Life insurance underwriting questions fall into five groups: who you are and what you’re worth, your medical history, your daily habits, your family’s health, and anything unusual about how you spend your time. The insurer is trying to answer one question with all of it: how likely are they to pay a death benefit during the term of the policy? Expect to answer in writing on the application, verbally during a tele-interview, and physically during a paramedical exam, and expect the company to verify your answers against outside databases.
Identity and Financial Questions
The application opens with the basics: full legal name, date of birth, Social Security number, and address. Age is one of the biggest pricing factors, so the carrier confirms it carefully and runs identity checks through third-party databases.
Then come the money questions. You’ll be asked about your income, your net worth, and any life insurance you already own or have applied for. These aren’t idle. The insurer is testing whether the death benefit you’re requesting is proportional to what your beneficiaries would actually lose. A 25-year-old earning $50,000 who asks for a $10 million policy raises flags because the coverage dwarfs any plausible economic need. The underlying legal concept is insurable interest: the policy owner must have a genuine financial stake in the insured’s life, or a close family bond the law recognizes.
Honesty on every one of these questions matters more than most applicants realize. If the insurer later discovers a material misstatement, like an undisclosed diagnosis or hidden tobacco use, it can contest or deny a claim. Every state imposes a contestability period, typically two years from the policy’s issue date, during which the company retains that right. Accurate answers at the start eliminate the risk.
Medical History Questions
Health is the core of underwriting, and the questions go well past “are you in good health?” Expect detailed inquiries about:
- Chronic conditions: diabetes, heart disease, high blood pressure, asthma, COPD, cancer history, autoimmune disorders.
- Surgeries and hospitalizations within the past five to ten years, including dates, reasons, and outcomes.
- Every current medication, with dosage and the condition it treats.
- Mental health diagnoses, including depression, anxiety, and bipolar disorder. Underwriters focus on whether treatment is stable and consistent rather than penalizing the diagnosis itself. Someone managing depression with regular therapy and medication often qualifies for standard rates.
- Height and weight, used to calculate BMI, which feeds directly into your rate class.
Most applications ask about physician visits going back five to ten years and request names and addresses for every doctor or specialist you’ve seen. The insurer may order medical records directly, and that retrieval can add a week or more to the timeline. Having your providers’ contact information ready prevents the delays that frustrate most applicants.
Sleep Apnea and CPAP Compliance
Sleep apnea deserves its own note because it’s common and heavily scrutinized. Underwriters care less about the diagnosis than about treatment. If you use a CPAP machine, expect to be asked for compliance data showing consistent nightly use. Applicants with moderate to severe sleep apnea who can document regular CPAP usage often qualify for standard rates or a modest table rating. Severe sleep apnea with no treatment frequently results in a decline.
Lifestyle Questions
Underwriters probe daily habits because lifestyle choices are powerful predictors of mortality. The level of detail surprises most applicants.
Tobacco and Nicotine
Any tobacco or nicotine use within the past 12 months (cigarettes, cigars, chewing tobacco, vaping, nicotine patches) typically puts you in a smoker rate class. Smoker premiums run roughly two to three times non-smoker rates for equivalent coverage. Even occasional use counts. Insurers test for cotinine, a nicotine byproduct, in blood and urine samples, so there is nothing to fudge.
Marijuana
Marijuana underwriting has grown more nuanced as legalization has expanded, and how you consume matters as much as how often. Edibles and tinctures are treated most favorably because they involve no lung exposure, and many carriers will offer non-smoker rates for occasional edible users. Vaping sits in the middle, with some insurers classifying it as non-smoking and others not. Smoking marijuana is treated most cautiously because of the respiratory parallels to tobacco. CBD products without THC are generally ignored. Occasional use, a couple of times a month, may still qualify for preferred rates; daily use often results in higher ratings or a decline.
Alcohol and Driving Record
You’ll be asked about alcohol consumption, and the underwriter is looking for patterns that suggest risk, not casual social drinking. A DUI conviction changes the calculus significantly. Carriers pull your motor vehicle report and treat recent DUIs as both a behavioral and a mortality risk factor. The usual consequence is a “flat extra” charge, an added dollar amount per $1,000 of coverage layered on top of the base premium for a set number of years. Multiple DUIs within five years can bring an outright decline.
High-Risk Hobbies and Travel
Skydiving, scuba diving, rock climbing, private aviation, and motorsports trigger supplemental questionnaires. The insurer wants to know your experience level, how often you participate, and whether you follow safety protocols. A certified recreational diver with 20 logged dives a year is a different risk than someone doing deep technical cave dives.
