Life & Critical Illness Underwriting Audits

We conduct Life & Critical Illness insurance Underwriting audits on internal or external Underwriters, Coverholders or MGAs who have in-house Underwriting teams. Our Life and Critical Illness auditors are independent and objective professionals who are also experienced Underwriters which gives us an important insight into the work we do.

A Life and Critical Illness Underwriting audit’s main concern is with those elements of the Underwriting process that may adversely affect mortality or morbidity.  These factors include, but are not limited to, adherence to treaty agreements, adherence to underwriting guidelines (internal and published) and implementation of the company’s overall underwriting philosophy.

Standard Life & Critical Illness Audit

Our standard scope of audit includes data collection and privacy protection management, adherence to AML and OSFI guidelines, internal controls and authority levels, compliance with underwriting guidelines (referrals, manual use, internal guidelines, preferred criteria etc.), errors and omissions practices, handling of “business decisions” and much more.  Our Life and Critical Illness audits can be tailored to your needs including, but not limited to

  • Determining training needs & identifying opportunities for improvement.  This is an important part of a successful audit; identifying weaknesses is only part of the conversation
  • Identifying best practices for Life and Critical Illness Underwriting (industry standards)
  • Measuring underwriter performance against industry standard and individual company expectations (appropriate medical, non-medical and financial risk assessment)
  • Evaluation of file documentation
  • Appropriate second-sign referral or Medical Department referral
  • Report on approaches to risk assessment, communication (internal and external), application of, and adherence to, underwriting guidelines
  • Identify patterns and validity of “exceptions” or “business decisions”
  • Adherence to treaty parameters

Our experts will work with you to develop an audit template that addresses any specific concerns you may have.  We will work within your timeline to deliver valuable information when you need it.

We believe a Life and Critical Illness Underwriting audit provides an opportunity for early detection of areas for improvement that benefits everyone; the writing company, their clients, their reinsurer, the underwriter and claims departments. Our auditors work cooperatively with you to ensure that each audit is an opportunity for constructive change.   We look forward to working together soon.