Life insurance underwriting: What is it & how does it work?

The underwriting process is when insurance companies evaluate your risk profile based on several factors – including health history, age, and gender.

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Amanda ShihAmanda ShihEditor & Licensed Life Insurance ExpertAmanda Shih is a licensed life, disability, and health insurance expert and a former editor at Policygenius, where she covered life insurance and disability insurance. Her expertise has appeared in Slate, Lifehacker, Little Spoon, and J.D. Power.&Rebecca ShoenthalRebecca ShoenthalEditor & Licensed Life Insurance ExpertRebecca Shoenthal is a licensed life, disability, and health insurance expert and a former editor at Policygenius. Her insights about life insurance and finance have appeared in The Wall Street Journal, Fox Business, The Balance, HerMoney, SBLI, and John Hancock.
Expert reviewedExpert reviewedThis article has been reviewed by a licensed Policygenius expert to ensure that sources, statistics, and claims meet our standard for accurate and unbiased advice.Learn more about oureditorial review process.


Eloise Spinello Eloise Spinello Associate Director of Partner Success, Policygenius ProEloise Spinello is a life insurance expert and the associate director of partner success for Policygenius Pro.

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After you apply for life insurance, you go through a process called underwriting with the insurance company. An underwriter works on behalf of the life insurance company to evaluate your application details, health information, and lifestyle to give you an insurance classification based on risk, which determines your premium.

The life insurance underwriting process takes an average of five to six weeks, though accelerated underwriting options can take as little as a few days. A Policygenius agent can walk you through the whole process and answer any questions you have along the way. 

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The underwriting process

Every life insurance company has its own underwriting guidelines to calculate your final premiums. The specific process varies across companies, but most underwriters follow roughly the same steps outlined below.

Step 1: MIB check

This happens before the underwriter looks at your application in detail. The MIB is a trade group that helps insurers share medical data and prevent fraud. It allows underwriters to see details about your medical records from previous life insurance applications (dating back three to five years).

If you’ve applied for life insurance before, it won’t hurt your classification. The MIB just shows the date of any medical impairments, treatments, and diagnoses as reported by previous underwriters in case anything was missed.

Step 2: Application quality check

The insurer goes through your life insurance application, including a phone interview, to make sure all of the correct information is there. Unless there's any missing medical history, an incomplete application won’t slow down the underwriting process. The phone call usually takes between 15 and 30 minutes and covers your health history, hobbies, and finances.

After that, you’ll start the official life insurance underwriting process. Each step can add some time to your application, but it’s necessary to finalize the premiums you’ll pay over the life of your policy.

Step 3: Medical exam

The first official step of underwriting involves a medical exam. The exam is similar to a checkup with your doctor, except it’s free to you. A medical technician will perform the exam at a lab or your home or work to gather information about the following:

  • Basic measurements: Height, weight, blood pressure — the typical steps of a physical. Your height-to-weight ratio plays a big role in how you’ll be classified and what you’ll pay for your life insurance policy. A high blood pressure reading becomes a particular concern as you get older and can impact your rates.

  • Blood analysis: A simple blood test can identify potentially risky health concerns. Heart disease, stroke, diabetes, blood-borne illnesses, and more can all be analyzed using a few vials of blood.

  • Drug analysis: A urine test for a full drug panel will alert the underwriter to the use of drugs like amphetamines, cocaine, and barbiturates. 

The results of your exam are sent to the underwriter. You can reuse the results of your medical exam to apply for other types of insurance, like disability insurance, or even for life insurance from another provider. You’re under no obligation to go with a particular life insurance company just because they paid for your medical exam.

Some insurance companies have policies that allow applicants to skip the medical exam, called no-medical-exam life insurance. While people with health concerns can get some no-med policies, they’ll have lower benefit amounts and higher premiums. No-exam options with similar premiums and coverage amounts to a regular term life policy are best for people who are generally healthy.

Step 4: Attending physician statement

If there are concerns from your medical exam results, the underwriter will order an Attending Physician Statement (APS). An APS is a summary of your medical history from your doctor’s point of view. For example, if you had high blood pressure during your exam, an APS would let an underwriter know the underlying cause. 

This step can prolong the underwriting process, adding anywhere from a few days to a few months, depending on how long it takes for a doctor’s office to comply with the request.

