What life insurance underwriting actually checks

If you apply for life insurance in Canada, an underwriter builds a picture of your health from several sources, and the form you filled out is only one of them. This article explains what those sources are, what each one can and cannot see, what Canadian law says an insurer is allowed to ask for, and where the process is genuinely uncertain. Knowing this before you apply is often the difference between a file that closes in three weeks and one that stalls for three months.

What underwriting is actually deciding

Life insurance underwriting is the process an insurer uses to decide whether to issue a contract, in which rate class, and with what exclusions. The Financial Consumer Agency of Canada states it directly: "As part of the application for life and health insurance, you need to prove that you're in good health," and insurance companies "may require that you complete a medical questionnaire or exam before approving you for a policy" (FCAC).

The legal duty sits on you, not on the insurer. Under the BC Insurance Act, an applicant and the person to be insured must each disclose "every fact within the applicant's or person's knowledge that is material to the insurance," and a failure to disclose or a misrepresentation "renders the contract voidable by the insurer" (ss. 51(1) and 51(2), BC Laws). FCAC is blunt about the stakes. If you don't answer completely and honestly, "the insurance company could cancel your policy or refuse any claim you make in the future."

The application and the authorization

The questions are familiar. Height and weight, tobacco or nicotine use, alcohol, medications, hospital visits, family history, occupation, travel plans, driving record, and how much coverage you already have.

The part people skim is the authorization at the end. That signature is what lets the insurer go and check everything else. Without it there is no medical exam, no MIB search, no prescription report, and no letter to your doctor.

The medical: fluids, not opinions

Whether you need a paramedical visit depends on your age and the amount you applied for. Modest face amounts on healthy younger applicants often go through with no exam at all. Larger amounts usually mean a nurse comes to your home or office, takes height, weight, blood pressure and pulse, and collects blood and urine.

Labs generally look for objective markers rather than opinions: blood sugar, kidney and liver function, cholesterol and other lipids, HIV and hepatitis, and cotinine, which is a nicotine metabolite. Exact panels vary by insurer and by amount, and no regulator publishes them. Two things are worth knowing. Cotinine doesn't distinguish a daily smoker from someone who only smokes at parties. And a result you weren't expecting is still information you now have about your own health.

If your answers point to a condition, the insurer may also order an Attending Physician's Statement, which is a written summary from your family doctor. That is usually the slowest step in the whole file.

The MIB check, and what it really is

MIB is a member consortium of North American life insurers that has provided underwriting risk assessment services "for over 100 years" (MIB). It gets misunderstood more than any other part of the process, so here is what it actually holds:

• Brief coded entries, not files. MIB says its codes "are proprietary, highly confidential, and can be thought of as a form of encrypting."
• Not a medical record. The codes do not "[r]epresent a full medical record nor include complete details about a medical condition, avocation or other factor."
• Not a verdict. MIB states that "[c]arriers are not enabled to make underwriting decisions based on your MIB Consumer File without further investigation," and the codes don't show whether another company approved or declined you.
• Not universal. You only have a file if you applied to a member carrier in the last seven years and "information of underwriting significance" was found (MIB).
• Yours to see. MIB will provide "a free copy of your MIB Consumer File (if one exists) once per year, on request," and you can ask for a correction if something looks wrong.

If you've been declined or rated in the past and never found out why, asking for your own file is a sensible first move.

The prescription history check

Most insurers also order a prescription history report through a third-party service, again on the strength of the authorization you signed. It typically shows dispensed medications, dates and dosages going back several years.

Underwriters read prescriptions as evidence of diagnosis. A blood pressure medication implies hypertension. A short course of something implies an episode that had a reason behind it. This is where applications most often come apart, and usually not through dishonesty. People simply forget a medication they took in 2021. The report doesn't.

It's worth being candid about the limits here. Unlike MIB, no Canadian government or regulatory body publishes how these reports are compiled, how far back they reach, or how you can request your own copy. What appears depends on which pharmacies report and how records get matched to you, so the picture is neither complete nor error free.