International travel plans also come up. If you’re headed to a region with active conflict or a State Department travel advisory, the insurer may postpone your application until you return or exclude coverage during the trip.
Family Medical History Questions
Underwriters ask about biological parents and siblings, not spouses or adopted relatives, because hereditary conditions affect your own risk. The focus is heart disease, stroke, cancer (particularly hereditary types), and diabetes. The threshold that gets the most attention is a biological parent or sibling diagnosed with one of those conditions before age 60, and such a history can keep you out of the best available rate class.
One gap in federal law is worth knowing before you answer. The Genetic Information Nondiscrimination Act of 2008 protects you from genetic discrimination in health insurance and employment, but it explicitly does not cover life insurance, disability insurance, or long-term care insurance.1National Human Genome Research Institute. Genetic Discrimination Life insurers can legally ask about and use genetic test results and family history in underwriting. A handful of states extend genetic protections to life insurance, but coverage is far from universal. If you’ve had genetic testing done, understand that the results can affect your application.
How the Insurer Verifies Your Answers
What you say on the application is only part of the picture. For traditionally underwritten policies, a paramedical examiner visits your home or office for 20 to 30 minutes and collects:
- Vital signs: blood pressure, pulse, height, and weight.
- A blood draw screened for cholesterol, glucose, liver and kidney function, HIV, and nicotine metabolites.
- A urine sample tested for drug use, protein, and glucose.
The examiner also walks you through a tele-interview covering medical history, medications, and lifestyle. For older applicants or higher face amounts, the insurer may require an EKG or additional cardiac testing.
Beyond the exam, the carrier pulls data from third-party sources. The MIB (formerly the Medical Information Bureau) is a database tracking medical and lifestyle information reported on previous insurance applications. If you disclosed a heart condition on an application five years ago, it’s in your MIB file, and the underwriter will see any inconsistency with what you’re saying now.2Consumer Financial Protection Bureau. MIB, Inc. The MIB holds coded flags rather than full records, but those flags prompt deeper digging.
Prescription history reports can go back up to ten years and show every medication filled under your name. Leaving a prescription off the application is counterproductive: the underwriter will see it regardless, and the omission itself becomes a credibility problem.
Insurers access these databases under the Fair Credit Reporting Act, which specifically permits consumer reports for insurance underwriting.3Office of the Law Revision Counsel. 15 USC 1681b – Permissible Purposes of Consumer Reports You have the right to request your MIB file and dispute inaccuracies, just as you would with a credit report.
How Your Answers Become a Rate Class
After reviewing everything, the underwriter assigns you to a risk class that determines your premium. The standard tiers, from cheapest to most expensive, are Preferred Plus (sometimes called Super Preferred), Preferred, Standard Plus, and Standard. Preferred Plus requires excellent health, no significant family history, ideal weight, no tobacco use, and clean labs. Preferred allows minor imperfections like slightly elevated cholesterol. Standard Plus means above-average health with one or two factors outside the ideal range, such as borderline BMI. Standard is the baseline for your age and gender. Each tier also has a smoker and non-smoker version, so “Standard Smoker” costs considerably more than “Standard Non-Smoker.”
Applicants who fall below standard receive a table rating, sometimes called a substandard rating. Table ratings run from A through J (or 1 through 10, depending on the insurer), and each step adds roughly 25% to the standard premium. A Table B rating means about 50% more than standard; Table D means double. Beyond the highest table rating, the insurer typically declines coverage.
If Your Answers Lead to a Decline
A decline isn’t the end of the road. Underwriting standards vary substantially between companies, and a condition one carrier won’t touch may be acceptable to another. An independent broker working with multiple carriers can often find placement for risks a single company declined.
If traditional coverage remains out of reach, two alternatives exist. Guaranteed issue life insurance requires no medical questions and no exam, and anyone who applies within the age range gets approved. The tradeoffs are lower coverage limits (often $25,000 or less), higher premiums, and a waiting period of two to three years before the full death benefit kicks in. Employer-sponsored group life insurance, if available through your job, also typically requires no medical underwriting, though coverage amounts are usually modest.
If the decline was based on a condition that’s improving (recent weight loss, newly controlled blood pressure, or a clean follow-up after cancer treatment), waiting six to twelve months and reapplying with updated records is sometimes the smartest move.