Life insurance medical questions and underwriting explained
- UK adults who smoke (2024)
- 10.6% [2]
- GP report
- You can ask to see it [3]
- Honest answers
- Protect the claim
- Protection claims paid 2025
- 97.9% [6]
What you need to know before applying
- Know the kinds of questions insurers ask.
- Understand how answers become an underwriting decision.
- Know your rights when a GP report is requested.
- See how pre-existing conditions are usually assessed.
- Understand why accurate answers matter so much.
What insurers ask about
Life insurance applications ask about the person being insured so the insurer can assess the risk of a claim during the term. MoneyHelper notes that cost and acceptance depend on factors including age, health and lifestyle. [1] Questions differ between insurers, but they usually cover similar ground.
Expect questions about current and past medical conditions, medication, recent symptoms not yet diagnosed, tests or referrals you are waiting for, height and weight, alcohol intake, and nicotine use including vaping. Many insurers also ask about close family members diagnosed with certain conditions before a particular age, and about occupation, hazardous hobbies and travel.
Nicotine questions are common because they affect pricing. ONS estimated that 10.6% of UK adults smoked cigarettes in 2024. [2] Insurers define “smoker” in their own way, often including e-cigarettes and nicotine replacement, and usually ask whether you have used any nicotine within a set period, such as the past 12 months.
| Area | Examples of what may be asked | Tip |
|---|---|---|
| Medical history | Diagnoses, treatment, hospital stays | Have dates and details to hand |
| Current health | Medication, symptoms, pending tests | Include undiagnosed symptoms if asked |
| Lifestyle | Height, weight, alcohol, nicotine | Answer the exact wording used |
| Family history | Parents or siblings with certain conditions | Note the age at diagnosis |
| Occupation | Job duties, working at height or offshore | Describe duties, not just job title |
| Hobbies and travel | Diving, climbing, motor sports, travel plans | Include occasional activities |
How underwriting decisions are made
Underwriting is how the insurer turns your answers into a decision. Many straightforward applications are decided automatically from the form. Others are referred to an underwriter, who may ask more questions, arrange a telephone interview, request a GP report or ask for a medical examination or tests.
The possible outcomes are usually: acceptance at standard terms; acceptance with a higher premium, sometimes called a loading; acceptance with an exclusion for a specific condition; postponement until more time has passed or tests are complete; or a decline. One insurer’s decision does not decide what another will offer, because underwriting approaches vary.
Under the FCA’s Consumer Duty, firms must act to deliver good outcomes, including fair value and support for customers with characteristics of vulnerability such as health conditions. [4] The FCA has also published findings on whether protection prices offer fair value. [5]
| Outcome | What it means | What you can do |
|---|---|---|
| Standard terms | Accepted at the normal price | Check the offer matches your application |
| Premium loading | Accepted at a higher price | Ask why; compare other insurers |
| Exclusion | A named condition is not covered | Understand exactly what is excluded |
| Postponed | Decision deferred for now | Ask when you can reapply |
| Declined | No cover offered | Ask for reasons; consider specialist help |
GP reports and medical tests
If the insurer needs more information, it may ask your GP for a report. You must give consent first. Under the Access to Medical Reports Act 1988, you have the right to see a report written for insurance purposes before it is sent, and to ask the doctor to correct anything you think is inaccurate. [3]
Choosing to see the report can add a short delay, but it lets you check that dates and details are right. Some insurers also use a nurse screening, blood tests or a medical examination, typically for larger amounts or older applicants. These are arranged and usually paid for by the insurer.
Medical evidence can also be requested at claim stage. If a claim is made, the insurer may check medical records against the original application. That is one reason to make sure the application matches your records from the start. Our claims guide explains that process.
Timing matters too. A GP report depends on the surgery replying, which can take several weeks. If you need cover by a particular date, for example before a house purchase completes, start the application early so there is time for any medical evidence. You can ask the insurer or intermediary for progress updates, and it may help to let your surgery know a request is on its way. Waiting for evidence is a normal part of underwriting, not a sign that cover will be refused.
