Underwriting
Underwriting
In the life insurance industry, underwriters perform the crucial role of evaluating the clients and properly categorizing their risk
factors. In this module, you will learn the basic concepts of underwriting, the life insurance application process flow, and how to
deliver excellent service that will benefit both our clients and our company. This module can help you because, as financial advisors,
you also function as field underwriters.
Are you ready? Let's begin!
Introduction
Learning Objectives
De nition of Underwriting
Let's Review
Risk Factors
Policy Transactions
Underwriting Decisions
Let's Review
Let's Review
Non-medical
Medical
Special Tests
Let's Review
Occupational Guidelines
GLOSSAR Y
Glossary
SUMMAR Y
Summary
KN OWLEDGE CH ECK
Knowledge Check
Congratulations!
Introduction
Watch this short video for an introduction to underwriting – as explained by Tina Dizon, Chief New Business and Underwriting Officer of Sun Life of
Canada (Philippines) Inc.
Introduction video by Tina Dizon, Chief New Business and Underwriting Officer of Sun Life of Canada (Philippines)
Inc.
LEARN MORE
Lesson 2 of 30
Learning Objectives
LEARN MORE
Lesson 3 of 30
Definition of Underwriting
LET'S REVIEW
Lesson 4 of 30
Let's Review
It is the process of evaluating an applicant’s MORTALITY and MORBIDITY. It also assesses the right risk classification of
Underwriting
Needs-based
Money Management
SUBMIT
With insurance underwriting, the focus is on the potential policyholder – the person seeking health or life insurance. This is why we will discuss the
following in more detail:
Beneficiary election
Policy transactions
Underwriting decisions
Risk Factors
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Beneficiary Election
Election by Right
Applicant
Juan and Maria are married. Juan is the applicant for an insurance policy to insure Maria (the insured). Juan may elect himself to be the beneficiary of the
insurance policy.
Relationship by Marriage
Juan is the applicant for an insurance policy for himself (the insured). Since Maria is his wife, he may elect Maria to be a beneficiary of his insurance policy.
Relationship by Consanguinity
Juan is the applicant for an insurance policy for himself, making him both the insured and the policy owner. Since Juan has a grandchild named Pedro, he
Business Affiliation
Juan is the applicant for an insurance policy for himself, making him both the insured and the policy owner. Carlo is Juan's business partner. Juan may
elect Carlo as a beneficiary for Juan's insurance policy.
Election by Order
Juan is the policy owner and the insured. Under beneficiary by order, who will receive the proceeds if he is taken out of the picture?
Click the hotspots in order from 1, 2, then 3 to understand the order flow.
Juan
Maria
In case Juan dies, Maria being the wife and the primary beneficiary will get the proceeds.
Grandmother of Juan
The contingent beneficiary (Grandmother of Juan) will receive the benefit only in the absence of the primary beneficiary
and the insured.
Election by Designation
Juan (husband)
Juan (husband)
Juan (husband)
Juan (husband)
Policy Transactions
Click the cards to learn the transactions that require the signature of the irrevocable beneficiary, and the transactions that do not require the signature.
Change of Beneficiaries
Policy Loan
Policy Surrender
VUL Withdrawal
VUL Surrender
Plan Change
Change of Address
Name Change
Complete the content above before moving on.
Lesson 9 of 30
The underwriter very seldom receives first-hand information on the insured. The underwriter depends on the documents and reports submitted by the
advisor, the medical examiner, insured’s attending doctors, and other sources of medical information.
These serve as primary sources of underwriting information. Most of these information sources are obtained or submitted by the advisor. This
underscores the very important role that you play in risk selection.
Application Form
Inspection Report
Financial Questionnaire
Financial Statements
Most of these information sources are obtained or submitted by the advisor. This underscores the very important role that you play in risk selection.
Underwriting Decisions
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LET’S REVIEW
Lesson 11 of 30
Let's Review
A beneficiary that could be removed anytime by the policy owner WITHOUT any consent needed. The proceeds
Contingency Beneficiary
Primary Beneficiary
Irrevocable Beneficiary
Revocable Beneficiary
SUBMIT
This is a type of underwriting decision where additional requirements were requested by the underwriter for further
appraisal yet the advisor did not respond within the given deadline.
Declined
Click the link below to download a copy of the Life Insurance Application Process Flow for future reference.
Life_Insurance_Application_Process_Flow.pdf
385.6 KB
C O NT I NU E
The application form must be answered truthfully and completely filled-out. Download a copy of the PDF to check out what information are needed.
To get you started, please download and open the Pre-Submission Checklist.
