Cardiac Arrhythmia and Life Insurance Approvals (Updated)

If you have an irregular heartbeat, it may seem impossible to obtain affordable life insurance. Many applicants are denied every day due to their arrhythmia, and any heart condition will often confuse traditional life insurance agents.

While an irregular heartbeat can certainly complicate the process of getting life insurance, it does not make it impossible. By taking the correct steps, you can get quality, affordable life insurance even with an irregular heartbeat.

This article is designed to help you understand what insurance companies look for when reviewing the application of someone with an arrhythmia.

It will also help you understand what steps you can take to improve your chances of approval. Perhaps the most important aspect of any insurance application begins with where you apply.


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The recent pandemic did change the underwriting rules at many life insurance companies as the death toll continued to rise. In general, most companies do not have the appetite or flexibility for risk that they had before 2019. Therefore, many cases that would normally get approved are getting postponed or declined today for clients with certain heart issues.

From 2019 to 2022, life insurance application volume increased dramatically while life insurance companies have been cutting their workforce and implementing work from home options. This added delays to underwriting decisions and correspondence at a company level.

Next, nurses who preform life insurance exams are in short supply, so sometimes those exams must be scheduled out two weeks in advance when next day service used to be available. Furthermore, doctor’s offices have outsourced their record keeping, moving medical records off site that underwriters need to approve a policy. These off site record facilities often take 30 days or longer to respond to a simple request if those records are not digitized.

The end result is that life insurance cases that used to be approved in a week may take much longer in today’s market, so if you have a term policy that is about to expire you want to start your search with that in mind.

No-exam policies are more difficult today for clients with arrhythmia unless they were very minor issues or many years in the past. If you are looking for life insurance today with any thing other than sinus rhythm, you should expect full underwriting.

It is not all bad news however.

We are seeing improvement in the industry and things are moving more quickly. Minor cardiac arrhythmia issues are generally OK, though it may just take a little longer to secure an approval. Clients still can still get a great policy with tremendous value as long as they are patient.


Since life insurance is all about determining risk, insurers will shy away from those they view as “high risk.” Even if your irregular heartbeat does not cause any symptoms, many insurance companies will still see it as a serious condition that affects the most important organ in your body.

These insurers may not differentiate between A-Fib, V-Fib, PACs or other kinds of arrhythmia.

However, there are life insurance companies that specialize in these types of high-risk applicants. If you have any type of irregular heartbeat, applying with these companies will give you the best chance at approval.

An independent underwriting agent who specializes in such conditions will know which companies are most likely to approve you at the best rates. This will also give you the ability to choose the best policy for you, as an independent agent will put your application to multiple companies.


Arrhythmia is a term used when a person’s heartbeat is irregular. It is a general term used to describe any number of irregularities. A person with an arrhythmia may have a heart that beats too slowly, too quickly or simply outside of a normal rhythm.

Because some forms of arrhythmia pose more serious health risks than others, the type of irregular heartbeat a person has will greatly influence his or her life insurance application.


The most common types of irregular heartbeats are premature contractions, either in the atria (PAC) or the ventricles (PVC). Both PVCs and PACs can be relatively harmless and do not always signify an underlying condition.


If the condition is controlled with medication, most people with premature contractions qualify for standard rates.

If your premature contractions do not require medication or other treatment, you may even qualify for preferred rates.


Another type of common arrhythmia is atrial fibrillation (also known as AFib), although it can be more serious than premature contractions.

This type of arrhythmia can cause poor blood flow and result in heart palpitations, fatigue, shortness of breath and fainting.

Since it can lead to additional problems or be a sign of underlying heart problems, life insurance companies take AFib seriously.

The best-case scenario would be if you have only had one episode, and it occurred after the age of 60. In this case, you may still qualify for standard or even preferred ratings.

But if you have had multiple episodes throughout your life, your approval may depend on how often the episodes occur and how recent the last episode was.

Most individuals with atrial fibrillation receive substandard rates. But if it has been more than two years and your condition has caused no symptoms, you may still qualify for standard rates.

If your AFib still causes symptoms, you have a family history of heart disease or you have additional health concerns, it may result in a denial.


What kind of health classes can you expect with AFib?

Single episode, long time ago and at an older age? Preferred is possible, Standard probable.

Multiple episodes, long time ago and controlled by medication? Standard is probable.

If you are still showing symptoms, or are avoiding your cardiologist, your application could be postponed.


Other types of arrhythmia such as atrial flutter, ventricular arrhythmia, bradyarrhythmia (bradycardia) and tachycardia will have an impact on life insurance approval, depending upon the seriousness of the condition.

The main questions life insurers will ask include:

What type of irregular heartbeat do you have?

Sinus arrhythmia, premature supraventricular, premature atrial beats (PACs) or premature ventricular beats without any other heart disease are not rated!

Therefore, they are considered benign by the life insurance company and do not come with higher rates.

Does the condition cause any physical symptoms?

The underwriters will specifically be looking for things like chest pain, syncope (fainting), or heart palpitations.

For an example of these specific questions about arrhythmia symptoms, check out the snippet from the underwriting questionnaire below:

life insurance irregular heart beat life insurance arrhythmia life insurance atrial fibrillation life insurance afib questionairre guidelines

Is the irregular heartbeat a symptom of an underlying condition?

Sometimes premature ventricular beats will be related to underlying heart disease, at which case the underlying condition will be rated.

When this is the case, we are looking at substandard rates for life insurance through the cases are still approvable.

At what age did you first experience arrhythmia?


