Life Insurance Underwriting Demystified

SA life insurers use a layered underwriting process - financial, medical, occupational and lifestyle. Understanding it shaves weeks off your application and prevents loaded or declined cover.

The four underwriting axes

Medical - blood test (HIV with consent, cholesterol, glucose, liver function), BMI, blood pressure, and either a tele-interview or full medical exam for cover over R3-R5m.

Financial - cover amount must be justifiable based on income (typically capped at 15-20x annual income) plus assets and debts.

Occupational - dangerous occupations (mining, offshore, security) attract loadings or exclusions.

Lifestyle - smoker status doubles premiums; private aviation, motorsport, scuba below 30m and certain travel trigger questionnaires.

Cover bands and what they trigger

Cover amount | Underwriting depth
R0 - R1m | Application form + tele-interview, often instant
R1m - R3m | HIV + cholesterol blood test, BMI, BP
R3m - R7.5m | Full nurse-led medical, ECG over 45 years
R7.5m+ | GP report, possible exercise ECG, financial questionnaire

The 12 questions that move premium most

Smoker status (within last 12 months)

Height & weight (BMI > 30 attracts loadings)

Family history of cardiac disease, cancer, diabetes before age 60

Recent specialist visits or hospitalisations

Prescription medication

Mental health diagnoses and ongoing treatment

Alcohol consumption per week

Recreational drug use

Driving record (DUI, reckless driving convictions)

International travel patterns

Hazardous hobbies (motorsport, aviation, mountaineering)

Occupation and travel for work

Non-disclosure - the existential risk

SA insurance law allows the insurer to void the policy from inception if material non-disclosure is discovered, even years later. The Long-Term Insurance Ombudsman regularly rules in favour of insurers on non-disclosure. Disclose everything; let the underwriter price it.

Speed tactics

Apply through an FSCA-registered broker who pre-screens against multiple insurers.

Schedule the medical for early morning, fasted - cleaner results.

Stop smoking 12 months before applying - non-smoker rates after 12 clear months.

Have your medical aid history ready - 5 years of claims.

Avoid applying immediately after starting new medication; let things stabilise.