Glossary

A blood test reporting average blood glucose over roughly the preceding three months, expressed as a percentage. Because it covers a period rather than a moment, underwriters read a series of A1c results as evidence of diabetic control, and the trend across several readings carries more weight than any single figure.

See also: Impaired risk, Table rating

A provision allowing part of the death benefit to be paid to the insured while living, on a qualifying terminal or chronic illness diagnosis. Amounts drawn reduce what beneficiaries eventually receive.

See also: Rider, Face amount

A full term life policy with the paramedical exam removed. The carrier substitutes data — prescription history, motor vehicle records, identity checks — for blood and urine. If nothing flags, the applicant receives the same rate class a fully underwritten policy would have produced. It is conditional: a file that raises questions can be moved into full underwriting anyway.

See also: Paramedical exam, Full underwriting, Simplified issue

The number of breathing interruptions per hour recorded in a sleep study, used to grade sleep apnea severity. Carriers pair it with CPAP compliance data, which modern machines record, to judge whether the condition is controlled.

See also: Impaired risk

Your age at the point a policy action happens, as opposed to your age when the original policy was issued. Conversion privileges are priced at attained age, which is why converting later costs more even though no new health evidence is required.

See also: Conversion right, Group conversion

A summary of your records requested directly from your doctor. Ordering one is the single biggest cause of delay in underwriting, because the timetable belongs to the practice rather than the carrier.

See also: Underwriting, Full underwriting

The person or entity designated to receive the death benefit. Designations override wills, which is why an out-of-date beneficiary is one of the more common and more painful administrative failures in life insurance.

See also: Face amount

A composite score for COPD combining body mass index, airflow obstruction, dyspnoea and exercise capacity, scored 0 to 10. It predicts mortality better than lung function alone, which is why build and walking distance carry weight in a respiratory file.

See also: GOLD stage, Spirometry

How far a melanoma has penetrated the skin, measured in millimetres. It is the strongest predictor of melanoma outcome and the figure that separates a mild skin cancer history from a serious one in underwriting.

See also: Postpone, Flat extra

The height and weight table a carrier uses to set the build component of a rate class. Build charts differ enough between carriers that the same applicant can clear preferred at one and miss it at another.

See also: Rate class, Underwriting

The savings component inside a permanent policy, which grows over time and can be borrowed against or surrendered. Term policies have none.

See also: Whole life, Term life

A measure of immune system strength, counting CD4 T-cells per cubic millimetre of blood. Underwriters look at whether the count is stable and in a healthy range over time rather than at any one figure.

See also: Viral load

Total cholesterol divided by HDL. Carriers underwrite this ratio rather than the total figure alone, which is why an alarming total with high HDL can still produce a good outcome and an unremarkable total with low HDL may not.

See also: Rate class, Paramedical exam

The opening period of a policy, typically the first two years, during which a carrier may investigate a claim and rescind the policy over material misstatements or omissions in the application. After it expires the carrier's ability to contest is sharply limited.

See also: Material misrepresentation, Incontestability clause

A contractual option to exchange a term policy for a permanent one from the same insurer with no new medical underwriting. It has a deadline, a defined menu of policies you may convert into, and pricing at attained age — all set out in the contract rather than the brochure.

See also: Attained age, Portability, Group conversion

A nicotine metabolite screened for in insurance blood and urine testing. It cannot distinguish how the nicotine was delivered, so cigarettes, vaping, patches, gum and pouches all produce a positive result and generally trigger tobacco rates.

See also: Tobacco class, Paramedical exam

The usage record a CPAP machine produces — hours per night, nights used, residual events. It is real data and carriers ask for it. Documented consistent use is strong evidence of controlled sleep apnea; a prescribed machine sitting unused reads worse than no diagnosis at all.

See also: Apnea-hypopnea index

Ductal carcinoma in situ — abnormal cells confined to a breast duct that have not invaded surrounding tissue. It is underwritten far more favourably than invasive breast cancer, so an application recording it simply as "breast cancer" invites a worse outcome than the history warrants.

See also: Postpone, Flat extra

A carrier's refusal to issue a policy. It reflects one company's underwriting manual on one day, not an industry verdict — appetite for a given risk varies widely and changes over time.

See also: Reason code, Postpone

The percentage of blood the left ventricle pumps out with each contraction, measured on an echocardiogram. It is the single most cited number in cardiac underwriting because it summarises how well the heart is working after an event, independently of what the event was.

See also: Impaired risk, Postpone

A flare-up of a chronic respiratory condition severe enough to need a change of treatment, a course of oral steroids, or hospital care. Frequency of exacerbations moves a COPD or asthma file more than the underlying lung function figure does, because it demonstrates instability rather than a fixed level of impairment.

See also: GOLD stage, Spirometry

The death benefit stated in the policy — the sum paid to beneficiaries on a valid claim. Distinct from cash value and from the total the policy might pay after riders.

See also: Term life, Graded death benefit

Sending an individual case to a reinsurer for a separate opinion, usually because it falls outside the carrier's automatic authority on amount or impairment. It adds time and it is one route by which a file a carrier would otherwise decline can still be placed.