Some people worry that insurers will read their entire medical record. In practice, a GP report usually answers specific questions the insurer asks about relevant conditions, rather than copying every note. You can ask the insurer what information it has requested. If something in the report is wrong or out of date, raise it with the doctor before it is sent; the Access to Medical Reports Act 1988 gives you that opportunity when you ask to see the report first.[3]
Pre-existing conditions
Having a medical condition does not automatically prevent you getting life insurance. Many people with conditions such as well-controlled asthma, high blood pressure, type 2 diabetes or a history of depression are offered cover, sometimes at standard terms and sometimes with a loading or exclusion. The outcome depends on the condition, how well it is managed, recent treatment and the insurer.
Underwriters typically look at when the condition was diagnosed, current treatment, test results, any complications, hospital admissions and time off work. Having details ready helps: medication names and doses, dates of diagnosis, most recent readings, and your specialist’s name. For more complex histories, an intermediary who knows different insurers’ approaches may help present the application, but no one can guarantee acceptance.
Applying with a pre-existing condition
What works well
- Many conditions are accepted, especially when well managed.
- Clear, detailed answers can reduce back-and-forth.
- Different insurers may reach different decisions.
What to watch
- Loadings or exclusions may apply.
- Leaving out details can put a future claim at risk.
- Recent tests or referrals can lead to postponement.
How the same condition can lead to different outcomes
Fictional applicants with high blood pressure applying for similar cover. Outcomes are illustrative, not predictions, and no prices are shown.
- A: diagnosed 5 years ago, controlled on one medication
- Often standard or small loading
- B: diagnosed recently, readings still being adjusted
- May be postponed or loaded
- C: high readings plus other risk factors
- May face higher loading or decline
- All three
- Must disclose accurately
The condition name alone rarely decides the outcome. Control, recent history and other factors matter, and different insurers weigh them differently.
Why accurate answers matter
The law requires consumers to take reasonable care not to make a misrepresentation when applying for insurance. The Consumer Insurance (Disclosure and Representations) Act 2012 sets out what happens if a misrepresentation is made: if it was deliberate or reckless, the insurer may treat the policy as if it never existed; if careless, the remedy depends on what the insurer would have done with the right information. [7]
In practice, that could mean a claim is paid in full, paid proportionately, subject to an exclusion or declined. The Financial Ombudsman Service considers complaints about non-disclosure and whether the insurer’s questions were clear. [8]
The good news is that most claims are paid. The ABI reported that 97.9% of new individual protection claims were paid in 2025. [6] Answering carefully is the best way to make sure your policy works when your family needs it. If you are unsure what a question means, ask before submitting.
Gather your details
Collect medication, diagnoses, dates and test results before starting.
Read each question fully
Answer the exact wording, including time periods.
Include pending tests
Mention symptoms or referrals if the question asks about them.
Check before submitting
Review answers against your records.
Keep a copy
Save your completed application for future reference.
Update if things change before cover starts
Tell the insurer about changes before the policy begins, if required.
If an insurer declines or postpones, ask whether it can explain the main reason. That information can help when approaching a different insurer, because you can provide clearer detail upfront. Declines from one provider are not the final word: underwriting manuals differ, and some insurers specialise in particular conditions. Keep a record of what each insurer asked and decided, and answer every new application just as carefully.
After you apply
Once cover starts, you normally do not need to tell the insurer about new health conditions, unless the policy says otherwise. Your premium and cover usually stay the same for the term. This is one reason some people prefer to arrange cover while in good health. Our guide to what shapes cost explains how age and health affect premiums.
Check the policy documents when they arrive, including any exclusions and the summary of your answers. If something is wrong, tell the insurer straight away. The FCA’s 2026 pure protection market study found competition generally works well but highlighted areas for firms to improve. [9]
Have your GP details, medication names and any recent test results to hand, and answer every question fully. Disclosing a condition rarely means you cannot get cover, but missing something can cause problems at claim time.
