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Last Updated on 17 November 2019

Medical Underwriting & Life Insurance


Medical underwriting for life insurance


Medical underwriting is part of life insurance, but what exactly is it? This guide will answer your questions about life insurance medical underwriting and explain how it affects you.

Key Points
  • Medical underwriting is a way for insurers to assess your health risks while reviewing your application for life insurance.
  • Underwriters look at a range of risk factors, including age, occupation, lifestyle, and health.
  • Life insurance purchased outside of superannuation generally involves underwriting, while life insurance purchased inside super may not require it.

Life Insurance Medical Underwriting

Underwriting is a confusing term for a simple concept: it’s simply a method insurers use to assess risk. When you submit an application for life cover, the insurer needs to know what level of risk you present before offering you a policy and a premium amount.

Medical underwriting is one way that insurers determine risk. If you apply for an underwritten life insurance policy, your insurer will want information about your medical history. You may have to fill out a questionnaire and take a medical exam.

It’s critically important that you answer all questions honestly. If you do not, your insurer is likely to find out the truth and it could lead to your claim being denied.

Although underwriting may seem like a scary concept designed to charge you higher premiums, it can actually work in your favour. According to Lifewise.org.au, 93% of life cover applicants don’t experience any issues with underwriting and pay standard premiums.

Risk Factors

Your insurer will consider a number of risk factors during the medical underwriting process. Here’s what they may look at and why.

Demographic

Unfortunately, age, gender, and location are all indicators of risk. The older you are, the higher your risk of death or illness. Females generally live longer than males, and people in cities have a higher life expectancy than those in remote areas.

Insurance underwriters will look at your demographic to see what your perceived mortality rate is, and factor this into the assessment.

Health

Your health is, unsurprisingly, one of the most important risk factors considered during the medical underwriting process. The underwriter may look at things like:

  • Any surgeries you have had in the past
  • Previous illnesses or injuries
  • Ongoing health conditions
  • Prescriptions you are currently taking or have taken

You may be asked to provide medical reports or contact details for your doctors or specialists.

People often worry about pre-existing conditions and how they may affect premiums. While some insurers do exclude people based on pre-existing conditions—meaning they will not pay out on claims related to the condition—others will still offer cover.

If your health changes over time after you are insured, you may need to disclose this information to your insurer. Your insurer may request that you answer questions in detail or undergo a medical screening for certain diseases.

Family Medical History

Underwriters may look at genetics as a risk factor for life cover. You may be considered a higher risk if there is a family history of a certain condition, like heart disease. However, if your family history is clear, then you should not have any problems.

Lifestyle

Your lifestyle can play a role in your level of risk, particularly if you engage in hazardous activities. You may be asked about your smoking, drinking, and exercise habits, as well as whether or not you participate in sports.

This is one area where premiums can be dramatically affected by an underwriter’s findings; if you are a smoker, your premiums could double on the spot. People involved with extreme sports like rock climbing, motocross, or snow sports may also face higher premiums.

If you display lifestyle risk factors, it doesn’t mean you can’t get life cover, but it may mean that you’ll have to pay more for it.

Occupation

Your job can affect your life insurance, especially if you work in a high-risk occupation. For example, based on job type alone, office workers typically present a lower risk than farm workers. People who work in dangerous jobs are more likely to be injured or even killed, and underwriters will factor that into their risk assessment.

Here are some job duties that may affect the risk level of your occupation:

  • Manual lifting
  • Working with heavy machinery
  • Use of specialised tools
  • Work with hazardous materials
  • Working at heights
  • Working underground

Each insurer defines their own job categories. However, the following industries are usually considered high-risk:

  • Firefighting
  • Mining
  • Manufacturing
  • Construction
  • Forestry
  • Armed Forces
  • Transport

Which Life Insurance Policies are Medically Underwritten?

Not all life insurance policies are medically underwritten. In most cases, policies purchased outside of superannuation will be underwritten while policies purchased inside of superannuation are not. Let’s look at why that is.

Policies inside superannuation

When you purchase life cover through your super fund, it is usually part of a group policy. Premiums and coverage are based on a group rather than an individual. In this case, underwriting is usually not necessary.

This may work in your favour if you present a high medical risk. On the flip side, it means that your level of life cover is generic, designed to suit a large group rather than your financial situation.

Many people with life cover through super are underinsured. If you do apply to increase your cover, the insurer may require underwriting.

Policies outside superannuation

When you buy a life insurance policy as an individual, the assessment is based solely on your level of risk, not risk spread out across a large number of people. You will likely need underwriting before an application is approved and a premium is set.

What Documents Do I Have to Provide?

You’ll likely be asked to provide some general documents as well as more detailed medical documents.

General documents include:

  • Proof of address
  • Proof of employment
  • Proof of income
  • General medical history
  • Description of hobbies (if applicable)

Medical documents include:

  • Completed questionnaire about personal and family medical history
  • Letter from doctor describing details of any previous or current medical conditions
  • List of prescriptions you are currently taking or have taken in the past five years

I Want Life Cover Outside of Super. Do I Have to Go Through the Underwriting Process?

Not necessarily. You may want to consider direct life insurance, which can be a way of avoiding underwriting. Life cover is usually purchased through super or a financial adviser; if you buy cover directly from a fund, you are buying direct.

You’ll likely have to complete a questionnaire about your medical history before your direct insurance application is approved. If it raises no red flags, then your application may move forward without a medical.

Direct insurance can be good for people who know what they want, and don’t need professional advice. It can be purchased online or over the phone, and you may be able to avoid the underwriting process.

However, if you aren’t sure which life cover is right for you, direct insurance may not be the smartest move.

Pros & Cons of Medical Underwriting

Medical underwriting isn’t something to be afraid of. While it can result in raised premiums for people at higher risk, it usually means less surprises. You know what you’re covered for and your insurer knows the details of your medical history, and has agreed to cover you anyway.

Medical underwriting can delay the process of your life insurance application approval, but it may also result in a more transparent relationship with your insurer. Remember to compare policies to find a low price on the cover that can give you peace of mind, whether or not that includes underwriting.

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