See also: Reinsurance, Full underwriting

A small whole life policy sized to cover a funeral and outstanding bills rather than replace an income. Premiums are level and the policy does not expire while premiums are paid. Sold both simplified issue and guaranteed issue.

See also: Whole life, Guaranteed issue

A fixed dollar charge per thousand dollars of coverage, added on top of the base premium for a defined number of years. Used for risks that fade with time — a recent surgery, a hazardous hobby — rather than risks built into your long-term mortality.

See also: Table rating, Substandard

A window after delivery — length set by state law — during which a new policy can be cancelled for a full refund of premium, no reason required.

See also: Contestability period

The traditional process including a paramedical exam with blood and urine samples, plus records and database checks. Slower than the no-exam routes but still the path to the largest face amounts and, for some impaired files, the best pricing.

See also: Paramedical exam, Accelerated underwriting

The Genetic Information Nondiscrimination Act, which restricts the use of genetic test results in health insurance and employment. It does not extend to life, disability or long-term care insurance — a gap that surprises people, and the reason a known genetic result can be considered on a life application. Some states add their own protections.

See also: Impaired risk, Material misrepresentation

The four-band severity classification for COPD, set by the Global Initiative for Chronic Obstructive Lung Disease and based on FEV1 as a percentage of predicted: stage 1 at or above 80%, stage 2 from 50 to 79%, stage 3 from 30 to 49%, stage 4 below 30%.

See also: Spirometry, BODE index

A death benefit that does not pay in full during the policy's first years. Death from natural causes inside that window typically returns the premiums paid, often with interest, instead of the face amount. Accidental death is usually covered in full from day one.

See also: Guaranteed issue, Face amount

The right to convert employer-provided group life cover into an individual policy when you leave, usually without new underwriting and usually inside a short window after coverage ends. Valuable precisely when your health would make individual cover expensive.

See also: Full underwriting

A policy that asks no health questions and declines nobody within its age band. Acceptance is certain, so the carrier prices for the worst case: small face amounts, the highest cost per dollar of coverage, and a graded death benefit for the first years.

See also: Graded death benefit, Simplified issue, Final expense

A state body that backstops policyholder obligations, up to statutory limits, if an insurer becomes insolvent. Every state operates one. Agents are generally prohibited from using its existence as a selling point.

See also: Face amount

An applicant whose health history places them outside standard underwriting. Impaired-risk cases reward carrier selection more than any other category, because appetite for specific conditions varies enormously.

See also: Substandard, Table rating

The contract provision that closes the contestability period, after which the carrier generally cannot void the policy for misstatements in the application. Fraud exceptions vary by state.

See also: Contestability period

A yes/no question on a simplified issue application that ends the application outright if answered yes. Typical examples cover terminal diagnosis, dialysis, oxygen use and nursing home confinement. The set varies by carrier, so one carrier's knockout is not another's.

See also: Simplified issue, Guaranteed issue

The regulated sale of an existing life insurance policy to a third party for more than its surrender value. It has tax consequences and can affect means-tested benefit eligibility, so it is worth pricing but not worth doing casually.

See also: Cash value, Accelerated death benefit

An inaccuracy on an application significant enough that it would have changed the underwriting decision. Materiality is the test — a wrong detail that would not have altered the outcome is not the same as an omitted diagnosis.

See also: Contestability period, Rescission

A membership organisation whose shared database records coded summaries of prior insurance applications. It stores signals rather than medical records, and carriers check it to spot inconsistencies between what you disclosed now and what you disclosed before. You are entitled to request your own file.

See also: Reason code, Underwriting

Your state driving history. Impaired driving convictions and a pattern of moving violations move rate classes independently of health, because they are a mortality signal a carrier can verify cheaply.

See also: Underwriting, Rate class

Working out how much cover a household actually requires by totalling debts, income replacement, ongoing costs and final expenses, then subtracting existing cover and liquid assets. It replaces income-multiple rules of thumb, which are shortcuts rather than answers.

See also: Face amount, Beneficiary

The nurse visit that no-exam policies remove: height, weight, blood pressure, and blood and urine samples, collected at your home or office and reported to the carrier. Often shortened to "the exam" or "the paramed".

See also: Full underwriting, Accelerated underwriting

The option to continue group term cover as an individual paying the insurer directly after leaving employment. It keeps the cover as term, unlike conversion which exchanges it for a permanent policy, and it may require evidence of insurability where conversion does not.

See also: Group conversion, Conversion right

A decision to defer rather than refuse, usually pending a recovery period, a pending test result or a treatment course being completed. A postpone is materially better news than a decline and often carries a stated date to reapply.

See also: Declination

The best rate class a carrier offers, reserved for applicants with excellent build, blood pressure and cholesterol, no tobacco use, a clean driving record and no significant family history. Carriers use different names for it — preferred elite, super preferred, preferred best — and set the thresholds differently.

