How Insurance Companies Underwrite LAD Heart Disease

At Shaw American, we’ve long believed that great underwriting is as much an art as it is a science—particularly when it comes to cardiovascular disease. One of the most critical and complex areas of evaluation remains LAD heart disease, which involves the artery responsible for supplying blood to a large portion of the heart muscle.

When an applicant has a history of LAD involvement—whether through angioplasty, stent placement, or bypass surgery—underwriters must look beyond surface-level data. The key questions are: How well was the condition treated? What does the follow-up show? And what does this say about long-term mortality risk?

Modern underwriting relies on detailed cardiology reports, including ejection fraction (EF), stress test results, and imaging evidence of perfusion. A strong recovery, demonstrated compliance with medical advice, and stable cardiac function can substantially improve the applicant’s rating class. Conversely, continued ischemia, multiple vessel disease, or poor EF often lead to standard or declined offers.

Underwriters must also interpret each case in context. A 55-year-old with a single LAD stent and five years of clean follow-ups is not the same as a 45-year-old with multivessel disease and recurrent angina. The nuances of plaque stability, inflammation, and lifestyle factors play a decisive role.

Ultimately, fair underwriting for LAD heart disease means applying both technical expertise and human judgment. The goal isn’t to penalize the past—it’s to understand the present and predict the future with compassion and accuracy. At Shaw American, that’s what we strive for every day: underwriting that recognizes both the data and the individual behind it.

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