Will an Abnormal EKG Derail your Life Insurance Approval?

Have you recently had an abnormal ECG? Are you concerned about obtaining life insurance because of the reading on your test? If so, read on to find out how your ECG test may affect life insurance ratings and prices.

Why let an abnormal test keep you up at night? The best thing you can do is get our underwriting experts involved immediately and run your own free quote.  They will know how to interpret your results, and they can put your worries at ease quickly.

You may even qualify for a policy with no exam.


Many people use these terms interchangeably and we will do the same in this article. However, an electrocardiogram (ECG) is the test the doctor administers that indicates irregular activity with the heart’s electrical system. An EKG reveals the heart’s electrical movement on a piece of paper. You may have noticed after you received your ECG that the doctor had a paper with lines going up and down – like a graph.

The ECG is measuring your heart’s electrical movement as blood pumps through your system. The EKG’s lines represent this movement. So, as your heart contracts and relaxes, the line moves accordingly. The lines of the EKG are waves and help doctors detect any heart rhythm abnormalities.

Here is a handy guide to this article, feel free to head directly to the section you need.

Understanding your EKG reading

The EKG reading represents three components: the P wave, the QRS complex, and the T wave. Let’s take a closer look at each one and how they relate to your heart function.

P Wave

The P wave measures the contraction of the atria. The atria pump blood from the top of the heart to the bottom chamber.

QRS Complex

This shows the contraction of the ventricles, which pump blood throughout the body.

T Wave

The T wave reflects how the heart re-polarizes and restarts the ventricles. This prepares the heart for its next beat.

An abnormal EKG reading may be indicative of a current or potential heart problem. Yet many people with an abnormal T wave may be perfectly healthy.


Depending on the cause of an abnormal EKG reading, life insurance may or may not be affected. Underwriters look at the underlying reasons for a faulty EKG, as well as other factors. Even if a heart problem exists, you’re not automatically disqualified from obtaining life insurance. The underwriter assesses each factor before deciding whether or not you can secure life insurance. Some questions the underwriter will try to answer are:

Are the wave irregularities major or minor?

As you may expect, major irregularities will set off more warning signals than minor wave changes. If your cardiologist records contain additional testing – like an echocardiogram – minor wave changes will be ignored.

Could the T waves indicate another problem with the heart, such as electrolyte imbalance?

Your ECG is not affected by sodium levels.  Whether too high or too low, sodium doesn’t seem to influence the electrical impulse conduction or cardiac arrhythmias in general.

Excessive potassium, calcium or magnesium, however, can affect an ECG, and deficiencies can mess up the test as well.  If you miss out on these nutrients, your ECG could show signs of complete node blocks, AV blocks or bradycardia.  It could also point to problems with your pancreas or thyroid.

Are the T waves inverted?

A flat T-wave or a T-wave that is shorter than expected is usually no cause for alarm.  However, inverted T-waves represent big changes between the peaks and valleys. The underwriter will likely look for other clues as to what is causing the abnormality, like family history or cardiovascular medical history.

If there’s nothing else in the file that presents a problem, it’s likely the T-wave inversions will be ignored for life insurance underwriting.

Do you have any other heart problems?

Cardiomyopathy, left ventricular hypertrophy, undiagnosed arrhythmias or bundle branch blocks can all show up in an abnormal EKG. The worst thing for an underwriter is the unknown. What exactly is causing the funky results?

As long as we can explain the test results – and there is additional cardiac evaluation – these findings will not affect your life insurance approvals.

Is there a family history of heart conditions?

When we talk about family history for a life insurance standpoint, we are focused on the family history of cardiovascular disease. Do you have a parent or sibling that died from cardiovascular disease before the age of 60? Does your family have a history of developing heart problems before age 60?

Many life insurance companies will consider these histories, however, some disregard them. This is why it’s important to work with an underwriting expert who knows the companies that penalize for family history and those who do not.

What is your overall health?

Your doctor, your family, and your friendly life insurance underwriter all want the same thing: They want you to live a long, long, long time.  The longer you are projected to live, the lower your life insurance.

Therefore, those in excellent health do not need to worry about an abnormal EKG reading. If your health is on the decline, or if you have major heart problems – unusual EKG results are more concerning.


The top tier life insurance agencies operate using ratings for their clients. These ratings indicate the type of coverage people receive and the cost of their insurance. A person with an abnormal EKG may still be eligible for a rating and not a decline. Here are the details of the basic life insurance ratings:

Preferred Plus

People with excellent health receive this rating. This means their weight, blood pressure, cholesterol, and family history are without blemish.

Standard Plus

People with almost perfect health fall into this category of insurance. For example, a person may have controlled high blood pressure but everything else is excellent.


People with average health receive this rating, even if they have a few minor issues.

Substandard or Table Ratings

After standard, there are 12 substandard or table rated health classes. Clients with heart issues usually end up with substandard life insurance rates.  However, that’s OK!

Considering that most people over-estimate the cost of life insurance by 300%, term life insurance is still very affordable (even at substandard rates).


Most insurance companies will not decline a person as long as they have additional tests that rule out a heart problem as the cause of the abnormal EKG. Tests can include an echocardiogram and stress test.

However, even if you don’t take the other tests, insurance companies consider other factors when making their decision. A rating of preferred plus or standard plus is even possible with an abnormal EKG.

Let’s look at a few examples, straight from the underwriters

Heart Life Insurance Case StudyMinor T Wave Abnormality

Brian S., a 41-year-old man has an abnormal EKG reading with a minor T wave abnormality. He doesn’t have a history of cardiac problems, however his primary physician ordered an echocardiogram anyway. His echo was normal, he has no family history of heart disease and has excellent health otherwise.

This applicant would be eligible for a preferred or preferred plus rating. In this case, the EKG doesn’t carry as much weight because the T wave abnormality is minor and his heath is pristine otherwise.

The underwriter can disregard the test results and approve this case with confidence.

Heart Life Insurance Case Study – Major T Wave Inversions

Karen L. is a 50-year-old woman whose EKG reading indicated major T wave inversions. Two close relatives died unexpectedly from heart attacks. Upon further testing, cardiomyopathy and ventricular arrhythmias were present. She appears to be in good health otherwise.

This patient’s application for traditional life insurance would be postponed, though there are other types of life insurance available. Certain policies do not ask any health questions at all and that’s what we would recommend here.

The abnormal EKG along with the family history leads to further testing, usually in the direction of the underwriter. New findings of cardiomyopathy, combined with ventricular arrhythmia would postpone approval until about 6 months or a year later.

Cardiomyopathy is much more serious from a life insurance standpoint, and this patient will need some treatment time before they will qualify for traditional life insurance. However, non-traditional policies are available in the meantime.


While an abnormal EKG can be unsettling, it does not always mean a heart problem exists. Further testing can rule out serious heart problems — and can help you qualify for life insurance.

It’s just like any other test, it needs to be interpreted, and it’s just a piece of a larger puzzle.

One thing we know for sure: an abnormal test result is scary. And it causes us to reflect on the things that are most important.

Like family.

Think about your family. Who would provide for them if you died? What would their Wednesday look like if you died Tuesday?

For many, financial reality is scary. However, there is no need for concern. Get our underwriting experts involved today and you will know all your life insurance options, even after an abnormal EKG.