Final Expense Health Questions: What Applications Actually Ask
Final expense health questions are a short set of yes-or-no questions about your current care, your diagnoses and your treatment, most of them with a stated time window. On the two insurers' applications quoted below, a yes to a knockout question ends the application, while other answers sort you between a preferred level plan, a standard one and a modified or graded death benefit plan. Guaranteed issue policies, like the two described below, ask no health questions at all.
Final Expense Health Questions at a Glance
The table quotes two simplified issue applications: The American Home Life Insurance Company's Patriot Series final expense application (the North Dakota version, form AMHFE07464ND) and a version of Transamerica Life Insurance Company's final expense application for ages 45 to 85 (form L122 1012T PA). Other insurers' forms differ.
| Question type | Wording on the form | What a yes does there |
|---|---|---|
| Care now (Transamerica) | "receiving hospice or home health care" | Not eligible for any coverage |
| Ever (American Home Life) | "Alzheimer's disease, dementia" | Not eligible; do not submit |
| Past year (American Home Life) | "angina (chest pain), heart attack" | Select the Modified Plan |
| Past 2 years (American Home Life) | "angina (chest pain), heart attack" | Select the Standard Level Plan |
| Past 4 years (Transamerica) | "cancer (other than basal cell carcinoma)" | One yes: graded plan; two: not eligible |
| Ever (Transamerica) | "chronic obstructive pulmonary disease" | One yes: standard; two: graded |
| Guaranteed issue (United Home Life) | No health questions | Coverage guaranteed, ages 45-75 |
How Final Expense Application Questions Are Built
Most questions follow one of four patterns.
Questions about right now
The first questions ask about the day you apply. American Home Life's Part A asks whether you are currently "receiving or been advised to receive home health care or hospice care"; Transamerica's Part C2, whether you are "hospitalized, bedridden, residing in a nursing home." American Home Life also asks whether you need help from anyone with "taking medications, bathing, dressing, eating, toileting, getting in or out of bed or chair, or moving about."
"Ever" questions
"Have you ever" has no time limit. Both forms put "ever" questions in a knockout section and in a sorting one. American Home Life asks about Alzheimer's disease and congestive heart failure in Part A, which ends the application, and about Parkinson's disease, multiple sclerosis and COPD in Part C, which only sorts applicants between plans. Transamerica asks about Alzheimer's disease in Part C2, a knockout, and about COPD in Part C4, where one yes points to its Standard product.
Look-back windows
Most other questions name a period, from "within the past year" to, on Transamerica's form, "within the past 4 years." The same condition can appear twice with different results. American Home Life asks about angina, a heart attack or a heart procedure within the past year in Part B, where a yes points to its Modified Plan, and within the past two years in Part C, where it points to the Standard Level Plan.
"Advised," pending and planned
Many questions also cover what a doctor recommended, and both forms ask about tests still waiting on results: American Home Life's Part A about any "diagnostic test which has not yet been started, completed, or for which results are not known" (HIV tests excluded), Transamerica's Part C2 about testing "for which the results have not been received."
Final Expense Knockout Questions and What a Yes Does
American Home Life's form prints its routing rules beside the questions:
Part A: "If you answer 'yes' in Part A, you are not eligible. Do not complete or submit this application."
Part B: "If any 'yes' answers in Part B, select Modified Plan."
Part C: "If any 'yes' answers in Part C, select Standard Level Plan." With no yes answers in Parts A, B and C: "select Preferred Level Plan."
Its benefits section warns: "The insurance for which you qualify may have a return of premium death benefit for the first two (2) years." Transamerica's form counts answers instead. Any yes in Part C2 ends the application. In Part C3, one yes makes you "potentially eligible for the Graded Death Benefit product," while two or more mean you are "not eligible for any coverage." In Part C4, the potential plan is its Preferred product with no yes answers, its Standard product with one, and the Graded Death Benefit product with two or more.
Which questions are knockouts depends on the form. Can You Get Final Expense Insurance With Pre-Existing Conditions? covers which conditions typically rule a plan out, and Level, Graded Death Benefit, or Modified: What Your Policy Actually Pays explains what modified and graded plans pay in their early years.
What Final Expense Underwriting Questions Are Checked Against
American Home Life's authorization lets any "pharmacy, pharmacy benefit manager, MIB, Inc." or medical provider with records about you share them with the insurer for 24 months from signing.
For the medical information check, MIB says that, with your authorization, "the carrier will cross check the information you provide on your application against any information in your MIB Consumer File" and follow up on any discrepancy. Its consumer guide says the alert goes out whether you "either forget to answer a question on the application correctly or you knowingly omit information." MIB will send you a free copy of your file, if you have one, once a year on request.
The prescription check works from pharmacy records: the Consumer Financial Protection Bureau lists Milliman IntelliScript as a company that "collects prescription drug purchase history" to score the mortality risk of life insurance applicants. How Final Expense Insurers Check Your Prescription History explains those reports.
