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How Does Life Insurance Underwriting Work?

Underwriting life insurance refers to the procedure a life insurance company takes to determine your eligibility for a policy and set your rates. It’s important to understand what underwriting is and how it works because it determines whether you get approved for life insurance and how much you’ll have to pay. Read on to learn more about how life insurance underwriting works.

How Life Insurance Underwriting Works

An underwriter evaluates your application details, health information, and lifestyle on behalf of the life insurance company to help determine your premium. During this process, the underwriter assigns you an insurance classification based on risk, or how likely you are to die.

Generally, life insurance underwriting takes around 5 to 6 weeks. Some insurers may use automated underwriting, which utilizes a computer program to analyze your information and determine your eligibility and rates. Accelerated underwriting is an option for some, which cuts the underwriting process for life insurance down to as little as a few days.

Manual life insurance underwriting, however, is completed by a person. This is a good underwriting option for those who may have more complicated needs or histories to explain, as it allows for human judgement based on context and not just data alone. But no matter which method an insurance company uses, underwriting all works to assess your risk profile and set your potential premium.

What Life Insurance Underwriters Look At

Underwriting factors in a broad range of information. Insurers examine the following risk indicators as part of the underwriting process:

Basic Information

  • Age: Younger people typically pay less for coverage because life expectancy is a major factor in determining life insurance prices.
  • Gender: Almost universally, females pay less than males of comparable age and health. You may be required to list the gender you were assigned at birth in your application because the life insurance market currently lacks clear and universal guidelines on transgender and non-binary people.


  • Medical background: Your body mass index, blood pressure, cholesterol, and any current medical issues are all factors underwriters take into consideration. If you can demonstrate that you’re taking good care of your overall health, you will likely be eligible for better rates or additional coverage.
  • Family history of illness: Your insurer may consider your family history of major illnesses, such as cancer or diabetes.
  • Smoking: Smokers’ life insurance is often more expensive because tobacco use is linked to health problems like respiratory and lung illness.
  • Use of drugs and alcohol: Your underwriter will assess your odds of relapsing if you have a history of alcohol or drug abuse.


  • General hobbies: Risky activities such as flying airplanes, bungee jumping, or scuba diving raise your risk profile, but some insurance companies accept applicants with high-risk lifestyles or offer policy riders for risky activities.
  • Occupation: If your job is inherently risky, such as if you work as a firefighter or trucker, you will be viewed as riskier than someone who works in an office.
  • Driving history: If you have a history of DUIs, DWIs, or other serious traffic infractions, your rates may increase.
  • Travel habits: Traveling to dangerous or war-torn nations can make you uninsurable, though insurers will also take your visit’s purpose and duration into account.
  • Nationality status: Some life insurance companies will not write policies for people on temporary visas.
  • Financial status: Your salary and net worth should be enough to justify the level of coverage you’re requesting. In addition, insurers want to confirm that you can afford the premium payments.
  • Criminal record: While some insurers will accept misdemeanors, it can be extremely difficult for those who have been convicted of a crime or those who are on probation to get life insurance.
  • Whether you already have a policy: To ensure you are not requesting too much life insurance, underwriters look up your existing policies to prevent overinsurance.

How to Prepare for Life Insurance Underwriting

Life insurance underwriters need a lot of information, which can feel intimidating. However, the process can be broken down into three basic steps:

1. Complete a life insurance application

While filling out your application, you should expect to answer questions about your health, the medical history of your family, and your exercise, drinking, and smoking habits. Also, you may be asked for information regarding your medication or treatment if you have a medical condition. Get as much of this information beforehand as possible so you can quickly and easily complete the application.

2. Get a medical exam

Some policies require a medical examination. Ensure you are as healthy as you can be prior to the visit. For example, if you have been meaning to quit smoking, it is beneficial to do so well before your life insurance underwriting process. The exam will either be conducted at an approved doctor’s office or your insurance company may send a nurse or medical technician to visit your home or place of business.

3. Obtain a statement from an attending physician

If an underwriter has concerns after seeing the results of your medical examinations, they may ask for an Attending Physician’s Statement, or an APS. This is a document from your doctor explaining your health status, especially if you are currently undergoing treatment for a condition. An APS serves as proof that you are addressing your health concerns.

