Lies, dirty lies, and insurance discrimination

My so-called cancer

By Howard Wolinsky

In 2003, I received the “best” rate available from Transamerica Life Insurance for a $600,000 term life insurance policy.

I was in the best shape of my life.

Seven years later, I was diagnosed with a single core of less than one millimeter of very low-risk  Gleason 6 prostate cancer. 

I was told then that pathologists score this as cancer. It looks like cancer but it doesn’t act like one.

But even in 2010, many urologists believed that this type of so-called cancer posed no health risks, that it would never metastasize. Laurence Klotz, MD, who coined the term active surveillance and helped develop this strategy of close monitoring, calls these lesions pseudo-cancers, a disease of aging that in all likelihood will cause no risk in our lifetime.

Low- and very low-risk men like us make up the majority of men diagnosed with prostate cancer. When I was diagnosed in 2010, only 6% of men opted for active surveillance. In recent years, in the U.S., this has grown to 55%. Sounds great, right? But that means 45% of men undergo unnecessary surgery or radiation and face a risk for impotence, reduced libido, penis shrinkage, and incontinence. And contrast this with Sweden where 94% of men opt for active surveillance.

More than 60,000 American men a year are diagnosed with Gleason 3+3= 6 and choose to leave it untreated because as Dr. Klotz said, Gleason 6 NEVER metastasizes and NEVER kills. The insurance companies are ill-informed on this issue and most likely protect their bottom line in an ignorant fashion.

My personal urologists, Scott Eggener, MD, of the University of  Chicago Medicine, and Brian Helfand, MD, PhD,  of NorthShore University HealthSystem, agree. 

I told my broker last year: 

“It felt wrong then. And my urologist then, Dr. Eggener, a leading authority on active surveillance, the approach that I followed, went to bat for me.”

Here’s what Dr. Eggener wrote to me on Jan. 19, 2013 (my highlights):

You have very low volume Gleason 6 prostate cancer.

Active surveillance for your type of cancer is not associated with an increased risk of mortality compared to the population of men without prostate cancer.

It is disappointing they won't insure you, but I am not surprised one bit.  To the non-medical community, cancer is cancer is cancer. It is really a shame they don't appreciate that.

SCOTT EGGENER, MD

Associate Prof of Surgery - Urologic Oncology

The University of Chicago Medicine & Biological Sciences

We got nowhere.

I told my broker in 2021: “Your underwriters held their ground. With more than a decade of research providing increased proof that very low- and probably low-risk prostate cancer is safe with monitoring, you'd think your underwriters and others in the industry would catch on.”

In 2013, my term policy expired and was up for renewal.

Initially, my broker indicated Transamerica wanted to drop me--based essentially on  having a non-cancer.

The broker shopped around, reaching out to several other insurers. They all rejected me. Their decisions weren’t based on age, or even that I had had a mild heart attack at age 57. They were avoiding me based on a non-lethal Gleason 6 lesion.

Transamerica came back with an offer. They wanted to rewrite my coverage from $500,000 to $100,000. And get this: they would keep my premium the same, just under $200/month.

I protested. I felt this was unjust. (Whoever said insurance companies were just?) Dr. Eggener wrote to my broker, stating that my Gleason 6 was not a risk--for me or for Transamerica.

My Gleason 6 was not a risk--for me or for my insurer.

I fought it as hard as I could. It was a horrible deal. In the end, I figured I couldn’t fight City Hall, or Transamerica. My family needed whatever coverage I could get. (I did have additional coverage through a whole-life policy from another company.)

I put the matter aside for nearly 10 years.

In late 2021, my broker called me. He had some questions about Gleason 6. He was calling on behalf of another client. But it reopened old wounds.

I felt that insurance rate and coverage discrimination were occurring regarding Gleason 6, a non-cancer. But I learned there were not only issues for life insurance, but also for health insurance, disability insurance and long-term care insurance.

I had retained all the emails going back to 2013.

I found:

--A questionnaire asked about my Gleason 6 cancer and also about a mild heart attack I had when I was 57. Transamerica mainly was interested in my non-cancer. Their underwriters clearly—to me anyway— were rating me—though the broker denied it.

--My broker said he had shopped around for another carrier but all other carriers rejected me. He even sent me a copy of one of the rejection letters. (attached)

--Transamerica offered a new policy, actually a carve-out from the old policy, dramatically decreasing my coverage while retaining the original premium levels.

