The review of an applicant's health that leads to acceptance at standard rates, an extra premium, a condition exclusion, postponement or decline.
Medical underwriting is the process by which an insurer appraises the risk an applicant represents before accepting them, and it is graduated by the amount applied for and by age: a simple declaration, a detailed questionnaire, a physician's report, laboratory tests, a stress test above certain thresholds. It ends in one of five decisions: acceptance at standard rates, an extra premium, exclusion of a named condition, postponement while a medical situation stabilizes, and decline. Its technical justification is antiselection: without it, those who know they are ill would insure more often and for larger amounts, pushing the average rate up and gradually driving good risks away. Its limit is political, since no one chooses their genetic inheritance or their medical history, and the French legislature has steadily narrowed what an insurer may ask. The problem solved and the problem created are two faces of one mechanism, and the balance point is a social rather than an actuarial judgment.
France's Lemoine Act of February 28, 2022 removed, from June 1, 2022, every medical formality for home loans where the insured share does not exceed 200,000 euros per borrower and repayment ends before the borrower's sixtieth birthday: a very large part of the borrower insurance market thus moved from individual selection to compulsory risk pooling.
souscription médicale, formalités médicales