How Life Insurance Medical Exams Works

When a life insurance company issues a policy it is, essentially, taking on an obligation that must be paid to beneficiaries in the event of your premature death. It’s “premature” because the life insurer doesn’t expect you to die until you have lived out your life expectancy at which point they will have collected enough premium and earned enough interest on it to cover the obligation. The life insurer expects that you will live up to the actuarial assumptions it made about your age, health, medical history and life style, which is why it is willing to assume the risk that you won’t. In order for it to do that, it needs to know more about you – inside and out, and that what the medical exam is all about.

You Want the Works or a la Carte?

If you are over the age of 40 and are applying for more than $100,000 of life insurance, you will be required to submit to a medical exam of some sort. A full-fledged exam includes a physical, urine specimen, blood work, EKG and x-rays. The lesser the amount of life insurance for which you apply, the lesser the medical requirements for underwriting. For instance, if, at age 40 you are only applying for $100,000, you may only be required to submit a urine sample in addition to completing a medical questionnaire. If you want $2 million of coverage you could expect to run the whole gamut of tests.

If you’re 35 or younger, applying for less than $250,000, you may only be asked for a urine sample and a blood specimen. But, the requirements vary from one company to the next. Another company may require a medical exam in the same situation.

The medical examination process, for most insurers, begins with a review of your medical history. In addition to answering some medical questions on Part I of your application, you will authorize the life insurer to access your complete medical dossier through the Medical Information Bureau (MIB). Chances are your records will reveal things that you had forgotten, however, the underwriters will frown on any information they uncover that conflicts with the information that you provided, so it is important to be totally forthcoming when answering their questions.

Next you will be scheduled for an exam. Most exams are conducted by a paramedical profession who will come to your home or office. The exams typically last less than twenty minutes and it consists of more questions about your history, measurements, and basic diagnostics such as blood pressure. They will also draw blood samples. All of their reporting is done on Part II of your insurance application. As part of Part II, and depending on the amount of insurance, the life insurer will also request an attending physician’s statement (APS) from your primary care physician.

For higher amounts of insurance, or if there are certain medical conditions involved, you may need to have your exam conducted by a physician with a bigger battery of tests including a stress EKG which measures your heart before, during and after walking briskly on the treadmill.

Underwriting requirements vary from one company to the next and many have specific requirements pertaining to non-smoking applicants, or for people who are older than age 60, or for people of a certain height-weight ratio. These are all variants that can affect the way your policy is priced.

It’s Up to the Underwriters

Once all of the requirements and reports are completed, it is all packaged up and sent to the underwriting team with the life insurer. If anything pops up on their radar in terms of a medical concern or questionable results of a test, they could order additional tests. In most cases, the underwriting review process is completed within 30 to 60 days at which point they will approve the policy as applied for, or modify it by applying a rating which will increase the premium amount.

Rated policies are a result of conditions found in the underwriting process that present a higher risk to the life insurer. They may have found that your blood pressure was above the norm, or that your height-weight ratio was just off. In many cases, ratings can be challenged if you will allow them to conduct some follow tests. For situations involving blood pressure and weight, it may be worth the extra testing if you can produce more favorable results.

Improving your Medical Exam Results

The results of your medical exam and the subsequent decision by the underwriters becomes a part of your medical history, so it would be important to approach your life insurance medical exam in the best possible condition. While you can’t cover up some medical conditions, there are ways to improve the results of the standard tests and diagnostics.

  • Get at least two nights of sound sleep prior to your scheduled exam.
  • Avoid alcohol for 24 hours prior to the exam.
  • Avoid coffee, cola and other caffeinated drinks.
  • Reduce your intake of sodium and high cholesterol foods 24 hours prior.
  • Keep your physical activity low for 24 hours prior.