I filed a complaint with the Illinois Department of Insurance last year. I just wanted to be heard and maybe help men and their families who encountered this issue in the future. I made no demands.  I had no remedies in mind, though I felt I had been bilked by being charged the same premium for a fraction of the coverage.

My broker--a childhood friend--and his company speaking for Transamerica replied with distracting and misleading information sent to the state Department of Insurance. Lies and dirty lies.

The brokerage made me seem like a deadbeat for not paying for my original policy--even though I let it lapse so I could accept the new policy with inflated rates. They also denied Transmerica had underwritten my new policy--an outright lie based on the fact that I had filled out a questionnaire whose only purpose appeared to be an exercise in underwriting.

Here’s the form I filled out:

Producer ____________________________________________ Phone ___________________ Fax ______________________

Client ____Howard Wolinsky_____________________________________ Age/DOB _65/09/29/1947________________ Sex __M____________________

If your client has Prostate Cancer, please answer the following:

1. Please list date of diagnosis: ______November 2010_______________________________________________________________________

2. How was the cancer treated?

I observation onlyX

I TURP (transurethral prostatectomy)

I radical prostatectomy

I radiation therapy (seed implant or external beam radiation)

I hormone therapy

I other, please specify _____________________________________________________________________________

3. Is your client on any medications?

I yes, please give details ___________________________________________________________________________

I  No X

4. What stage was the cancer?

clinically localized, low-risk prostate cancer

______________________________________________________________________________________________________

5. What was the Gleason score?

Latest: SA was 6.08 ng/mL 

______________________________________________________________________________________________________

6. Please give the date and result of the most recent PSA test:

11/29/12

______________________________________________________________________________________________________

7. What was the PSA prior to treatment?

_______________There has been no treatment . My last two biopsies turned up no cancer in Dec. 2011 and Dec. 27,  2012 _______________________________________________________________________________________

8. Does your client have any other major health problems (ex: heart disease, etc.)?

please give details  Had a mild heart attack in February 2005. My cardiologist told me I shouldn’t consider myself a heart patient. My cholesterol scores are great. _________________________________________________________________________

Does this not sound like underwriting--which Transamerica denied they had done?

My broker, told me on January 19, 2013:

Howard, Just so you see, this is the data we share with probably 8 companies and you see the type of answer we have gotten as well.  So far we do not have any positive response.  I just wanted to share this with you...... 

The information on the form may not be perfect in every respect but it is representative based on our conversations and information in your prior medical history that was used to obtain the first policy.

Note that Lincoln National referred to watchful waiting not AS—another sign of outmoded thinking:

RE: XRAE NEW QUOTE:#2822 AGENT:Persky

From: "East, Janice" <Janice.East@lfg.com> + Date: 1/18/2013 8:42:29 AM To: jcapone@lganet.com

CC:

Expires: 2/18/2013 8:42:29 AM

Sorry, no offer due to history of prostate cancer without treatment/ watchful waiting.

Sincerely, Janice

Your opinion of our service is important to us. Our goal is to provide a consistent and positive experience. We welcome and value your feedback. Please feel free to send all comments to bramcoteamcares@lfg.com

Janice East, MBA Underwriter

Bramco Underwriting & New Business

Lincoln Financial Group 100 North Greene Street Greensboro, NC 27401

Toll Free: 866-226-9456 ext 4872

Direct: 336-691-4872

Fax: 336-335-2924

Email: janice.east@lfg.com

You?re In Charge?

Find us on facebook: www.facebook.com/LincolnFinancialGroup

From: Bramco UW

Sent: Friday, January 18, 2013 9:25 AM

To: East, Janice

Subject: FW: XRAE NEW QUOTE:#2822 AGENT:Persky

Bramco QQ

From: Jim Capone [mailto:jcapone@lganet.com]

Sent: Thursday, January 17, 2013 4:14 PM

  To: Bramco UW

Subject: XRAE NEW QUOTE:#2822 AGENT:Persky

BRAMCO Quick Quote Team:

Larry Gordon Agency, Inc. has reviewed this potential customer and has determined that they are a likely candidate for one of

your classes. Please reply with the BEST CASE SCENARIO considering the limited information provided …

Be sure to include any additional tests/notes that this quote would be "SUBJECT TO." Below is the information we've gathered.

