If you want to take out life insurance or disability insurance, you usually have to fill out a health declaration. This contains a series of questions about your health. After you make the statement a medical advisor will assess your health situation. This results in advice to the insurer on whether you can accept it and, if so, under what conditions. On this page you will find all information about how that process works exactly.
1. Before you start
Insurance helps you deal with risks and uncertainties, such as disability or the moment you die. The benefit to which you are entitled at such a time is offset by a premium that you have to pay.
In order to determine the amount of the premium, it is important that your insurer knows how big the risk is that you will become incapacitated for work or die during the term of the insurance. For the insurer, a good risk assessment is therefore extremely important.
In order to be able to estimate this risk as well as possible, information is needed about your health and your lifestyle. A health declaration is usually used for this. By filling this in, you give the medical advisor who gives advice to the insurer insight into your health. Based on this advice, the insurer decides whether to accept your application. And at what premium. For this, the medical advisor must have the same knowledge about your health as you do in advance.
That is why you are asked to fill in the health declaration. And sometimes, if your answers warrant it, the medical advisor asks for additional information from treating physicians or information from further medical examinations. Of course, this is only allowed if you give permission for this yourself.
What about my privacy?
When filling in the health declaration, you reveal a lot of personal information. It is important that the insurer handles this carefully. All kinds of rules apply to this. All people involved in the medical assessment have a duty of confidentiality. Your health declaration and any other (medical) information will be included in a medical file. This is kept under the responsibility of the medical advisor. Employees of the insurer who are not under the responsibility of the
medical advisor falls should not look into your medical file. And of course, your personal information may not be shared with third parties, such as another insurer.
2. While filling in
The health declaration is an extensive form with many questions. You really have to take the time to fill it in. This way you give a good insight into your health now and in the past. And also in your lifestyle, for example whether you smoke or drink a lot of alcohol.
This insight is necessary to be able to make a good assessment of the risks. Because health risks can occur in all kinds of areas, you will be asked many questions in order to give a clear picture. There are many complaints, diseases and conditions that can have a consequence for your risk of disability or premature death. For example, a very comprehensive overview is given of diseases and conditions that you could have or have had. This ensures that you do not forget or overlook anything.
Events from long ago
We understand that it can be very difficult to give all the information about your health, especially if it has been a long time. Nevertheless, it is important that you fill in the statement as completely as possible. Events from a long time ago can also affect your health in the future, and therefore the risk you want to insure. And that also applies to things that you may find less relevant yourself, or that happened a long time ago. The examples on the right show that it can be difficult to properly estimate which information is or is not important to report in the health declaration. Therefore, if you have doubts, it is best to fill in as much as possible. Or contact the medical advisor or medical team to consult.
Careful and complete
It is therefore important to complete the health declaration as completely and as carefully as possible. That may mean writing down a lot. For each complaint, illness or condition that you report, you must fill in additional information in the appendix of the health declaration. This can be, for example, about the treatment you have had or the medicines you are taking. Fill all this in carefully, because this way you avoid having to answer additional questions and the acceptance process is not delayed. You will then be informed by the insurer as soon as possible whether he can insure you, under what conditions and at what premium. So be complete when filling in, it is better to give too much than too little information. Only if you have had cancer and have been cured of it, in some cases you do not have to report it after a number of years. You can read which cases these are in the health declaration.
Risk factors
All kinds of data can affect your life expectancy or the risk of becoming incapacitated for work. Of course, a certain disease or condition does not necessarily mean that this risk is more likely to occur, but the combination with other factors, for example your lifestyle, can lead to negative effects. The medical advisor wants to be able to see the whole picture well and therefore asks all this information to you. A complaint such as back pain can have an underlying cause that does affect, for example, your life expectancy. Questions about these types of complaints contribute to ensuring that nothing is overlooked.
'I broke my knee fifteen years ago'
An example with disability insurance...
You broke your knee when you were twenty. Since the fracture healed, you have never really suffered from it again. You are now 35 years old. You might think that this is not important enough to fill in on your health declaration for your disability insurance. Yet this information is very relevant. There is an increased risk of premature wear and tear. That can increase the likelihood of disability, especially if you're doing physically demanding work.
What are the consequences if I do not complete the health declaration completely?
It is very important that you fill in the health declaration as completely as possible. After all, the information is necessary for the insurance you want to take out. If you do not complete the statement completely, it can have major consequences, for you or for your next of kin.
1. If the insurance has not yet taken effect...
If, when assessing your health declaration, the medical advisor suspects that you have not provided certain information, this information will still be requested from you. This means that your application will be delayed and it will therefore take longer before you can actually take out the insurance.
2. If the insurance has already taken effect...
It may also happen that the medical advisor only discovers when you make a claim that you have not provided all the information. For example, because you have not filled in the health declaration completely or incorrectly. You have then violated the obligation to communicate. The insurer will then have to determine whether this has consequences. There are several possibilities, such as:
- The insurer stops the insurance
- The insurer does not provide a death or disability benefit
- The insurer requests a benefit back
If you have knowingly provided incorrect information, you can end up in the fraud registers of insurers, making it more difficult for you to take out insurance.
In short, when filling out:
- complete
- open and honest
- not afraid to tick yes
If you still have questions or doubts, contact the medical advisor or the medical team.
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Health Data Review Committee |
Why do I have to report for my term life insurance that I have ever had back pain? I'm not going to die from that before, am I?
Hereditary predisposition
Can the medical advisor ask about a hereditary predisposition to a certain disease or condition? That depends on the amount for which you want to take out insurance.