The Approval Process for Life Insurance Underwriting

Every life insurance provider has its own underwriting standards. Although the exact procedure varies between companies, most underwriters adhere to the general procedures listed below.

Step 1: MIB Check

This takes place before the underwriter examines your application. A trade association called the Medical Information Bureau (MIB) assists insurers in exchanging medical data and preventing fraud. It enables underwriters to view the specifics of your medical history using earlier life insurance applications.

Step 2: Quality Check

During this step, the insurer reviews your life insurance application, and they may conduct a phone interview as part of the process. The underwriting procedure won’t be slowed down unless you have incomplete medical information. The call typically lasts 15 to 30 minutes and covers your health background, interests, and financial situation.

Step 3: Medical Exam

The medical exam is comparable to a doctor’s checkup. Either at an approved doctor’s office or in your home, a medical technician will conduct the examination to collect data on the following:

  • Standard physical measurements: These include height, weight, and blood pressure.
  • Blood analysis: A quick blood test can reveal potentially dangerous health issues.
  • Drug analysis: A comprehensive urine test will let the underwriter know about any possible drug use.

If these results raise any questions, the underwriter will request an APS. This provides a summary of your doctor’s official perspective on your medical history.

Step 4: Prescription Check

The underwriter will review each prescription drug you’ve received in the last 3 to 5 years. The prescription check serves to confirm the facts in your application, similar to the medical examination, APS request, and MIB check.

Step 5: Motor Vehicle Report

In a motor vehicle report, or MVR, your past 7 years of driving are outlined in detail. The report lists traffic infractions such as speeding or reckless driving incidents, vehicle offenses, accident reports, points on your driver’s record, and DUI convictions.

Step 6: Actuarial Table Review

Life insurance underwriters use an actuarial table, which is a statistical analysis of your life expectancy. This determines the risk you represent to the insurer and the possibility that you will pass away at any given age.

Step 7: Awarding Credits

Using an internal credit system, underwriters may occasionally offer you a small boost to help you pay less on your premium. For instance, if you have a chronic medical condition, an underwriter may grant you credits that reduce your rates if you’re actively making efforts to improve your health.

Step 8: Your Overall Rating

The underwriting process may take 5 to 6 weeks unless you apply for a no-exam policy, which can take as little as one day. Your application can also take longer to process due to outside factors, such as a visit to a doctor’s office for an APS. However, after the procedure is finished, all that’s needed to put the policy into effect is to verify the premiums and sign the document.

Life Insurance Underwriting Decisions and Categorizations

Each life insurance provider has its own set of classifications and underwriting standards. Therefore, the risk class that a company assigns to you may vary from one company to the next. The most common risk classes are:

Preferred Plus

This is also known as Super Preferred, Preferred Best, or Preferred Elite. It is the best rating you can get, and people who fit into this category are often young, healthy, and free of serious illnesses or long-term conditions. As a result, they often have the lowest premiums on life insurance policies.


A person with this rating is generally in good health, although they may be older or have some minor conditions that make them slightly riskier for the insurer. The rates that come with a Preferred rating still tend to be on the lower end.


If you’re given a Select rating, a few things about your application are a cause for concern. For instance, a person with a Select rating may suffer from a chronic condition or have a history of disease in their family.


A Standard rating in life insurance means the life insurance provider has reservations about your application. This may be because of existing serious medical conditions or a history of cancer in the family. You may still be able to get life insurance, but will pay more and have fewer options than someone with a Select rating or higher.

Can You Be Denied Life Insurance Coverage?

If you have high-risk medical problems or dangerous hobbies, or if you omitted critical information on your application, your life insurance application may be rejected. People who are advanced in age might also not be eligible for standard life insurance, though this depends on the insurance company.

But even those who are denied coverage have alternatives, such as applying for a life insurance policy that does not require a medical exam. This kind of insurance policy does not require any physical examinations or investigations into your medical history; the only criteria may be your age. However, these policies are substantially more expensive than standard life insurance, so those who are eligible for a standard policy should pursue that option first.

Plan for your family’s future. Get a life insurance quote today.

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Plan for your family’s future. Get a life insurance quote today.

Get a quote