Impaired risk refers to applicants whose expected mortality or morbidity is higher than standard due to health history, lifestyle, occupation, or avocations. Underwriters adjust pricing and terms to reflect the additional risk using table ratings, flat extras, exclusions, or coverage limits. Assessment considers diagnosis details (severity, treatment, stability), objective data (labs, imaging, EKGs), and behavioral factors (tobacco, compliance). Carriers may seek facultative reinsurance for large cases or nuanced impairments, allowing external reinsurers to offer opinions and share risk. Impaired risk is not a denial category; it is a pricing tier that enables issuance when standard rates are not actuarially appropriate. Proper documentation, timing after stabilization, and carrier selection materially influence the final offer and long-term insurability.

Advisors pre-shop challenging cases with BGAs and reinsurers, gather specialist notes, and time applications after stability-post-treatment clean scans, improved A1C, or tobacco cessation. They model premiums with tables or flat extras, layer coverage across carriers, and calendar reconsideration milestones to improve pricing as risk factors resolve.