What is your life insurance rating? If you're shopping for life insurance, you'll quickly discover that your premiums are based on a number of factors such as age, gender, medical history, driving record, and tobacco use. Your premium will also depend on the type of policy and the amount of coverage that you select. When you apply for coverage, your insurer will assign you to an underwriting class (i.e., preferred, standard non-smoker, standard smoker, and substandard) based on these factors. We've designed this tool to help you determine which underwriting classification you're likely to be eligible for. However, since every insurance company has its own underwriting criteria, results of this tool should be used only as a guideline. 1. Have you used tobacco in the last 12 months? Yes No 2. Is your occupation generally considered hazardous compared with most occupations? (e.g., military servicemember, police officer, firefighter, race-car driver, coal miner) Yes No 3. In the past three years, have you had three or more moving-vehicle violations, or in the past five years, have you been convicted of driving under the influence of alcohol or drugs? Yes No 4. Do you fly for recreation? Yes No 5. In the past two years, have you engaged in any hazardous activities or sports such as hang gliding, hot-air ballooning, mountain or rock climbing, motor vehicle or boat racing, or skin, scuba, or sky diving? Yes No 6. Do you regularly travel to underdeveloped countries for business or pleasure? Yes No 7. Have you ever been convicted of a misdemeanor (other than a traffic violation) or a felony? Yes No 8. Have you ever used illegal, restricted, or controlled substances except as prescribed by a physician? Yes No 9. Has a physician told you that you are overweight? Yes No 10. Are you being treated for depression, anxiety, or other mental disorders? Yes No 11. Are you being treated for or have you recently suffered from respiratory disorders such as asthma, bronchitis, or sleep apnea? Yes No 12. Are you being treated for or have you recently suffered from a hernia, ulcers, gallbladder disorders, or other digestive or stomach disorders? Yes No 13. Do you have any serious physical defect, including loss of hearing or sight? Yes No 14. Does your family (parents and/or siblings) have a history of cancer, heart disease, or kidney disease? Yes No 15. Have you been diagnosed with or are you being treated for high blood pressure, high cholesterol, or other disorders of the heart or blood vessels? Yes No 16. Would you describe yourself as a person who is in excellent overall health? Yes No 17. Would you describe yourself as a person who is in poor overall health? Yes No 18. Have you been advised to seek treatment for drug or alcohol abuse? Yes No 19. Have you been diagnosed with or are you being treated for cancer, heart disease, AIDS, or any other life-threatening illness? Yes No
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