If an insurer requires a medical examination of an applicant in connection with the application

1. Underwriting Guidelines

• Proposed Insured's ages are from 1 month 1 day to 70 years of age's 70 years of age is only acceptable for certain insurance plans.
• One life insurance plan can be selected at a time with or without riders, e.g. waiver of premium rider, accidental rider, hospital and surgical rider, hospital benefit rider, dread disease rider, term life rider, payer benefit rider, etc.
• The underwriting acceptance is based on various risk factors, e.g. health status, occupation, life style, financial risk factor, etc.

2. Underwriting Documents Required

• If the proposed Insured is aged between 1 month 1 day and 15 years:

1. Insurance application for juvenile [aged below 16 years]
2. Copy of birth certificate or copy of valid ID Card
3. Copy of health check-up documentation at the insured age of 1 year old.
4. Authorization of the juvenile's parent to disclose the proposed Insured's medical treatment history
5. Agent's report
6. Temporary binding receipt

• If the proposed Insured is aged 16 years and above:

1. Insurance application [aged 16 years & above]
2. Copy of valid ID card
3. Authorization of the Insured
4. Agent's report
5. Temporary binding receipt

• For Personal Accident Policy [PA], please use the PA application.

• Once the company receives the completed documents outlined under item 2, the company will underwrite as follows:
  • Issue a standard premium rate policy to an Insured without further request for documentation.
  • The company may request additional information to support the underwriting decision, e.g. a request for an additional physical examination, a request for past medical history, and the completion of an additional questionnaire. The company will notify the proposed Insured of any additional requirements.
  • The company may underwrite the case with a higher premium rate policy based upon the present health status, past history of health, occupation. The company will issue a counter-offer to the proposed Insured. Once the proposed Insured accepts the counter-offer with an extra premium paid [if any] or with a premium refund [if any], the company will issue a policy for the proposed Insured.
• Once the company underwrites and accepts the case, whether at its standard rate or sub-standard rate, it will issue a policy with a 'free look' form to the Insured. The Insured needs to review the policy for correctness, sign the 'free look' form, and return it to the company.
• Should the company not receive the additional documents/requirements within a specified period, the company will terminate the application and return all premiums [if any] to the proposed Insured.
• If the proposed Insured declines the company's counter-offer, the company will terminate the application and refund all premiums [if any] to the proposed Insured.
• If the company postpones or declines the application, the company will notify the proposed Insured by letter and refund all premiums [if any] to the proposed Insured.

4. Underwriting Time Frames

• The company will issue a policy within 15 days from the date of document completion for a standard rate case.
• If any additional documents or information is required, the company will notify the proposed Insured by letter within 30 days from the date of the application's submission.
• Once the Insured receives a policy with the 'free look' form and finds that it is correct, the Insured has to sign the 'free look' form and return it to the company within 15 days from the date of receiving the policy.

Head of Product Development

Robert Powell

When taking out a Life Insurance Policy, you may be required to undergo a medical examination. But why do you need it and what is actually involved? 

When you take out an insurance policy, the provider will determine how much you’ll be required to pay in premiums. This process, called underwriting, assesses the insurance risk, and usually requests information about occupation, medical history, pursuits, hobbies and financial situation. Essentially, it means you’ll only be paying the premiums that are required for the amount of cover you need. 

During this process, a provider may need more information about your medical wellbeing in order to make a properly informed decision about your application. For example, if you have a pre-existing condition, you may have to go through a medical examination before you’re approved for cover.

What is a medical examination?

Generally, medical examinations are pretty straightforward, and only required to ensure the information you have provided is correct so the insurance provider can make an informed decision in relation to your application.

You can think of it as a form of risk protection, making sure the insurer has all the facts before they decide to offer a policy.

The exam isn’t usually an invasive process. Rather, it’s generally a quick check-up with a medical professional who will ask you some questions and also do a quick examination.

There are usually a couple of steps involved:

1.  A verbal questionnaire - some of these questions will relate directly to your insurance application and others will be more general in nature. It’s crucial to remain open and honest during this process. 
2. Sample collection - some insurance providers may require you to provide samples including urine, blood and saliva. 
3. General information will also be collected including height, weight, blood pressure and pulse. In some cases, an insurance provider may require further tests such as x-rays or ECGs. 

If insurance providers have more cause for concern, they may require a more in-depth examination. Again, it’s to assess risk and to make sure both you and the provider have a full understanding of your health before implementing a policy. 

What is being checked in a medical examination?

Generally speaking, a medical examination is looking for chronic conditions and overall health. It’s also looking at whether there is the likelihood that something may develop in the future. Of course, no one has a crystal ball but your overall health can show a few indicators.

Insurance providers are looking for conditions such as:

• High cholesterol 
• Sexually transmitted infections
• Glucose levels which may indicate diabetes 
• High blood pressure 
• Urine acidity which may indicate an issue with your kidneys 

Of course, there are many other issues that medical professionals look for when it comes to insurance. Your examination is compared against your application form as well so the insurance provider has a thorough understanding of your situation. 

Preparing for a medical examination

There’s not much to do by way of preparing for an examination. First and foremost, you must ensure you answer all questions on your application form honestly. This means the medical professional knows what to expect. 

A good tip is to schedule your medical examination first thing in the morning as you may be required to fast. Have all paperwork ready and ensure you have a list of your medications.

Taking out a life insurance policy

While medical examinations aren’t mandatory in Australia, some insurance providers will require applicants to undergo one. 

At the end of the day, your insurance policy is there to financially protect you and your family, providing peace of mind. Remaining honest through the whole application process is important to ensuring you are paying the right premiums and also, that the insurance provider is covering you for the amount you and your loved ones need.

When you need your questions answered or if you need any assistance, contact TAL on 131 825 or get an quick quote using the online TAL CoverBuilder. 

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