SLOCPI_Checklist_03Sep2018.pdf
81 KB
To get you started, please download and open the Proof of Temporary Life Insurance.
Proof_of_Temporary_Life_Insurance.pdf
5.9 MB
Complete the content above before moving on.
Lesson 13 of 30
You must be careful when filling out the application form. Be guided by the Do’s and Don’ts provided here.
DO's
DON'Ts
Do not submit typewritten
applications.
Th t Lif I
The temporary Life Insurance
questions are answered YES.
The face amount exceeds the
retention limit.
Example: 30 = 18
The number on the left side of the equation [e.g. 30] reflects the age of our client.
The number on the right side of the equation [e.g. 18] reflects the income multiplier.
Age
The number on the left side of the equation [e.g. 30] reflects the age of our client.
Income Multiplier
The number on the right side of the equation [e.g. 18] reflects the income multiplier.
As the age increases, the income multiplier decreases. The multipliers vary by age being higher at the younger ages reflecting the number of productive
years.
NOTE: Even if the prospect needs Ps. 30M insurance coverage based on Financial Needs Analysis, Underwriting will
decline insurance coverage more than the annual salary x income factor of the prospect.
If the total amount applied for and existing coverage with Sun Life exceeds the amounts shown below, the excess will be subject to reinsurance. Do not
collect premiums if beyond our retention limit.
Click the image to enlarge.
NOTE:
Exchange Rate = Ps. 50.00 per US$ 1.00. Calculation of retention limit is inclusive of all existing death benefits under regular
underwritten policies, GIO, SIO + the current Application.
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LET'S REVIEW
Lesson 15 of 30
Let's Review
SUBMIT
Non-medical
Non-medical Limits is the maximum amount of a policy that an insurer will issue without the applicant taking a medical examination, although medical
questions are asked each time during the application process. Always aggregate death benefit of basic life policies + GIO + SIO + Term benefit issued
within the past 24 months and add to pending application. Do not include WPD, WPDD, CI and FMB products and riders in the aggregation.
Always aggregate the death benefit of basic life policies + GIO + SIO + Term benefit issued within the past 24 months
and add to pending application.
Do not include WPD, WPDD, CI and FMB products and riders in the aggregation.
Click the image to enlarge.
Non-medical limits will be based on aggregation of all CI policies and CI benefits issued within the past 2 years.
Include all issued and pending CI products and CI benefits, such as CIB, Sun LifeAssure, Sun Maiden and Female Critical Illness in the aggregation.
Critical Illness maximum issue limit will be increased from Ps. 8 Million to Ps. 15 Million per life. Issue limit for Female benefit policies and riders will
remain at Ps. 2 Million.
Random requirement of medical exam and may be done from time to time (exclude: GIO and single pay apps). **cotinine for non smoker rate policies
only.
Underwriter reserves the right to require medical exam depending on the profile of the case.
Complete the content above before moving on.
Lesson 17 of 30
Medical
1
Click the image to enlarge.
Please take time to download the PDF file so that you can study it and use the guidelines for reference in case the
clients have questions regarding the FME.
FME_Guidelines.pdf
347.9 KB
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Sample template for LOA request.
Click the image to have a larger view.
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Use the link below to download a copy of the Medical (LOA) Process for Provincial Accredited Laboratories form for future reference.
Sample-LOA_for_JUAN_DELA_CRUZ.pdf
443.6 KB
Examiner's Limit
Regular Examiners are usually nurses who conduct Medical Examinations but only up to a certain amount of coverage.
Mobile examiners are more flexible and can usually conduct medical exam anywhere or preferred place of the insured.
Special Examiners are usually doctors who conduct Medical Examinations regardless of the amount of coverage.
Mobile examiners are more flexible and can usually conduct medical exam anywhere or preferred place of the insured.
Use the link below to download a copy of the Medical Examiner's/Paramedic's Limits for future reference.
Examiners_Limit.pdf
253.5 KB
Use the link below to download a copy of the Blood Test Requirements & Cotinine Guidelines for future reference.
Blood_Test.pdf
269.2 KB
Application Form
Once the applicant signs the application form, he or she now has within 30 days to submit and complete all requirements needed. In the event that
the applicant fails to complete all requirements, the officer will not be able to proceed with the application process.
