Who pays for any reports or medical exams required as part of the underwriting process for insurance?

Why life insurance companies require a medical exam

Most people are eligible to buy life insurance in some form. Still, the type of policy, level of coverage, and cost depend on several factors unique to each applicant's situation. Your age, overall health, family history, lifestyle habits (such as whether you're a smoker), and other factors help the life insurance company estimate your life expectancy. The longer your life expectancy, the lower your risk and cost to insure – and vice-versa.

Some policies let you skip the medical exam and only ask a few questions about your health; others don't even ask health questions. But that doesn't necessarily mean they're a good deal. Policies that don't ask for health information typically have to charge more per $1,000 of coverage because the insurer must assume the applicant has medical issues.

If you're buying a substantial policy to provide for your family, it generally makes sense to get a "medically underwritten policy" –. If you are in excellent health, you'll pay less for coverage because the insurance company knows that whatever other factors affect your risk, health isn't a problem. In fact, if you have a well-managed medical condition (such as high blood pressure) but are otherwise in good health, it may still make sense to get a medically underwritten policy. After all, the insurance company has checked your health and doesn't have to assume the worst.

Concerned about keeping life insurance protection as you age? Consider a permanent policy.

Life insurance comes in two primary types — term life insurance and permanent life insurance.

• Term life insurance lets you get a large amount of coverage at a relatively low cost. However, that coverage only lasts for a limited period of time – or “term” – which usually ranges from 10 to 30 years. Once the term is over, there’s nothing left to the policy. If you want continued protection, you have to apply for new coverage.

• Permanent coverage – like whole life insurance or universal life insurance – provides life insurance that does not expire. As long as your premiums are paid up, your policy will stay in force.1 It also builds cash value over time.2 Importantly, you can access the policy’s cash value via loans or withdrawals while still keeping the policy in force.3 Because it provides more value, permanent insurance costs significantly more than term life insurance – at least at first.

Either type of coverage may require a medical exam, especially if you're getting a large policy. So, say you're relatively young and healthy, and qualifying for coverage won't be an issue. You could get a term policy and save money initially. However, when the term expires, you'll have to apply for new coverage, and rates will be higher because you're older. In the meantime, you could also develop a health condition, such as diabetes or a heart arrhythmia, that further drives up your cost of coverage or maybe even disqualifies you from getting a medically-underwritten policy. Instead, you'd have to apply for a no medical exam policy, but you'll pay even more – if you can get the same amount of coverage. These policies typically have coverage limits.

On the other hand, if you get a permanent whole life policy when you're young and healthy, your premiums will never go up or down and will always be based on the health rating you had when you applied. So if you get coverage at age 30, whole life premiums will be higher than they would be for a 20-year term policy. But fast-forward two decades later: if you apply for a new 20-year term policy at age 50, the cost could be almost 4x higher – even if you're in good health. (See for yourself by trying out our life insurance calculator and entering different ages.) But the monthly premiums of a whole life policy will be the same as they were at age 30 – and the protection will last as long as you live.

What takes place during the life insurance exam?

If the policy you're applying for requires a medical exam, the life insurance company will arrange for it and cover the costs. A representative will usually contact you to schedule your appointment, and the examiner will come to your home or office. The exam usually takes 15 to 45 minutes, depending on what's required. There are typically two parts: a questionnaire and a basic physical exam.

Part 1: The Questionnaire

The policy underwriters (insurance company professionals who assess your risk) will consider both your medical and lifestyle information, so the questionnaire will likely cover the following:

• Family medical history
• Your prescriptions
• Current and previous doctors’ contact information
• Details of current diagnoses
• Recent doctor visits

Part 2: The life insurance physical exam

• Recording your weight, height, body mass index (BMI), and vitals – including your pulse and blood pressure
• Depending on your circumstances and the insurer's requirements, you may also have the following tests:
  • urine sample
  • blood test
  • electrocardiogram (EKG)
  • x-rays
  • treadmill stress test,
  • cognitive ability test.

