Life Insurance Medical Exam Underwriting and Requirements

Shawn Plummer

CEO, The Annuity Expert

If you are considering buying a life insurance policy, you will likely have to undergo a medical exam. This can seem daunting, but it is important to understand what to expect. This guide will discuss the medical exam in detail and tell you what you can do to prepare for it. In this section, we’ll go through all of the phases involved with underwriting and also provide some tips on how to pass the exam with flying colors!

What Is Underwriting When Applying For life Insurance?

Underwriting is the process that life insurance companies use to assess risk. During underwriting, the life insurance company will review your medical records and decide whether to provide coverage. If you are approved for coverage, the life insurance company will set your premiums based on the level of risk they have determined you pose.

What Is an Insurance Underwriter?

Insurance underwriters are experts who evaluate and assess the risks of insuring people and assets. Insurers set rates for insured risks that insurance underwriters have authorized. Underwriters examine various factors to assess the probability and extent of risk. For example, an underwriter works on behalf of the life insurance firm to evaluate your application information, health records, and lifestyle to determine your premium level.

Step 1: MIB check

Before the underwriter delves further into your application, this stage takes place. The MIB is a trade association that works with insurance companies to share medical records and combat fraud. It allows underwriters to access information regarding your prior life insurance applications (dating back three to five years), which they can use in their evaluations.

It won’t affect your classification if you’ve previously applied for life insurance. The MIB check aids the underwriter by demonstrating any medical impairments, treatments, and diagnoses documented by past underwriters. This mechanism ensures that premiums are lower for both providers and applicants.

Step 2: Application quality check

After the MIB verification, the insurance company goes through your life insurance application to ensure that all required information is supplied. It’s not unusual for applications to be missing unintentionally valuable information. An incomplete application will not delay underwriting unless the missing data pertains to your medical history.

Insurance companies often conduct a telephone interview to double-check your application information. The conversation lasts around 15 to 30 minutes, and you’ll be asked about your health history and financial background.

Step 3: Medical exam

The first formal stage of the underwriting procedure begins with a medical checkup. The examination is similar to a routine checkup with your doctor, except you are not charged. A medical technician will perform the exam at a laboratory, home, or business.

When the underwriter receives your exam results, they determine whether you are eligible for coverage.

Basic measurements

Your height-to-weight ratio significantly influences how you’ll be classified and, eventually, what you’ll pay for your life insurance policy. In addition, when you become older, high blood pressure readings become more important because they can affect your rates.

Blood test

A simple blood test can discover potential health issues such as heart disease, stroke, diabetes, blood-borne diseases, and other illnesses.

Drug test

A complete drug panel may reveal the usage of drugs such as amphetamines, cocaine, barbiturates, and more.

Reusing The Medical Exam

You can reuse the findings of your medical evaluation to apply for long-term care insurance or life insurance from a different provider. You do not have to select a life insurance company just because they paid for your medical checkup.

Skipping The Medical Exam

Some insurance companies have medical examinations that applicants can skip through their policies and underwriting processes. While some no-exam plans may be approved for individuals with health issues, they will receive lower benefit amounts and higher premiums.

Skip The Exam, Get Coverage Instantly.

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Step 4: Attending physician statement

If the underwriter has concerns about your medical examination findings, they will request an Attending Physician Statement (APS).

An APS is a compilation of your medical history from a doctor’s viewpoint. It contains information on each condition you’re receiving treatment for, such as how long you’ve been treating it and how long symptoms have existed.

This step may extend the insurance underwriting process by a few days to several months, depending on how long it takes for a doctor’s office to comply with your request.

Step 5: Prescription Drug History

The insurance company will look at the medications you’ve been given in the last three to five years. The prescription check, like the medical exam, APS request, and MIB check, ensures that your application is truthful.

Step 6: Motor vehicle report

Your driving history beginning seven years ago will be recorded in your motor vehicle report, also known as an MVR. If your MVR reveals anything concerning, your premiums will be greater. You may even be denied a policy if you have a recent DUI.