Medical Exam
Take note of the validity periods of these medical exams as they will be useful when submitting requirements:
1. Medical exams are valid for three (3) months if done for the current application.
2. Medical exams are valid for six (6) months if taken from a previously issued standard policy.
3. Medical exams are valid for three (3) months if taken from a previously rated, declined, postponed, or NPW’ed case.
NOTES:
1. For #2 and #3 above, complete the Non-Medical portion of the Application.
2. Underwriter reserves the right to require a medical examination depending on the assessment results.
Special Tests
Special tests such as Cotinine test, PSA, CBC have a validity of one (1) year. These special tests will be required if the sum of the client application and
all Sun Life policies issued within the past 2 years equals or exceeds the stated limit.
Financial Requirements
Financial requirements are valid for one (1) year, unless there are updates due to year-end changes in financial statements. So always make sure that
you have with you your most updated financial statements.
Complete the content above before moving on.
Lesson 18 of 30
Special Tests
Special Test Limits for Basic Life + Renewable Term Benefit (RTB)
1
Click the image to enlarge.
Use the link below to download a copy of the Special Test Limits for Basic Life + Renewable Term Benefit (RTB) for future reference.
Special_Test_Limits.pdf
442.1 KB
Inspection Report
The Inspection Report is required if the aggregate total in force + pending with SLOCPI + Other Companies equals the stated limit.
NOTE: The Underwriter reserves the right to require Inspection Report depending on assessment results.
For requests to rush inspection reports, cost in excess of regular inspection report will be paid by the advisor.
Financial Requirements
Financial requirements are necessary if the aggregate total in force + pending with SLOCPI + Other Companies equals the stated limit.
Note: Exchange rate used is US$ 1.00 = Ps. 50.00
LET'S REVIEW
Lesson 20 of 30
Let's Review
The maximum amount of insurance that an insurer is willing to carry at its own risk on any one life.
Reinsurance
Reinstatement
Retention Limit
Non-Medical Limits
SUBMIT
This is the maximum amount of a policy that an insurer will issue without the applicant taking a medical examination,
Retention Limit
Financial Requirements
Inspection Report
Non-Medical Limit
SUBMIT
1
Click the image to enlarge.
2
Click the image to enlarge.
Use the link below to download a copy of the Guardianship Proceedings for Minors for future reference.
Guardianship_Guidelines.pdf
1.3 MB
Lesson 22 of 30
These are some of the Underwriting Guidelines for the proposed insured age 70 and above.
Use the link below to download a copy of the Guidelines for Ages 70 and Above.
Guidelines_for_Ages_70_and_Above.pdf
964.5 KB
Lesson 23 of 30
1
Click the image to enlarge.
2
Click the image to enlarge.
3
Click the image to enlarge.
4
Click the image to enlarge.
5
Click the image to enlarge.
Use the link below to download a copy of the Guaranteed Insurability Offer (GIO) Guidelines for future reference.
Guaranteed_Insurability_Offer_(GIO)_Guidelines.pdf
1.7 MB
Lesson 24 of 30
Play the video to learn more about the Underwriting Considerations for Foreign Travel Guidelines.
(If you are on a slow internet connection, this section may take a few moments to load. Thank you for your patience.)
Take time to download the Foreign Travel Guidelines PDF file to know more. Click the link below.
Foreign_Travel_Guidelines_with_WPD_WPDD_Ratings_01June2017.pdf
599.2 KB
REVIEW OF RATING
Reconsideration of a rating or a declined application may be considered subject to our usual Policy Change guidelines once
the insured is no longer travelling and a reasonable period of time has elapsed (e.g., 1 year). Some lapse of time is necessary
to ensure that the insured has had time to settle into a new lifestyle or occupation that does not include the travel and
reduces/eliminates the chances that he will return to such a lifestyle. It also ensures that any disease that may have
surfaced as a result of the travel has been resolved.
SOLICITATION
Solicitation is defined as the entire new business process from illustration, application to completion of underwriting requirements including
examinations and policy delivery.
2. Mandatory and underwriting requirements should be completed before client leaves for abroad.
1. Application form, basic mandatory requirements, age/amount requirements. Complete residence and business addresses
should be written in the Application form. P. O. Box is not allowed.
2. AMLA Form (SSS or GSIS and TIN) and valid government issued ID with picture and signature.
3. A cover letter describing the country of destination, purpose of travel, duration of previous and current travel,
occupation and details of duties, employer, income, etc. This will help in the evaluation of the application.
4. Indicate in the Application Form and proposal the extra premium and include the extra premium in the payment, if
known.
REQUIREMENTS FOR NON-FILIPINO CITIZENS
1. Application form, basic mandatory requirements, age/amount requirements. Complete residence and business addresses
should be written in the Application form. P.O. Box is not allowed.
2. AMLA Form; Alien Certificate of Registration (ACR) or I-Card showing immigration status; and photocopy of passport with
picture and signature.
