How Insurers Assess Risk for Life Insurance
When you apply for life insurance, the insurer needs to decide whether it can offer cover, how much the cover should cost and whether any special terms are required.
This process is called underwriting.
Underwriting is not a judgement about whether somebody is healthy, unhealthy or somehow deserving of cover. It is an assessment of probability. The insurer is trying to estimate the likelihood of a claim during the proposed policy term and price the policy accordingly.
That is why two people applying for the same amount of life insurance can receive different premiums or different decisions.
For people with a medical history, understanding this process can be particularly useful. Having a condition does not automatically mean that life insurance will be refused. Insurers look at the condition itself, how severe it is, how well it is controlled and the wider picture surrounding your health. If you are trying to understand how an existing diagnosis might affect an application, start with our guide to [life insurance with pre-existing conditions](/life-insurance-pre-existing-conditions).
What does a life insurer assess?
There is rarely one piece of information that determines the outcome of an application.
Instead, an insurer considers several factors together. These can include your age, current health, previous medical history, medication, smoking status, alcohol consumption, occupation, hobbies and sometimes aspects of your family medical history. The amount of cover and length of the policy also matter. An insurer considering £500,000 of cover for 35 years is taking on a different risk from one considering £50,000 for ten years.
The result is an overall assessment rather than a simple pass-or-fail test.
How does age affect life insurance?
Age is one of the most important factors in life insurance pricing. All other things being equal, somebody applying at a younger age will normally represent a lower mortality risk during the policy term than somebody considerably older. That is one reason life insurance premiums generally increase as applicants get older.
Age alone does not determine whether somebody can obtain life insurance, however. An older applicant in good health may still be able to obtain straightforward cover, while a younger applicant with significant medical or lifestyle risks may require more detailed underwriting.
The insurer looks at age as one part of the complete picture.
How do pre-existing medical conditions affect an application?
Medical history is a major part of underwriting, but insurers are interested in much more than the name of a diagnosis.
They may want to know when the condition was diagnosed, its severity, what treatment you have received, which medication you take, whether symptoms are stable and whether there have been recent investigations or hospital admissions. For some conditions, recent test results can also be important.
Someone with well-controlled high blood pressure, for example, may present a very different risk from somebody whose blood pressure remains persistently high despite treatment. The same principle can apply to diabetes, mental-health conditions, heart problems and many other diagnoses.
The existence of a medical condition does not by itself tell you what underwriting decision will be made. It is also worth understanding what insurers may regard as a pre-existing medical condition (/article/what-counts-as-a-pre-existing-condition-for-life-insurance), because the term can cover a much wider range of medical history than people sometimes expect.
What about a previous cancer diagnosis?
A history of cancer usually requires more detailed underwriting. The insurer may consider factors such as the type of cancer, stage or grade, treatment received, when treatment finished, whether there has been any recurrence and the length of time since treatment.
That means two people who can both accurately say that they have previously had cancer may receive very different underwriting decisions. In some circumstances cover may be available. In others, an insurer may want more time to pass before considering an application. A previous cancer diagnosis should therefore not automatically be interpreted as either an acceptance or a refusal.
How do diabetes and high blood pressure affect underwriting?
Conditions such as diabetes and high blood pressure illustrate why insurers look at management and control rather than simply the diagnosis.
For diabetes, an insurer may consider the type of diabetes, age at diagnosis, treatment, recent control and whether there are any complications. Our guide to [life insurance for people with diabetes](/article/life-insurance-for-people-with-diabetes) looks at those considerations in more detail.
With high blood pressure, an insurer may be interested in recent readings, medication and whether there are other cardiovascular risk factors. You can read more about how this may affect an application in our guide to life insurance with high blood pressure.
A well-managed condition may be viewed differently from the same condition where control is poor or complications have developed. This is also why providing accurate information can help the underwriting process. The insurer needs enough detail to distinguish between different levels of risk.
What about mental-health history?
Mental-health conditions can also form part of a life insurance assessment.
The insurer may ask about the type of condition, treatment, medication, time away from work, hospital treatment and how recent or severe symptoms have been. A history of anxiety, depression or another mental-health condition does not automatically mean somebody cannot obtain life insurance.
