Guidance on Underwriting & Claims

The true value and purpose of the cover offered by our industry, providing financial resilience and peace-of-mind to households, individuals and businesses, has never been more apparent than during this historic phenomenon. So at this challenging time, we wish to continue to partner with our clients to offer cover to as many customers as possible, while ensuring sound risk management judgement and decisions are made to ensure fairness across the wider pool.



Through our multi-expertise Research & Development center, the SCOR Knowledge Community, we have the experience and resources necessary to provide our clients and partners with informative data about the pandemic.

Our doctors, epidemiologists, actuaries and data scientists are tracking and analyzing all available medical and epidemiological information. We are keen to share that knowledge with our clients, through our monthly updated COVID-19 medical memo, including a focus on risk factors. You will find a link to that memo at the end of this page.

In case you would like to track the progress of the pandemic worldwide and to gain access to estimates on how it could evolve short term, our data analytics teams have developed a dashbaord based on data from the Johns Hopkins University.  




Guidance on Risk assessment and Claims considerations of COVID-19

Based on the huge amount of data we are able to gather and analyse and on our projections, we would like to share with you an overall guidance on the approach to the Underwriting risk assessment and Claims considerations of COVID-19. This is based on 5 main learnings that are outlined as follows:

  • This virus particularly affects the vulnerable, with much higher mortality rates observed for people above 60 years old and for people of all ages with co-morbidities

  • There is little genetic variation with very few mutations occurring so far

  • The Case Fatality Rate (CFR, probability of death when tested positive) is highly dependent on other factors such as pressure on healthcare services, local testing policy etc…1

  • Countries across the globe continue to prepare for and respond to cases of COVID-19 with mitigation measures

  • Currently there is no specific antiviral treatment available for COVID-19 virus, hence patients are only receiving supportive care

Risk assessment for underwriters

SCOR’s guidance for underwriting applications including mortality, critical illness, disability benefits and medical expenses, is to encourage a cautious approach and adhere to robust risk management principles when assessing risks linked with possible exposure to COVID-19.

  • Life Cover: High impact mainly for people aged above 60 years and people of all ages with co-morbidities
  • Critical Illness: Not all products will be impacted. High incidence of respiratory failure, kidney failure and multiple organ failure, critical or intensive care benefits.
  • Disability benefits: Depending on products and markets, disability benefits are likely to be heavily impacted by the ongoing economic aftermath of the pandemic which will be influenced by positions of governments, social security and health-related public entities. The risks linked to higher exposure of COVID-19 for certain occupations should also be considered when assessing Disability cover.
  • Medical expenses: Impact depends on public health services in each country. If the cost of the treatment is covered by the government, minimal to no impact is expected although Insurers may be asked to cooperate and provide some flexibility on allowing shorter waiting periods or eliminating waiting periods for such benefits as Hospital Cash Benefit or Daily reimbursements benefits.

General Recommendations

  • Due to the potential non availability of the doctors to perform medical exams and lab screening, SCOR is ready to discuss alternative mitigation approaches to replace medical evidence such as blood test, medical exams and physician reports. However, we recommend a conservative approach when it comes to underwriting products with potentially increased anti-selection.
  • We would recommend you consider the pricing and risk impacts of members increasing cover or applying for new cover under group insurance arrangements, particularly where there is automatic acceptance in place. SCOR is happy to have further conversations with you to determine a pragmatic approach, risk mitigations in product wording or other factors to manage any anti-selection that may arise.

COVID-19 positive or symptoms

In the event of receiving an application from an individual that has been infected with COVID-19, our guidance is that in all cases the applications should be postponed for at least 3 months after the life to be assured has recovered and been discharged from hospital/quarantine or self-isolation. This is due to the ongoing risk of complications which are still not completely understood. Any ongoing complications, symptoms etc. will need to be assessed carefully and on their own merit.

In order to manage cases with any evidence of symptoms linked to diagnoses of COVID-19, you may need to consider adapting your health questionnaire (paper or electronic) with the following questions:

  1. Have you tested positive for Coronavirus/COVID-19?
  2. Within the last 30 days have you experienced symptoms of a new or unexplained continuous cough, a high temperature or fever, breathing difficulties or any other symptoms of coronavirus/COVID-19?
  3. Within the last 30 days have you been in direct contact with someone who’s been confirmed or suspected to have Coronavirus/COVID-19?
  4. Within the last 30 days have you been self-isolating due to symptoms of Coronavirus/COVID-19?
  5. Within the last 30 days have you been advised to self-isolate for any other reason?