Step 5: Prescription check

The underwriter will check all the medications prescribed to you over the past three to five years. As with the medical exam, APS request, and MIB check, the prescription check confirms the information in your application.

Whether your underwriter requires this step depends on your other medical reports. Life insurance policies with higher coverage amounts may also require a prescription check.

Step 6: Motor vehicle report

A motor vehicle report, or MVR, details your driving history as far back as seven years. It notes driving violations like traffic citations (think: speeding or reckless driving tickets), vehicular crimes, accident reports, driving record points, and DUI convictions.

Your premiums will be higher than someone who has a clean driving record if your MVR reports anything concerning. If you have a recent DUI on your record, you may be denied a policy.

Step 7: Actuarial tables

Life insurance underwriters use an actuarial table — a statistical analysis of your life expectancy — to estimate the likelihood that you’ll die at any given age and what risk you pose to the insurer. Where you fall on an actuarial table depends on your health profile, including smoking status, any medical diagnoses, family history, and occupation.

Underwriters look at two separate actuarial tables for life insurance underwriting:

  • Mortality table: A mortality table shows the mortality probability of a given population, based on age and gender only. It’s used as a statistical baseline to predict when you’re most likely to die.

  • Build table: A build table uses your body mass index (BMI) — which looks at your height and weight — to determine how healthy you are and predict your life expectancy. 

Life insurance may be more expensive if you are overweight. But multiple coverage options are available, and rates can improve if you lose weight later

Step 8: Credit system

Sometimes underwriters can give you a little bump to help you get more affordable premiums using an internal credit system.

For example, if a chronic illness results in a Standard (or Substandard) classification, an underwriter might give you credits to lower your rates if you’re actively taking steps to improve your health and undergoing preventative care.

The APS and prescription check let an underwriter know what you’re doing to keep health problems from getting worse, which can boost both your health and your wallet. There’s also the option to lower your premiums by reapplying for life insurance in the future once you’ve taken steps to improve your health. 

Step 9: Your final rating

Unless you get a no-exam policy, the underwriting process can take anywhere from five to six weeks. Outside sources — like a doctor’s office for an APS — can add time too. But once the process is complete, all that’s left is to confirm the premiums and sign the policy to put it in force

Key underwriting factors

All insurance products involve some degree of underwriting to get a picture of your personal background and any risks related to the kind of insurance you’re purchasing. Here’s how underwriters look at each of the following aspects of the application:

  • Age: Premiums are lower when you’re younger. But if you're older and have fewer financial obligations — closer to retirement, for example — you usually need less coverage.

  • Citizenship status: Temporary visa and green card holders won’t qualify for coverage with some insurers. 

  • Coverage amount: An insurer might do more to check your risk if you need a higher death benefit. The underwriter will use your financial details to make sure you’re not getting more coverage than you need.

  • Criminal history: Misdemeanors won’t have a big impact on your rates, but people convicted of felonies who are currently on probation won't be considered.

  • Driving record: A risky driving history (speeding, accidents, or DUIs), can raise your rates or lead to an application decline. 

  • Drug use: Using cannabis won’t keep you from getting a policy, but using hard drugs can result in an application decline.

  • Existing coverage: If you have other life insurance policies, underwriters check to make sure you aren’t applying for too much insurance.

  • Foreign travel: Countries fall into categories based on safety issues, medical care availability, and government stability. Travel to countries of concern can make you uninsurable. The frequency of travel and length of stay is also considered. (More on this below.)

  • Gender: Females live six to eight years longer than men on average, [1] so they generally get lower life insurance rates. But other medical risks can raise rates for any gender. 

  • Health history: One of the most important life insurance underwriting factors. The healthier you are, the better your rates will be.

  • Hobbies: Like your job, certain hobbies — like aviation — will affect your rates, since there’s usually increased risk. 

  • Income & net worth: The amount of insurance you buy should match the financial loss your family will experience if you pass away. 

  • Insurable interest: The person buying a policy on you needs to be able to prove they’d suffer financially if you passed away. Since people usually buy a policy for themselves or their spouse, it’s rarely an issue.

  • Military service: Military members with more dangerous duties (fighter pilots, Navy SEALs, or people being deployed to dangerous areas) could be uninsurable. 