As with other medical conditions, the individual circumstances matter. Different insurers can also assess medical histories differently, which is one reason a more complicated application may benefit from being considered by somebody familiar with different underwriting approaches. Our guide to [life insurance with a mental-health history](/article/life-insurance-with-mental-health-history-uk-guide) explains the process in more detail.
Does smoking affect life insurance?
Smoking status can have a significant effect on premiums.
Insurers usually ask about tobacco use and may also ask about nicotine products such as vaping or nicotine replacement products. The precise definition of a smoker varies between insurers, so somebody who has recently stopped should not simply assume they can declare themselves a non-smoker. The application questions should be answered exactly as they are asked.
Smoking does not normally prevent somebody obtaining life insurance, but it can materially affect the price. We explain this further in our guide to [how smoking can affect life insurance premiums](/article/how-does-smoking-affect-the-cost-of-life-insurance-premiums).
What about alcohol, weight and lifestyle?
Insurers may also ask about alcohol consumption, height, weight and other lifestyle factors. Again, these questions are assessing risk rather than making a moral judgement.
Very high alcohol consumption or a combination of several health risk factors may affect the terms offered. Weight can also be considered alongside other information such as age, blood pressure, diabetes and cardiovascular health. One factor in isolation may have relatively little effect, while several factors together may produce a different underwriting result.
Does your job matter?
Occupation can affect life insurance where the work exposes somebody to unusual levels of danger.
An insurer may therefore be interested in what you actually do rather than simply your job title.
Somebody working in an office for a construction company presents a different occupational risk from somebody regularly working at height on building sites.
Offshore work, certain military roles, aviation and other hazardous occupations can also require additional information.
For many ordinary occupations, however, employment has little or no unusual effect on life insurance underwriting.
Can hobbies affect life insurance?
Some recreational activities can also be relevant.
Insurers may ask about activities such as scuba diving, mountaineering, aviation, motorsport or parachuting.
The important details can include how frequently you participate, the level at which you take part and the circumstances involved.
An occasional recreational activity may be assessed differently from somebody participating regularly or at an advanced level.
As elsewhere in underwriting, detail matters.
Does overseas travel matter?
Normal holidays are unlikely to be treated in the same way as regularly living or working in a higher-risk location.
An insurer may ask about residency, prolonged periods overseas or future plans to live or work abroad.
Where travel is relevant, the destination, duration and purpose can all affect the assessment.
This is another area where circumstances matter more than a simple yes-or-no answer about travelling overseas.
How do insurers combine all this information?
Underwriters do not normally look at each factor completely separately.
Imagine somebody has mildly raised blood pressure that is well controlled with medication and no other major health issues. That may produce one assessment.
Another person might have high blood pressure alongside smoking, diabetes and a strong cardiovascular history.
Although both applicants technically have the same diagnosis, the overall risk picture is very different.
This is why comparing your situation with somebody else's experience can be misleading.
Even two people with apparently similar medical histories can receive different decisions because of age, treatment, test results, policy term and other factors.
What medical questions will insurers ask?
The questions depend on the insurer and the information provided during the application.
You may be asked about diagnoses, medication, consultations with doctors, hospital treatment, investigations, time away from work and symptoms you have experienced.
Some applications can be completed using the information you provide. Others may require more detail.
If you want to know what to expect before applying, our guide to [the medical questions asked for life insurance](/article/what-medical-questions-are-asked-for-life-insurance) explains the process.
The safest approach is to read each question carefully and answer what is actually being asked rather than trying to decide for yourself whether a piece of medical information is important.
What can happen after underwriting?
Some applications can be accepted immediately at the insurer's ordinary premium.
Others require more information before a decision is made.
An insurer might ask additional medical questions, request information from your GP with the necessary permission, arrange a medical examination or ask for particular test results.
After considering that information, the insurer may offer cover at its standard rate or at a higher premium to reflect the assessed risk.
In some circumstances it may postpone a decision until the medical situation is clearer. An application can also be declined where the insurer is not prepared to accept the risk.
If that happens, it does not necessarily mean every insurer will reach the same conclusion. Our guide to [why life insurance can be refused](/article/can-life-insurance-be-refused-common-reasons-explained) explains some of the reasons an application may not proceed as expected.
Why can different insurers give different answers?
Insurers do not all underwrite risk in exactly the same way.
They can use different underwriting guidelines, have different levels of appetite for particular conditions and assess combinations of medical and lifestyle factors differently.