How to prepare for your life insurance exam

To help save time filling out your questionnaire, it helps to gather the types of personal information items that will likely be asked for, including:

• A copy of your driver’s license or other photo ID
• A list of prescriptions, including the dosage amounts
• Names of any doctors you’ve seen in recent years (typically 5 years)
• Types and dates of any surgeries you’ve had in recent years

There's not much you can do to prepare for your medical exam. You can't make significant improvements to your health in a short amount of time, but you can take some steps to ensure the best possible results:

The week before your exam:

• Eat Healthily. Limit high-cholesterol foods, salt, sugar, and fat.
• Avoid non-essential over-the-counter medications such as antihistamines and decongestants, which can raise blood pressure and glucose levels.
• Avoid alcohol which can negatively impact liver enzymes and cause dehydration.
• Increase your water intake. Being well-hydrated flushes toxins in your body that may impact your blood and urine samples. Being well hydrated will also help with your blood draw.

12-24 Hours before the exam:

• Avoid strenuous exercise, which can negatively impact your blood pressure and cholesterol levels.
• Go to bed early. A good night’s sleep will help improve your vitals.

Day of exam:

• Schedule it early in the day, if possible
• Avoid caffeine
• Avoid food and drink (except water) if you're required to fast – even if it's not required
• Drink a glass of water shortly before your exam
• Wear lightweight clothing (for your weigh-in) and a short sleeve shirt (for the blood draw).

Once your exam is complete, the results go to the company's underwriting team. The underwriting process can take as little as a day or two, but more often, a few weeks. During that time, an underwriter will look over the details of your application, your health information, and your lifestyle to determine your insurance risk class: the larger the policy, the more detailed the underwriting process.

Once underwriting is completed, you'll find out if you were approved and at what rate. If you've been working with an experienced agent and no health surprises are uncovered, you're unlikely to have higher premiums than you expected. However, there may be instances where a person is approved for life insurance coverage but not for the total amount due to risk factors uncovered during the underwriting process.

How to avoid having a life insurance exam

As we've noted, if you're in good health – especially if you're a non-smoker – you're most likely going to pay less for medically-underwritten life insurance that may include a health exam. However, if you have been denied coverage or believe you have a medical condition that would result in denial, there are two kinds of policies that never require a medical exam.

• Simplified issue insurance requires a health questionnaire but not a physical exam. These policies generally have coverage limits (a maximum of $500,000 is typical), and premiums are more expensive.
• Guaranteed acceptance insurance is a type of life insurance that does not deny coverage for health reasons. There are typically no health-related questions or exams – but there may be a waiting period until you qualify for a benefit payout. Final expense policies usually fall into this category, and coverage limits are lower than even a simplified issue policy: generally, $50,000 or less, depending on the provider. While monthly premiums may appear low, the cost per $1,000 death benefit is almost always higher than other forms of coverage.

Workplace life insurance

Many companies offer employer-sponsored life insurance plans as an employee benefit. These plans feature affordable group rates and may not require a health exam unless you apply for coverage over a certain limit. If offered by your employer, this could be an excellent choice, especially if you have health issues that limit your ability to purchase other coverage.

Explore your options

If you're looking to purchase life insurance and want more guidance about how to get a policy that fits your needs at a price you can afford, Guardian can help you find a nearby financial representative who can help guide you to the right solution.

Frequently asked questions about life insurance medical exams

What exam do you take for life insurance?

Insurers often require a life insurance medical exam for life insurance policy applicants. It typically consists of two parts: a questionnaire and a physical exam. The examiner will often come to your home or office and perform a short physical examination that includes basic height and weight measurements, a check of your vital signs, including pulse and blood pressure, and taking blood and urine samples.

How do you prepare for a life insurance test?

There's not much to do to prepare for the life insurance medical exam. However, there will be some questions to answer, so it helps to gather certain information related to your medical history. For the physical exam, it's a good idea to take care of yourself in the week leading up to the exam by eating healthier (avoiding alcohol, increasing water intake, and limiting salt, sugar, fat, and high cholesterol foods), drinking more water, and getting plenty of sleep.