How does the underwriting process work?

When you apply for insurance, your application goes through a process known as underwriting.

This is where an insurer assesses your personal risks to determine:

  • whether the insurer can accept your application
  • whether any ‘exclusions’ (specific conditions or events that you are not covered for) will apply
  • whether standard rates will apply or any ‘loadings’ (additional premium where there is an increased risk) will apply.

Why is underwriting important?

Underwriting establishes up-front what you’re covered for, and just as importantly what you’re not covered for – giving you more certainty if you make a claim.

Underwriting is also important for assessing the price of your cover, which is based on the risk of you claiming. If your personal risks are similar to most people at your age, you will be offered our standard rate. If your personal risks are greater risk than most, we’ll explain why and ensure you understand the impact that has on your cover and premium.

What does the underwriting process look like?

You
Step 1

Submit your application

With your financial adviser.

Step 2

Complete your
Personal Statement

Online, over the phone or with your adviser.

1–2 days

Insurer
Step 3

Commence Underwriting

We assess your application and Personal Statement. We may accept your cover on the spot or request additional information (e.g. results of medical tests, financial information).

1–2 days

Step 4

Make a decision

We may accept your cover on standard rates or amended terms (i.e. with exclusions or loadings) or decline your cover. We also determine your premium if you are accepted.

You
Step 5

Receive your outcome

Your cover will commence when we accept your application.

4–5 days
after all info received

Once your fully-underwritten cover has been accepted, you don’t need to go through the underwriting process again (unless you want to alter your policy). Better still, your policy terms and conditions can’t be reduced and your policy can’t be cancelled by an insurer as long as you keep paying your premiums (see The Insider’s Advantage).

What are the main risk factors?

The underwriting process takes into account all of the information you provide in completing your application for insurance to assess your personal risks. This includes:

  • Age
    The cost of buying insurance
    increases gradually as you get older, as statistically your age-related risk factors increase.
  • Body Mass Index (BMI)
    Being overweight increases the risk of many major diseases, such as diabetes and heart disease.
  • Personal health
    Some medical conditions can impact the risk of claim (e.g. raised blood pressure, and cancer) and/or the risk of Disability (e.g. back or joint problems and arthritis).
  • Family medical history
    Conditions such as coronary heart disease, multiple sclerosis and some types of cancer can have known genetics links.
  • Lifestyle
    Using tobacco products, recreational drugs and alcohol consumption (over the recommended limits) are well recognised risk factors.
  • Financial position
    The assessment of your financial information is to ensure that the level of cover proposed is appropriate for you.
  • Hazardous pastimes
    Most pastimes will generally be covered by your insurance, but some hazardous ones (e.g. hazardous forms of scuba diving or private aviation) may be excluded
  • Occupation
    Some occupations carry an increased risk of accidental death or disability (e.g. working at heights, with heavy machinery or explosives).
    Employment history, experience and length of employment are also factors considered for disability cover such as Total and Permanent Disablement (TPD) and Income Protection insurance (IP).
  • Residency and travel
    Underwriters will check the relevant country(s) for any increased risks that may affect you, such as security risks associated with war or political instability, or health risks such as the prevalence of certain diseases.

You can find more information, including common reasons why exclusions and premium loadings are attached to a policy, here.

The insurer’s personal statement is designed to capture all relevant information from you. It’s important that you are  as honest and accurate with your answers as possible to avoid any delays or complications at claim time. Read more about your duty of disclosure and why it matters.

Can you get exclusions or loadings removed?

If you’ve been offered cover with an exclusion or premium loading, you may be able to get this re-assessed in the future if your situation changes.

For example, if you have high cholesterol when you applied for insurance but you’ve since lowered your cholesterol, you can ask your insurer to remove your premium loading for cholesterol.

Can you get life insurance without underwriting?

Some life insurers offer cover without any underwriting, usually direct to the customer (not through financial advisers).

This can make it faster and easier to get life insurance. However, with non-underwritten cover, there are usually blanket exclusions for pre-existing medical conditions and dangerous pastimes – meaning your detailed medical history will be assessed at claim time rather than application time. This can add time and complexity to the claim process.

Also, premiums for non-underwritten life insurance are typically higher than those for underwritten life insurance. For healthy people in particular, buying insurance without underwriting may increase your premium as you are generally assumed to have ‘average’ risk factors, rather than being assessed on your personal risks.

OneCare is issued by OnePath Life Limited (OnePath Life) ABN 33 009657 176, AFSL 238341. OneCare Super is issued by OnePath Custodians Pty Limited (OnePath Custodians) ABN 12 008 508 496, AFSL 238346. OnePath Life is not a related body corporate of OnePath Custodians. We recommend that you read the OneCare Product Disclosure Statement and Policy Terms available at www.onepath.com.au or by calling 133 667 before deciding whether to acquire, or to continue to hold the product.