1. Individual Health Insurance Underwriting (New Business & Renewals)

• Review medical declarations, reports, and diagnostic results to assess medical risk
• Calculate risk-based premium surcharges for pre-existing conditions and health issues
• Request additional medical examinations or reports when needed for accurate pricing
• Review claims history and health changes at renewal to adjust premiums accordingly
• Document all decisions with clear medical rationale

2. Group Medical Insurance Underwriting

• Analyze group medical declarations to identify high-risk members, if needed
• Estimate potential claims costs from high-risk conditions, calculate aggregate premium loadings based on overall group medical risk profile and provide clinical justification for premium adjustments above standard rates

3. Mid-Term Changes: Overage Dependents & High-Risk Additions

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