This month I was thrilled to see a revised disability insurance underwriting guidebook. Before you think I’m the most boring person at kiddush, hear me out. When you apply for life or disability insurance, the insurance company essentially takes on a financial risk by insuring you. To offset that risk, they do their homework before deciding on your application. This can include an online medical questionnaire, requesting medical records from a specialist or other requirements. Once the underwriter completes their review, I can finally tell you your exact premiums for different policies.

Yes, the underwriting process can feel tedious. But here’s the thing: the insurance company that’s thorough now is the one you want backing you later. Over the years, there’s been no shortage of Dreck Insurance Co. iterations approving policies like they’re handing out candy—only to leave their policyholders uncertain about whether claims will be paid. Not good.

So, what’s my job in all this? Advocacy, plain and simple. While I can’t work miracles—underwriting gives ballpark boundaries—I can make sure your application is presented in the most favorable light. That might mean writing a cover letter to explain your health history upfront or pushing back when a decision feels overly strict. These little nudges can make a big difference. I’m proud to have several clients who unfortunately were previously denied life insurance when they applied online or with other brokers, and after some hard work, ended up with typical quality policies together.

Underwriting guidelines for life and disability insurance are written by company medical directors (think doctors, nurses and researchers). These are based on health studies, actuarial claims, and of course, their professional evaluations. One way insurers control risk is by putting exclusions on your disability insurance policy, meaning they’ll pay out for almost anything except that one excluded condition (putting life insurance aside here, which alters premiums instead).

For example, 47% of all disability insurance policies issued by a major U.S. carrier include at least one exclusion. These exclusions can range from minor to more major, and I get how frustrating they can be. The good news? Many exclusions can be reconsidered and removed if your symptoms improve over time or more time has passed.

Now, let’s talk mental health. Until relatively recently, individuals with any history of mental health treatment were often outright denied individual disability insurance coverage. Wild, right? Millions of people live and work while managing mild anxiety or depression—garden-variety challenges that are far from debilitating. Thankfully, times have changed and the industry has caught up with reality. Today, applicants with mild mental health histories can often qualify for the same policies as those without such histories. Progress!

As brokers, we get a front-row seat to these changes—and sometimes, we even get to influence those changes in real-time (with a little guts). Case in point: I recently worked with Guardian Life, a Fortune 250 company, to improve their national underwriting guidelines for two situations (explaining my excitement about the new underwriting guide showing these changes).

Here’s what went down. First, a client applying for life insurance had a parent with polycystic kidney disease (PKD), a serious condition with a 50% heritability rate that can lead to kidney failure. Despite the client’s preventative scans showing no evidence of the condition, the initial underwriting decision assigned astronomical premiums based solely on family history. It didn’t make sense. I (politely) pushed back and escalated the decision to the highest level of medical directors for the entire company. I wanted to explain why this approach was illogical and unfair.

The result? Not only did my client’s premiums improve to standard rates, but the company adjusted its guidelines for future applicants in similar situations.

In another instance, I advocated for better treatment in disability insurance underwriting for women who experienced a specific pregnancy complication that normally would have “dinged” their applications. After escalating the issue with special meetings and presenting health data to the doctors to support a more reasonable approach, the updated guidebook now reflects significant changes. These updates don’t just help one client—they set a precedent for everyone.

Now, let’s bring this home. A good broker doesn’t just fill out paperwork and hope for the best. We take ownership of the process, push for better outcomes and ensure you’re protected with coverage you can trust. Yes, underwriting can be a pain sometimes, but the goal is to get you a policy that gives you peace of mind. And if we can move the needle for future clients along the way? Even better.

Jamie “Elisheva” Kopelman is a disability, life and health insurance broker with National Financial Network in Manhattan. Kopelman is passionate about making financial jargon simple and giving her clients quality insurance protection that fits any budget. She lives in New York City with her family and can be reached at [email protected] or by phone at (631) 560.4701