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When is medical evidence automatically requested… Everything you need to know

When is medical evidence automatically requested… Everything you need to know

For most clients, submitting an application where there are no medical or other disclosures will mean that terms are offered pretty quickly. Such clients are usually deemed as relatively low risk and as such medical evidence will not be required.  Where the client is slightly older or requires a particularly high sum assured however, they potentially pose more risk for the insurer and as such medical evidence may be requested. In such cases, setting the clients’ expectations in terms of what will be required is vital to ensure that they are aware of what is required and not taken by surprise. In this article we look at when medical evidence might be requested for different benefit types.


Life Cover

Understanding an insurers’ requirements to assess a protection application before submitting the case can make a big difference in ensuring the process is as smooth as possible. Where medical disclosures are made, it’s reasonable to expect an insurer to ask for further medical evidence to better understand the client’s condition, but there will also be cases where medical evidence is required on clean applications. Knowing such requirements in before completing the application will help advisers set their client’s expectations and possibly reduce “not taken up” rates. 

To read more click here 

Critical Illness

Critical illness will often be recommended in conjunction with life cover either via a life and accelerated critical illness plan or life with separate critical illness. Where this is the case, if the sum assured for either benefit is above the non-medical limits then the insurer will request medical evidence. As the likelihood of suffering from a critical illness is higher than death the sums assured at which medical evidence is required on CI is lower than for life. As such, unless the CI sum assured is significantly lower than the life sum assured, it is more likely that an automatic request for medical evidence will be triggered on the CI element of the plan.

This article looks at what sums assured would trigger an automatic request for medical evidence at different ages.

To read more click here

Income Protection

Like life and critical illness cover, the benefit level at which medical evidence would automatically be requested when taking out income protection is unlikely to affect most younger clients whose income is often more modest. As they progress through their career and hopefully start to earn higher incomes however, it becomes a much bigger factor. With non medical limits being triggered at annual benefits of around £35,000 for those in their late thirties those on higher salaries will often be hit.

This article considers the benefit amounts that will trigger automatic medical evidence requests for income protection.

To read more click here

Family Income Benefit

The non medical limits for Family Income Benefit plans are by far the hardest to calculate. Unlike the other benefits types, insurers do not publish a table highlighting the sums assured which will trigger such requests as is it not just dependent on age and sum assured but the remaining term also.

In this article we consider what calculations insurers use along with the actual limits used.

To read more click here

Watch out for future “Everything you need to know” pieces where each week we will cover a different topic and provide you with the information you need to know to discuss the topics with your clients.

About The Author

Adam Higgs

Adam leads Protection Guru's detailed protection research and benchmarking of both product and operation features provided by insurers and has a vast knowledge of the protection market. He has been instrumental in building the protection comparison service Quality Analyser and maintaining the data to enable adviser to quickly and easily compare protection products based on qualitative measures. He also works with adviser firms to help in panel reviews and with insurers to help them understand the shape of the market, their strengths and the areas that could be improved in their products. In his spare time and when not spending time with his wife and two children, Adam is a keen Arsenal fan and enjoys hacking his way around a golf course.

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