Life insurance underwriting is the process insurers use to review your application and determine approval and pricing. By evaluating factors like health, medical history, and lifestyle, insurers assess risk and assign a rate class.
What Is Life Insurance Underwriting?
Life insurance underwriting is the process insurance companies use to review your application and decide whether to offer coverage and at what price. During underwriting, insurers evaluate a combination of medical information, lifestyle habits, and background data to assess overall risk. This review helps determine how likely a claim is to occur and guides the approval decision.
The primary goal of underwriting is to place applicants into specific risk classes, which directly affect premium rates. Healthier individuals typically qualify for lower costs, while those with higher risk factors may pay more or be offered different policy options. Understanding how underwriting works can help you set expectations and choose coverage that aligns with your health profile and financial goals.
Medical Exams (When Required)
Many traditional life insurance policies require a medical exam, especially for higher coverage amounts. The exam is typically brief, free, and can often be completed at your home or workplace. Its purpose is to give insurers a clearer picture of your overall health so they can determine eligibility and pricing.
A typical life insurance medical exam may include:
- Height and weight measurements
- Blood pressure and pulse readings
- Basic health questions about medical history and lifestyle
- Blood and urine samples to screen for common health indicators
Not all life insurance policies require an exam. No medical exam and simplified issue policies use alternative underwriting methods and may be available for applicants who want faster approval or prefer to avoid testing.
Lab Tests and Health Screening
If blood or urine samples are collected during underwriting, they’re used to screen for common health indicators that may not be immediately visible. These lab results help insurers better understand overall health and confirm information provided on the application. Lab testing is a standard part of underwriting and is used to determine eligibility and pricing — not to automatically deny coverage.
Common lab markers insurers review include:
- Cholesterol levels
- Blood sugar levels, including A1C for diabetes risk
- Liver and kidney function
- Nicotine or tobacco use
Abnormal lab results don’t automatically result in a decline, but they may affect your risk classification or premium rate. In many cases, results are evaluated alongside other factors such as age, medical history, and lifestyle before a final decision is made.
Protect Against the Unexpected
Prescription History Checks
Life insurance companies review prescription history to gain insight into an applicant’s ongoing or past medical conditions. This information is typically obtained through a third-party prescription database and helps insurers verify details provided on the application. Reviewing prescription data allows underwriters to better understand overall health patterns rather than relying solely on self-reported information.
Prescription history can reveal chronic conditions being treated, whether medications are taken consistently, and any recent changes in treatment. This step is often used even for no-exam life insurance policies and plays a significant role in underwriting decisions, particularly when determining eligibility and premium rates.
MIB Reports (Medical Information Bureau)
The Medical Information Bureau (MIB) is a shared database used by life insurance companies to help verify information provided on insurance applications. It does not contain full medical records or detailed diagnoses. Instead, it uses coded entries to indicate that certain medical conditions or risk factors were disclosed on prior insurance applications, helping insurers confirm consistency and accuracy during underwriting.
MIB reports are primarily used to prevent fraud or misrepresentation and are only one piece of the underwriting process. An MIB record by itself does not cause a life insurance decline — it’s simply one data point considered alongside medical exams, lab results, and prescription history. Applicants also have the right to request a copy of their MIB report, which can be helpful if questions arise during the underwriting review.
How Long Underwriting Takes
Life insurance underwriting timelines can vary widely depending on the type of policy you apply for and how much information the insurer needs to review. Some applicants receive decisions quickly through accelerated processes, while others require full medical underwriting, which takes longer.
Typical Underwriting Timelines
| Policy Type | Typical Timeline |
|---|---|
| Instant or Accelerated Underwriting | Minutes to a few days |
| No Medical Exam Policies | A few days to about a week |
| Fully Underwritten Policies | About 2–6 weeks |
Working with an experienced agent can help avoid common delays, choose the right policy type upfront, and improve the overall outcome of your application. To explore your options, you can get a quote online or call us at (800) 442-9899 to speak with a licensed advisor.
How Life Insurance Underwriting Works: FAQs
What is life insurance underwriting?
Life insurance underwriting is the process insurers use to evaluate risk and decide whether to approve an application, what coverage to offer, and at what price. Underwriters review health, lifestyle, and financial information to determine your rate class and premium.
Why does life insurance underwriting matter?
Underwriting determines approval, cost, and coverage limits. A favorable underwriting outcome can save thousands of dollars over the life of a policy, while a poor outcome can raise premiums or result in a decline.
What information do underwriters review?
Underwriters typically assess:
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Age and gender
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Medical history and current conditions
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Height, weight, and BMI
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Blood pressure and cholesterol
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Prescription history
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Family medical history
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Smoking and tobacco use
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Alcohol or drug use
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Occupation and hobbies
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Driving record
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Financial justification (for higher coverage amounts)
What is the life insurance medical exam?
A medical exam is a brief health screening that may include:
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Blood and urine samples
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Blood pressure check
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Height and weight measurement
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Health questionnaire
Exams are usually free, conducted at your home or office, and take about 20–30 minutes.
Do all life insurance policies require underwriting?
Most fully underwritten policies do, but not all. Alternatives include:
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Simplified Issue Life Insurance
These options use limited or no underwriting but typically cost more.
How long does the underwriting process take?
Underwriting usually takes 1–6 weeks, depending on:
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Whether a medical exam is required
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Speed of medical record retrieval
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Complexity of health history
No-exam policies can be approved in minutes to days.
What is a life insurance rate class?
A rate class (or health class) is the category you’re placed in after underwriting. Common classes include:
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Preferred Plus / Super Preferred
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Preferred
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Standard Plus
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Standard
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Substandard (table ratings)
Your class directly affects your premium.
How does smoking affect underwriting?
Smoking has a major impact. Tobacco users are placed in smoker rate classes, which are significantly more expensive. Some insurers consider cigar or vaping use differently, but disclosure is critical.
How do pre-existing conditions affect underwriting?
Pre-existing conditions don’t automatically disqualify you. Many well-managed conditions — like controlled high blood pressure or diabetes — can still qualify for coverage, though possibly at a higher rate class.
Can underwriting results differ between insurance companies?
Yes. Each insurer has its own underwriting guidelines. One company may offer Preferred rates while another offers Standard for the same applicant. This is why shopping multiple carriers matters.
Can an underwriter deny my application?
Yes, but a denial with one company does not mean you’re uninsurable. Different insurers evaluate risks differently, and alternative products may still be available.
Can I improve my underwriting outcome?
Often, yes. You may improve results by:
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Losing weight
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Quitting smoking
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Improving blood pressure or cholesterol
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Providing updated medical records
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Correcting errors in medical reports
Reconsideration is sometimes possible after improvements.
What happens after underwriting is complete?
You’ll receive one of four outcomes:
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Approved as applied
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Approved at a higher rate
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Approved with exclusions or riders
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Declined
Your agent can help you accept, negotiate, or explore alternatives.
How can an agent help with underwriting?
An experienced agent can:
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Pre-screen your health profile
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Submit applications to the most favorable insurers
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Advocate during underwriting
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Request reconsideration
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Find no-exam or guaranteed options if needed
This often leads to better approvals and lower rates.