That means an applicant who receives an increased premium from one insurer may not necessarily receive exactly the same terms elsewhere.
Equally, a decline from one insurer does not establish that every insurer will make the same decision.
This can be particularly important for people with pre-existing medical conditions.
The objective should not be to conceal the medical history or find an insurer that asks fewer questions. It is to find an insurer whose underwriting approach is appropriate for the circumstances while providing the information requested accurately.
[Compare life insurance options with a pre-existing condition →](/quote-pre-existing-conditions)
Why honesty on the application matters
The safest approach to any insurance application is to answer the questions accurately and completely.
Do not minimise a medical condition because you believe it is unimportant, but equally do not try to diagnose yourself or provide information that was not asked for.
Read each question and answer what the insurer actually wants to know.
If you are unsure about dates, medication or previous treatment, it can be worth checking before submitting the application rather than guessing.
Accurate disclosure gives the insurer the information it needs to assess the application and reduces the risk of problems being discovered when a claim is later made.
What happens if you leave information out?
An insurer may investigate the accuracy of information supplied during the application if a claim is made.
If relevant information was answered incorrectly or omitted, the consequences can depend on what happened and what the insurer would have done if it had received the correct information originally.
That makes deliberately withholding information a particularly poor strategy.
The objective should be to obtain cover that you can rely upon rather than obtaining the cheapest possible premium by giving an incomplete picture of the risk.
Our guide to [what can happen if information on a life insurance application is inaccurate](/article/what-happens-if-you-lie-on-a-life-insurance-application) explains why disclosure matters.
Can you improve your chances of getting cover?
There is no legitimate trick that guarantees acceptance, and you should not change or hide information simply to make an application look better.
What can help is applying with accurate and up-to-date information.
If a medical condition is being properly treated and monitored, having recent results available can sometimes make the situation easier for an underwriter to assess.
Timing may also matter. Somebody currently undergoing investigations may receive a different response from somebody whose investigations have finished and whose condition is stable.
For more complicated medical histories, choosing where to apply can also matter because underwriting approaches differ between insurers.
Should you apply to several insurers at once?
Not necessarily.
For a straightforward application, this may not be an issue, but where somebody has a significant medical history it can sometimes be more useful to understand likely underwriting approaches before making multiple formal applications.
That can reduce unnecessary applications and help identify providers more comfortable with the particular circumstances involved.
A specialist protection intermediary may be able to discuss the case with insurers or use experience of their underwriting approaches before recommending where an application should be made.
Does an increased premium mean the policy is poor value?
Not automatically.
An insurer charging more is saying that it believes the risk is higher than for the applicant represented by its standard premium.
Whether the resulting policy represents good value is a separate question.
You still need to consider the amount of protection, policy term, affordability and whether the financial need justifies the cost.
For some applicants, paying an increased premium for meaningful protection may still make sense. For others, a different amount of cover or policy structure may be more appropriate.
Why underwriting matters for people with pre-existing conditions
If you have a medical history, underwriting is not simply an obstacle between you and a policy.
It is the process that determines whether an insurer can offer meaningful cover based on your actual circumstances.
A diagnosis such as diabetes, high blood pressure, a mental-health condition or previous cancer does not tell you the outcome on its own.
The detail surrounding that condition can matter enormously.
Understanding this can make life insurance feel much less binary. The question is often not simply:
“Can I get life insurance?”
It may instead be:
“Which insurers will consider my circumstances, what information will they need and what terms might they offer?”
That is the purpose of our wider [life insurance with pre-existing conditions hub](/life-insurance-pre-existing-conditions): to help you understand the underwriting process before comparing your options.
The bottom line
Life insurance underwriting is a process of assessing probability.
Insurers consider age, health, medical history, lifestyle, occupation, hobbies and the cover being requested to decide whether they can insure somebody and on what terms.
Having a pre-existing condition does not automatically mean that cover is unavailable, and the same diagnosis can produce different outcomes depending on its severity, treatment, stability and the insurer involved.
The most useful approach is to be accurate about your circumstances and understand that underwriting is rarely as simple as healthy versus unhealthy.
If your medical history makes the application less straightforward, comparing suitable insurers before applying can be particularly valuable.
[Compare life insurance options with a pre-existing condition →](/quote-pre-existing-conditions)
