Life insurance premiums are calculated through an underwriting process that uses information gained through an applicant’s application. Since life insurance falls under the category of risk insurance and is not compulsory, the insurers have to place each applicant in certain classifications; that is, they must make a determination whether the applicant will be either a high risk or a low risk applicant.

That underwriting process begins with the underwriter creating a risk profile for each applicant. Underwriters use manuals and medical opinion in order to determine what terms a policy will fall under and what amount of premium will be attached to that life insurance policy. This also depends on insurance type and level of cover.
Premiums create a central fund from which claim payments are made following an insured event. These premiums must be reasonably priced. Life insurance companies cannot charge high premiums that make their insurance available to select groups only. Yet the premiums charged must sustain company profitability while keeping an influx of funds available for future claim payouts. Those with high-risk behaviours or health are more likely to make a claim in the future, so their premium or contribution to that central fund will be higher.
For example, an applicant whose weight is not proportional to height may be either underweight or obese. Both have certain health risks. Perhaps that applicant is also a smoker, increasing the health risk. The underwriter will take the applicant’s medical information and apply it to a group with similar conditions. The underwriter then notes that this group is likely to be diabetic later in life, have high blood pressure, stroke, or heart problems, creating a risk factor for an earlier death. This means it is more likely that a claim will eventually be paid. It doesn’t mean a claim will be inevitable, just that there is a strong likelihood of a claim. Also taken into account will be the age, occupation, recreational pastimes, where the applicant lives, and income in case of income protection insurance and other financial information.

Under the Insurance Contracts Act of 1984, all applicants have a duty of disclosure regarding their application. This duty ensures that insurers have all necessary information to make an informed, fair decision about an applicant’s risk. This protects all applicants paying premiums by keeping their premiums at a reasonable level. If an applicant gets a lower rate under false pretences, then it reflects on the pool, possibly creating higher rates for the rest of those contributing to the central fund.

If an applicant does not comply with the disclosure of duty and has been proven to be in non-compliance, any claim that the applicant makes for the insurance may be denied and that policy cancelled even if premiums are up to date.

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