You’ve decided to get life insurance. That’s a smart move.
Before an insurer can approve your policy, you’ll go through underwriting. Underwriting is the review process insurers use to decide:
whether to offer you coverage,
how much coverage to offer, and
what your price (premium) should be.
To do that, they look at basic details about you and your health to estimate risk.
This guide explains underwriting step by step. By the end, you’ll know what information insurers may ask for, what usually happens next, and how to move through the process with confidence.
Let’s break it down and help you get the coverage you want.
Step 1: Completing the Life Insurance Application
Think of the application as the insurance company getting to know you in uncomfortable detail. You'll start with the basic details like name, age, gender, and contact info. Then it gets more personal. They want your complete medical history, like every pre-existing condition, past surgeries, medications you take, and even your family's health background. It's how insurers predict your future health risks and decide what to charge you.
But they don't stop at medical stuff. Expect questions about your lifestyle: What do you do for work? (Desk job or underwater welder?) Any risky hobbies? (Golf or BASE jumping?) Do you smoke? How much do you drink?
Every answer feeds into your risk profile. Be honest here because lying or omitting information can void your policy later when your family needs it most. If you smoke, say so. If you skydive on weekends, admit it. The premiums might be higher, but the coverage will actually work.
Step 2: The Medical Examination Process
After you submit your application, most insurers want proof you're telling the truth about your health.
So, a healthcare professional will show up (often at your home or office for convenience) and run through the basics like height, weight, blood pressure, and pulse. They might ask follow-up questions about your health history or current medications to clarify anything from your application.
Depending on the policy amount and your age, they might also take blood and urine samples. These tests check for issues like high cholesterol, diabetes, liver function, kidney health, or drug use, or anything that could affect your life expectancy.
The results go straight to the insurance company and paint a clearer, more objective picture of your health than your application alone. This is where they verify you're actually the low-risk (or high-risk) person you claimed to be. The better your health markers, the better your premium. It's that simple.
Step 3: Review of Medical Records
The medical exam gives the insurer a snapshot. Your medical records give them the full movie.
These records show everything about past diagnoses, treatments you've undergone, surgeries, and medications prescribed over the years. They reveal patterns, maybe you've managed high blood pressure well for a decade, or perhaps you've ignored a doctor's advice about diabetes management. All of this matters.
Insurers request access to these records (with your permission, obviously) to do two things: First, get a complete picture of your health history that goes beyond what a single exam can show. Second, verify you were honest on your application. If you claimed you've never had heart issues but your records show a cardiac event three years ago, that's a problem for you.
The more transparent the information, the fairer your premium will be.
Step 4: Occupational and Lifestyle Risk Assessment
Insurers care about how you live, not just how healthy you are right now.
Your occupation is a big factor. A software developer sitting at a desk all day is a low risk profile. But a deep-sea fisherman working 16-hour shifts in rough waters is a high-risk profile. The more dangerous your job, the more likely you are to face life-threatening situations regularly. That affects your premium.
Your hobbies count too. Activities like skydiving, rock climbing, motorcycling, or scuba diving statistically increase your chance of serious injury or death.
If you have a risky job or hobby, expect questions. Some insurers might add exclusions (your policy won't pay out if you die doing X activity), charge higher premiums, or, in extreme cases, decline coverage altogether.
Step 5: Risk Classification and Premium Rating
After reviewing your health, lifestyle, occupation, and hobbies, the underwriter puts you into a risk category. This is the moment that determines your premium and whether you even get approved.
Here's how it typically breaks down:
Preferred Plus / Super Preferred: You're in excellent health, no smoking, great family history, safe job, boring hobbies. You get the best rates.
Preferred: Still very healthy, maybe one minor controlled condition or a slightly elevated risk factor. Rates are good, just not the absolute best.
Standard Plus: Average health with some manageable issues. Maybe you're overweight but not obese, or you have well-controlled high blood pressure. Premiums are moderate.
Standard: Typical health profile with a few risk factors. This is where most people land. Rates are reasonable but not discounted.
Substandard / Rated: Significant health issues, risky occupation, or dangerous hobbies. You'll pay higher premiums, sometimes substantially higher, because you're statistically more likely to die sooner.
Declined: The insurer decides you're too risky to insure at any price. This can happen with severe health conditions, extremely dangerous occupations, or a combination of major risk factors.
Insurers use decades of data to predict life expectancy and price accordingly. If you're classified lower than expected, you can sometimes improve it by getting healthier, quitting smoking, or changing risky behaviors, then reapplying later.
Final Thoughts on the Underwriting Process
The underwriting process has a reputation for being complicated and stressful. Now you know better.
Yes, there are steps. Yes, there's some paperwork and probably a medical exam. But none of it is designed to trip you up. It's simply how insurers assess risk fairly and price policies accurately. The more prepared you are, the smoother it goes.
Go into underwriting informed, confident, and ready. Answer honestly, provide what they need, and don't stress about the process. You're protecting the people who depend on you. That's worth a little paperwork and a blood test.
Get started, get covered, and get that peace of mind locked in.