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How Can I Avoid Taking the Life Insurance Medical Exam?

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Life insurance medical exams are really quite routine. But if you want to avoid a medical exam at all costs, you could buy a simplified issue policy, which requires only that you answer a few medical questions, or a guaranteed issue policy, which requires neither an exam nor questions.

Keep in mind, though, that if you're in general good health, or even with a history of some health issues, you'll likely get a much better rate, amount of money your beneficiaries will receive at your death, by buying the underwritten policy that requires a medical exam. That's because simplified issue and guaranteed issue policy rates assume you are a riskier applicant.

Do I Need to Pass a Medical Exam to Get Life Insurance?

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Depending on your age, general health, family history and the amount of life insurance you apply for you might need to go for a medical exam. Your insurance company might also need to do some more additional tests to help them underwrite your life insurance policy to the best of their ability.

Insurers will probably require you to have a general check up where the doctor will check your blood pressure, pulse, height and weight. You may be asked to participate in additional tests that might include providing a urine sample to help identify if you are a smoker or a drug user. It will also show if you have high blood sugar levels and any signs of kidney disease. You may also be asked for a blood sample as doctors use blood tests to determine your general health, and they can see signs of many different conditions and diseases in your blood.

You could also be asked to take an electrocardiogram (ECG) for any irregularities in your heart or you could be asked to have a chest X-ray for the same reasons and also to check your lungs as well. 

What to Expect from your Life Insurance Medical Exam

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Now that you have decided to purchase life insurance you may be required to undergo a medical exam. The primary reason life insurance companies need to administer medical exams is to judge how much premium to charge a potential policyholder. If the company determines you are likely to die at an early age, they will want to collect more premiums early in your life, but if they feel you will live longer they would not need to collect as much from you in the early part of your life because you will be around longer to continue to make premium payments.

Life insurance companies try to accurately judge how long a potential policyholder will live with two factors: Longevity Charts and Medical Exams and History

Longevity charts are statistics on the mortality rates of people. Basically, longevity charts give an insurance company a way of knowing how many men, women, and children die when they are various ages. This information can help an insurance company determine what risk they are taking by choosing you as a policyholder. For example, say a longevity chart reveals that men at age 29 die on average at a higher rate than women at age 29. From that statistic the insurance company would be taking a larger risk by insuring a man than a woman. This is why insurance for children is very inexpensive, because the risk of a child dying is very low so the insurance company does not have to charge a large premium.

Your medical exam and history is the second factor in determining how much risk you are for the life insurance company. Usually your medical exam can be done in the privacy of your home or office unless the insurance company will require additional tests then you may be referred to a clinic to complete your medical exam. Things you can routinely expect to be asked about during your life insurance medical exam would be:

1. Your medical history

2. Your family's medical history

3. Information about how to contact your primary doctor

4. Lifestyle habits such as smoking, drinking, recreational drug use and exercise

5. How much life insurance you are interested in purchasing

Procedures you can routinely expect to be performed during your life insurance medical exam would be:

1. Measurement of your weight and height

2. Measurement of your blood pressure and pulse

3. Blood work (to check things such as cholesterol, glucose, protein, and HIV)

4. Urinalysis (to check things such as protein, glucose, creatinine and cocaine)

After undergoing the medical exam your insurance company will review the results to determine if you are insurable and for what premium. The time to fully process this information may take a few months. If you failed the medical exam or feel something on the medical exam was inaccurate you will want to ask the insurance company to send a copy of your medical exam results to you or your doctor. This way if you failed because you have a health problem you can address that with your doctor, but if you failed because of a mistake by the insurance company you and your doctor can remedy the situation immediately so your mistaken results will not stay on your health record and cause you to be denied for other insurance.

After the Results of the Life Insurance Medical Exam, What Happens?

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If your medical exam results correlate with the classification used when your premium rate was originally quoted, you'll have no problem getting that rate. If a medical problem is discovered, you might be offered a policy with a higher premium.

There are two types of risk ratings: "flat" ratings, sometimes called temporary flat extras, and "table" ratings. Underwriters assess health conditions based on a tightly defined underwriting manual to determine how to rate certain health conditions.

For instance, an underwriter might apply a flat rating for a short period of time for a person who has just had surgery. Conversely, a person with high-blood pressure would likely receive a table rating. Table ratings increase premiums by a set amount, depending on the medical condition and your age. If you disagree with a rating you receive, get your agent involved. Agents can argue the rating, although it might mean submitting to additional medical tests to prove you qualify for a better rating.

Even if you end up declining the life insurance policy, your test results become part of your record in MIB Group's database (formerly the Medical Information Bureau), a clearinghouse of medical information that insurers share which stores information for seven years after you apply for a life, health, disability income, long term care or critical illness insurance policy.

