Based on the patient’s current or pre-existing medical conditions, a medical underwriter determines whether or not the applicant should be granted medical coverage. After evaluating an applicant’s health, a medical underwriter can decide whether to accept or deny the individual’s insurance coverage, and, if the applicant is accepted, what premium rate to charge for that particular client, based on the financial risk that accepting the applicant entails. Medical underwriting may be seen as a harsh practice some who are denied coverage due to a minor condition, despite the fact that it was created with the goal of lowering insurance premiums for individuals. Insurers, on the other hand, may argue that the practice prevents people from seeking coverage only when they need surgery or other expensive medical procedures.
Some insurers may argue that disqualifying some applicants, the return on investment of insurance premiums is boosted, making premiums more affordable for the general public and ensuring a profit for the insurer. Because of the negative reaction to medical underwriting among some Americans, the practice has been prohibited law in some states and within some insurance companies. As a result, these states have the highest average premiums in the country. While it may be argued that prohibiting medical underwriting allows otherwise uninsurable applicants to obtain coverage, insurers frequently argue that doing so would raise premiums even more, making insurance and medical coverage unaffordable even for those who are healthy and have no pre-existing conditions.
More serious illnesses such as heart disease, arthritis, and most cancers are examples of medical conditions that may cause a medical underwriter to deny coverage to an individual. Obesity, anorexia, and old injuries, all of which are less serious and often curable, may also prevent certain people from being accepted an insurer. The criteria used a medical underwriter may differ depending on the insurance company or the state or region in which the applicant lives. Millions of people in the United States are currently uninsurable due to a pre-existing condition that may or may not be severe enough to justify a premium denial. This issue continues to elicit discussion across the country.