How to Answer Medical Questions for Final Expense Insurance
Prepare before you sit down with an agent or a phone interviewer:
- Gather dates. A window such as "within the past 2 years" turns on when something happened, so check the dates rather than estimating.
- List your medications and doses. American Home Life's comments section asks for "diagnosis, dates, durations, medications, dosages"; Transamerica's supplement adds frequency and your doctors' names.
- Answer as written. Transamerica's agreement says the agent "does not have the authority to waive any question on this application."
- Report health changes before the policy arrives. Transamerica's form says "the insurance will not take effect if the facts have changed."
Your doctor's office can confirm what a diagnosis was called and when treatment ended. Your doctor is the source on your own health, and this page is not medical advice.
The Declaration You Sign and the Two-Year Contestable Period
On American Home Life's form you confirm that your statements and answers, "to the best of my knowledge and belief," are "all accurate, complete and correctly documented." Transamerica's adds: "I understand that any omissions or misstatements in this application could cause an otherwise valid claim to be denied under any insurance issued from this application."
The National Association of Insurance Commissioners' Life Insurance Buyer's Guide says: "It's important to tell the truth on the application." The insurer checks, and false statements found after the policy is issued could lead it to reduce or cancel your coverage. The Texas Department of Insurance adds: "Life insurance policies have a two-year contestable period." A company that learns "you gave wrong information or didn't disclose something" can deny a death claim in that period, even over a mistake, and must return the premiums to your beneficiary. The Contestability Period Explained: A Policy's First Two Years walks through a claim review. Check the copy of the signed application you receive, and tell the insurer in writing if an answer is wrong.
When Guaranteed Issue Is the Route
Neither simplified issue form mentions guaranteed issue; a knockout simply ends that application. United Home Life says that when its Guaranteed Issue Whole Life is applied for directly, "there are no health questions, no medical exams, no complicated forms to fill out," for issue ages 45 to 75. Mutual of Omaha's online guaranteed whole life application, for ages 45 to 85 (50 to 75 in New York), has three steps: personal information, beneficiaries and payment.
On United Home Life's policy, the trade is a limited early benefit: a death from natural causes in the first two policy years pays a refund of all premiums paid plus interest, while an accidental death pays the full benefit. Guaranteed Issue vs. Simplified Issue: Which Is Right for You? compares the two kinds of policy.
More on this topic: Final Expense Insurance With COPD: What Applications Ask · Final Expense Insurance With Heart Disease: What Underwriters Look At · Final Expense Insurance After Cancer: How Underwriting Really Works
The forms quoted here are examples, and the Transamerica version may since have been revised. Questions, windows and plans differ by insurer, state and form; your own application and policy govern.
Sources
- The American Home Life Insurance Company: Application for Individual Whole Life Insurance, Patriot Series Final Expense Plans, North Dakota (form AMHFE07464ND)
- Transamerica Life Insurance Company: Life Application, issue ages 45-85 (form L122 1012T PA); Solutions Final Expense forms listing
- United Home Life Insurance Company: Guaranteed Issue Whole Life Insurance consumer brochure (200-677)
- Mutual of Omaha: What's the process for applying for guaranteed whole life insurance online?
- MIB: Who is MIB?; Request Your MIB Consumer File; A Consumer's Guide to MIB's Underwriting Services
- Consumer Financial Protection Bureau: Milliman IntelliScript
- National Association of Insurance Commissioners: Life Insurance Buyer's Guide
- Texas Department of Insurance: Life insurance guide
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Check If You QualifyFrequently Asked Questions
What are knockout questions on a final expense application?
They are the questions whose yes answer ends that application. On American Home Life's form, a yes in Part A means you are not eligible; on Transamerica's form, a yes in Part C2, or two or more in Part C3, means no coverage. Each insurer sets its own knockouts, and guaranteed issue policies ask no health questions.
Are medical questions asked for simplified issue final expense insurance?
Yes. A simplified issue application asks a set of yes-or-no health questions, and on the two quoted here the answers decide which plan you can apply for. With your authorization, the insurer also checks them against records such as your MIB file and pharmacy history.
Does one yes answer disqualify you from final expense insurance?
Not necessarily. On Transamerica's form, one yes in Part C4 points to its Standard product and one yes in Part C3 to its Graded Death Benefit product, while American Home Life sends a yes in Part B to its Modified Plan. Only certain questions end an application on their own, and they differ by insurer.
How far back do final expense health questions go?
Each question sets its own window. The forms quoted here use the past year, the past two years and, on Transamerica's, the past four years, while questions that begin with “have you ever” have no time limit. Answer each question for the period it names.
What happens if you answer a final expense health question wrong?
Before the policy is issued, MIB says an insurer that finds a discrepancy will follow up with you. Afterward, the Texas Department of Insurance says, a death claim in the two-year contestable period can be denied over wrong information, even information given by mistake, with the premiums returned to the beneficiary. If you spot an error, tell the insurer in writing.