How life insurance underwriting works

What does life insurance underwriting mean?

The insurer compares your application and any supporting evidence with its current underwriting criteria. It can offer standard terms, change the price or benefits, postpone a decision, ask for more information or decline the application.

Insurers do not all use the same rules. Products, evidence requirements, pricing models, reinsurance and risk appetite differ.

Is underwriting the same as a medical examination?

No. Underwriting is the complete assessment. A medical examination, GP report or screening appointment is only one possible source of evidence.

Many applications are assessed using the application answers alone.

Does underwriting mean cover has started?

No. A quote, submitted application, referral or request for medical evidence does not normally create active cover. Check the insurer's written acceptance, start date and first-premium requirements before relying on the policy.

Some insurers provide separately documented temporary cover. Never assume it applies unless the insurer confirms it. Do not cancel existing cover until suitable replacement cover has started.

What are the stages of life insurance underwriting?

An initial quote is provisional and may use limited information or standard assumptions. The complete application normally follows six stages:

Keep each stage distinct. A quote shows an indicative price, the application supplies the information to assess, and the offer sets out the terms the insurer is prepared to provide for that particular application. Acceptance is the applicant's agreement to those terms. Active cover begins only on the confirmed basis and date.

1. Choose the type, amount and term of cover.
2. Complete the insurer's application questions.
3. Receive an automated decision or manual referral.
4. Provide clarification or evidence if requested.
5. Receive and review the final offer.
6. Accept the terms and confirm when cover starts.

New information can lead to further questions or revised terms. Increasing cover, adding benefits or reinstating a policy may also require new underwriting. Previous acceptance does not guarantee the same decision later.

Can you withdraw an application?

You can ask the insurer or broker to withdraw an application. Ask for written confirmation that it has been closed.

Withdrawal does not necessarily require the insurer to delete information it has a lawful reason to retain. A future application may ask about earlier postponements, declines or applications. Answer the precise question accurately.

What information may an insurer ask for?

The questions depend on the product, amount of cover and insurer. This table gives examples, not a list of facts everyone must volunteer.

Answer the questions actually asked. Do not use this table as an alternative application form.

Age and the requested policy term can affect the products, price and evidence required. Occupation, travel and activities can matter too. Describe what you actually do, how often you do it and any safety measures requested. Let the insurer assess the risk.

The amount and purpose of cover may lead to medical or financial evidence. Thresholds vary between insurers and can change.

Answer exact questions about smoking, vaping and nicotine. Definitions and qualifying periods differ.

How should you answer application questions?

Consumers must take reasonable care not to make a misrepresentation. In plain language, read each question carefully and answer it accurately and completely to the best of your knowledge.

• Read the full question.
• Follow its stated time period.
• Check information rather than guess.
• Ask if the wording is unclear.
• Correct mistakes promptly.
• Keep a copy of the application and final terms.

If an answer changes or becomes inaccurate before cover starts, follow the insurer's process and correct it promptly. Do not minimise an answer or let another person guess for you.

After ordinary life cover starts, you do not normally need to report later health changes unless the policy requires information for a change, reinstatement or claim. Check the policy terms.

What if you find a mistake?

Tell the insurer or broker promptly and keep a dated record. If an answer is reviewed during a later claim, an inaccuracy does not automatically justify rejection.

For a consumer policy, the insurer generally needs to establish that reasonable care was not taken and that the answer affected the terms it would have offered. Policies entered into or changed before 6 April 2013 can be governed by different rules.

Read the life insurance payouts and claims guide for the claim process.

How can health affect underwriting?

A diagnosis, disability, symptom, medicine or body measurement does not produce one automatic result. The insurer may consider:

• the diagnosis or symptoms;
• dates and severity;
• treatment and medication;
• test results;
• planned investigations; and
• stability or recent changes.

A broad condition label does not determine the outcome by itself. Read about life insurance with pre-existing conditions for the fuller application journey.

If asked about mental health, answer the specific questions about diagnosis, symptoms, treatment, time away from work or hospital care. Medication may be considered alongside the condition, dose, duration and stability.

An insurer may consider height and weight with age, medical history and the cover requested. Do not use online BMI cut-offs to predict a decision because criteria differ. One measurement may not explain the final outcome.

Do not alter prescribed treatment, delay healthcare or make unsafe changes to influence an application.

How are disability and long-term conditions treated?

Disability does not automatically prevent someone obtaining life insurance. In Great Britain, different treatment in insurance must satisfy specific legal conditions, including reliance on relevant information from a reasonable source and treatment that is reasonable.

Insurers should not rely on stereotypes about independence, capability or quality of life. The relevance and source of the evidence and the reasonableness of the treatment all matter. Northern Ireland has separate anti-discrimination legislation.

