Underwriting is how the insurer assesses your risk before deciding what cover to offer and at what premium. You complete an application, the insurer may request medical evidence, and the outcome is standard rates, a loading, an exclusion, or a decline.
Under the Insurance Contracts Act 1984 s20B (in force since 5 October 2021), you have a duty to take reasonable care not to make a misrepresentation. This replaced the older duty of disclosure for consumer insurance contracts. Answering the insurer's questions truthfully and completely is the single most important step in the process.
What underwriting typically asks for
- Personal details: age, gender, occupation, income, country of residence.
- Lifestyle: smoking and nicotine use, alcohol, recreational drug use, dangerous hobbies (rock climbing, scuba diving, private aviation, motorsport).
- Medical history: current and past conditions, medications, hospitalisations, surgeries.
- Family medical history: parents and siblings, particularly heart disease, cancer, and certain hereditary conditions diagnosed before age 60.
- Financial information: income, debts, existing insurance, business interests (for larger sums insured or business cover).
What evidence the insurer may request
Depending on age, sum insured, and disclosures, the insurer may add:
- Tele-underwriting interview (a structured phone interview with a trained nurse or underwriter).
- Medical examination (blood pressure, BMI, urinalysis).
- Blood tests (cholesterol, glucose, liver function, HIV, hepatitis).
- Resting and exercise ECG for higher sums insured or cardiac history.
- Personal Medical Attendant's Report from your GP or specialists.
- Financial evidence such as recent payslips, tax returns, Notice of Assessment, or accountant-prepared financials for larger sums insured.
Indicative evidence thresholds from the panel adviser guides:
- TAL Accelerated Protection PDS (12 December 2024), adviser guide medical evidence requirements: nil up to $500K; nil up to age 55 for $500K-$1M; J or A+J between $1M-$1.5M; A+H+J or more between $1.5M-$2M.
- AIA Priority Protection PDS (Version 32, 9 November 2025): similar tiered structure with medical and financial evidence escalating with sum insured.
- Other panel insurers (Zurich, OnePath, ClearView, NEOS, Encompass, Acenda, Futura) follow comparable tiered structures published in their adviser guides.
How long underwriting takes
- Simple cases: 1 to 7 business days where no medical evidence is needed and all questions return clean answers.
- Standard cases: 2 to 6 weeks where one or two reports or tests are needed.
- Complex cases: 6 weeks or more where Personal Medical Attendant's Reports, specialist letters, or financial-evidence reviews are required.
Underwriting outcomes
Four possible decisions:
- Standard rates: cover at the published premium for your age, gender, smoker status, and occupation class.
- Premium loading: an uplift expressed as a percentage of the standard rate (commonly 25% to 100% for moderate risk factors). The Policy Schedule shows the loading.
- Exclusion: cover issued but a specific condition or activity is excluded from claim payment. Common examples: pre-existing skin cancer history excluded for new skin cancer claims; specific pastimes excluded.
- Decline: the insurer chooses not to offer cover at this time. A broker can often re-shop the application across the other 8 panel insurers because underwriting standards differ across insurers.
The duty to take reasonable care s20B framework limits insurer remedies on claim if a misrepresentation later comes to light. Under Insurance Contracts Act s28A-D, for non-fraudulent misrepresentation the insurer can reduce the sum insured proportionately, impose an exclusion, or treat the policy as if it had never been entered into (only if they would not have entered into the contract had they known the true facts). Fraudulent misrepresentation allows full avoidance under s28(2).
Where the panel insurers document the duty
- AIA Priority Protection PDS (Version 32, 9 November 2025), Section 10.2.
- Zurich Wealth Protection PDS (1 November 2025), duty section.
- TAL Accelerated Protection PDS (12 December 2024), Section 5.
- OnePath OneCare PDS (1 October 2025), Application duty section.
- ClearView ClearChoice PDS (13 May 2024, update 5 June 2025), duty section.
- NEOS Protection PDS (6 December 2024), Important Information section.
- Encompass Protection PDS (26 September 2025), duty section.
- Acenda Insurance PDS (27 September 2025), duty section at pages 118-119.
- Futura Protection PDS (1 October 2025), duty section.
Simplified-issue or guaranteed-acceptance options
Some direct-to-consumer products use simplified underwriting (limited questions, no medicals) or guaranteed acceptance. These typically apply lower sum insured caps, longer pre-existing condition exclusions, and tighter on-claim assessment. They sit outside the panel and are not part of IMFL's retail broker offering.
Practical tips for the application
- Be exact, not approximate. Insurers prefer specifics over rounded estimates.
- Disclose conditions even if you think they are minor. A well-controlled condition with full disclosure typically gets standard or near-standard rates.
- Provide documentation if you have it. A GP letter confirming a condition is stable can move a loading to standard rates.
- Do not exit a current policy until the new policy is on risk. Existing in-force cover is typically more valuable than a marginal premium saving.
Regulator anchor
The Insurance Contracts Act 1984 s20B sets the duty framework. The Insurance Council of Australia and the Life Insurance Code of Practice 2019 set industry conduct standards. ASIC's Regulatory Guide 274 covers sales practices. AFCA at afca.org.au is the external dispute resolution pathway if an underwriting decision is disputed.