How does underwriting work in Term Insurance?

Introduction

Every term insurance provider maintains unique and intricate life expectancy tables, which they use to establish premium rates. Many factors, beyond age and gender, come into play in determining mortality rates. These factors encompass health status, family medical history, smoking habits, occupation, and financial situation.

Term insurance companies meticulously collect all this comprehensive information about your health, allowing them to compare your expected lifespan with the average person of your age and gender. This comparison helps them set the appropriate premium rate you need to pay.

This entire process falls under the umbrella of underwriting in term insurance. This blog will delve into the internal mechanics of underwriting in term insurance through our insightful guide. Discover how underwriting establishes your coverage and premiums, leading to a clear grasp of this crucial aspect. Uncover the pivotal factors influencing underwriting decisions and thoroughly understand how this procedure moulds your term insurance journey.

What is Underwriting in Term Insurance?

Term insurance constitutes a contractual agreement between an insurer and you. In the unfortunate event of your passing, the insurance company disburses a death benefit to your selected beneficiary, often referred to as a term insurance payout. As you acquire a term insurance policy, you transfer the financial risk of your demise to the term insurance company. In return, you commit to regular payments, known as premiums.

The methodology behind establishing premiums for term insurance is known as term insurance underwriting. This process empowers insurers to evaluate the monetary risk associated with an individual. Underwriters gather essential particulars about an applicant and subsequently utilise an actuarial table to compute the anticipated lifespan of the individual. The insurer can pinpoint an appropriate premium rate for their term insurance policy by ascertaining an individual's life expectancy.

How Does the Term Insurance Underwriting Process Work?

Let's delve into the steps taken by insurance companies to conduct the underwriting process for term insurance:

Step 1: Review the Completed Application Form

Initially, the insurance company assesses the application form you have submitted. It's crucial for the policyholder to complete the form meticulously, providing accurate details regarding medical conditions, pre-existing illnesses, lifestyle habits, etc.

The following documents need to be attached by the policyholder along with the application form:

• A copy of the Aadhar card and PAN card.
• A copy of the driving licence.
• A copy of the passport for residential proof.
• Income proof documents, including Income tax returns, salary slips, bank passbooks, etc

Step 2: Underwriting Stage

1. Once the insurance company completes the evaluation of the application form, it officially enters the underwriting stage. There are primarily two types of underwriting:

A: Medical Underwriting:

Medical underwriting encompasses health status, past health issues, family health history, lifestyle, and addictive habits. The underwriter evaluates the insurance plan for the applicant by thoroughly analysing their medical condition.

In cases where the health risk for the insured is higher, the premium might be adjusted upwards, i.e., higher than the standard rate. The insurance plan might even be postponed or declined if the health risk is exceptionally high. Alternatively, higher-risk elements could have a waiting period or an exclusion clause.

The medical underwriter gathers information such as:

• Pre-existing ailments and other medical conditions.
• Prescriptions from medical practitioners or doctors.
• MER (medical examination report) containing tests and samples, as required.

The medical underwriter examines all details along with the completed form, determining whether the insurance policy can be accepted at the specified price point. The key is to ensure that all pertinent information is disclosed from the outset of the policy.

B: Financial Underwriting

Financial underwriting takes into account things like employment, income, the size of the family, the ability to pay the premium, etc. When the underwriter approves the applicant's insurance plan, they consider how well it fits their needs. The underwriter suggests more suitable options if the chosen insurance plan surpasses the applicant's budget.

During the underwriting process, the policyholder's capability to pay the premium for the term insurance policy on time is ensured. Accordingly, insurance products are recommended based on the applicant's financial status.

A financial underwriter examines the following documents of the policyholder:

• Salary certificates, Form 26AS, Income Tax Return
• Bank passbooks or credit card statements.
• Profit and loss statement of a company along with AOA, MOA, Board Resolution, etc., if applicable.
• Other utility bills like gas, water, electricity, or telephone bills.

2. Additionally, several other factors are considered during underwriting by the insurance company:

• Gender: The insurance company considers your gender, as certain health risks are associated with specific genders. This helps them assess potential medical conditions and determine premium rates.
• Age: Age plays a significant role in insurance. An early insurance purchase is advantageous in various aspects. Furthermore, younger applicants are viewed as less risky to the insurance company, leading to lower premiums.
• Family Medical History: The insurance company examines your medical history and your family's medical history. This assessment increases the likelihood of certain genetic medical issues in the future, such as diabetes, high blood pressure, and heart problems.
• Mental health: Your mental health history matters too. Conditions like depression and anxiety are taken into account to understand the risk they pose. Stable mental health could lead to better premiums, but insurers are working to avoid discrimination based on mental health.

Underwriters utilise the gathered information to assign an appropriate risk classification. This classification, along with the policyholder's gender and age, aids in determining the suitable premium rate.

Step 3: Final Evaluation by the Underwriter

After undergoing financial and medical underwriting, the underwriter reviews your assessment reports meticulously. At this stage, additional documents may be requested.

Potential outcomes of this assessment include:

• Acceptance: When the risk falls within the standard range, the insurance policy is accepted without any premium increase.
• Postponement: Temporary high risks might lead to a postponement of the insurance policy until the risk subsides or is mitigated.
• Rejection: If the risk is exceedingly high and the insurance policy cannot be accepted, it is declined.
• Counteroffer: In instances where the risk is elevated and cannot be accommodated at the standard rate, the insurance company might present a counteroffer. This could involve reducing the policy tenure or sum assured, increasing the premium, or implementing a temporary or permanent waiting period or exclusion clause.

What are the risk categories in the term insurance underwriting process?

