financially protected if something happened to him.

He often spoke about not wanting his child to experience the instability and hardship he had faced growing up. Having built a stable life, maintained employment, and established a loving family, he viewed life insurance as an important part of protecting that future.

My concern was balancing advocacy for the client with my responsibility to the insurance carrier. As advisors, we have an obligation to present cases fairly and accurately. While I wanted to help the client secure coverage, I also needed to ensure that any recommendation aligned with sound underwriting principles and reflected the true risk profile of the case.

DG What steps did you take upon learning about the situation?

MV Rather than focusing solely on the application itself, I spent considerable time understanding the client's journey. I learned about his rehabilitation experience, his commitment to sobriety, his stable family life, and his dedication to helping others who were facing similar struggles. In fact, he had become something of a success story within the rehabilitation community and was actively involved in supporting others on their recovery journeys.

Once I had a complete understanding of the situation, I began consulting with several underwriting and reinsurance professionals with whom I had developed relationships over the years. Rather than simply submitting the case and hoping for the best, I wanted to discuss the broader context and determine whether there was an insurer willing to consider the entirety of the client's story.

DG What options did you present to the client?

MV At the outset, I prepared the client for several possible outcomes:

• A rated (substandard) offer with higher premiums
• A postponement pending additional evidence or time since recovery
• A decline

Given his previous insurance experience, including prior declines, we discussed these possibilities openly and realistically.

DG What were the pros and cons of these options?

MV A standard offer would provide the most affordable protection and meet the client's objectives, though this seemed very unlikely. A rated offer would still provide coverage but could significantly increase premiums and potentially limit the amount of insurance he could comfortably maintain long term. A postponement might eventually lead to better underwriting results but would leave the family temporarily unprotected. A decline would require us to explore alternative solutions, potentially including simplified issue or guaranteed issue products, although those options would likely provide less coverage at a higher cost.

DG Did you seek outside expertise during this situation?

MV Absolutely.

This was not a case that should be handled in isolation. I consulted with multiple underwriters and reinsurers to discuss the nuances of the client's circumstances. Their perspectives helped ensure that the case was assessed fairly and comprehensively.

Ultimately, one reinsurer recognized that the client's history, while difficult, was only one part of the overall picture. They were willing to consider the significant evidence of rehabilitation, stability, and positive lifestyle changes that had occurred over time.

DG How did you help the client stay calm and make rational decisions throughout this situation?

MV Transparency was critical. Rather than creating unrealistic expectations, I explained the underwriting process in detail and prepared him for a range of possible outcomes. I wanted him to understand that while I would advocate strongly on his behalf, the final decision rested with the insurer. By setting realistic expectations, we were able to reduce uncertainty and avoid disappointment should the outcome not be ideal.

DG What communication processes worked best with the client?

MV Frequent, honest communication proved essential. The client appreciated knowing where the case stood, what information was being reviewed, and what potential challenges remained. Rather than waiting for a final decision, I kept him informed throughout the process so he always understood the next step.

DG How did your approach build trust, even during a challenging time?

MV Trust was built through listening. Instead of viewing the application solely through an underwriting lens, I took the time to understand the person behind the file. The client knew he was being heard and that his story mattered.

Equally important, I was candid about both the opportunities and the obstacles. Clients generally respond well when they know their advisor is providing realistic guidance rather than simply telling them what they want to hear.

DG How did the client react to your advice? Any disagreements?

MV There were no disagreements. Because expectations had been established early, the client understood the realities of the situation. In fact, he consistently expressed gratitude that someone was willing to take the time to fully explore the possibilities rather than immediately concluding that coverage was unattainable.

DG What was the eventual outcome for this client?

MV The outcome exceeded everyone's expectations. After extensive review, the insurer offered the client the full amount of coverage he requested, at standard rates.

When I called him with the news, he became emotional. Having previously been declined and expecting either a heavily rated policy or no offer at all, he was overwhelmed with relief. For him, the policy represented more than insurance. It represented validation of the progress he had made, the life he had rebuilt, and the security he wanted to provide for his family.

DG Reflecting on this case, is there anything in your approach that you'd change?

MV If anything, this case reinforced the importance of gathering the complete story before drawing conclusions. Many advisors may have looked at the underwriting history and assumed the outcome was predetermined. This experience reminded me that the details behind the file often matter as much as the facts contained within it.

DG What did you learn from this situation as an advisor?

MV I learned that underwriting is not always about finding reasons a client should be declined. Sometimes it is about finding the evidence that supports why a client deserves consideration. Most importantly, I was reminded that every application represents a person, a family, and a story. Understanding those stories often leads to better outcomes for everyone involved.