1. What is the client's date of birth? *required

9/29/1947

1. What is the client's gender? *required

Male

1. What is the desired Face Amount? *Required to view pricing

$250,000.00

1. What type of coverage is desired?

(Term: 10,15,20,25,30) (Permanent: UL, VUL, SUL,Whole Life)

20 year term

1. What is the client's height?

5' 10"

1. What is the client's weight in lbs.?

180

Does the client's chest measurement EXCEED their waist measurement? (ex. Chest 40 inches, Waist 36 inches)

Yes

1. Has the client ever used any of the following tobacco products: Cigarettes, Cigars, Pipe, Chewing Tobacco, Nicotine Gum, Nicotine Patch, or any other tobacco product?

No

1. Have any of their family members (biological) had an OCCURRENCE of the following conditions: cardiovascular disease, cerebrovascular disease (stroke), diabetes, or cancer? Please select all that apply.

None

1. Has the client EVER been treated (medications) for cholesterol? Yes

Is the client currently being treated for cholesterol?

Yes

When did the client start to control their cholesterol at their CURRENT levels with treatment?

Jan-2010

1. What is the client's total cholesterol? (example: 210)

179

1. Has the client EVER been convicted of a DWI, DUI, reckless driving, moving violation, license revocation or suspension?

No

1. Has the client EVER participated in any hazardous avocations? (Aviation, Climbing/Mountaineering, Gliding, Motor Sport, Parachuting, Scuba Diving, etc.)

No

1. Has the client ever had any other medical conditions? If yes, check all that apply:

Prostate Cancer, Coronary artery Disease

When was the client diagnosed with coronary artery disease? Feb-2005

Did the client have a heart attack (myocardial infarction)?

Yes

When was the heart attack?

Feb-2005

Did the client have an angiography?

Yes

Did the client have a bypass (CABG) or angioplasty/stent?

Yes. (Angioplasty/stent.)

Any current symptoms of chest pain or angina?

No

When was the client's last follow up with their cardiologist?

Nov-2012

When was the client diagnosed with prostate cancer?

Jan-2010

Did the client have a prostatectomy?

No

Was the client treated with radiation therapy for Prostate Cancer? No

Is the client being treated by "watchful waiting" for Prostate Cancer? Yes

When did the client's treatment for prostate cancer end?

Jan-2010

What was the stage of the client's prostate cancer? (ex. 1-4)

1

What was the client's gleason score? (ex: 2,4,6,8,etc.)

6

Did the client's prostate cancer metastasize (spread)?

No

What was the client's pre-treated PSA reading? (ex. 7.5)

6.08

What is the client's current (post-treated) PSA reading? (ex .01)

6.08

Did the client have a reoccurrence of Prostate Cancer? No

1. List all other details: foreign travel, medications, financials, APS summaries or quote related information not previously provided.

(XRAE will not evaluate your answer to this question. However, it will be evaluated if sent to a carrier(s) for review.)

Client had two biopies. 12/30/2011 and 12/20/12

He had needle biopies in 2011 and 2012 A-L, Findings were benign in all cases.

 Simply reply to this email and your response will be recorded in our system. Thank you in advance for your time and consideration.

Thank you for your time.

Sincerely, Jim Capone

Larry Gordon Agency, Inc.

Tracking URL:http://agency13.agency.xrae.com/link/13/2822:9408

I didn’t know what to expect from the Illinois Department of Insurance. I concluded that the state analyst mainly bought the lies of the insurer and ignored what I had to say. In my experience in civic affairs as a newspaper reporter and as a citizen and consumer, I have observed that industries, such as the insurance industry, have made state agencies their lapdogs. 

We, as citizens, patients, consumers, need to stand up and be heard.

I  urge any of you who feel you have been bilked by an insurance company because of a Gleason 6 diagnosis to contact me at howard.wolinsky@gmail.com and share your story.

I want to see what trends emerge. If something jumps out, maybe I’ll write more about this and we can raise some hell.

Sincerely,

Howard Wolinsky

The Active Surveillor

P.S. When my broker called me about his other client,  I shared these articles:

Is Gleason 6 cancer? https://www.medpagetoday.com/special-reports/apatientsjourney/90601

My 10-year review: https://howardwolinsky.medium.com/reflections-on-a-decade-on-active-surveillance-coexisting-with-prostate-cancer-9081bbc7b84

I may be done with biopsies: https://www.medpagetoday.com/special-reports/apatientsjourney/85971

My lame cancer: https://www.medpagetoday.com/special-reports/apatientsjourney/65621

The disappearing cancer: https://www.medpagetoday.com/special-reports/apatientsjourney/81775

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