Term insurers commonly employ the following risk categories: preferred plus, preferred, and standard. Although the general criteria for these categories are quite consistent across the industry, each insurer may impose specific requirements. Applicants failing to fall within these categories will likely receive a substandard rating.

1. Preferred Plus:

This represents the finest health classification achievable for term insurance applicants. To meet the criteria, one must maintain exceptional health, possess an ideal BMI, and lead an exemplary lifestyle. Additionally, certain conditions must not be present, including:

• a history of tobacco usage within the last three to five years
• a family history of heart disease and cancer
• DWI (or more than two moving violations within three years)

Insurance companies extend preferential rates to policyholders with a preferred plus rating for term insurance.

2. Preferred:

Individuals classified within this group share similar characteristics with those bearing a super-preferred classification. They are considered in good health, with only minor factors distinguishing them, such as slightly elevated blood pressure.

Applicants with pre-existing health conditions can still achieve a preferred rating for term insurance if their condition is effectively managed. For instance, if an individual is effectively controlling their diabetes and has no additional health concerns, insurers might offer a preferred rating. This rating is accompanied by slightly higher premiums than the preferred plus rating.

3. Standard:

The majority of term insurance applicants are categorised as standard risk. People in this category typically have higher BMIs, average life expectancies, and probable health issues.

This category does not mandate a flawless driving record and is less stringent regarding smoking than the preceding two. Qualification can be achieved if an individual has refrained from smoking for 12 months (as opposed to three to five years).

4. Substandard:

Term insurance providers utilise a numerical or alphabetical table rating system to categorise applicants as substandard. Policyholders in this category often grapple with severe health issues, such as severe asthma, Type 1 diabetes, bipolar disorder, multiple sclerosis, and epilepsy. The assigned rating (e.g., 2, 3, 4, A, B, C, etc.) corresponds to the degree of risk, resulting in higher premium rates for term insurance.

What is the Duration of the Underwriting Process for Term Insurance?

The timeline for the term insurance underwriting procedure varies, spanning from a few days to potentially over a month. The duration of an insurer's decision-making hinges on two key factors:

• the extent of information required by the underwriter
• the time necessary to collect all essential information

A straightforward health history will likely result in a swift approval process for term insurance. However, if your health profile is intricate and the insurer seeks an APS (Attending Physician Statement), several weeks might postpone the decision. In broad terms, most term insurance applications receive approval within two to six weeks.

What are the warning signs for term insurance underwriters?

While each life insurance company possesses unique standards for the underwriting process, most adhere to common underwriting principles concerning "warning signs." These risk factors could prompt the insurer to modify coverage limits, elevate life insurance rates, or decline an application outright. Among these factors, smoking habits and a medical history containing a severe or life-threatening illness like diabetes, heart disease, cancer, HIV/AIDS, or blood-borne diseases stand out. Other factors that can influence your insurability encompass:

• Excess weight: Generally, a body mass index (BMI) exceeding 40 may prompt insurers to seek additional medical details. A BMI surpassing 45 often results in application rejection.
• Unregulated blood pressure: Insurers may offer coverage if high blood pressure is managed with medication, but uncontrolled or untreated conditions could lead to rejection.
• Travel plans: Applications may face rejection if the applicant intends to travel to unsafe or volatile regions.
• Alcohol consumption: Elevated alcohol intake, even if moderate (e.g., 3 or 4 beers daily), may lead to heightened premiums. Heavier consumption could result in application denial.
• Substance usage: Employing substances like cocaine, crack, or heroin typically leads to automatic application rejection. Different insurance providers handle marijuana usage diversely.
• Hazardous hobbies: Engaging in perilous leisure activities such as skydiving or car racing might result in notably higher premiums or, in certain instances, application denial.
• Risk-associated professions: Applicants involved in hazardous occupations, like pilots or police bomb technicians, might require coverage from specialised carriers or employer plans.
• Poor driving record: A reckless or impaired driving history may prompt some insurers to reject an application.

Possessing one of these conditions doesn't necessarily preclude you from obtaining coverage. Nevertheless, your choices may be restricted, and your insurance premium may be elevated. It's essential to recognize that advancements in medical science could yield new possibilities. For instance, a diagnosis of HIV once rendered medically-underwritten coverage unattainable. However, certain life insurance companies, including Guardian, now offer policies for specific applicants with an HIV diagnosis and other conditions.

What Are the Effective Strategies to Obtain the Best Premium Quotes?

Listed below are suggestions that could assist you in navigating the underwriting process, mitigating risks to save on premiums, and obtaining your life insurance policy promptly:

• Cultivate a Healthy Lifestyle: Avoid adopting detrimental habits like regular smoking or excessive alcohol consumption to maintain a favourable health profile.
• Prepare Health Information: Gather your details to provide an accurate health summary.
• Uphold a Clean Driving Record: Strive to maintain a driving record devoid of traffic violations, accidents, or instances of driving under the influence.
• Apply for Coverage Early: Opt for a life insurance policy early in your life or as soon as you earn. Avoid unnecessary delays that might complicate the underwriting process.
• Provide Accurate Information: Ensure full disclosure of accurate information about yourself and your family while completing the proposal form. Inaccurate health and income details could lead to the rejection of your life insurance application.
• Opt for Safe Hobbies: Engage in safe hobbies and avoid risky activities that could result in higher premiums or, in some cases, denial of the application.

Conclusion

In conclusion, understanding how underwriting works in term insurance is essential for making informed coverage and premium decisions. You can navigate this process confidently by grasping the factors influencing underwriting assessments. Remember, your health, lifestyle, and personal circumstances shape your term insurance experience. Empower yourself with this knowledge to secure a well-suited and financially sound protection plan that aligns with your unique needs.