What Should Physicians Know About the Disability Insurance Underwriting Process
Feb 1, 2024
Jamie Fleischner

Jamie Fleischner

1 Feb, 2024

Disability insurance is an essential safety net for physicians, providing financial security in the event of an inability to work due to illness or injury. However, navigating the underwriting process of obtaining disability insurance can be complex and daunting. Understanding the nuances of this process is crucial for physicians to ensure they obtain the best possible coverage.

The Underwriting Process: An Overview

1. Application

The first step in obtaining disability insurance is completing an application. This form gathers basic information about you, such as your date of birth, address and contact information. Once submitted, you will move to the next stage in the process.

2. Medical Questions

After submitting your application, you’ll likely need to answer detailed medical questions. Ths can be through a an online health questionairre or a phone interview. These questions are designed to give insurers a clear picture of your current health status and medical history. Honest and accurate answers are vital, as any undisclosed medical conditions could affect your policy’s validity. Typically they will ask questions about your history over the last 10 years head to toe. They will also ask about foreign travel plans and risky hobbies such as scuba diving.

3. Blood and Urine Tests

If you are applying for more than $10,000/month, companies may require you to undergo a medical examination, which typically includes blood and urine tests. These tests can reveal underlying health conditions that might not be evident from your medical history alone, such as high cholesterol, diabetes, or other risk factors that could influence your risk profile. If you are finishing your medical residency or fellowship, this may be waived, even if you are applying for more than $10,000/month.

4. Retrieval of Medical Records

Insurers often request access to your medical records to verify the information provided in your application and during the medical examination. This step is crucial for the underwriting process, as it allows insurers to comprehensively assess your health status and any potential risks. Companies request records about half of the time and it can hold up the process. It can take 4-6 weeks to retrieve records.

Possible Outcomes

Once the underwriting process is complete, there are several potential outcomes:

  • Approved: Your application is accepted at the rate you applied for. This is the ideal outcome, indicating that the insurer views you as a standard risk. They will send you the policy for you to sign and provide bank information authorizing the initial draft which places the policy in force.
  • Declined: Your application is not accepted. This can occur if the insurer deems the risk of insuring you too high based on your health status or other factors.
  • Exclusions: In some cases, your policy may be approved with certain exclusions. These exclusions typically relate to pre-existing conditions, meaning the policy will not cover disabilities arising from these conditions. Typical exclusions are back, neck, mental health or pregnancy.
  • Modified: Approximately 30-40% of applications are approved with an exclusion or are denied. Sometimes the company will add a rating. This could mean a higher premium or modified terms compared to what was initially applied for.

Guaranteed Standard Issue (GSI) for Medical Residents

A notable exception to the standard underwriting process is the Guaranteed Standard Issue (GSI) policy, specifically designed for medical residents. GSI policies offer a unique advantage: they require no medical questions or exams, making the application process much simpler and ensuring coverage for residents who might otherwise be deemed high risk.

Set for Life Insurance has GSI available at multiple hospitals around the country including WashU/Barnes, Mayo Clinic, UChicago, University of Rochester and NYPresbyterian. Please note you must go through an authorized broker to obtain the GSI policies as they are not avaialble through all brokers or agents.

However, the most significant caveat with GSI policies is that they must be applied for before seeking any other type of disability insurance. If a resident applies for a traditional policy and is either rated (assigned a higher premium due to risk) or declined, they become ineligible for a GSI policy. This exclusivity underscores the importance of considering a GSI policy early in one’s medical career.

GSI policies also allow for future increases in coverage as the physician’s income grows, without the need for additional medical underwriting. This feature makes GSI an attractive option for residents, providing them with a solid foundation of disability insurance that can adapt to their evolving financial needs.


The disability insurance underwriting process is intricate, with various steps designed to assess the risk of insuring an applicant. Physicians, particularly those in the early stages of their careers, need to understand this process and the unique opportunities available, such as Guaranteed Standard Issue policies. By navigating the underwriting process wisely and considering their options, physicians can secure the disability insurance coverage they need to protect their future financial stability.

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