Factors that may increase an individual’s risk greater than that which is normal for his or her age.

After health insurance premium income, the deficiency that remains after payment of insurance claims and administrative expenses.

Procedure and policy book that summarizes methods used by a specific insurance company to evaluate and rate risks. Underwriters use this as a reference book to research background information on underwriting impairments. It gives suggestions for underwriting actions to take when various impairments are present.

Insurance company’s income from its operations as distinct from its investment earnings.
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The measure of the profitability of an insurer’s underwriting activity. This refers to earned premiums (net of reinsurance) with net operating expenses and claims incurred (net of reinsurance) subtracted. The underwriting profit does not include any investment income.

Instructions giving information on data required for insurability for a given situation and optional information sources needed to provide underwriters with needed information about the insured (e.g., medical records or physical examination report). These requirements are graduated based on the insured’s age and the amount of insurance coverage.

A service that has been billed on an insurance claim for which there is either insufficient or no supporting documentation to validate the service or procedure in the patient’s medical record.