  • Occupation: Most occupations are considered “safe,” but some have higher mortality rates. Lumber workers, for example, could require a flat extra fee, or be declined.

  • Previous applications: Your previous life insurance application records, including health classifications or declines, can notify the underwriter of potential concerns. 

  • Tobacco use: Smokers will pay more for life insurance than non-smokers. If you have medical conditions caused by tobacco use, that will matter too. 

Because every insurance company has its own underwriting rules, how much each of these factors impacts your rates can vary between providers. The best life insurance company for you will depend on your specific needs and history.

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How foreign travel affects your life insurance application

Sometimes life insurance applicants are surprised to hear that travel is considered during life insurance underwriting. During the life insurance application process you’ll be asked about any past and planned foreign travel out of the U.S. or Canada, usually within two years. For future travel plans, in addition to the destination, you’ll likely be asked about the purpose of the travel, the length of the trip, and, if it’s repeated travel, and how many times a year you go to said destination. Underwriters take a holistic approach when evaluating travel on a life insurance application, so just because you’re traveling to a locale that might be deemed riskier than others doesn’t mean you will automatically receive a lower health classification on your application. Historically, life insurance companies have not underwritten based on domestic travel and you should not see any impact on your life insurance policy if you are traveling within the United States or Canada.

Diplomats, embassy employees, and missionaries assigned to countries with a moderate to high level of risk will likely be denied life insurance coverage. Other careers that don’t require long-term travel but involve some level of risky travel, like a pilot with overnight stays in Mexico where there is a US Department of State travel warning, would get coverage on a case-by-case basis that is up to the underwriter’s discretion.

For the most part, yes, though there are some states that have legislation that prohibits life insurance companies from underwriting based on travel.

The following states have legislation that does not allow for life insurance companies to take any adverse action based on lawful foreign travel:

  • Florida

  • Georgia

The following states have legislation that does not allow for life insurance companies to take adverse action based on previous lawful travel:

  • California

  • Connecticut

  • Colorado

  • Illinois

  • Maryland

  • Massachusetts

  • New York

  • Oklahoma

  • Washington

While travel does impact your life insurance application, each insurer treats travel differently. Depending on where you're going, one insurer might offer you the best possible rates, while another may not offer you coverage at all. Work with a Policygenius agent to find an insurer that will work with your travel plans.

The life insurance underwriting process may seem complex, but once you share some initial information, the process doesn’t involve much legwork from you. Your insurance agent or broker can ensure that you have a smooth experience, and if you need to speed up your timeline to an offer, a no-exam policy can help you secure financial protection for your family more quickly.

Frequently asked questions

What is life insurance underwriting?

Underwriting is how insurance companies measure the risk of insuring you to set your premiums. An underwriter weighs your age, health, gender, hobbies, occupation, driving record, and medical history.

How long does the life insurance underwriting take?

It takes about five to six weeks, though delays in ordering records or scheduling exams can extend that timeline. No-exam life insurance can offer approval in two weeks or less.

What do life insurance underwriters look for?

The underwriter looks for risk factors that could shorten your lifespan, like a smoking habit or history of illness. The more risks you present, the more you’ll pay for your policy.

Can travel affect life insurance underwriting?

Yes, for applicants in some states, foreign travel can be considered when underwriters are evaluating your application, though generally only travel to risky countries will affect your application.


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Policygenius uses external sources, including government data, industry studies, and reputable news organizations to supplement proprietary marketplace data and internal expertise. Learn more about how we use and vet external sources as part of our

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  1. Global Health Observatory (GHO) data

    . "

    Female life expectancy

    ." Accessed March 29, 2022.


Amanda Shih is a licensed life, disability, and health insurance expert and a former editor at Policygenius, where she covered life insurance and disability insurance. Her expertise has appeared in Slate, Lifehacker, Little Spoon, and J.D. Power.

Rebecca Shoenthal is a licensed life, disability, and health insurance expert and a former editor at Policygenius. Her insights about life insurance and finance have appeared in The Wall Street Journal, Fox Business, The Balance, HerMoney, SBLI, and John Hancock.

Expert reviewer

Eloise Spinello is a life insurance expert and the associate director of partner success for Policygenius Pro.

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