Step 7: Actuarial tables

An underwriter computes a statistical analysis of your life expectancy called an actuarial table. The table predicts the probability that you will die at various ages and the insurer’s risk.

Underwriters use two separate actuarial tables to calculate the risk of life insurance:

Mortality table

A mortality table depicts the chance of dying for a specific group of people based on age and gender, ignoring many particulars specific to each health profile. It’s used as a statistical baseline to predict when you’re most likely to die.

Build table

Your body mass index (BMI) — which takes your height and weight into account to assess your health and predict how long you will live — is used to determine your health and forecast your life span.

Step 8: Credit History

After the underwriter has completed all of the tests, tools, and checks to determine your insurance classification, they may use a credit system to offer you a tiny boost to assist you in saving money on your premiums.

Step 9: Confirming final rating

After the medical underwriting is completed, all that remains is to approve the premiums and sign the policy to put it into effect.

Understanding Your Health Status

When shopping for life insurance quotes, the prices will be dictated by policy type, age, and health status. There are typically five different general health classifications based on current and past health conditions:

  • Preferred Plus: The best classification status to qualify for, which means your premiums will be the cheapest. You are the fittest of the fit with zero negative family health history. You are in excellent health.
  • Preferred: The second highest health classification. For example, you’re in great health but have a few minor health issues, or a family member has had health issues in the past.
  • Standard Plus (Regular Plus): You are in good shape but not the best. Maybe slightly outside the life insurance policy’s height and weight requirement range? Family health history is also in good shape.
  • Standard (Regular): Your height to weight range could be better with your average health status. You might have a few improvements needed to be made in regards to your medical tests. Your family’s health might have negative instances in their history. You can still get life insurance, but it won’t be the cheapest premium rate.
  • Substandard: You have or had negative health issues. You can get life insurance, but it won’t be cheap compared to the other classifications.

Find The Best Life Insurance Coverage At The Cheapest Cost!

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Find Life Insurance Coverage with No Medical Exams

Apply for affordable life insurance with no medical exams. Then, apply for same-day coverage in less than 10 minutes.

Medical Underwriting When Applying For Life Insurance Coverage

In a life insurance application, health-related questions are always asked. The life insurance company wants to evaluate the risk they’re taking on by insuring you. Below are common health-related questions asked on an application.

Disclaimer: Don’t be discouraged if you fall into one of these medical categories below. It doesn’t mean you can’t buy life insurance. On the contrary, over 90% of our applicants obtain life insurance coverage. However, you need to talk to one of our experts, a free service for you. They will provide you with the best policy for any medical condition.

Have you ever consulted a member of the medical profession regarding or have you been diagnosed or treated for:

