May 20, 2015 in Insurance

6 steps to ace your life insurance exam

Ready to buy life insurance? Not so fast — you might first have to undergo a medical exam to help the insurer estimate your life expectancy and determine your rate. The longer you’re likely to be around to pay premiums, the less they’re likely to charge you for coverage.

“Generally speaking, the healthiest 20 percent get rated ‘preferred plus,’ the next 30 percent get ‘preferred,’ the borderline 30 percent rate ‘select,’ and the remaining 20 percent get ‘standard,'” explains Geoffrey Gordon, president of the Andrew G. Gordon Insurance Agency in Norwell, Massachusetts.

“Depending on your age, each step up from standard will save you, on average, 20 percent on your premium as a rule of thumb,” he adds.

Better health stats make a big difference

If you are obese or use tobacco, alcohol or drugs, you can kiss “preferred plus” goodbye. At the same time, something as subtle as a slight elevation in blood pressure can increase your quote by 20 percent, Gordon says.

You may not have time to slim down or stop smoking before the examiner arrives, but adhering to these tips may improve your rating and save you thousands over the course of your life insurance.



A life insurance exam is typically performed by a paramedic in your home or office, at the insurance company’s expense. It takes about 30 minutes.

During the paperwork portion, you’ll be asked for a photo ID (so don’t bother substituting your younger sibling) and a list of your current and former doctors, including addresses and phone numbers.

You’ll also be quizzed about the state of your health, including current therapies, medications and vitamin supplements, and about whether you smoke, drink, use drugs or engage in dangerous pastimes, such as sky diving or caving.

You’ll need to roll up your sleeves

Once the paperwork’s completed, the paramedic will check your height, weight and pulse rate, draw your blood, request a urine sample, check your blood pressure and, in some cases, administer an electrocardiogram, or EKG. Most insurers make the results of your exam available to you or your doctor.

“They’re screening for signs of the ‘big three’: cancer, diabetes and cardiovascular disease,” says Gordon. “Because a lot of people are borderline between ratings, the longer you can go watching what you eat and exercising, the better your chance of making your goal.”



Cathy Kamhi, an independent registered nurse and paramedical examiner based in Largo, Florida, performs dozens of insurance exams every week. For better results, she says to prepare by drinking a lot of water starting one week before your appointment.

“It works to clean toxins from your system,” she says. “That week, I would make an effort to drink eight glasses a day. Being well-hydrated also makes it easier to draw your blood.”

Skip the drive-thru

If you’re a fast-food fan, this would also be the time to avoid the saturated fats and carbohydrates that elevate blood pressure and cholesterol, and replace them with lean proteins, fruits, leafy vegetables and “good fats” like olive oil.

While you’re at it, dial back on sugar and salt.

“I would avoid sugar more than salt,” Kamhi advises. “If a person’s kidneys are good, salt shouldn’t really be a problem anyway. But if you’re not healthy and may be borderline diabetic, your blood sugar is going to come out better if you’re not eating a lot of sugar.”



Now that your diet has improved and you’re well-hydrated, it’s time to address a couple more favorites: alcohol and coffee.

“If you can avoid alcohol, your blood test will show that you don’t have alcohol onboard,” says Kamhi. “That’s going to look better to an underwriter.”

Gordon agrees: “It is a consideration. Livers are a really important organ. When they do those chemical profiles, that’s what they’re looking for.”

While you won’t be marked down for coffee use, drinking too much Joe or caffeinated energy drinks before your test certainly won’t help your numbers.

“If someone has borderline blood pressure, you should probably pass on the coffee, because it will bring it up a little bit if you’re really sensitive,” says Kamhi. “It’s best if you don’t have coffee, but if someone really has to have it, go easy.”

No shellfish or poppy seeds?

Kamhi offers two more surprising tips. “Some underwriters say don’t eat shellfish, probably to avoid a high cholesterol read, and poppy seeds, because they can test positive for opium,” she says.

“But a bagel with a few poppy seeds on it? I wouldn’t sweat it.”



Life insurers have ample reason to worry about smokers: The Centers for Disease Control and Prevention estimates that tobacco use cuts 10 years off your life. It’s not uncommon for insurers to charge smokers two and even three times as much for coverage as nonsmokers.

You need to kick whatever form of nicotine you’re using long before you apply for life insurance. Ceasing smoking a few days before your exam is no better than fibbing about tobacco use on your application.

Telltale signs in your body

“They test for a byproduct of nicotine called cotinine, at a threshold above the point that won’t be triggered by breathing secondhand smoke,” explains Mike Woods, in-house underwriter at Pinney Insurance in Roseville, California.

“It depends on the frequency and how long since their last use, but if they’re regular users of (tobacco), most likely they’re going to test positive for cotinine,” he says.

Gordon agrees: “If you smoke, admit it. Nicotine shows up for longer than you could normally refrain, unless you’ve quit for good.”



When the big exam is scheduled for the next day, Kamhi has three pointers for optimal results:

  1. Fast during the 12 hours before your physical. Drink water as needed, but not to excess.
  2. Limit extreme exercise (anything that might leave you dripping in sweat), because that can marginally mess with cholesterol levels in the blood and elevate protein levels in the urine. “When people do have protein in their urine, the insurer will always recheck the urine,” she says.
  3. Get a good night’s sleep. “Eight hours if you can, especially if you are borderline for blood pressure,” Kamhi says. “Avoid stress.”


If you’ve followed the tips so far, you’ve done almost everything you can to present yourself as the picture of health.

But on exam day, Kamhi says there’s one simple technique you can use to lower your blood pressure, thus making you appear less at risk for heart attack, stroke or kidney failure.

“If your blood pressure tends to run a little high, once the blood pressure cuff is on, raise your arm level to your heart, and you’ll see a drop of about 10 points. If you’re at 130, it will go down to about 121 millimeters of mercury,” she says.

In that position, the heart doesn’t have to work as hard. “When you hold your arm at that level, it doesn’t take as much effort to move the blood,” Kamhi says. “If you’re borderline and part of it is nervousness, lie down and put your cuffed arm to heart level.”



So you gave it your best shot and your rating still fell short of the mark. What can you do?

Plenty, if you work with an independent life insurance agent. With a little digging, your professional may find another insurer who is willing to underwrite you at a better rate.

“It’s about finding which carrier has the best approach,” says Gordon. “The key is, you want to have a developed conversation with the underwriter of company B or C or D where you say, ‘Look, company A decided to go with standard on this guy, but here are the numbers. Here’s what we think; what do you think?’ Oftentimes, if you have that conversation, you can get stuff done.”

Better luck next time

Failing that, Kamhi says, there’s always next year.

“If you do get downgraded based on something on your exam, all you have to do is fix it and reapply a year later and get your premiums lowered,” she says. “If you can quit smoking, the rates will go down for the other risks, too, such as blood pressure.”