So, we like to know as much about your clients as possible. That way we can avoid having to decline any future claims through misrepresentation.
During the application process we ask your client to supply as much information as possible about their level of alcohol consumption.
Full disclosure by your client allows us to make a fair and accurate assessment, while lack of information means we have to make assumptions which could result in terms being harsher or cover being declined.
We also check to see if your client’s occupation is connected with high alcohol intake or the sale of alcohol.
We may then request a Patient Health Report (PHR) and/or medical examination to collect details about past and present alcohol consumption and any treatment or complications due to alcohol consumption.
We will take in to account the results of any investigations, particularly Liver Function Tests (LFTs) or other alcohol markers and any clinical signs of the effects of alcohol consumption following an examination.
If your client is involved in a hazardous activity, we need to know:
- How many times they take part each year.
- How often they take part (e.g. weekly/monthly/twice a year on holiday).
- Where (if abroad, confirm which countries).
- Qualifications and club memberships.
- The type, size and their involvement in any races with regards to motor sports.
- The depth and types of any diving.
Information about underwriting decisions can be found in the PDF file: Guide to underwriting hazardous activities PDF size: 109.6KB .
Separate questionnaires for each type of hazardous activity can be found in our document library [Add link when page is built].
Recreational drug use is a known increased risk to both mortality and morbidity.
The question about recreational drug use is only presented to customers applying for Life Cover, Critical Illness Cover (CIC) and Waiver of Premium (WOP). It isn't asked on Income Protection Benefit (IPB) applications because there is a standard policy exclusion.
There are no legal implications for your client if they answer 'yes' to this question, but we will decline cover.
Smoking remains the main cause of preventable disease and premature deaths in the UK.
Smoker rates are applied to anyone who has smoked any cigarettes (including e-cigarettes), cigars, a pipe, or used nicotine replacements within the last 12 months.
Smoking is regarded as an additional risk factor when underwriting any associated conditions and will usually result in a higher extra premium being charged or even the application being declined.
We may ask your client to take an immediate urine test to check the validity of their answer to this question.
Build – including BMI tables
Body Mass Index (BMI) is a simple index of weight-to-height that is commonly used to classify overweight and obese adults.
The World Health Organisation (WHO) have set the following BMI ranges:
- BMI less than 18.5: underweight
- BMI between 18.5 and 24.9: ideal weight for height
- BMI between 25 and 29.9: overweight
- BMI between 30 and 39: obese
- BMI 40 or over: very obese
A BMI over 25 can indicate that a person is overweight. Overweight and obese adults, and those with a large waist measurement can be at increased risk of some health conditions like Type 2 Diabetes and heart disease.
Depending on your client’s BMI, we may also ask for their trouser, dress or skirt size, which may incur an additional premium in its own right. If a measured waist is provided in any medical evidence we obtain we will use this in our assessment.
Potential premium increases for BMI
The guide below shows how your client’s premium may increase due to BMI, but doesn’t include any possible increase for trouser, dress or skirt size. It assumes that there aren’t any health conditions present.
|BMI||Age next birthday|
|Min||Max||0 - 35||36 - 55||56 - 75|
|40+||-||Decline||Moderate - Decline||Moderate - Decline|
|BMI||Age next birthday|
|Min||Max||0 - 35||36 - 55||56 - 75|
Income protection benefit
|BMI||Age next birthday|
|Min||Max||0 - 45||46 - 65|
Certain occupations have a higher risk of accidental death or disability, work-related stress or depression, or propensity for minor illness or injury that prevent your client from working. These risk factors need to be considered when underwriting your client’s application.
Occupation classes help determine premium amounts and the definition of disability for disability products.
All occupations can be categorised into one of five occupation classes - 1, 2, 3, 4 and H01. The following table shows whether the occupation class will affect the premium and/or the definition of disability:
|Benefit||Is premium affected?||Is definition of disability affected?|
|Life cover||No, unless occupation has a hazardous element||N/A|
|Critical illness cover (CIC)||No||Yes|
|Total and Permanent Disability (TPD)||No||Yes|
|Income Protection Benefit (IPB)||Yes||Yes|
|Waiver of premium (WOP)||No||No|
Class 1 occupations are the lower risk occupations through to class 4, which are deemed to be a higher risk.
