20th July, 2026

If you have applied for any form of life insurance, you would possibly have had to go through this whole long list of health questions and after which the insurer would provide you with an underwriting outcome.

What is insurance underwriting then? It is the process of evaluating a risk of insuring an individual based on risk factors which include age, health, lifestyle, medical history etc, in the case of life insurance to assess the risk and profitability of offering the policy to the applicant.

 

So what are the plausible underwriting outcomes?

  • Standard term
  • Acceptance with loading
  • Acceptance with exclusion
  • Postponement
  • Decline
 
STANDARD TERMS
This is the best outcome possible. It means that the insurer accepts your application as per the usual contract. Typically if you are healthy, you will not have issues buying a protection plan. 
 

ACCEPTANCE WITH LOADING
When the insurer comes back with this counteroffer, it means that the insurer is willing to cover your medical condition but would require you to pay a higher premium for it as compared to a standard policy. 

For example, an insured with a high BMI might find themselves having to fork out more premiums for the same coverage than someone who has a more ideal BMI.

 

ACCEPTANCE WITH EXCLUSION
On the other hand, if the counteroffer states an acceptance with exclusion, the insurer would not able to insure your existing / pre-existing health condition. However, they are agreeable to provide coverage for other non-related health conditions.

For example, an insured with breast cysts might find that insurers would not be able to cover them for breast cancer.

POSTPONEMENT
This does not mean that the insurer is saying ‘no’. It just means that the insurer is unable to make a decision based on current health status but could potentially offer you terms in the foreseeable future.

For example, an infant that was born with low birth weight might have their case postponed and the insurer would be able to underwrite the case as the child grows and develops.

DECLINE
This means the insurer is unable to offer any terms for coverage. In certain cases, a serious chronic medical condition may warrant you to be uninsurable. 

So what should I do?

Before you make an official application to the insurers, you can engage the help of our advisers to do a preliminary underwriting for you to find out how the insurers will assess the declared medical condition. The preliminary outcome will not be official and can be subjected to more requirements in a formal application, if required. However, this will provide you with a good indication of what is the likely outcome.

Each insurer has their own risk pool and may have varying risk tolerance towards different health conditions. Hence, you may be surprised that while insurer X decides to accept your application with loading, insurer Y could accept you based on standard terms.

It is not the end of the world if you receive a less than ideal underwriting outcome. It is imperative to note that underwriting decisions are not cast in stone. We usually would advise our clients to accept the terms first and request for the insurer to review their terms from time to time.

Certain conditions might pose an issue now but be less crucial in an underwriting decision in future. Should there be improvement in condition or if a condition stabilises, the insurers would be able to underwrite the risk and offer better terms. Likewise, have you been a smoker paying higher premium rates? If you have stopped smoking, it is also time to review your rates.

One last thing.

On a more practical note, even though there might be exclusion or loading imposed on a policy, the insurer is still able to provide coverage to you for other health conditions that may occur. Afterall, insurance is a tool to outsource risk that is too huge for us to manage by ourselves.