See also: Rate class, Standard

A pharmacy benefit data source showing which medications you filled, when, at what dose and how often. Underwriters read it for patterns, and it frequently reveals a condition by inference even when the application does not mention one.

See also: MIB, Underwriting

A share of applications that would have qualified for accelerated underwriting but are deliberately routed through full underwriting anyway, so the carrier can audit its model against real evidence. Being sent for an exam therefore does not necessarily mean anything was found.

See also: Accelerated underwriting, Full underwriting

The pricing bucket an application lands in once underwriting is finished, running from preferred plus at the top through standard and then a series of substandard steps. The rate class, not the diagnosis, is what sets the premium — which is why two people with the same condition routinely pay different amounts.

See also: Table rating, Standard, Preferred plus, Substandard

The coded explanation attached to an adverse underwriting decision and recorded against your file. After a decline the reason code matters more than the decline itself, because it tells you whether the obstacle was medical, financial, behavioural or administrative.

See also: MIB, Declination

A request to re-rate an in-force policy after documented improvement — better readings, a completed treatment, time elapsed since an event. Carriers generally permit it after a waiting period, but it is never automatic: you have to ask, with current records.

See also: Table rating, Rate class

Insurance a carrier buys to transfer part of the risk it has written. Treaty terms agreed with reinsurers shape which conditions a carrier will accept and on what basis, which is a large and largely invisible reason two insurers price the same file differently.

See also: Facultative referral, Impaired risk

Cancellation of a policy from inception, treating it as though it never existed, with premiums returned instead of the death benefit paid. The outcome an accurate application is meant to prevent.

See also: Material misrepresentation, Contestability period

An optional provision added to a policy for extra cost or in place of other benefits — waiver of premium, accelerated death benefit, child cover, accidental death. Availability varies by product and by carrier.

See also: Accelerated death benefit

Preventive surgery undertaken to lower the chance of a cancer developing, such as mastectomy or oophorectomy following a BRCA-positive result. It changes an underwriting file materially: a genetic predisposition with completed risk-reducing surgery is assessed differently from the same result with surveillance alone.

See also: GINA, Postpone

A policy underwritten from a short health questionnaire rather than an exam. Answers are still checked against prescription and MIB data, so accuracy matters. Coverage ceilings are lower and pricing higher than accelerated underwriting, and decisions typically arrive in days.

See also: Guaranteed issue, Accelerated underwriting, MIB

A breathing test measuring how much air you can move and how fast. Its key output for underwriting is FEV1 — the volume forced out in one second — expressed as a percentage of what someone of your age, sex and height would be expected to manage.

See also: GOLD stage, BODE index

The baseline rate class, priced for average mortality. Table ratings are expressed as percentages above standard, so it functions as the reference point for everything below it.

See also: Rate class, Table rating

A small mesh tube placed to hold a narrowed artery open, usually during a percutaneous coronary intervention. Underwriters price the coronary artery disease that made it necessary rather than the device itself, so what matters is the extent of disease, the ejection fraction afterwards and whether anything has recurred.

See also: Ejection fraction, Impaired risk

Any rate class priced above standard because the file carries elevated mortality risk. Substandard is not a decline — it is an offer, and it is usually negotiable across carriers.

See also: Table rating, Flat extra, Rate class

A step above standard, usually lettered A to J or numbered 1 to 10. Each step adds a set percentage to the standard premium. Carriers use both conventions and do not place the steps identically, so a table 4 at one carrier is not necessarily a table 4 at another.

See also: Substandard, Flat extra, Reconsideration

A carrier programme that improves a rated offer by a set number of tables where the file meets defined criteria. It is not universal, it is rarely disclosed to applicants, and it can move an offer materially without anything about the applicant changing.

See also: Table rating, Substandard

Cover for a fixed number of years — commonly 10, 15, 20 or 30 — that pays only if death occurs inside the term. It builds no cash value, which is why it costs far less per dollar of death benefit than permanent cover.

See also: Whole life, Face amount

A separate pricing track for tobacco and nicotine users, typically costing substantially more than the equivalent non-tobacco class. Definitions differ: some carriers rate cigars, vaping or nicotine replacement differently from cigarettes, and the look-back period varies.

See also: Rate class

A temporary interruption of blood supply to the brain whose symptoms resolve without lasting damage — often called a mini-stroke. Underwritten more mildly than a completed stroke and usually with a shorter postpone period, but treated as a warning sign rather than a non-event.

See also: Postpone, Impaired risk

The process of assessing an applicant's mortality risk and translating it into a rate class or a decline. It is the step between applying and being priced, and it is where every document, database and disclosure gets weighed.

See also: Rate class, Full underwriting, Attending physician statement

The quantity of HIV genetic material in a blood sample. Sustained suppression to undetectable levels on antiretroviral therapy is the central measure in HIV underwriting, and carriers read a multi-year pattern rather than a single result.

See also: CD4 count, Impaired risk

Permanent cover that stays in force for life while premiums are paid, with a level premium and a cash value that accumulates over time. Costs substantially more per dollar of death benefit than term.

See also: Term life, Final expense, Cash value