Underwriting

Underwriting is the decision to accept a risk, and on what terms. Most quotes pass automatically. The ones that do not wait under Sales > Underwriting for a person to decide.

What sends a quote to underwriting

When a quote is finalised, the system checks it. A quote is referred when:

• an underwriting rule of the product with the outcome Refer to underwriter applies,
• the sum insured is below the product's minimum or above its maximum,
• the customer failed the identity check, or
• the product is not active.

A quote is declined outright when:

• an underwriting rule with the outcome Decline applies, or
• the insured is younger or older than the product allows.

The reasons are stored on the quote, so the person who prepared it sees exactly why.

Since version 4 a quote is also referred when:

• a questionnaire question is unanswered, or an answer asks for a document that is not attached yet,
• the questionnaire score falls in a band set to Refer (or Decline),
• a member has not made a health declaration, or declared a condition that has no terms yet (products with medical underwriting),
• a medical exam or a survey is still waiting for results, or a survey graded the risk D or E,
• the insured has made more claims than the product allows in its look-back period,
• the quote would take the company over an exposure limit.

Questionnaires and risk scores

On a product, the Questionnaire tab holds the questions a proposer answers: yes or no, a number, a choice from a list, text or a date. For each question you can:

• only ask it after a given answer (for example "What was modified?" only when "Has the car been modified?" is yes),
• give points to answers; the total is the quote's risk score,
• ask for a document for a given answer (an engineer report, a repair invoice).

In the product's Underwriting section, score bands turn the score into a price change and a decision: for example 0-9 Low -5%, 10-24 Medium +10%, 25-44 High +25% and referred, 45 and up declined. The band shows on the premium as its own line.

Answers also become risk factors named q_<code>, so ordinary rating and underwriting rules can use them.

To supply a document the questionnaire asks for, add it under the quote's Files tab and choose the matching Evidence category. The quote is screened again at once.

Medical underwriting

Switch on Medical underwriting on a health or life product. On each quote, the Underwriting menu then offers:

• Health declaration for each member: conditions, since when, treatment, smoking, height and weight;
• Medical terms (underwriters): a loading on that member's premium and conditions excluded from cover. Exclusions are printed with the member on the policy.

The Medical exams tab requests an exam at a clinic or laboratory, records the result and tells the underwriter when it is in.

Surveys and inspections

The Surveys tab on a quote (or a policy) asks a surveyor to visit. The report gives a grade from A to E and recommendations with priorities and due dates; Follow up marks each one done or waived.

The queue

The Assigned to me tab shows your referrals; All waiting shows everyone's. A referral is given to the underwriter with the fewest open referrals among those whose authority covers it, and they are told. Take it moves a referral to you; Escalate passes it to someone with a higher authority; Defer puts the decision off until a date, when it comes back by itself.

The Waiting for a decision tab lists the referred quotes with the customer, the product, the sum insured, the premium and why it was referred. Users who can edit in the Underwriting module are told when a new one arrives, provided their Underwriting referral waiting notification is on.

Open a quote to see the full risk details, the insured items and the premium calculation.

Accept

Choose Accept. You can accept as quoted, or on modified terms: a loading (a percentage added to the premium), special exclusions, and conditions. A condition marked must be met before issue stops the policy from being issued until someone ticks it under Underwriting > Conditions met; the others are printed on the policy as special conditions. Write your notes, then confirm.

What you changed against the automatic result is kept with the decision as the override. The quote becomes Approved, the premium is recalculated with the loading, and the person who prepared the quote is notified.

Decline

Choose Decline and give the reason. The quote becomes Declined and cannot be issued.

Authority limits

Under Settings > Underwriting authority the main account sets how far each person (or everyone in a role) may decide, per line of business: the highest sum insured, the highest loading, and whether they may decline. With no limits set, anyone with the underwriting Approve permission may decide anything. Once one limit exists, only people with a limit can decide, and a decision beyond it is refused with the reason: escalate it instead.

Exposure limits

Sales > Exposure limits sets the most sum insured the company will carry in one zone, catastrophe zone, industry, customer or scheme, with a warning level. Type the same zone codes in the quote's risk details. The screen shows what each limit carries today; a quote that would go over is referred (or declined), and the quote shows the accumulation check.

A second opinion on large risks

To have a senior person confirm the acceptance of large risks, the main account can add an approval chain for Underwriting: accept a referred risk, starting from a chosen sum insured. See Approval chains.

The record

Every decision is kept on the quote under Underwriter decisions: who decided, when, the loading and the notes. The Decided tab of the queue lists the quotes that have already been through underwriting.