Association of Home Office Underwriters - AHOU

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Glossary

1

Home office underwriting

The carrier-level underwriting function that sets risk selection philosophy, underwriting rules, authority limits and audit standards for the field and for automated decision systems, rather than handling individual case work alone.

2

Risk classification

Placing an applicant into a rate class (preferred, standard, table rated, substandard, declined) based on mortality or morbidity risk; a core agenda topic at AHOU because class definitions drive pricing and reinsurance.

3

Medical underwriting

Assessment of an applicant's health history, prescriptions, lab results and impairment severity to estimate mortality risk; usually guided by a medical director and an underwriting manual.

4

Attending physician statement (APS)

A physician-completed record of an applicant's diagnoses, treatment and history, ordered when the application or a paramedical exam raises questions that the application alone cannot resolve.

5

Accelerated underwriting

Programmes that issue coverage without traditional fluids or exams for eligible ages and face amounts, relying on data sources and rules engines; a frequent discussion point on thresholds, exclusions and post-issue review.

6

Predictive underwriting

Use of statistical or machine-learning models, built on historical claims and application data, to score risk or to decide which cases need additional evidence; governance and explainability are recurring concerns.

7

Evidence of insurability

The information package an underwriter relies on - application answers, prescription history, MIB codes, motor vehicle records, labs or APS - to support an underwriting decision.

8

MIB

The member-owned life and health insurance data exchange that flags previously coded conditions and underwriting actions on applications, used as a protective check within evidence of insurability.

9

Prescription history database

A pharmacy claims data source that shows dispensed medications and dosing patterns; underwriters use it to infer conditions, severity and adherence when applicants omit or understate treatment.

10

Table rating

A debit applied to standard mortality (for example Table 2, Table 4) to price a substandard risk; tables are usually expressed as a percentage of standard mortality per 1,000 of coverage.

11

Substandard risk

An applicant whose expected mortality exceeds standard because of an impairment, offered coverage with a rating, exclusion or reduced face amount rather than a standard offer.

12

Facultative versus automatic reinsurance

Facultative cover is submitted case by case to a reinsurer; automatic cover follows a pre-agreed treaty with retention and jumbo limits where the direct writer keeps the underwriting decision in-house.

13

Contestability period

The initial policy period (commonly two years) during which a carrier may rescind or adjust a claim if a material misrepresentation is found; it shapes how thoroughly cases are underwritten at issue.

14

Underwriting audit

A retrospective review of issued cases against the underwriting manual and authority limits, used to measure decision quality, documentation and consistency across underwriters and automated rules.

15

Chief underwriter

The senior home-office role accountable for underwriting philosophy, manual and rule changes, authority delegation and regulatory positions on risk classification.