An HR Glossary for HR Terms
Glossary of Human Resources Management and Employee Benefit Terms
Evidence of Insurability
What Is Evidence of Insurability?
Evidence of Insurability, or EOI, is a documentation of good health required by health insurance providers in order to obtain certain types of insurance. While most insurers use a basic questionnaire to verify overall health before granting policy access to prospective clients, EOI goes beyond basic information to establish a more specific level or explore a specific area of health.
What Is Required to Show Evidence of Insurability?
EOI requirements vary depending on the insurer and the type of insurance being requested. It may be as simple as answering more detailed health history questions than the general insurance questionnaire, or it may go so far as to involve physical documentation of additional tests or examinations by a licensed physician or specialist.
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What Kinds of Insurance Require Evidence of Insurability?
Generally speaking, some form of EOI is required in order to obtain health coverage beyond garden-variety personal health insurance coverage. For example, any of the requests below would likely require additional EOI:
- Excess coverage: A guarantee of insurance coverage in excess of the standard amount offered by a policy or for a specific type of coverage, such as accident coverage
- Additional policy members: Adding a dependent or other person to a policy, especially if that person was not covered under a prior policy
- Late application or reinstatement of coverage
- Reapplying for coverage after being declined
Why Is Evidence of Insurance Required?
EOI is required because it gives insurers the information they need to calculate the additional risk of providing insurance coverage for applicants who did not follow standard procedure or who are requesting additional coverage. Insurance is a calculated risk, and while general policies are designed to offset some uncertainty at the individual level by virtue of the general good health of other policy members, individual policies and exceptions must be approved by internal underwriters whose job it is to determine whether the additional revenue is worth the additional liability of added coverage.