What insurers are not allowed to ask

This is the part most people get wrong. Under Canada's Genetic Non-Discrimination Act, S.C. 2017, c. 3, no one may require an individual to undergo a genetic test, or to disclose the results of one, as a condition of "providing goods or services," "entering into or continuing a contract or agreement," or "offering or continuing specific terms or conditions in a contract or agreement" (ss. 3 and 4, Justice Canada). Section 5 requires written consent before genetic test results are collected, used or disclosed. Section 6 carves out treating health care practitioners and researchers. The penalties in section 7 are real: up to $1,000,000 and five years in prison on indictment, and up to $300,000 and twelve months on summary conviction. The Supreme Court of Canada upheld the Act in 2020.

Before that law, the picture was different. In a statement dated 10 July 2014, the Office of the Privacy Commissioner recorded the industry position that an insurer "would not require an applicant for insurance to undergo genetic testing," but that where testing had already been done, "the insurer would request access to that information." The OPC's own conclusion was that insurers should refrain from requesting existing results until they could show the information was demonstrably necessary and effective (OPC, Canada.ca).

Family history is a separate thing entirely. Being asked whether a parent had a heart attack before age 60 is not a genetic test result, and applications still ask it. That distinction trips up a lot of the clients I talk with in Burnaby and across Metro Vancouver.

The two year line

Under the BC Insurance Act, once a life policy has been in effect for two years during the lifetime of the insured person, a failure to disclose or a misrepresentation does not, "in the absence of fraud," render the contract voidable (s. 52(2)). Age is handled on its own footing: if age was misstated, the benefit is increased or decreased to the amount the same premium would have bought at the correct age (s. 54(2)).

What this doesn't tell you

• Rate tables are proprietary. No insurer publishes how it turns a blood sugar reading or a past cancer into a rate class, and two companies can land in different places on the same file. That is precisely why comparing more than one insurer matters.
• The evidence on genetic underwriting is contested. Research commissioned by the Privacy Commissioner (Hoy and Durnin, 2012) cited simulation findings suggesting roughly 3% as "a likely upper bound on the price of insurance resulting from a ban," and argued the affected group was too small to move the market much. Insurers and actuarial voices argued at the time that the cost would be considerably higher. Both positions are on the public record, and the question was resolved by Parliament rather than settled by the evidence.
• Nothing here predicts your outcome. Requirements, lab panels and decisions vary by insurer, age, amount and product type. Group coverage through work and simplified issue policies run on different rules again.

Talk it through before you apply

The most useful thing you can do is spend fifteen minutes talking about what your file is likely to look like, so the application goes to a company whose guidelines actually fit your situation instead of one that doesn't. Milo Sarmiento is an independent insurance and investment broker based in Burnaby who compares Canada's major insurers and works with families across the Vancouver area in English and Tagalog. Book a free, no pressure call and bring your questions.

This article summarises published rules and research for general information, is current as of the date shown, and is not personalized financial, tax or legal advice.

Sources

• Department of Justice Canada. *Genetic Non-Discrimination Act*, S.C. 2017, c. 3. laws-lois.justice.gc.ca
• Province of British Columbia. *Insurance Act*, R.S.B.C. 2012, c. 1, Part 3 (Life Insurance). BC Laws. bclaws.gov.bc.ca
• Financial Consumer Agency of Canada. "Getting an insurance policy." Canada.ca, page modified 16 October 2025. canada.ca
• MIB Group. "Facts About MIB." mib.com
• MIB Group. "Request Your MIB Consumer File." mib.com
• Michael Hoy and Maureen Durnin. "The Potential Economic Impact of a Ban on the Use of Genetic Information for Life and Health Insurance." Office of the Privacy Commissioner of Canada, March 2012. priv.gc.ca
• Office of the Privacy Commissioner of Canada. "Statement on the use of genetic test results by life and health insurance companies," 10 July 2014. canada.ca