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Difficulty: Very hardRisk Classification

A comprehensive risk appraisal is being conducted on a 38-year-old life insurance applicant. The medical underwriting file confirms insulin-dependent diabetes diagnosed 20 years prior, currently managed with stable glucose levels. Concurrently, the inspection report verifies the applicant actively participates as a volunteer structural firefighter and frequently engages in deep-sea wreck diving. Based on standard mortality evaluation protocols, how will the underwriting department most likely classify this applicant and structure the policy premiums?

  1. A
    The applicant will be classified as an uninsurable declined risk, because standard industry guidelines universally prohibit issuing policies when a chronic systemic health impairment coexists with extreme-risk avocations.
  2. B
    The applicant will be classified as a standard risk by applying an exclusion rider to practice risk avoidance for the activities, while absorbing the managed medical history at baseline rates.
  3. The applicant will be classified as a substandard risk, assessed a tabular rating to account for the systemic medical condition, and charged a concurrent flat extra premium for the hazardous activities.Answer
  4. D
    The applicant will be classified as a substandard risk using a single aggregated tabular rating, because the physical hazards of the hobbies and the morale hazard of the illness both create a progressively increasing risk of mortality.

Answer

The applicant will be classified as a substandard risk, receiving a tabular rating for the health condition and a flat extra premium for the hazardous activities.
The applicant presents two distinct types of risk. The chronic medical condition represents a mortality risk that increases with age, which underwriters address using a tabular rating. The hazardous occupation and avocation represent a constant risk of accidental death, which is addressed using a flat extra premium. Because the applicant represents a higher-than-average risk but remains insurable within tolerable actuarial limits, they are placed in the substandard classification and subject to both specialized rating methods simultaneously.

Step-by-Step Solution

1
Evaluate the medical risk profile.
A 20-year history of insulin-dependent diabetes presents a significantly higher mortality risk that typically increases as the insured ages.
This disqualifies the applicant from standard rates and requires a tabular (or multiple table) rating to account for the progressively increasing risk.
2
Evaluate the occupational and avocational risk profile.
Volunteer firefighting and wreck diving present high accidental death exposures.
Because these activities represent a constant, flat hazard rather than a risk that worsens with biological age, they are priced using a flat extra premium (a specific dollar amount per thousand of coverage).
3
Synthesize the overall risk classification and rating structure.
The applicant falls below average health and lifestyle standards but remains insurable.
The underwriter will classify the individual as a substandard risk and apply both the tabular rating and the flat extra premium concurrently to accurately price the distinct components of the total risk.

Key Concept

Substandard Risk Classification and Layered Rating Methods
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Topics

Risk Classification

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