Common questions
Do I need a medical exam for life insurance?
Often not. Many applications are decided from your answers alone. An insurer may ask for a GP report, a nurse screening, blood tests or a full medical examination if you have a relevant medical history, apply for a large amount of cover or are older. These are usually arranged and paid for by the insurer. If a GP report is requested, the Access to Medical Reports Act 1988 gives you the right to see it before it is sent. The need for tests is not a refusal; it simply means the insurer wants more information before deciding.[3]
Can I get life insurance with a pre-existing condition?
Often yes. Many people with conditions such as asthma, high blood pressure, diabetes or a history of mental health conditions are offered cover. Depending on the condition and how well it is controlled, cover may be offered at standard terms, with a higher premium, with an exclusion, or postponed. Different insurers assess the same condition differently. Providing clear, detailed information about diagnosis dates, treatment and recent results helps underwriters make a decision. No one can promise acceptance, but a condition alone rarely makes cover impossible. Accurate answers remain essential to protect any future claim.[1]
What happens if I forget to mention something on my application?
If you realise before the policy starts, tell the insurer straight away so it can reconsider. If the policy has started, contact the insurer too; it is better to correct it now than at claim stage. Under the Consumer Insurance (Disclosure and Representations) Act 2012, what happens depends on whether the mistake was careless or deliberate and what the insurer would have done had it known. Outcomes range from no change, to a revised premium, an exclusion, or in serious cases cancellation. Raising it early gives the best chance of keeping cover that works.[7]
Does vaping count as smoking for life insurance?
Many insurers treat vaping and e-cigarettes as nicotine use and price applicants as smokers, but definitions vary. Some also include nicotine patches, gum and pouches. Questions usually ask about use within a set period, often the last 12 months. Answer the exact wording rather than choosing the label that feels closest. ONS estimated that 10.6% of UK adults smoked cigarettes in 2024, but population figures do not decide your premium. If you have stopped, ask whether the insurer can review your premium after you have been nicotine-free for its required period.[2]
Do I have to tell the insurer if my health changes after cover starts?
Usually not. Once a term life policy has started, most policies do not require you to report new health conditions, and your premium and cover typically stay the same for the term. However, if your health changes after you apply but before the policy begins, you may need to tell the insurer, so check the application wording. Also tell the insurer if the original application contained a mistake. If you apply for new or additional cover later, you will need to answer questions about your health at that time.[1]
Why do insurers ask about family medical history?
Some conditions, such as certain heart conditions and cancers, can have a hereditary element. Insurers may ask whether parents or siblings were diagnosed with specific conditions before a particular age, often 60 or 65, because this can affect the risk assessment. The questions and age limits vary. If you do not know the details, say so rather than guessing. Family history usually matters less than your own health, and many people with a family history of illness are offered standard terms. Answer honestly, as the Consumer Insurance (Disclosure and Representations) Act 2012 requires reasonable care.[7]
Related guides
Sources
- MoneyHelper — What is life insurance? (2026-09-28)
- Office for National Statistics — Adult smoking habits in the UK: 2024 (2025-01-01)
- legislation.gov.uk — Access to Medical Reports Act 1988 (1988-07-29)
- Financial Conduct Authority — The Consumer Duty (2023-07-31)
- Financial Conduct Authority — Price and value outcome: good and poor practice update (2026-07-10)
- Association of British Insurers — Protection insurers pay out £7.84 billion in claims in 2025 (2026-06-29)
- legislation.gov.uk — Consumer Insurance (Disclosure and Representations) Act 2012 (2012-03-08)
- Financial Ombudsman Service — Insurance complaints we can help with (2026-09-28)
- Financial Conduct Authority — MS24/1.5 Market Study into the Distribution of Pure Protection Insurance Products: Final Report (2026-09-21)