Class 1 occupations will have comparably cheaper premiums and a more lenient definition of disability, depending on benefit type.
The fifth occupation class is H01 and is applied to housepersons, students, retired and unemployed clients.
The occupation class is established when the policy is first set up. For current policies, your client is not required to tell us about any changes in occupation. However, some older policies do require your client to tell us about a change of occupation, so please check the individual policy terms and conditions.
Working at height
Working at height usually involves additional risk, so we include this as a separate question on the application. We rate the risks by product depending on whether someone works above the Private Dwelling House (PDH) height or not.
We don’t rate the occupation from job title alone, only from a positive answer (for certain occupations) to the working at heights question on the application form. If your client answers positively to the working at heights question, the most likely outcome is in the attached table:
|Life cover||A rating will be applied|
|Critical illness cover (CIC)||An occupation exclusion will be applied|
|Waiver of premium (WOP)||This benefit won’t be available|
|Total and Permanent Disability (TPD) – own occupation definition||This benefit won’t be available|
|Total and Permanent Disability (TPD) – specified work tasks (SWT) definition||This benefit will normally be available|
|Income Protection Benefit (IPB)||This type of policy won’t be available|
Apart from the obvious risks associated with warfare, military service is associated with a higher risk of disability and death due to numerous risk factors.
All service personnel including Army, Royal Navy, and Royal Marines, Royal Air Force and Army Reserves (Formally Territorial Army) will need to complete an Armed Forces Questionnaire when applying for cover. The Questionnaire is integrated into the Interactive Underwriting application, so an additional questionnaire is not needed if the application is submitted via this route.
Our cover for armed forces personnel
We offer armed forces personnel, life and critical illness cover, but not income protection benefit.
Certain occupations may attract premium loadings. For example, those who work with bomb disposal, diving and aviation. But our policies do not usually exclude war risks.
We will consider mortgage life cover for services personnel who are due to go, or are on, a tour of duty to an active theatre of operations within six months. An extra premium is charged for two years.
Critical Illness Cover
We offer critical illness cover to all services personnel, but with a ‘tour of duty’ exclusion. The exclusion is ‘any accident or injury arising while you are undertaking a tour of duty to an active theatre of operations or conflict’.
If a client is about to go on a tour of duty to an active theatre of operations or conflict, we would only consider critical illness cover if related to a mortgage.
Certain occupations may attract specific exclusions. For example, those who work in diving and aviation.
Ministry of Defence Schemes
The Ministry of Defence (MoD) has an armed forces scheme and a war pensions scheme that pay out on death or disability. The amount varies depending on the length of service, rank, level of disability etc.
The MoD also has a scheme for refunding additional life insurance premiums charged because of a forces’ occupation. The details are not straightforward and have various exceptions, but in general terms, the MoD will refund 90% of any additional premiums for sum assured up to £179,000.
For further details, please refer your client to their HR department to see if they are eligible and to obtain the necessary form JPA F010.
Current, future and past residency and travel are important risk factors.
Residence or travel outside the United Kingdom can involve increased risk. For example, clients may travel to war zones, politically unstable areas or areas where there are health related risks.
Tax rules and legislation restrict who we can offer cover to outside the UK. We abide by HM Revenue and Customs (HMRC) regulation and the European Union's Third Life Directive.
For clients who have arrived in the UK or travelled for a long period outside the UK within the past five years we may need medical evidence to assess their application. It depends on the duration of the stay, time since arrival in the UK and the countries they travelled to.
We will consider clients who are:
- Permanently resident in the UK.
- Temporarily travelling within the European Union (EU), United States of America (USA), Canada, Australia and New Zealand.
- Temporarily travelling to countries not listed above on an individual consideration basis.
- Planning a permanent move abroad, whilst they remain in the UK.
- Crown Employees or in the Merchant Navy.
We will consider cover for applicants who will definitely be moving abroad, as long as the move is not within three months of the application.