Life insurance underwriting: what it is & how it works

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

Policygenius content follows strict guidelines for editorial accuracy and integrity. Learn about our editorial standards and how we make money.

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 to complete, but an insurance broker can make the process easier by keeping you updated along the way. Below, we’ll walk through all the steps to expect during underwriting. 

Ready to shop for life insurance?

Start calculator

The underwriting process

Every life insurance company has its own underwriting manual or 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 in the past, it won’t hurt your classification. The MIB check helps the underwriter by showing them the date of any medical impairments, treatments, and diagnoses as reported by previous underwriters. This checks and balances system helps keep premiums lower for insurers and applicants.

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 you have any missing information related to your medical history, an incomplete application won’t slow down the underwriting process. The phone call usually only takes between 15 and 30 minutes and you’ll be asked about 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, ultimately, 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, barbiturates, and more. 

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 and underwriting processes that allow applicants to skip the medical exam. While people with health concerns can be approved for some no-exam policies, they’ll have lower benefit amounts and higher premiums. No-exam options that offer similar premiums and coverage amounts to a regular term life policy, such as accelerated underwriting insurance, are only available to 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 showed signs of high blood pressure during your exam, an APS would let an underwriter know the underlying cause. 

This step can prolong the life insurance 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 even 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:

  1. Mortality table A mortality table shows the mortality probability of a given population, based on age and gender, and doesn’t account for the many variables that are unique to each health profile. It’s used as a statistical baseline to predict when you’re most likely to die.

  2. Build table A build table takes 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 or obese, according to CDC standards. But multiple coverage options are available for most individuals, and rates can improve if you lose weight later

Step 8: Credit system

A credit system check is sometimes used by underwriters to give you a little bump and help you get more affordable premiums.

For example, if a chronic illness results in a Standard (or Substandard) classification, the underwriter’s credit system can make your premiums more affordable 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 pursue 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 whether you present any risks related to the kind of insurance you’re purchasing. Here’s how underwriters look into 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 convicted felons currently on probation will not 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.

  • 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: As with occupations, 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, 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.

Ready to shop for life insurance?

We don't sell your information to third parties.

The life insurance underwriting process may seem complex, but once you provide some initial information, completing the process is straightforward and 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 skip over some underwriting steps, a no-exam policy can accelerate your timeline to an offer so you can secure financial protection for your loved ones.

Frequently asked questions

What is life insurance underwriting?

Underwriting is how life insurers rate the risk of insuring you to set your premiums. They assess your age, health, gender, hobbies, occupation, driving record, and medical history.

How long does the life insurance underwriting process take?

It takes approximately five to six weeks, though delays in ordering records or scheduling exams can extend that timeline. No-exam life insurance may offer approval in two weeks or less. Brighthouse can offer same-day coverage for qualifying applicants.

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.