Medical and financial evidence

Making sure your clients get the fairest price for their cover.

The full picture

We work out the cost of your client’s cover based on the information they provide during the application process and any additional information we request from them.

To secure the fairest terms for your client it’s essential this information is as complete and accurate as possible. We use a variety of ways to collect information, so we get the full picture about your client’s circumstances.

When we ask for evidence

If your client is a certain age or requests a certain level of cover, we will automatically ask for some types of medical evidence from them, even if they have no known medical conditions.

We use this evidence to make sure we apply the correct terms, based on complete and accurate information, at the application stage. Automatic evidence also protects your client if they need to claim, as any increased risk factors at the time of applying are identified and factored in to the cost of their cover.

When we need a Declaration of Health (DOH)

The DOH provides your client with the opportunity to tell us about any changes to their health or other relevant circumstances since the application was submitted.

The information given on the application is valid for 6 or 3 months depending on the amount of cover. After this period, a DOH can be used to extend the validity of the application, provided the application date is less than 12 months old. A new application will be needed if the application is more than 12 months old.

A DOH is only valid for two months from the date the client signs the form.

  • Once the underwriting decision or validity date has expired (see table below).
  • When the requested policy start date is beyond the validity date.
  • When the direct debit is not collected within 60 days of the policy start date.
When we need a Declaration of Health (DOH)
Type of cover Sum assured Medical information is valid for
(from date of application or medical examination)
Life cover £500,000 or below 6 months
Over £500,000 3 months
Critical Illness Cover (CIC) £350,000 or below 6 months
Over £350,000 3 months
Income Protection Benefit (IPB) Any amount 6 months
Mortgage Payment Insurance (MPI) Any amount 6 months

Changing the application

A DOH will also be required if your client wants to:

  • Extended the policy term by more than five years.
  • Increase the sum assured by more than 10% of the original sum for Life and CIC policies. However, any increase less than £10,000 does not require a DOH even if it’s more than 10% of the original sum assured.
  • Increase the sum assured by more than £30,000.
  • Increase the sum assured for IPB and MPI to more than 10% of the original benefit.
  • Reduce deferment periods for MPI and IPB.
  • Add any optional benefits.

Types of disclosure we may use

When we ask for information to help with underwriting your client’s application, we will ask for one or more of the following documents.

Types of disclosure we may use
Document Explanation Completed by
Application form The most important piece of underwriting evidence, as this forms the basis of the contract. Please make sure answers are precise and accurate so we can get your client on risk as soon as possible. Client
Telemedical Interview (TMI)

This is where a specially trained nurse or underwriter contacts your client to speak to them about a medical condition they have disclosed on the application form or about their general health for age sum assured purposes.

For more information see ‘What happens during a telemedical interview (TMI)’ below.

Client
Simple Financial Information (SFI) This is a form that allows your client to provide information about existing cover, earnings, net worth and last year's profits (for Key Person cover). Client
Personal Assurance Questionnaire (PAQ)

A financial questionnaire that provides information about your client’s income, concurrent and existing cover and details relevant to their personal needs.

For higher sums assured or complex applications, this form may need countersigning by an independent third party such as an accountant, solicitor or bank manager who is independent of the application.

Client and possibly an independent third party
Business Assurance Questionnaire (BAQ)

A financial questionnaire that provides information about income, concurrent and existing cover and details relevant to your client’s business needs.

For higher sums assured or complex applications, this form may need countersigning by an independent third party such as an accountant, solicitor or bank manager who is independent of the application.

 

Client and possibly an independent third party

Patient Health Report (PHR)

This is a report is based on your client’s medical records. The report covers:

  • The current health of your client, including any treatment that has been prescribed, any outstanding investigations and any certified time off work.
  • Any relevant past medical history, including details of any investigations that were undertaken.

The report can be requested either as part of the age sum assured evidence or due to medical disclosures made by your client.

 GP
Specific Medical Reports (SMR)

These are based on your client’s medical records.

The reports cover:

  • Cardiovascular – Body Mass Index (BMI), blood pressure (BP), cholesterol, diabetes and impaired glucose tolerance
  • Lifestyle - alcohol, smoking and drug use
  • Mental health
  • Recent referrals for further investigations
 GP
General Practitioner’s Report (GPR) This is a standard industry format report, based on your client’s medical records. The report covers:
  • The current health of your client, including any treatment that has been prescribed, any outstanding investigations and any certified time off work.
  • Any relevant past medical history, including details of any investigations that were undertaken.
  • Details of any medical conditions that have occurred within the immediate family.

It can be requested either as part of the age sum assured evidence or due to medical disclosures made by your client.

 GP
Targeted Reports

This is short questionnaire that is sent to your client’s GP instead of a General Practitioner’s Report. It asks specific questions relating to a condition that has been disclosed by your client.

A maximum of two targeted reports will be issued per customer; above this a PHR will be issued. A PHR will always be requested over age sum assured limits, irrespective of the disclosed conditions.

 GP
Health Check Nurse –Full Screening (Also known as a Nurse Screening Examination [NSE]) 

This is a report based on a screening performed by a nurse at a convenient place for your client. For example, at their place of work or at home. It can be requested either as part of the age sum assured evidence or due to medical disclosures made by your client.

Information collected during the screening includes:

  • Your client’s medical and family history.
  • Drinking and smoking habits, height and weight, blood pressure.
  • Urinalysis (including cotinine test if your client is a non-smoker), peak flow reading.

