Life Insurance Assessment Explained

Looking to take out life insurance but not sure how the application process actually works?

When a life insurance provider agrees to cover you, they are factoring in how long you might live before you make your claim, and making sure that they’ll get enough back from you in insurance premiums before they need to pay out your policy. As a result, they will assess your application and cover amount based on your health, your lifestyle and the hazards you are exposed to either in your work or personal life, to determine how long you are likely to live.

Your life insurance policy is then paid for in monthly premiums, and when you pass away, your family can put in a claim to the insurance company and be paid a lump sum amount to cover immediate expenses such as the funeral, and ongoing costs such as living expenses.

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Coverage is the amount of money that you will be paid in the event of a claim. An insurance consultant can help you determine an appropriate amount. Calculator
Provides a lump sum payment if you become totally and permanently disabled and are unable to return to work.
Provides a lump sum payment if you suffer a serious medical condition. Cover can be taken out for 40-60 medical conditions depending on the policy you choose.
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So how do I apply for life insurance?

  • Stage 1. Submit a policy application

You will need to start the application process by completing the paperwork with your chosen provider. You must answer all the questions truthfully (as best you can), and you will need to sign a declaration that the information you have provided is accurate. By deliberately providing incorrect or misleading information, you risk voiding your insurance policy and leaving your family with nothing when they claim.

  • Stage 2. Medical assessment

Some insurance companies will require that you have an actual physical examination before you are approved, others will just need you to answer questions about your medical history on your application form. Most of us run into a number of medical issues in our lives, and it is almost impossible for you to remember all of them. If you can’t remember something about your medical history, simply point it out to your insurance adviser or provider and give them the name of the doctor you saw at the time, who should have the relevant medical records.

  • Stage 3. Risk assessment

With the information from your application, the life insurance provider will work with an underwriting team to assess your eligibility by considering your level of risk in areas such as your medical history, your lifestyle activities, sports you engage in and your occupation. They will then make a decision on the premium you should pay. All of the information in your insurance application will be kept confidential, and be used only to assess your life insurance needs and policy by people directly involved in assessing your premiums.

What happens after I've been assessed?

Once your application and details have been assessed:

  • The life insurance company will notify you in writing of their findings. Usually the company will accept your application and then send you a policy schedule with details of the cover and policy you have applied for, as well as the premiums, which have been finalised for you.
  • If a life insurance provider cannot accept your application they will instead offer you amended terms of insurance so that you can still obtain some form of cover. For example, if you have a history of serious pre-existing medical conditions, or you regularly take part in high-risk activities, then your insurer will do one of two things with your application:
  1. Apply a loading: If the insurance underwriter finds you to be a high risk, the premiums you have to pay for your insurance may increase above those provided on your original quote. This is usually preferable, because having a loading applied means that you still have full insurance coverage, you’re just paying a little extra.
  2. Place exclusions on your policy: The other thing your insurer might do is exclude certain things from your policy. This means that if you have a history of blood disease, you won’t be able to claim for any instances related to this condition, or if you regularly participate in high-risk sports such as sky diving, then you won’t be able to claim for any illnesses or injuries resulting from sky diving.
  • If you find that you are a high-risk applicant, you should look at policies with exclusions as a last resort. When you take out life insurance you want to have the most comprehensive cover possible because you can never predict what will happen in the future. Look for insurers who will add a loading to a high-risk application, rather than exclude certain claim types.
  • Once your life insurance assessment has been finalised and your policy has been issued, your provider will keep your details on file until the time you or your family make a claim.
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What kind of information will I have to provide?

During the application process you will usually be asked to disclose the following information:

  • Height and weight
  • Date of birth
  • Gender
  • Lifestyle habits (do you smoke, drink or take recreational drugs?)
  • Your own medical history
  • Your family's medical history
  • Information about your occupation and hobbies

What can I do to reduce my premium?

While you can't do much to change your age or family history, you can reduce your premium amount by making certain lifestyle changes such as:

  • Quitting smoking (keep in mind that most insurance companies will ask you if you have smoked within the last 12 months)
  • Losing weight
  • Reducing alcohol intake
  • Improving your driving record

Making these changes will improve your life expectancy, and therefore make you less of a risk to insure. The less of a risk you are, the less the insurance company needs to charge you to keep you insured.

If you still feel like you're paying too much for your life insurance, try:

  • Switching to a different insurance company
  • Finding a company that specialises in covering people in your situation
  • Asking about payment discounts if you pay your premiums in full annually, rather than in monthly instalments
  • Ensuring that all the information that your insurer has on you is correct - incorrect information about you medical history could lead to you paying more

What if the life insurance assessment reveals health problems?

