So you've decided to get life insurance—smart move. But then you hit submit on your application and… crickets. What's actually happening behind the scenes? Welcome to underwriting, the process that determines whether you get approved, what you'll pay, and how long you'll wait. Here's the thing: underwriting isn't some mysterious black box. Once you understand how insurers assess your risk, you can navigate the process with confidence and maybe even snag a better rate.
What Is Life Insurance Underwriting?
Life insurance underwriting is essentially a risk assessment. When you apply for coverage, an underwriter reviews your application and evaluates various factors—your age, health, occupation, lifestyle, and family medical history—to determine how likely you are to pass away while the policy is active. That sounds morbid, but it's just actuarial science. The insurer needs to know: if we insure you for $500,000, what's the statistical likelihood we'll have to pay out that claim?
Based on their assessment, they'll place you into a risk class, which determines your premium. Lower risk means lower premiums. Higher risk means higher premiums—or possibly a denial if your risk is too high for that particular insurer to cover.
How Underwriters Evaluate Your Risk
Underwriters dig into several key areas to build a complete picture of your health and lifestyle. Here's what they're looking at:
Medical exam results: For traditional policies, you'll likely undergo a medical exam that collects your height, weight, blood pressure, and samples of blood and urine. These tests can reveal conditions like high cholesterol, diabetes, or liver issues that might not show symptoms yet.
Personal and family medical history: Chronic conditions, past surgeries, current medications, and your family's health history all matter. If heart disease runs in your family, underwriters take note—it could affect your risk class.
Prescription database checks: Every major insurer uses prescription databases like Milliman IntelliScript to review your medication history from the past five to seven years. They're looking for prescriptions that point to undisclosed conditions. If you're taking blood pressure medication but didn't mention hypertension on your application, that's a red flag.
MIB Group records: The Medical Information Bureau (MIB) is a database used by 99% of life insurers in the U.S. and Canada. If you've applied for individual life, health, disability, or long-term care insurance in the past seven years, there's likely a file on you. MIB doesn't store your complete medical records—just coded information about conditions and hazardous activities that's significant to underwriting. Underwriters use it to verify consistency across applications.
Lifestyle and occupation: Tobacco use is a major factor—being smoke-free for three to five years can significantly lower your premium. Risky hobbies like skydiving or rock climbing, a history of DUIs, and dangerous occupations can also bump you into a higher risk class.
Understanding Risk Classes
After reviewing all this information, underwriters assign you to a risk class. Think of these as pricing tiers—the better your class, the lower your premium. Here are the main categories:
Preferred Plus (or Preferred Select): This is the gold standard. If you're in excellent health, maintain a normal height-to-weight ratio, have a favorable family health history, haven't used tobacco in three to five years, and don't engage in risky activities, you'll likely land here. You'll pay the lowest premiums available.
Preferred: You're healthier than average for your age and gender, but maybe you take medication for blood pressure or cholesterol, or your family history isn't perfect. You'll still get competitive rates—just not the absolute best.
Standard: This means you have average mortality risk—you're as likely to pass away as others your age and gender. It's a perfectly respectable rating, and your premiums will be reasonable.
Substandard (or Table Ratings): If you have significant health issues, a serious chronic condition, or other factors that increase your risk, you'll receive a substandard rating. Premiums will be higher—sometimes significantly so. In some cases, you might be declined coverage altogether, though you may still have options with guaranteed issue or simplified issue policies.
There are also separate classes for tobacco users—Preferred Tobacco and Standard Tobacco—which mirror the non-tobacco classes but with higher premiums due to the health risks associated with smoking.
How Long Does Underwriting Take?
If you're going through traditional underwriting with a medical exam, expect the process to take anywhere from three to eight weeks. The timeline depends on how quickly you can schedule your exam (usually within three to five days), how fast the lab results come back (up to four weeks), and whether the insurer needs to request your medical records from your doctor (which can take anywhere from one day to six weeks).
But here's the good news: many insurers now offer accelerated underwriting. If you're young, healthy, and have a straightforward application, you might get approved in as little as 24 hours—sometimes even instantly. These policies skip the medical exam and rely on data from prescription databases, MIB, and other digital records to make a decision. Simplified issue policies, which only require you to answer health questions, can provide approval in just a few days.
Why Honesty Matters
It might be tempting to downplay a health issue or leave out a medication to try to secure a lower rate. Don't. Insurers have access to comprehensive databases that reveal your prescription history, past insurance applications, and more. If they find discrepancies, your application could be delayed, your premium increased, or your coverage denied. Worse, if you pass away and your beneficiaries file a claim, the insurer can investigate and potentially deny the payout if they discover material misrepresentations.
Being upfront about your health not only speeds up the process but also ensures your loved ones are protected when it matters most.
Shopping Around Makes a Difference
Here's something most people don't realize: different insurers use different underwriting guidelines. One company might rate you as Standard, while another places you in Preferred. The same applicant could receive vastly different premiums depending on the insurer. That's why it pays to shop around or work with an independent broker who can compare quotes from multiple carriers. A broker can also steer you toward insurers that are more lenient on specific conditions—like diabetes or high blood pressure—helping you secure the best rate for your situation.
What Happens After Approval
Once you're approved and assigned a risk class, the insurer will send you a policy offer outlining your coverage amount, premium, and terms. Review it carefully. If your risk class isn't what you expected, ask your agent or the insurer for clarification. In some cases, you can appeal the decision or provide additional documentation—like proof that you've quit smoking or managed a chronic condition successfully—to improve your rating.
If you accept the offer, you'll pay your first premium, and your coverage will begin. Congratulations—you're now protecting the people who depend on you.
Underwriting might feel invasive, but it's just the insurer's way of pricing risk fairly. By understanding what underwriters look for and being honest throughout the process, you'll move through approval smoothly and secure the coverage your family needs.