  • High blood pressure, high cholesterol, abnormal electrocardiogram, chest pain, irregular heart rhythm, palpitations, heart murmur, heart attack, angina, phlebitis, peripheral vascular disease, or any other disease or disorder of the heart or blood vessels?
  • Hepatitis, ulcer, internal bleeding, colitis, acid reflux, GERD, or any other disease or disorder of the stomach, gall bladder, esophagus, liver, pancreas, spleen, intestines, colon, or rectum?
  • Does your blood or immune system disorder include anemia, blood clots, bleeding, immune deficiency, leukemia, or lymphoma (excluding HIV)?
  • Cancer, tumor, melanoma, or any other malignant disorder?
  • Diabetes, high blood sugar, or any other disease or disorder of the pituitary, thyroid, or endocrine glands?
  • Albumin, protein, blood, or sugar in the urine or any other disease or disorder of the kidney or bladder?
  • Cyst, polyp, lump, further growth, or any disease or disorder of the skin or lymph nodes?
  • Any disease or disorder of the uterus, cervix, ovaries, or breasts?
  • Any disease or disorder of the prostate or reproductive system?
  • Any sexually transmitted disorders or diseases?
  • Pregnancy, complications of pregnancy, or infertility? If now pregnant, what is the expected date of delivery?
  • Asthma, shortness of breath, chronic cough or hoarseness, bronchitis, emphysema, COPD (chronic obstructive pulmonary disease), sarcoidosis, pneumonia, TB (tuberculosis), sleep apnea, or any other disorder of the respiratory system?
  • A disorder of the brain, spinal cord, or nervous system including chronic headaches, convulsions or loss of consciousness, seizures, tremors, paralysis, fainting, stroke, MS (multiple sclerosis), or TIA (transient ischemic attack)?
  • Depression, anxiety, psychosis, suicidal thoughts or attempts of suicide, anorexia or bulimia, obsessive-compulsive disorder, bipolar disorder, or other mental, nervous, or emotional disorder?
  • Arthritis or disorder of the bones, skin, or muscles?
  • Any disease or disorder of the eyes, ears, nose, or throat?
  • Been treated by a member of the medical profession or at a medical facility? Had an electrocardiogram, x-ray, blood test, or other diagnostic tests, excluding an HIV test?
  • Had surgery or biopsy, or been an inpatient or outpatient in a hospital, clinic, or other medical or mental health facilities?
  • Has it been advised by a medical professional member to have surgery, medical treatment, biopsy, or diagnostic testing, excluding HIV testing, that has not yet been completed?
  • Have you been referred to any other medical professional or facility member?
  • Been unable to work, attend school, perform normal activities like age and gender, or be confined at home?
  • Have you ever used amphetamines, barbiturates, cocaine, heroin, crack, marijuana, LSD, PCP, or other illegal, restricted, or controlled substances, except as prescribed by a licensed physician?
  • Have you ever been addicted to prescription medication or been advised by a physician to discontinue using habit-forming drugs?
  • Have you ever consumed alcoholic beverages? If Yes, give the type and number of drinks per day or week. Have you been advised by a physician or other licensed medical practitioner to limit or cease the use of alcoholic beverages?
  • Do you smoke or consume tobacco?
  • Been counseled, sought help or treatment, or been advised by a physician or other licensed medical practitioner to undergo counseling or treatment for alcohol problems?
  • Attended or joined any organization due to alcohol or related problems?
  • Are you currently taking, or have you been advised to take any prescribed medication?
  • Have you tested positive for exposure to the HIV infection or been diagnosed with ARC (AIDS-Related Complex) or AIDS (Auto Immune Deficiency Syndrome) caused by HIV infection or other sickness or condition derived from such infection?
  • In the past five years, have you been diagnosed, treated, tested positive for, or been given medical advice by a member of the medical profession for any disease or disorder not previously stated on this application?

Having a Preexisting Medical Condition

It may be difficult to get life insurance due to a preexisting medical condition or impairment under some circumstances, but don’t fret; we can help you find a solution. First, contact us for a life insurance quote that requires no exam. In the meantime, I’ve listed examples of conditions or impairments that might give you a hard time getting coverage.

Disclaimer: Every insurance company has different parameters, so please use this as a reference.

  • Activities of daily living (ADL’s) limitations requiring assistance
  • Alcoholism with less than two years of sobriety since alcohol treatment or diagnosis
  • Alzheimer’s disease or dementia
  • Amyotrophic Lateral Sclerosis (ALS)/Lou Gehrig’s disease
  • Autism, under age 8
  • Bankruptcy, Chapter 7 that has not been discharged
  • Body Mass Index (BMI) over 48.
  • Cancer, the majority of stage 4 only
  • Cardiac defibrillator
  • Chronic Myeloid Leukemia
  • Chronic Obstructive Pulmonary Disease (COPD) requires oxygen
  • Chronic pain treated with Methadone
  • Congestive heart failure (CHF) is not resolved
  • Coronary artery disease diagnosed before age 35
  • Criminal history, currently on probation or parole
  • Cystic fibrosis
  • Diabetes Mellitus, applicants, aged 0 to 17 only
  • Diagnostic testing is advised but not completed yet
  • Down syndrome, age 0 to 16 and over age 40
  • Driving violations that involve multiple DUIs, with the last one occurring within the last three years
  • Drug treatment or illegal drug use (other than marijuana) in the last three years
  • Esophageal varices
  • Heart valve stenosis, severe without heart valve replacement
  • Kidney failure requiring dialysis
  • Muscular Dystrophy
  • Pregnant currently with complications such as gestational diabetes, toxemia, eclampsia, or pre-eclampsia
  • Pulmonary fibrosis
  • Pulmonary hypertension
  • Quadriplegia
  • Sclerosing cholangitis
  • Sickle cell anemia, age of applicant under 30
  • Suicide attempts within the last year
  • Transplant recipient of a liver, heart, or lung

