In simple terms underwriting is the process whereby applicants are classified according to their degrees of insurability so that the appropriate premium may be charged and the terms offered may be reviewed.
The application process involves answering questions that are designed to capture the information we need to build a clearer picture of the life to be insured and the risk factors which may increase the likelihood of them claiming.
Duty of disclosure
We rely on the client giving full, accurate and honest disclosure of relevant facts on the application form. You should ensure that your client understands that withholding information, or even just forgetting something, could ultimately lead to a situation where a claim will be refused.
Underwriting risk factors
- Family History
- Height and weight
- Lifestyle (smoking, drinking, drugs)
- Residency and travel
- Level and type of cover applied for
Additional underwriting requirements
This information is obtained for two reasons - due to the level of cover applied for or due to disclosures on the application form. Automatic evidence, obtained because of the level of cover, can be found in our non-medical limits section.
Wherever possible, where your client has disclosed information, we will make decisions based on the completed application form alone. Where further clarification is required we will obtain one or more of the following:
- A General Practitioner Report (GPR)
This is a medical report completed by the applicant's GP based on their overall history. In order to avoid delays we will always try to request alternative evidence. A GPR is more likely to be requested where there are multiple medical problems, or where technical information is required which the client is unlikely to know.
- A Targeted GPR (TGPR)
This is a medical report completed by the applicants GP. Unlike the GPR, the TGPR provides detailed information pertaining to a specific condition, for example diabetes or cancer, and not the applicant’s full medical history.
- A medical examination
The client undergoes a medical by a nurse or a doctor which provides us with details of their current health.
Sometimes the underwriter needs more information pertaining to a disclosed condition. In this instance a nurse will call the client to obtain the relevant information. This helps to speed up the application process.
- Other medical tests
These can include cotinine (a test to confirm smoker status) , HIV, ECG and other blood tests.
- Hobby questionnaires
If a client has a hobby such as scuba diving or mountaineering we will require further information from them. In certain instances we will require a specific questionnaire to be completed in order to obtain the relevant information to assess the risk.
- Financial questionnaire
This is required when cover levels exceed the financial limits and provides us with details about the client's financial situation to confirm the cover levels applied for are justified. For Business Protection Cover the financial questionnaire is included in the application form.
Likely underwriting outcomes
Once the underwriters have all the information they need, one of the following decisions will be made – the adviser and client will be advised of the decision in the acceptance letter.
|Decision||What it means|
|Accept on standard terms||Client is accepted on VitalityLife’s normal rate of premium.|
|Loading/rating||This is an increase charged on the premium because the applicant is a higher risk than average. The increase to the premium will vary by case, to match the increased risk.|
|Accept on special terms||
This is where we exclude coverage for a certain condition, but generally charge our normal rate of premium.*
Rating and an exclusion
This is a combination of the above.
|Postpone||The underwriting decision needs to be delayed - this usually happens when a client has recently been diagnosed with a condition or is currently showing symptoms of illness which are still being investigated or remain undiagnosed.|
|Decline||Cover cannot be offered because the risk is too high.|
Loadings/ratingsThe majority of ratings are in the form of percentage extra mortality (EM), and are a multiple of the basic premium. A rating of +55% EM will therefore be an additional 55% of the basic premium. Extra mortality is charged from +27.5% to +440% - above this amount the risk is considered too speculative and will be declined.
This is not appropriate for risks which are not age related, for example cancer. For this risk a cash extra is charged, based on the sum assured. An extra will be charged for every £1,000 of the sum assured, expressed as an amount "per mille". These are usually temporary loadings applied to the first few years of the policy. For example, if the rating were £5 per mille for 8 years, and the sum assured were £80,000, the annual extra would be calculated as 5 x 80, then divided by 12 for the monthly extra premium (£33.33).
ExclusionsFor serious illness and disability benefits it can be more appropriate to use an exclusion. Wherever possible we will offer full cover with an extra premium, but if the client has a pre-existing condition which has a high chance of causing a claim we will exclude that condition. Exclusions are never used for Life Cover.
Where to next?
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