You usually want to be young when applying for life insurance.

With arrhythmia however, older is better!

If you were diagnosed before age 40, life insurance rates tend to be higher.

Were you diagnosed after 55 or 60?

Good news! The underwriters at certain life insurance companies do not even care about an irregular heartbeat after age 55.

How often do you experience irregular heartbeats?

Often?  Never at all?  Do you experience irregular heartbeats infrequently?  Only with exercise?

Obviously isolated, one time or infrequent irregular heartbeats are ideal.

The life insurance underwriting team will gauge your condition based on the answers we put in the application as well as information in your attending physician statement (APS report).

When was your last episode?

This is a negative rating factor if the most recent episode was within six months or if you are waiting on test results from your cardiologist.  In that case, the application will usually be postponed.

After 6 months, if it has been a long while since your last irregular heartbeat that is a good sign.  The longer the better, and after 5 years many life insurance companies do not add any

Has the condition resulted in hospitalization or surgery?

We never want to go to the hospital, yet these hospital visits do not mean your application will be denied.

The valuable cardiology tests you get in a hospital (echocardiogram, ECG, or maybe even a stress test) can help underwriters better understand your condition.

Do you take medication for your arrhythmia?

Common medications for arrhythmia include:

  • Beta-blockers – which reduce the heart’s heart rate and workload,  (Example: Metoprolol or Toprol XL)
  • Calcium channel blockers (CCB) which also reduce the normal heart rate. (Example: Verapamil or Calan)
  • Sotalol (Betapace, Sorine)
  • Procainamide (Procanbid)
  • Flecainide (Tambocor)
  • Amiodarone (Cordarone, Pacerone)

Taking these medications will not result in an extra rating for your life insurance application, so follow your doctor’s orders!

Do you have any additional conditions or risk factors for heart disease?

Smoking is a big deal here, so is family history. Applicants with a high BMI (overweight) might also receive higher rates in combination with cardiac arrhythmia.


Preferred / Preferred Plus

We get arrhythmia life insurance approvals all day at preferred for limited PVCs controlled without medication, or single incident events that were 5 years or more in the past.

PAC’s usually come back with a preferred or preferred plus health class.

Asymptomatic tachycardia or sinus tachycardia with no other health issues may go preferred.

Atrial flutter that is corrected through surgery (like an ablation) in some of our older applicants have also rated preferred. This is unusual, however it happens on occasion.

Infrequent atrial fibrillation with normal echocardiogram tests and ECGs with no underlying heart disease can also go preferred.

Standard / Standard Plus

Multiple arrhythmia episodes in the past or PVC’s controlled with medication usually qualify for standard rates.

Afib episodes of 1 per year or less with a history of control will also qualify here, however, cardiologist followup is crucial.


If there are underlying conditions along with the cardiac arrhythmia, usually we will get a life insurance approval at substandard rates (or table rates).

Multifocal PVC’s, PVC’s over 20 minutes, or three PVC’s in a row (ventricular tachycardia) usually rate at moderate substandard.

Chronic atrial fibrillation or an applicant currently in AF without a cardiac evaluation usually rate between moderate substandard to decline.

Decline or Postpone

If you were recently diagnosed (within the last 6 months), life insurance companies will want more information and will usually postpone the application until your next cardiologist followup.

If there are severe underlying heart conditions, there is a possibility the application could be declined. However, we will know if a decline is likely before we submit the paperwork, and we will explore other options in advance.

This saves your time, and it saves you any embarrassment that might come along with a life insurance denial.


Let’s look at an actual client file to give you an idea of what to expect in underwriting.


Lyndsey. Female. 41 years old. She is a commercial pilot with four children / step children under the age of 18.

She has heart palpitations that her doctors assigned to atrial fibrillation. Her AFib was caused by hyperthyroidism, and the doctor prescribed Tapazole to treat the thyroid.

Three months after starting the medication, her palpitations disappeared and she has been fine ever since.

In Lyndsey’s case, she has no other underlying health issues and she did not smoke.  No family history of cardiovascular disease and her height, weight and blood pressure were all fine.

The underwriters wanted to see that the AFib was an isolated event, and it certainly seemed that way. The APS from her primary doctor noted this as well, and Lyndsey was approved with preferred rates.

A+ rated company for Lyndsey C., quoted on 3-18-2022

20 Year Term Life Insurance$500,000$1,000,000$2,000,000
Monthly Rate$35.38$64.36$123.17

A+ rated company for Lyndsey C., quoted on 3-18-2022

30 Year Term Life Insurance$500,000$1,000,000$2,000,000
Monthly Rate$56.36$103.79$201.03

Using a laddering strategy, Lyndsey stacked two-term policies for $3 million in combined protection at great rates. Her AFib did cause us to do more homework and her policy did require a paramedical exam.

However, she was not rated for cause and her rates were very low.


As you can see, there are many factors that will influence your approval and rating class. The type of arrhythmia you have is the most important aspect, but insurance companies will ask many questions to determine the risk your irregular heartbeat poses to your health.

Aside from living a healthy lifestyle, the best thing you can do to improve your chances is to apply with our underwriting experts.

Applying with a qualified underwriting expert who specializes in applicants with irregular heartbeats will put you in the best position for success

Our service and expertise are free, and we know which insurers are best for your specific case.

We can put your application to multiple life insurance companies and get your best rate.

As a general rule, life insurance will never be less expensive tomorrow than it is today, and the only way to get approval is to apply.

Get in touch today! We can’t wait to help your family!