Apply For Life Insurance While You’re Young.

Life insurance companies use your life expectancy to set the price. So anything that could shorten your life expectancy can make the insurance more expensive.

Buy a life insurance policy when you are young and healthy. If you wait, your rates will increase because of your age. And if new health problems arise, they can go up even more.

You can still get life insurance if you have a medical condition, like diabetes or high blood pressure. Life insurance companies will vary in how they view your preexisting conditions. Some types of life insurance do not require a medical exam.

What Percentage Of People Are Denied Life Insurance?

According to industry estimates, as many as 20% of people who apply for life insurance are denied coverage. There are various reasons why an insurance company may deny coverage, but some of the most common include a history of smoking, high blood pressure, and obesity.

If you have been denied life insurance, it is important to understand why. This way, you can take steps to improve your chances of being approved in the future.

A Warning About Running Life Insurance Quotes Yourself.

If you think you might get declined for life insurance coverage due to a preexisting condition, do not by any means apply for coverage and hope for the best. If you are officially declined from coverage, most insurance companies will not accept you for at least two years for those reasons alone.

So talk to an expert first. Let them consult with you on your options, then go from there. We can run additional life insurance quotes that don’t require a medical exam.

Some annuities have enhanced death benefits if you can’t get coverage at all.

So let’s get a quote for life insurance now!

Find The Best Life Insurance Coverage At The Cheapest Cost!

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Need Help Getting Life Insurance Coverage?

Life Insurance Medical Exam

If you have a preexisting medical condition and want to buy life insurance, you will need help from an expert. This person can help ensure you get coverage, so you don’t get declined.

Warning: Applying for life insurance without a medical exam can be risky. If you get declined coverage, it could be at least two years before you can get any life insurance.

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Frequently Asked Questions

What is a paramedical exam?

A paramedical exam is a medical examination that a trained medical professional conducts to assess an individual’s health and fitness for a specific purpose. This could be for employment, insurance purposes, or eligibility for certain types of medical treatment. The scope of a paramedical exam can vary depending on the reason it is being conducted. Still, generally speaking, it will involve taking some basic vital signs (such as blood pressure and heart rate) and measuring height and weight. In some cases, more comprehensive tests, such as blood tests or urine analyses, may also be carried out.

What happens if an incomplete life insurance application is submitted to an insurer?

An incomplete life insurance application to an insurer could result in the denial of benefits to the insured or may only provide partial coverage. Therefore, an applicant must be as forthcoming as possible when completing a life insurance application to ensure that they can receive the full benefit of the policy.

Shawn Plummer

CEO, The Annuity Expert

I’m a licensed financial professional focusing on annuities and insurance for more than a decade. My former role was training financial advisors, including for a Fortune Global 500 insurance company. I’ve been featured in Time Magazine, Yahoo! Finance, MSN, SmartAsset, Entrepreneur, Bloomberg, The Simple Dollar, U.S. News and World Report, and Women’s Health Magazine.

The Annuity Expert is an online insurance agency servicing consumers across the United States. My goal is to help you take the guesswork out of retirement planning or find the best insurance coverage at the cheapest rates for you. 

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