It is possible that in the course of health checks and assessments, an issue with your health is uncovered that you didn’t know about. In this case, the insurance company is required to notify you of any unusual test results and provide you with details of how this will affect your coverage and application. From that point the test results will be sent to your current doctor and you can then organise a consult to discuss the details of the findings.

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Who will receive the benefits?

While you are the one being covered – and prodded and poked – for the life insurance policy, there are a number of ways you can structure the policy depending on your family and financial situation. For example, you can be assessed for a life insurance policy as:

  • An individual. In this instance it is your name on the policy, and the benefits will be paid to you in the event of a claim. When you die, the beneficiaries you have nominated in your policy will receive the benefits and payouts, or they will go to your estate.
  • Joint ownership. You can also apply for a joint life insurance policy for yourself and your partner or spouse. In this instance the claim payouts will be shared by all beneficiaries, or in the event of your death, will go to your spouse.
  • Another person or company. This is an option to consider if you manage or control your own company, because in the event of a pay out, all amounts go to an employer.
  • Investment portfolio. Your life insurance policy can also be set up to pay claims to an investment fund and the fund itself will have instructions on how to distribute any benefits. In this instance the investment portfolio can be managed by you so that it suits your and your family’s investment needs.

How much cover do I need?

There are a few different ways to determine how much cover you need to take out. A common method is to simply take your annual salary and multiply it by 10 (so if you make $50,000 a year, take out cover for $500,000).

On top of that, you might also want to consider the immediate expenses that will need to be covered after your death (eg. your funeral), mortgage repayments that still need to be made, other loans or debts that you still need to pay off, school fees and education costs for your children and a retirement fund for your partner.

If you total these costs together, you will have a rough idea of how much cover you need.

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Important factors to consider

Before taking out a life insurance policy, make sure you consider and know the answer to the following questions:

  • What is and isn't covered by my policy?
  • How much will be paid when my family or I make a claim?
  • Who is guaranteed to receive the benefit payment if I die?
  • How much are the premiums and will they increase in the future?
  • Can I increase or change my cover in the future if need be?
  • Can I switch to a new insurance policy?

Knowing this information will ensure that there won't be any surprises when paying your premiums, or further down the track when it comes time to claim, or if you decide you want to change your cover or your policy. Make sure you read the PDS of whichever policy you end up going with so you know the ins and outs of your insurance plan.

Want to know more?

Q. Will I need to undergo a medical examination while applying for life insurance?

A. Depending on your insurance provider, a medical examination, blood test and/or urine sample may be required. Some companies allow you to apply online without a physical exam, but they will ask you about your lifestyle and medical history, and will most likely check your medical records and history in the event of a claim. Other life insurers may only require a medical examination if they are concerned that something about your lifestyle, family history or medical history may make you a high-risk customer.

Q. What if an insurance company refuses my application?

A. Start by requesting information on why you have been denied - sometimes the underwriter simply needs more information on something in your application. If it is because of your health or lifestyle, don't give up; different insurance companies have different standards to adhere to when accepting and denying life insurance applications, and just because one refuses you, doesn't mean they all will. Finally, get an updated check-up from your doctor. This may show the insurance company that the medical condition they are concerned about has stabilised or is being adequately treated, which may change their decision.

Q. Can I still apply for life insurance while pregnant?

A. Yes, your life insurance premiums should be unaffected by the fact that you are pregnant. Some life insurance companies may not accept an application from you until after you have given birth, but many others will, so keep trying. Pregnancy can sometimes cause high cholesterol in women, but insurance companies will either waive any extra premium amounts caused by this (because there is a justified cause), or you can just have your blood taken again after you give birth. Pregnancy can also cause extra weight gain in women, so if you apply for life insurance after you've given birth and have not lost the extra weight this will affect your premium.

Q. How long will it take to get my life insurance application approved?

A. Depending on the insurance company, the time it takes for your application to be approved can vary vastly. Some companies will claim to accept your application within minutes when you apply online (though in reality it may take around 24 hours for the policy to officially be in place); others can take several weeks to approve you, especially if you need to have a medical examination and blood test as part of the application process. If the insurance company requires medical records to be sent from your doctor, this can further delay the approval process. It really depends on what is involved in the application process.

Q. Should I purchase life insurance directly or with an adviser?

A. There are advantages and disadvantages to purchasing insurance both directly and with a adviser. If you already know which life insurance policy you need, purchasing directly without advice is often simpler (you can do it within minutes online or over the phone) and cheaper. However, sometimes the amount of cover you're offered is less than what you'd get if you went through an advisor, and there tend to be more exclusions placed on your policy. If you decide to purchase life insurance directly, make sure you read through the PDS thoroughly so that you are well informed about what you are and are not getting.

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