MIB is jointly owned by about 470 insurance companies. So, if you go shopping around for other life insurance, keep in mind your medical information remains at every insurer's fingertips for the near future. Note that MIB's database does not contain actual medical records but rather codes that represent medical conditions and tests, hazardous hobbies and even your bad driving record.

Is There a Medical Exam Required For Life Insurance?

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There's a good chance you will need to undergo a medical exam if you are buying life insurance, whether it's term life or whole life. Typically, insurance medical exams are done by paramedical, who are licensed health professionals. Paramedical are often independent contractors hired by the insurance company who come to your home.

There are medical questions on Part I (some insurers call it Part A) of a life insurance application that are usually completed by your agent in your presence, or online by you. Part II (or Part B) is the medical form that is completed by a paramedical or a physician.

After receiving your application for life insurance, your agent or life insurer will call one of several paramedical services that specialize in mobile exams. They'll give the paramedical service information on you, the amount of insurance you're applying for, and the name of the insurance company. Most paramedical professionals stay current on insurers' underwriting requirements.

What do the Life Insurance Companies Look for in the Medical Exams?

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The insurance company wants to know if you have any health condition that could shorten your life - and increase the company's risk by having you take a medical exam. When samples of blood, urine are collected, the insurer will test for the presence of antibodies or antigens to the HIV virus; cholesterol and related lipids; liver or kidney disorder; diabetes; antibodies to hepatitis; prostate specific antigen (PSA); and immune disorders. The urine sample might go through routine analysis, plus screening for certain medications, cocaine and other drugs.

There are two ways your blood can be drawn: through a finger prick or with a needle. A younger person might be asked for a finger-prick blood sample. If you're buying a large amount of life insurance, you might have to submit to a full blood profile.

Results are sent directly to the life insurer's home office for the underwriter to review. You can usually send a written request if you want a copy of the results, and some insurers will automatically send you a copy of your lab work. If there's anything of concern about the lab results, you would need to consult your own doctor. Goldstein says, "It's not uncommon to have abnormalities that don't mean anything."

An insurance underwriter then reviews your life insurance application and the results of your medical exam. They then decide your insurance rating, which sets your premium. If there are lingering questions about your health, they may request additional information or medical tests. In the very rare event you are unknowingly quite ill - chronically or terminally - your application would be declined and you would have to look for a high-risk carrier or one that offers guaranteed issue life insurance.

Smokers pay higher premiums for life insurance because of their higher mortality rate. If any nicotine does show up in your results, you'll be considered a smoker. The test even detects nicotine that is delivered through a transversal patch.

What’s Involved in a Life Insurance Medical Exam

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Nearly all medical exams can take place at your home or office, since many paramedical carry their own supplies and have centrifuges for blood sampling. Although the insurer might order what is called an attending physician's statement (APS) from your doctor, you cannot have the life insurance medical exam done by your own physician.

A paramedical professional will call you to schedule your appointment. If you can't schedule an appointment, you'll usually have the option of going to a clinic specified by the insurer. The exam isn't optional - you must have it or your application won't be processed. The insurance company pays the paramedical service or examining physician directly, so you're not financially responsible for the exam or any lab work.

In a basic exam, the paramedical will take your medical history, physical measurements of height and weight, blood pressure, pulse, and blood and urine samples. Beyond that, tests vary based on your age and policy amount.

For example, MetLife will order an in-home EKG for applicants age 50 and older who are applying for face amounts of at least $1 million. For applicants age 70 and older who are applying for $2 million policies and higher, MetLife forgoes the paramedical exam and requires an exam by an M.D. chosen by MetLife (not your own doctor). The doctor will ask the same medical questions as a paramedical and get your height, weight, blood pressure and pulse, plus do a brief medical exam such as listening to your heart.

Jacki Goldstein, Vice President of Life Underwriting at MetLife, emphasizes that this is not a comprehensive medical exam and does not include sensitive issues, such as a breast exam for women. Goldstein also stresses that the M.D. life insurance exam is not a substitute for good routine medical care.

When age and face amounts get higher, a treadmill test may be required. MetLife requires treadmill tests for applicants who are at least 50 and applying for over $10 million in insurance or applicants 76 and older applying for $5 million or more.

If you're applying for a low face value life insurance policy, you may not even be asked to do a paramedical exam. For example, if you're age 40 and applying for $50,000 of life insurance, MetLife requires no specific tests or measurements. And for some cases MetLife asks for a "simple paramed" exam, encompassing the basic measurements and blood and urine work but without the paramedical question list. Guidelines for tests will vary among life insurers.

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