Attending Physician Statements – What They Are and Why They Matter
When it comes to life and disability insurance, an Attending Physician Statement (APS) isn’t just more paperwork; it’s a crucial piece of the puzzle for insurance underwriters.
Key Takeaways
- Attending Physician Statements (APS) are essential medical documents written by your doctor that are used in life and disability insurance underwriting.
- Delays in APS are common and can slow or halt application processes.
- APS carries major weight in claim outcomes, insurance rates, and eligibility determinations.
But what is an APS? Why do you need it? And why does it matter to insurance providers?
Let’s break it all down.
What Is an Attending Physician Statement (APS)?
An Attending Physician Statement (APS) or Attending Physician Report (APR), as it is sometimes called, is a detailed medical summary written by your current or former doctor that contains key health data points, including diagnosis, treatment history, prognosis, functional status, and an overall health picture.
Think of it as a professional “snapshot” of your overall health written by a doctor who knows you best.
Why Insurance Companies Request APS Reports
When applying for life or disability insurance, you expect the process to be fairly straightforward: answer a few questions, maybe take a medical exam, and then wait for approval.
However, sometimes, there can be another step.
An insurance provider might request an Attending Physician Statement (APS) for applicants seeking life insurance, filing for long-term disability, or undergoing medical underwriting.
The reason for an APS request is to confirm medical conditions when red flags arise on insurance applications or during paramedical exams. An APS request could also be made because the provider wants to ensure that the coverage they offer matches your needs and circumstances.
For example, in life insurance, an APS makes it easier for underwriters to determine the right coverage amount and premium. Whereas, in disability insurance, an APS could be used to confirm whether a medical condition could impact your ability to work.
Thus, an APS request shouldn’t be a cause for any alarm. Its main purpose is simply to help the underwriting team get a more detailed account of your overall health to better assess impairment risk and validate claim history.
The only downside is that securing an APS can often take time, mainly due to physicians’ busy schedules and clinical responsibilities, which can result in it becoming a bottleneck in the insurance process.
What’s Included in an APS?
While an APS is considered a summary of your overall health, it is usually extremely detailed.
A typical APS often includes:
- Detailed accounts of diagnoses and when they started
- List of prescribed treatments and medications in chronological order
- Detailed accounts of any functional limitations and work restrictions
- Prognosis and expected recovery period
- A detailed doctor’s outlook on your recovery and long-term health
- Supporting medical findings relevant to a claim or coverage
How Long Does It Take to Get an APS?
Herein lies the problem.
I am sure most of us have waited on paperwork from a doctor’s office that has taken way longer than it should. And that is to be expected.
Physicians are busy caring for patients and carrying out clinical responsibilities. Filling out insurance forms and paperwork isn’t always at the top of their to-do list. That means an APS request can sometimes take weeks, or even months, to complete.
This delay can stall an insurance application or slow down a claim decision.
What’s worse is when an APS report has vague or incomplete information that requires further clarification. This can cause even further delays or, worse, a claim denial, making the insurance process even more frustrating for applicants and advisors alike.
This is why having an insurance broker or advisor on your side can be so beneficial. They can help speed up the process by constantly reminding your doctor of its urgency and also ensuring that once completed, the APS has all the information needed by the underwriting team.
How APS Impacts Disability and Life Insurance Claims
As an APS is written by your family doctor or current physician, insurers trust it as a reliable source to validate claim history.
APS holds a lot of weight and can influence the outcome of your application in many ways. For example:
- For disability insurance, it’s often the deciding factor in whether long-term disability benefits are approved.
- For life insurance, it can affect your premiums, coverage limits, or exclusions.
- If details are missing or unclear, it might even delay or jeopardize a claim.
That’s why accuracy matters so much. A strong, well-completed APS can mean a smoother path to approval. On the other hand, errors or omissions in an APS can jeopardize legitimate claims or cause delays in the claim process.
Privacy, Consent, and Legal Considerations
One concern many people have is: “Who gets to see this report?”
The answer: Only those directly involved in processing your insurance application or claim can review this statement, as APS contains confidential health information protected by law.
An APS also requires signed medical records release forms from applicants and claimants. Thus, any incorrect handling of this information can cause legal and compliance issues for insurers.
Canada’s strict privacy laws ensure your medical history isn’t shared with anyone. At McIver Insurance, we take these safeguards extremely seriously and ensure your information is handled with care at every step of the insurance or claim process.
Trends Shaping the APS Process
The APS process for decades has been a slow and tedious process. But change is on the horizon as advancements in technology and AI are making it easier for insurers to collect and review reports.
There’s also been a recent push to standardize APS templates to ensure all relevant information is mentioned clearly in an effort to reduce ambiguity and delays.
There is also growing awareness around physician burnout and administrative overload, leading to a rise in APS summary services and third-party vendors to help speed things up.
These improvements are designed to make the experience less stressful for clients and medical professionals.
Tips for Applicants
An APS is most commonly requested in cases where an underwriting team requires further information to assess eligibility and claim validations.
As such, by submitting a complete and accurate insurance medical questionnaire upfront with supporting evidence or medical chronology summaries, one can, in many ways, reduce the need for unnecessary APS requests.
However, even if an APS is required, there are steps you can take to make the process smoother. The most important of which is to follow up with physicians or use third-party APS service providers to expedite APS collection.
At McIver Insurance Inc., we help coordinate with physicians, follow up on delays, and keep your application moving by being proactive and relentless.
Trusted Life Insurance, Disability Insurance, & Group Benefits Provider in Nova Scotia
Getting an APS request may feel like yet another obstacle hampering your insurance or claim process. But it doesn’t have to be.
An APS is really about ensuring fairness and accuracy in the insurance process. This document provides valuable context that helps underwriters make better decisions for you and for their company.
But we understand how frustrating it can be waiting for these reports. That’s why we walk alongside our clients, guiding them through the process and helping to smooth out any bumps along the way.
With the right support, an APS doesn’t have to feel like a roadblock. It is simply another step towards the financial security and peace of mind you deserve!
Frequently Asked Questions
Q1) What is an Attending Physician Statement (APS)?
An APS is a detailed medical report provided by a doctor who has treated or is currently treating a patient. It is often required by insurance companies to evaluate health risk or validate claims.
Q2) How long does it take to receive an APS?
It can take several weeks or even months, depending on the physician’s schedule and responsiveness. Delays are unfortunately common due to the astronomical workload of doctors.
Q3) What is the difference between an APS and regular medical records?
An APS is a summary of a patient’s condition written by a physician specifically for insurance purposes. Medical records, on the other hand, are complete histories without the focused narrative insurers rely on.
Q4) Do all insurance companies require APS documents?
No. However, it is commonly requested for applications with chronic conditions or inconsistent medical history.
Q5) What can I do if an APS delays my insurance application?
You can work with your advisor to follow up with your doctor or use APS retrieval services (if available) to speed up the process.