Ask for the insurer's explanation and use its complaints process if you dispute an individual decision.

Why do insurers ask about family medical history?

An insurer may ask about specified conditions affecting certain close relatives and the ages at which they occurred. Follow the relatives, conditions and time periods stated in the question. Do not speculate beyond what is asked.

What are the rules on genetic tests and life insurance?

Under the Government and ABI Code, participating insurers must not require or pressure applicants to take a predictive or diagnostic genetic test.

A predictive test estimates the chance of developing a condition in future. A diagnostic test investigates or confirms an existing condition and can form part of relevant medical information. Participating insurers must not request or use predictive results obtained through scientific research.

Family medical history can still be requested. Answer the question asked. If you are unsure whether a result is protected, check whether the insurer participates in the Code and consult the current ABI genetics guidance.

Why was an application referred to an underwriter?

Some applications can be decided automatically. Others need a person to review an answer, the amount of cover or further evidence. Referral is not rejection.

Ask what information is outstanding rather than trying to infer the outcome.

Can a solely automated decision be reviewed?

If an insurer makes a significant decision solely through automated processing, data-protection safeguards can apply. “Solely automated” means there was no meaningful human involvement.

Safeguards can include information about the decision and routes to make representations, request human intervention and contest it. Additional restrictions apply when a solely automated decision uses health or genetic information.

These rights do not apply to every automated referral or calculation. Ask whether the decision was solely automated, how to correct inaccurate data and what review process is available.

Will the insurer request a GP report or medical?

Many applications need no additional medical evidence. Where more information is required, an insurer may ask for:

• a targeted GP report;
• consultant or hospital information;
• nurse screening;
• blood, urine or other tests; or
• a medical examination.

A request for a report or examination does not mean the application will be declined. The insurer will often arrange and pay for evidence it requests, but procedures differ.

Do not arrange and pay for a report or test yourself unless the insurer asks you to and confirms the cost arrangements.

Can you see a medical report?

In England, Wales and Scotland, the Access to Medical Reports Act 1988 can apply when an insurer asks a doctor who has treated you to prepare a report.

The insurer needs your permission to request it. You can ask to see it before it is sent and request correction of inaccurate or misleading information. If the doctor refuses a correction, you can ask for your written comments to be attached. Limited information can be withheld to prevent serious harm or protect another person.

If you request access, contact the doctor within the applicable 21-day period to arrange to see the report. Northern Ireland has a separate statutory regime.

How must the insurer handle health information?

Health and genetic information receive additional protection under data-protection law. The privacy notice should explain why the insurer collects it, where it comes from, who receives it, how long it is kept and the rights available to you.

The medical-report consent and the insurer's wider privacy notice perform different functions, so read both.

What underwriting outcomes are possible?

The insurer may offer the requested cover, change the offer, request more information or make no offer. The final terms matter more than the initial quote.

A loading or rating is an increase to the insurer's standard premium for that application. “Standard” does not mean one price for every applicant.

The initial quote may use limited information or assumptions. Review the final price, cover, term and changed benefits before accepting.

Terms can differ between benefits. For example, an insurer may change critical illness cover without changing the death benefit. Ask exactly which benefit the wording affects.

Why can insurers reach different decisions?

Insurers differ in product design, risk appetite, reinsurance, underwriting guidance, evidence requirements and pricing models.

One insurer's decision does not predict every other insurer's decision. A different outcome does not mean an insurer is better for everyone with that condition.

How long does underwriting take?

There is no standard timeframe. Timing depends on whether an automated decision is available, clarification required, medical or financial evidence, third-party responses and application complexity.

Ask:

• What is outstanding?
• Who needs to provide it?
• When is the next update expected?

Some steps can be prioritised, but the insurer cannot always control third-party response times.

What should you do after postponement or decline?

A postponement delays a decision. It is not necessarily a permanent decline. A closed application may simply mean the process was not completed.

1. Confirm whether the outcome is postponement, decline or closure.
2. Ask for the explanation the insurer can provide.
3. Check and correct inaccurate information.
4. Record any future review date.
5. Consider a broker or preliminary enquiry before further full applications.
6. Answer future questions about previous applications accurately.

Another insurer may reach a different decision, but no result can be promised.

Can you ask the insurer to review its decision?

You can ask the insurer to correct factual errors and explain any review or complaint process. This does not require it to accept the application.

How can a broker help with underwriting?

Depending on its service and insurer panel, a broker may explain application questions, identify insurers to approach, make preliminary enquiries and liaise while evidence is collected.

A broker cannot guarantee acceptance, price, terms or that medical evidence will not be required. Any LifeNest introduction must clearly state the broker's name, advice status, panel scope, fees, preliminary-enquiry service and how information is shared.