To enable us to use this form of evidence, your client must supply a telephone number so that the nurse can contact them to arrange the appointment.

 Medical professional
Health Check Nurse –Mini Screening (Also known as a Nurse Screening Examination [NSE])

This is a report based on a screening performed by a nurse at a convenient place for your client. For example, at their place of work or at home. It can be requested either as part of the age sum assured evidence or due to medical disclosures made by your client.

Information collected during the screening includes:

  • Height and weight
  • Blood pressure
  • Urinalysis (including cotinine test if your customer is a non-smoker)
 Medical professional
Health Check Doctor (Also known as a Medical Examination Report [MER])

This is a report based on a medical examination completed by your client’s GP or an independent doctor provided by a third party.

It can be requested either as part of the age sum assured evidence or due to medical disclosures made by your client.

Information collected during the examination includes:

  • Your client’s medical history
  • Medical details about your client’s immediate family
  • Drinking and smoking habits
  • Examination of your client’s heart and chest function
  • Blood pressure
  • Urinalysis
  • Cotinine test (if your client is a non-smoker) - this is sometimes performed as a saliva test or sometimes as part of the urinalysis.
Medical professional

Other medical tests

Other medical tests
Human Immunodeficiency Virus (HIV) Test

This test is always performed using a blood sample. The test is required as part of age sum assured evidence or based on your client’s answers to application questions.

It can be requested in conjunction with a Health Check Nurse or Doctor. The nurse or doctor will send the sample straight to the laboratory and the results are sent directly to us.

In accordance with the Statement of Best Practice on HIV, we will request an HIV test directly with your client. Whenever possible we will not tell you that your client is required to undergo an HIV test.

Please read our HIV Policy for more details.

Cotinine Test

Cotinine is a chemical that is made by the body from nicotine and is an indicator that nicotine has been inhaled or otherwise introduced into the body.

The cotinine test is performed as part of the urinalysis or as a saliva test during an examination (Health Check Nurse/Doctor).

It is requested when a non-smoking client is required to undergo an examination either as part of age sum assured evidence or due to a medical disclosure that is made by your client.

The test is able to distinguish between passive and active smoking.

Electrocardiograph (ECG)

An ECG is a test that measures the electrical activity of the heart and is a valuable tool in detecting past and present problems relating to the heart. The test is performed during exercise using a treadmill or bicycle. An ECG is normally requested as part of larger age sum assured evidence.

Blood tests

These are usually requested for larger sums assured but can also be requested to help with the underwriting of any case where the underwriter requires further clarification.

Non-fasting Blood Profile (NFBP) - a blood profile that includes all the tests below. This test ensures we collect all risk data, so eliminating unnecessary delays due to omitted tests.

Liver function Tests (LFT) - used to analyse the functioning of the liver.

Lipids - used to calculate the cholesterol level in the blood.

Renal Function Test (RFT) - used to analyse the functioning of the kidneys.

Full Blood Count (FBC) - analyse the constituents of the blood.

Glycosylated Haemoglobin (HbA1c) - provides a longer-term trend, similar to average, of how high the blood sugar has been over a period of time.

Checking your details form

'Checking your details' (CYD) forms are sent out at the point we make a final underwriting decision on a life.

They include all possible amendments that have been made since the application was submitted. However, only the client will see the risk information, such as the medical answers.

It’s important that the client checks the information thoroughly and makes any amends if necessary. Amendments can potentially cause the terms to change, which may delay the application going on risk.

To reduce the chance of this happening, please double check the following before submitting the application form:

  • The spelling of your client’s name.
  • Their date of birth.
  • Their occupation details.
  • The document is signed and dated.

If there are any amends, an underwriter will review these and depending on the stage of the application there may be:

No change to the decision - a letter is issued to the client thanking them for the information and that there is no change to the decision.

New decision made - if the application has been authorised it will be reissued with the new terms.

If the application has not been authorised the new terms are applied, and a new offer letter issued.

Further information required - an underwriter reviews the information and decides if further investigation is required.

  • If the case has been authorised, we will send a letter to the client to tell them that we require further information and that we will maintain cover for 60 days whilst we carry out this review. However, if we cannot obtain the information within this time period at the end of the 60 days the policy will be cancelled.
  • If the case has not been authorised, we write to the customer to tell them that the original decision has been removed and the underwriting process restarted.

What happens during a telemedical interview (TMI)

If your client has disclosed a medical condition on their application form, we may need to contact them for more information.  In some cases, rather than write to your client's doctor, we can speed up the underwriting process by asking your client to talk to one of our specially trained team.

TMI can also be required for age sum assured purposes.

Your client can talk freely and in confidence to a trained member of staff who has an understanding about the nature of the medical condition and knows what information is required to underwrite the policy.

We will contact your client to let them know that we need some further information over the phone. This will be by text, email and letter. You will also be sent an email, to keep you updated with progress.

The customer will then have our freephone number, so that they can call at their convenience to complete the telephone interview. We will not call them to complete the interview – we wait for when it’s convenient for your client to call us.

Lines are open Monday to Thursday 9am to 6.30pm. Friday 9am to 6pm. All calls are recorded and kept for future reference. Deaf or hard of hearing clients can also use telemedical interviews if they have access to Type Talk, or a similar service.