July 4, 2019
A guide to underwriting decisions - in plain English
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A guide to underwriting decisions – in plain English

Advancements in medical screening and changes in lifestyle mean that an increasing number of us are living with diagnosed medical conditions.

And if we do not already live with a condition, it is increasingly likely that we will do as we get older.

Furthermore, it is likely that those who have previously applied for insurance products and have been declined now believe they are uninsurable.

Some people do not even try to take out protection insurance due to perceived ineligibility. It is estimated that every year around 500,000 applicants attempt to obtain cover. But, for a variety of reasons do not complete the journey to secure the valuable financial protection they need.*

How insurers accommodate existing conditions

No two people are the same – we are each a unique combination of lifestyle, medical conditions, family history, occupation, pastimes and other factors.

Meanwhile, each insurer will have its own unique commercial considerations. And its own underwriting philosophy – which means that different insurers may view your client in different ways.

For core protection products, including those that cover many chronic conditions. Underwriters have the difficult task of assessing each risk and making a decision. Ideally offering cover at what they consider to be a fair and equitable premium.

They have a number of decisions at their disposal – standard terms, ratings, exclusions, postponements and declines. Underwriting outcomes can vary by the insurer as the protection offered, experience and philosophy of each insurer can be so different. However, here is a rough guide to definitions listed from the most favourable to the least:

Accept on standard terms or accepted at ordinary rates

 Depending on the severity or history of the medical condition disclosed. The type of insurance product being applied for and the insurers own underwriting philosophy. An insurer may feel the nature of the disclosure is an acceptable risk and keep the premium as it was quoted and not increase.

The vast majority of protection applications are accepted on standard terms. Around 70 per cent to 80 per cent of all life cases. 60 per cent to 70 per cent for critical Illness. And around 50 per cent to 70 per cent for income protection.*

Rate (or Load)

Some disclosures might trigger or result in a rated decision. Where the applicant pays a percentage or fixed ‘addition’ on top of their standard premium. Providers tend to adopt this where there is a higher risk, for example for life and critical illness applications. They can increase standard premiums up to a maximum of 600 per cent.*


There is an argument that some cover is better than none. Exclusions can be a route for people to secure some valuable protection. Exclusions are where a claim will not be paid if it arises from the excluded condition.

Recently, we have seen the development of conditional exclusions. Where, if there is no recurrence of the disclosed condition, the exclusion can be removed or reviewed after a set period. Sometimes, exclusions can also result in a reduced premium – cancer is an example of this with critical illness cover.  


A rarely adopted route, but usually applied where the applicant is undergoing investigations. Or treatment for a newly diagnosed or uncontrolled condition. The insurer in these cases opts to defer and review at a later date when the condition has stabilised.


Only a small minority of protection applications are declined – far less than consumers might think. Industry figures indicate around 5 per cent to 10 per cent of underwritten cases are declined altogether. So, at least nine in ten applicants will get some form of positive decision when applying for protection.*

The role of the underwriter is changing. It is becoming more about adding value and experience and considering the best outcomes for applicants. Communicating decisions (particularly the tougher ones) and the rationale behind them, to applicants.

Support is available. And as an industry, we are committed to improving access to insurance for consumers with chronic health conditions and disabilities.

Source: *FT Adviser May 2019

Our process

When a client has a pre-existing condition or has suffered a serious illness in the past, the first thing we do is pick up the phone and speak to underwriters at many of the UK’s leading insurance companies. Discussing all of our client’s medical history helps us to identify the best company to apply to and avoids wasting time applying to companies who may be too expensive or worse, decline an application.  By completing our research thoroughly, we are able to shorten our research process and obtain the best possible terms for our clients.

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Next steps

Whilst you are welcome to get a quote online we would recommend you talk to one of our advisers.

Any quote we provide you with will take into account to your circumstances, your medical history, as well as your budget!

An online quote is just that – a quote – it isn’t a definite offer of cover. What really matters is the premium you are offered, after your application has been assessed.

Call Freephone 0800 644 4468 – Monday to Thursday from 09.00 to 19.00 and on Friday between 09.00 and 17.00.

Please feel free to read our Independent client reviews, or read about the team at Future Proof

Take a look at our handy guides ‘What Cover is Right for me?’

Do you suffer from a medical condition and concerned you can’t secure Life Insurance?  Please view our ‘Medical Guides’ for further information.

Whilst we will make every endeavour to help someone to arrange insurance, there is no guarantee of success.  All applications are subject to underwriting.

Links to third-party websites exist for information only and we accept no responsibility or liability for the information contained on any such sites. The existence of a link to another website does not imply or express endorsement of its provider, products or services by us or St. James’s Place.

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