3. Advisor's report to include occupation and nature of duties, details of immigration status, duration of approved stay in
the Philippines.
Occupational Guidelines
1
Click the image to enlarge.
2
Click the image to enlarge.
Use the link below to download a copy of the Occupational Guidelines for future reference.
Occupational_Guidelines.pdf
547.8 KB
Occupation_Guidelines_with_Simplified_WPD_WPDD_Ratings_01June2017.pdf
1.2 MB
Click the Glossary button to familiarize yourself with terms used in Underwriting.
GLOSSARY
Lesson 26 of 30
Glossary
Alkaline Phosphatase
–
Alkaline phosphatase is an enzyme found in bone, liver, bile ducts, placenta and other tissues.
Creatinine (Serum)
–
This test measures the amount of Creatinine in the blood. Creatinine is a break-down product of Creatine phosphate in muscle and is usually produced
at a fairly constant rate by the body. Creatinine is measured to see how well kidneys are working.
HDL
–
Good cholesterol
LDL
–
Bad cholesterol
RTB
–
Renewable Term Benefit
GIO
–
Guaranteed Insurability Offer
SIO
–
Simplified Insurability Offer
PSA
–
Prostatic Specific Antigen
CBC
–
Complete Blood Count
Complete the content above before moving on.
Next: Summary
Let’s wrap up this Module and review key concepts.
LET'S WRAP UP
Lesson 27 of 30
Summary
What is Underwriting?
Underwriting is the process of evaluating the risk and exposures of potential clients by evaluating the applicant’s MORTALITY and MORBIDITY.
Underwriting is important because when an individual applies for insurance coverage, he or she is asking the insurance company to take on the potential risk of
having to pay a claim in the future.
Risk Factors
Beneficiary Election
Policy Transactions
Sources of Underwriting Information
Underwriting Decisions
Insurance Application Form
Medical Exams
Special Tests
Financial Requirements
Knowledge Check
Ready to show what you know? Choose the best answer for each question.
Question
01/05
It is the process of evaluating an applicant’s MORTALITY and MORBIDITY. It also assesses the right risk classification of the
Underwriting
Needs-Based
Money Management
Question
02/05
The maximum amount of insurance that an insurer is willing to carry at its own risk in any one's life.
Reinsurance
Reinstatement
Retention Limit
Non-Medical Limits
Question
03/05
A beneficiary that could be removed anytime by the policy owner WITHOUT any consent needed. The proceeds payable to this
beneficiary are subject to estate tax.
Contingent Beneficiary
Primary Beneficiary
Irrevocable Beneficiary
Revocable Beneficiary
Question
04/05
This is a type of underwriting decision where additional requirements were requested by the underwriter for further appraisal
yet the advisor did not respond within the given deadline.
Declined
05/05
This is the maximum amount of a policy that an insurer will issue without the applicant taking a medical examination, although
medical questions are each time asked during the application process.
Retention Limit
Financial Requirements
Inspection Report
Non-Medical Limit
Lesson 29 of 30
Congratulations!
DOWNLOAD
Lesson 30 of 30
Downloadable Resources
Life_Insurance_Application_Process_Flow.pdf
385.6 KB
SLOCPI_Application_for_Life_Insurance_14June2018.pdf
187.7 KB
Pre-Submission Checklist
SLOCPI_Checklist_03Sep2018.pdf
81 KB
Proof_of_Temporary_Life_Insurance.pdf
5.9 MB
Full Medical Examination (FME) Guidelines
FME_Guidelines.pdf
347.9 KB
Sample-LOA_for_JUAN_DELA_CRUZ.pdf
443.6 KB
Examiners_Limit.pdf
253.5 KB
Blood_Test.pdf
269.2 KB
Special Test Limits for Basic Life + Renewable Term Benefit (RTB)
Special_Test_Limits.pdf
442.1 KB
Guardianship Proceedings for Minors
Guardianship_Guidelines.pdf
1.3 MB
Guidelines_for_Ages_70_and_Above.pdf
964.5 KB
Guaranteed_Insurability_Offer_(GIO)_Guidelines.pdf
1.7 MB
Foreign_Travel_Guidelines_with_WPD_WPDD_Ratings_01June2017.pdf
599.2 KB
Occupational Guidelines
Occupational_Guidelines.pdf
547.8 KB
Occupation_Guidelines_with_Simplified_WPD_WPDD_Ratings_01June2017.pdf
1.2 MB
Module Handout
Underwriting.pdf
30.2 MB
Click the EXIT Module button to exit. You may proceed to the next module.
EXIT MODULE