Above the question limit
If you take out insurance above the question limit, a medical examination may be required. Above the question limit, you can also receive questions about the risk of a serious, untreatable hereditary disease of yourself or your family or about the results of previously performed genetic tests (a chromosomal or DNA test). If it is known that you have a hereditary predisposition to a disease, you must report this, even if you do not (yet) have this disease.
Below the question limit
If it concerns an amount below the question limit, the medical advisor may not ask about a hereditary predisposition. However, if a doctor has seen during a genetic examination that you have a hereditary predisposition and you already have complaints or symptoms, you must report this. If it is known that you have a hereditary predisposition to a disease, but you do not (yet) have this disease, you do not have to tell us. Have you undergone surgery or other preventive treatment as a precaution but have no complaints or symptoms of this disease? Then you do not have to report this operation or treatment.
You can read more about heredity in this joint brochure of the Erfocentrum and the Dutch Association of Insurers (brochure in Dutch).
3. After completing
Once you have completed the health declaration, it will go to the medical advisor for review . He issues an advice to the insurer.
The final decision is not made by the medical advisor, but by the insurer. If the customer is informed about this decision, there is always an explanation from the medical advisor. You can get this advice first, so before it goes to the insurer. This can be useful, for example if you suspect that the insurer does not accept you. If the medical advisor does indeed advise negatively, you can ensure that this is not forwarded to the insurer. This is called 'blocking right'. You can then withdraw your request. The insurer will not reject your application. On the explanation of the health declaration you can read how you can use this. An insurer will never ask if you have been refused because of your health before. An insurer will also not pass on a rejection to another insurer.'
It is also important to know that insurers all have their own criteria for determining whether or not they want to insure someone, and under what premium and conditions. So it is certainly not the case that you have nowhere to go if you have been rejected by one insurer. It can therefore be useful to request quotes from several insurers.
Request additional information
The medical advisor bases the advice on the completed health declaration. Sometimes the information entered in the health declaration is not sufficient to properly assess your health. The medical advisor then has several options. He can request additional information from one of your doctors. For example, with your doctor or medical specialist. Your (written) permission is always required first. It is not allowed to request more information than is necessary to assess your health situation. The medical advisor may also decide that a medical examination is necessary. In some cases you will receive a general health inspection; In other cases, the medical examiner will examine you for specific conditions. The medical examiner is never the same as your own doctor and is not part of the medical team that advises the insurer. The inspection is part of the acceptance procedure. If you refuse, you will not be able to take out the insurance.
Incidentally, it can also happen that you are asked to cooperate with a medical examination because you have applied for insurance for a very high amount.
It is worthwhile to request multiple quotes
The medical advice
The medical advisor assesses your health situation. Based on this, an advice to the insurer follows. Usually the advice will be that someone can be insured at a normal premium and normal conditions. In that case, we speak of the standard premium. That is the premium that the insurer charges for people with an average risk. But sometimes the medical advisor estimates the risk higher. Then there will be a different advice to the insurer. The advice is, for example: offer insurance with restrictive conditions. Or a higher premium. Or sometimes even: don't offer insurance at all. As described earlier, in such a case it is wise to request multiple quotes.
If your health changes...
After completing the health declaration, changes can of course occur in your health situation. What do you do then? Imagine that you get complaints after you have completed the health declaration and sent it to the medical advisor. It is important that you still report this to the insurer. If you do not do this, you may face the same consequences as if the health declaration is not completed completely. However, if you get the complaints after you have already been accepted for the insurance, this will no longer have any consequences for your insurance. You don't have to report this.
'We look at long-term health'
Max Hendriks has been a medical advisor for almost twenty years. What he likes about his job? "That it is always about customization, every file is different."
"The big challenge for a medical advisor is to come to a personal medical advice based on all kinds of different data," says Max. "In doing so, we have to take into account both the interests of the insurer and those of the customer."
As a medical advisor, what do you pay attention to when assessing a health declaration?
"The medical advisor pays attention to all matters that may have consequences for a person's health. But don't worry too much about this: it is certainly not the case that you cannot take out insurance if your health is less good, or if you have had complaints in the past. If you think about it, everyone will have to deal with a certain complaint, illness or condition at some point in his or her life. Therefore, do not be afraid when filling in the statement. The vast majority of people can simply take out insurance. In some cases, the insurer will set different conditions."
Is a medical advisor actually independent? He works for the insurer, doesn't he?
"The medical advisor is paid by the insurer. He is employed or hired. That's not to say, however, that he's not objective. A medical advisor is first and foremost a doctor. And that means that he must comply with many laws, rules and codes. For example, medical disciplinary law also applies to the medical adviser."
Why do you sometimes have to pay a higher premium, while the treating specialist says that you no longer have anything wrong?
"There is an important difference between an attending physician (such as a medical specialist) and an evaluating physician (such as a medical advisor at an insurer). They look at you in a completely different way, so to speak. The attending physician usually looks specifically at your disease and the treatment options. The evaluating doctor looks at the whole picture. This also concerns, for example, the possible long-term consequences of a treatment. And what risks there are for the insurer. He compares you to large groups of other people. And then, on the basis of, among other things, guidelines, results of scientific research and statistical data, he comes to his advice to the insurer."
What should I do if I have a question about completing the health declaration?
"If you have doubts about your answer when filling out the statement, or perhaps do not fully understand the question, it is best to contact the medical advisor or the medical team of the insurer directly. Then you can consult, so that you can continue with the fill-in. That's better than giving the wrong or incomplete answer. On the insurer's website, where the health declaration is also located, you will find the direct telephone number or e-mail address."
If you have doubts about your answer when filling out the statement, or perhaps do not fully understand the question, it is best to contact the medical advisor directly
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