What Do They Test for in a Life Insurance Exam?

Life insurance companies use underwriting to assess the risk of insuring an individual. A key part of this process involves gathering comprehensive health information through a medical evaluation to understand an applicant’s current health status and determine appropriate coverage terms.

Collecting health information ensures a fair risk assessment. Understanding an applicant’s health profile helps insurers balance offering financial security with maintaining financial stability, leading to informed decisions about eligibility and coverage.

Medical Examination Components

A typical life insurance medical exam assesses an applicant’s physical health. It begins with basic physical measurements: height, weight, blood pressure, and pulse rate. These metrics indicate overall health and can signal underlying conditions. Height and weight determine Body Mass Index (BMI), a factor in risk assessment.

Blood tests reveal various health markers. Common tests include cholesterol (HDL, LDL) and triglycerides, which can indicate heart disease risk. Glucose and HbA1c levels screen for diabetes or pre-diabetes, showing blood sugar patterns. Liver function tests (ALP, ALT, AST, GGT) assess liver health and detect inflammation.

Kidney function is assessed via creatinine and BUN levels, indicating waste filtration. Blood samples are also screened for HIV and hepatitis B/C. Cotinine, a nicotine metabolite, is tested to detect recent nicotine use. Prescription drug presence is noted and compared with the applicant’s disclosed medical history.

Urine tests complement blood analysis, screening for conditions and substances. Glucose in urine can indicate diabetes. Protein and microalbumin in urine are markers for kidney disease, as healthy kidneys filter protein efficiently. Persistent protein in urine suggests a need for further evaluation.

Urine samples are analyzed for drug metabolites, including cocaine, opiates, amphetamines, and marijuana. Cotinine is also detected in urine to confirm nicotine use. An Electrocardiogram (ECG) might be required for specific age groups or higher coverage amounts, measuring heart activity to detect potential problems.

Medical History Assessment

Evaluating an applicant’s medical conditions relies on self-reporting and official documentation. The application form asks about past diagnoses, surgeries, chronic conditions, and current medications. Applicants also provide family medical history, as hereditary conditions can indicate potential risks.

If an applicant’s medical history is complex, insurers may request an Attending Physician Statement (APS). An APS is a report from the applicant’s healthcare provider detailing health history, current conditions, and treatments. This document helps insurers understand the medical situation and provides crucial information for an accurate risk assessment, though it can extend the underwriting period.

Beyond self-reported information and physician statements, insurers use the Medical Information Bureau (MIB) during underwriting. The MIB, a non-profit, maintains a database of coded medical conditions and risk factors reported by member insurers. Its purpose is to help verify applicant information, detect omissions or misrepresentations, and guard against fraud. MIB reports detail previous life insurance applications, diagnoses, and medical treatments, but not detailed medical records.

Lifestyle and Habits Evaluation

Life insurance underwriting assesses an applicant’s lifestyle and habits, as these influence health and longevity. Smoking and nicotine use are scrutinized via application questions and cotinine tests. Nicotine indicates a higher health risk. Honesty about use is important, as discrepancies can lead to complications.

Alcohol consumption is also evaluated. Applicants report drinking frequency and quantity. Insurers may review medical records for alcohol-related issues or treatments, and liver function tests can indicate excessive use. Driving records are checked for incidents like DUIs.

Illegal drug use is assessed via application questions and drug screens on blood and urine samples. These tests detect substances like cocaine, opiates, amphetamines, and marijuana metabolites. Positive results typically lead to a decline in eligibility. Past drug use can also be a factor, often requiring a sobriety period before coverage consideration.

High-risk hobbies and occupations are also assessed. Activities like extreme sports, aviation, or hazardous professions increase an applicant’s risk profile. Insurers use these details to understand potential injury or health risks impacting life expectancy. Driving records are reviewed, as reckless incidents or multiple violations indicate higher risk.