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Difficulty: Very hardRisk Classification

An insurance underwriter is evaluating four life insurance applications. Based on standard underwriting principles regarding medical history, lifestyle, and occupational hazards, arrange the following applicants in order of their expected risk classification, from the most favorable (lowest expected mortality and premium) to the least favorable (highest expected mortality or uninsurable).

  1. 1A 35-year-old non-smoker, BMI 23. Medical history includes a localized basal cell carcinoma surgically removed five years ago with no recurrence. Employed as an architect.
  2. 2A 42-year-old who quit smoking two years ago, BMI 27. Diagnosed with mild hypertension that has been well-controlled on a single prescription medication for three years.
  3. 3A 38-year-old non-smoker, BMI 25, with no significant medical history. Works full-time as a structural ironworker on high-rise buildings and participates in amateur motorcycle track racing.
  4. 4A 55-year-old current cigarette smoker, BMI 34. Suffered a myocardial infarction (heart attack) three months ago and has poorly controlled Type 2 diabetes.

Answer

The correct order from most favorable to least favorable risk classification is: the 35-year-old architect (Preferred), followed by the 42-year-old former smoker (Standard), followed by the 38-year-old ironworker (Substandard), and finally the 55-year-old with a recent heart attack (Declined).
The applicants represent the four primary risk categories in descending order of favorability: Preferred (minor/cured health history with excellent current health), Standard (controlled chronic conditions and standard BMI), Substandard (significant occupational/avocational hazards despite good health), and Declined (recent severe cardiovascular event combined with multiple comorbidities).

Step-by-Step Solution

1
Evaluate the 35-year-old architect for Preferred eligibility.
Assigned to Preferred class.
Basal cell carcinoma is a highly curable, non-melanoma skin cancer. After five years with no recurrence, it does not negatively impact the mortality rating. The applicant's excellent BMI and safe occupation secure the most favorable rating.
2
Evaluate the 42-year-old former smoker for Standard eligibility.
Assigned to Standard class.
Smoking cessation over 12 months ago removes the tobacco rating at most carriers. Controlled hypertension is acceptable but typically prevents Preferred status, placing the applicant in the Standard risk category.
3
Evaluate the 38-year-old ironworker for Substandard rating.
Assigned to Substandard class.
Perfect physical health is offset by severe occupational and avocational hazards. The elevated risk of accidental death requires a Substandard rating, typically handled with a flat extra premium charge.
4
Evaluate the 55-year-old applicant with a recent heart attack.
Assigned to Declined class.
A recent cardiovascular event (under 6 months) is a strict rule-out for coverage. Combined with smoking and uncontrolled diabetes, the risk is too high to insure.

Key Concept

Risk Classification
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Topics

Risk Classification

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