When constructing these questions, it is important to explain to applicants the difference between “self-isolation” and “social distancing” as these categories should be treated very differently and to avoid issues where applicants have misunderstood the question. Also, that within the group that are self-isolating, rules are structured in such a way as to identify those with no additional risk and others that do.

At a high level, those who have been given a definite diagnosis of COVID-19, we are recommending postponing such cases until they have been symptom free for 3 months. When someone has disclosed they have been self-isolating for reasons of having COVID-19 like symptoms or have been in direct contact with someone known to have COVID-19, then we are recommending they are postponed until they have been symptom free for a minimum of 1 month.

Where health questionnaire cannot easily or quickly be updated then you should consider how else the above information can be established. For example through a supplementary tele-interview or through a Statement of Good Health being used that specifically covers the COVID-19 questions.


Underwriting Philosophy and Temporary Recommendations

The number of applications for insurance for older applicants is generally not significant in most markets. However, we feel the underwriter should underwrite these lives conservatively. This should also be the case for those customers of any age with significant chronic conditions or those conditions considered high risk.

Because of the unprecedented situation caused by the COVID-19 pandemic, SCOR feels it is important that underwriting philosophies are temporarily adjusted to be slightly more robust for those applicants where medical evidence suggests there is a greater risk.

The evidence referred to can be found on the links provided and shows there are increased risks for COVID-19 relating to advancing age (particularly ages over 60) and to specific medical conditions. In view of these findings, we feel the following changes should be implemented until the time of crisis has passed:

Claims Information

The majority of COVID sufferers make full recovery so at this stage, our view is that the impact to claims mortality experience is minimal; this applies particularly to Disability claims with longer deferred periods. Those that are more severely affected typically have some other co-morbidity and are often elderly. Our advice is to be aware of COVID-19 as a potential claims cause factor where there is a history of acute respiratory failure or other underlying risk.

Strain on medical Systems: Adaptation of claims processes in the interim

Depending on containment measures in various countries, there may be considerable added pressure on family doctors and hospitals, which are typically the sources of claims evidence. The extent of the impact will depend on the individual country’s health care systems. What insurers can do to help claimants process claims, while ensuring as an industry we minimise the strain on medical facilities and build customer trust at this difficult time, will also depend on the individual country’s health care systems. 

We encourage you to reach out to your local claims contact at SCOR for advice in this area. We can provide guidance on the requests linked to benefits such as Medical expenses or Hospital Cash Benefit where the waiting period may need to be adjusted or some flexibility applied.


Disability Claims

In addition to the direct health and social impacts resulting from the pandemic, the future economic consequences are unknown, however they are estimated to be severe:

  • Likely recession
  • GDP could shrink due to productivity losses and business interruption
  • Sharp increases in unemployment
  • Changes in household spending patterns
  • Severe supply chain disruptions

Financial strain often impacts physical and mental health conditions. Consider utilising rehabilitation providers, as many can service clients over the phone, to support information gathering. In particular using these services at the commencement of claims, when there may be limited access to treatment or contact with employers. These services will give the added benefit of additional customer support which is focused on goal-oriented treatment and recovery.

This is undoubtedly a difficult time and especially for those that find themselves affected by COVID-19. As such this is an excellent time to signpost claimants to nationally available support services as well as those provided by your companies. It’s also where we get to make a real difference to claimants in being available to talk to them about their concerns, provide help and support or even to be there in the event that the customer is ill and on their own.

Finally, SCOR will of course continue to support all current product wording in respect to the existence (or not) of any pandemic exclusions. If you have any questions regarding the application of such exclusions again, please reach out to your local SCOR claims contact.



The challenge we face as an industry is to ensure we continue to provide the necessary protection to as many people as possible whilst also understanding the risks we manage. At SCOR, we will continue to be by your side and provide you with the necessary service, expertise and support.

The situation is evolving continuously, and we are learning more every day. As a result, the guidance we give might evolve as there are new developments in the current crisis.

Finally, do not hesitate to contact your local SCOR team for advice or to get more specific guidance for your local market.




    1. To clarify, the CFR is not the same as the mortality rate. The mortality rate is considered the actual death rate.


    Do not hesitate to read the latest memo on the epidemiologic assessment of COVID-19 by SCOR Global Life's Knowledge Community