What Does a Life Insurance Medical Exam Look For?
Learn what insurers assess during a life insurance medical exam and how your health impacts your policy's cost.
A life insurance medical exam assesses an applicant’s health status. This helps insurers understand potential risks and gather objective health data for underwriting. The process ensures premiums reflect the individual’s health profile and projected longevity.
The Examination Process
The life insurance medical exam typically begins with a review of the applicant’s personal and family medical history. A paramedical professional, often a nurse or medical assistant, conducts the examination at a convenient location, such as the applicant’s home or office. This initial stage involves asking detailed questions about past diagnoses, current medications, and any history of major illnesses within the applicant’s immediate family.
Following the medical history review, the paramedical professional takes several physical measurements. These measurements usually include height and weight to calculate the Body Mass Index (BMI). Blood pressure and pulse readings are also taken to assess cardiovascular function.
A blood sample is a standard component of the examination, collected through a venipuncture. This sample is then sent to a laboratory for detailed analysis. Simultaneously, a urine sample is collected for urinalysis, which can reveal various health indicators. Depending on the applicant’s age and the amount of coverage requested, an electrocardiogram (EKG) might also be performed to assess heart rhythm and electrical activity.
Health Markers and Medical Conditions Evaluated
The laboratory analysis of blood samples provides insights into various health markers. Cholesterol levels, including HDL and LDL, are examined to assess cardiovascular risk. Fasting glucose or HbA1c levels are measured to detect indicators of diabetes or pre-diabetes. Additionally, liver and kidney function are evaluated.
Urine analysis screens for the presence of substances that could indicate underlying health issues or lifestyle choices. This includes testing for nicotine byproducts, which indicate tobacco use, and the presence of illicit drugs. The urinalysis also checks for protein or blood, which can signal kidney problems, and elevated glucose levels, another potential indicator of diabetes.
Physical measurements provide further health insights. Blood pressure readings are assessed for hypertension, with consistent readings above 120/80 mmHg considered elevated. Pulse rate is evaluated for irregularities or abnormally high resting rates, which could suggest cardiac concerns. The Body Mass Index (BMI), calculated from height and weight, helps identify individuals who may be underweight, overweight, or obese, conditions that can impact overall health and longevity.
The comprehensive medical history questionnaire completed during the exam is important. This document provides information on past medical conditions, surgeries, and chronic illnesses. Details regarding current prescription medications are reviewed, as they can indicate ongoing health management for specific conditions. Family history of significant diseases, such as heart disease, cancer, or diabetes, is also considered, as it can highlight genetic predispositions to certain health risks.
Impact of Exam Findings on Policy Costs
The findings from the medical exam directly influence the underwriting classification assigned to a life insurance applicant. Underwriters analyze all collected data, including laboratory results, physical measurements, and medical history, to determine the applicant’s overall risk profile. A healthier profile leads to a more favorable classification and lower premiums.
Insurance companies use several underwriting classifications to categorize applicants, such as Preferred Plus, Preferred, Standard Plus, Standard, and various Substandard or Table Ratings. Individuals in the Preferred Plus category exhibit exceptional health with no significant medical issues or adverse family history, qualifying them for the lowest premium rates. Conversely, those with certain medical conditions or less favorable health markers may be placed in Standard or Substandard classifications, resulting in higher premiums.
For example, elevated blood pressure, high cholesterol, or a history of certain chronic conditions could lead to a Standard or Substandard rating. Each Table Rating represents an additional percentage increase over the Standard premium rate. In some instances, particularly with severe medical conditions or significant adverse findings, an applicant may face a policy denial if the perceived risk is too high. The goal is to align the premium charged with the actuarial risk of insuring the individual.