The Lookback Periods Underwriters Use (And What They Actually Review)

You filled out the application and maybe booked a quick exam. Then you hear this: “Underwriting will look back a few years.” What years? Which records? I’m a licensed life insurance agent, and I walk clients through this every day. Lookbacks are not random. Carriers follow consistent windows for different data sources. When you know what gets reviewed, you can present clean facts, avoid delays, and often land a better rate class.

What “lookback” actually means

Underwriters verify your story by pulling a few standard data sets. Each one has its own time window. Think of it like a timeline with overlapping lenses:

• A prescription history lens
• A driving history lens
• A prior-application lens
• A medical-records lens (if an APS is needed)
• Sometimes a lab-history lens from recent insurance exams

They compare those snapshots with your application answers. Consistency earns trust. Gaps trigger simple follow-ups.

Typical lookback windows by source

These ranges are common across many carriers. Exact rules vary by company and state, so treat this as a guide.

1) Prescription history (Rx database)

Common window: several years of fills and refills.
What they see: drug names, strengths, fill dates, and prescribers. No doctor notes.
What they’re checking:

• Meds that signal certain diagnoses
• Overlap that suggests escalation vs routine care
• Stop/start patterns that need context

How to prep: list current meds with doses and a plain-English reason, plus stop dates for anything you no longer take.

2) Driving record (MVR)

Common window: roughly 3–5 years.
What they see: DUIs, reckless driving, suspensions, and clusters of tickets.
What they’re checking: frequency and recency. A single old ticket rarely matters; fresh serious events do.

How to prep: write ticket or DUI month/year. If a better pricing window starts soon, mark the re-apply date now.

3) Past insurance applications (MIB)

Common window: recent years of application activity and high-level codes.
What they see: dates, member companies, and brief risk codes. Not full charts.
What they’re checking: alignment with your current answers and timelines.

How to prep: note when and where you applied before, plus outcomes. Short and factual.

4) Attending Physician Statement (APS)

Common window: often the last 2–5 years or from diagnosis forward.
What they see: problem list, visit notes, labs, imaging summaries, and plans.
What they’re checking: stability, control, and follow-up. Trend lines matter.

How to prep: complete any near-term follow-ups before the request goes out. Ask your clinician to update med lists with stop dates.

5) Lab history from prior exams

Common window: recent results from insurance exams if sharing was authorized.
What they see: vitals and lab values.
What they’re checking: consistency with today’s file.

How to prep: schedule a morning home exam, hydrate the day before, sit quietly five minutes, and ask for a second BP reading. Bring a two-week BP log if white-coat spikes are common.

What underwriters actually review inside those windows

• Timeline consistency: dates on meds, diagnoses, and visits that match your application
• Control vs uncertainty: treated hypertension with steady readings reads better than sporadic checks
• Risk signals in combos: for example, certain med pairs point to migraines vs mood disorders vs neuropathy; context keeps them from guessing
• Recent events: ER visits, surgeries, new referrals, or fresh imaging orders
• Function: work status, daily living, and return-to-baseline after a procedure

They are not hunting for perfection. They want a clear, stable story that matches the numbers.

How lookbacks influence your rate class

Your class drives most of the price. Lookbacks can:

• Lift the class when records show stable care, good readings, and routine follow-up
• Hold the class if findings are neutral and consistent
• Lower the class (or trigger a short postponement) if something looks very recent or unresolved

Short, factual notes often fix the third path.

The one-page prep that wins reviews

Create a simple sheet you can paste into your application notes or send to me before we submit:

Med summary
Drug | dose | how often | plain reason | prescriber | start date | “stable” if true
Stopped meds with stop dates

Key tests
Test name | month/year | one-line result

Vitals
Last BP you know; last A1C or lipids if relevant

Sleep apnea
CPAP compliance line or a short clinician note confirming regular use

Driving
Any DUI, reckless, or clusters of tickets with month/year

Past applications
Company | month/year | outcome (approved/declined/postponed/no policy placed)

That single page removes 90% of the guesswork.

Timing matters more than most people think

Lookbacks reward stability. A small calendar shift can change your lane.

• New diagnosis with a scheduled follow-up next week? Apply after the visit so the chart says “stable, routine care.”
• Nicotine quit date approaching a friendly carrier rule? Many carriers treat ex-vapers as non-tobacco at 12 months; some want 24 for top class.
• Driving event close to aging off? Mark the re-apply date and place a smaller layer now if your family needs protection today.

What happens when lookbacks find surprises

Underwriters often ask for one of three things:

1. Short interview to confirm dates or reasons for a med
2. Targeted APS from a specific clinic and timeframe
3. Quick nurse exam when numbers could help the class

Speed helps. Same-day answers keep the file warm.

Common myths

“They’ll comb through my entire lifetime.”
No. Lookbacks are bounded. They aim at recent and relevant history.

“Any difference between my app and a database kills the case.”
Not true. Small gaps get fixed with dates and a line of context.

“No-exam means no lookbacks.”
Accelerated paths still run data checks. Clean signals often land top classes without labs.

“If I had a rough clinic BP once, I’m stuck.”
A morning home exam with two readings and a short BP log can improve your class.

Mini stories from recent files

Short opioid course after surgery
Rx file flagged a pain med. We sent the surgeon’s discharge note showing a 7-day script and no refills. Offer moved from Standard Plus to Preferred.

Anxiety on SSRI
Two prescribers looked messy. A one-paragraph clinician summary confirmed a stable dose, steady therapy, and full work routine. Approved at the expected class.

Ex-vaper at 13 months
Two carriers priced tobacco to 24 months. A third allowed non-tobacco at 12 months with clean labs. Same person, lower bill.

Sleep apnea
APS request incoming. We offered a CPAP compliance report instead. Underwriter cleared it with no class hit.

Driving cluster aging off
Applicant had multiple tickets 35 months old. We set a re-apply date for month 37, placed a small layer now, and then replaced with a better class later.

If an APS is requested, keep it tight

• Call the clinic’s records desk and ask about turnaround
• If a full chart will take weeks, offer a clinician summary plus recent labs or the assessment/plan page
• If a visit is already on the calendar, complete it so notes say “stable” instead of “pending”

Your privacy and consent

You sign authorizations in the e-app that permit specific checks. These are standard and time-bound. Want to see what was pulled? Ask for your MIB Consumer File or request the same APS set from your clinic. If a vendor is involved, I can send you the consumer request link.

No-exam vs short exam: which path fits your file?

• Accelerated works well when lookbacks are quiet and your story reads clean
• Quick exam helps when strong labs or vitals would lift the class

Price the same specs both ways. If the exam saves real dollars across a long term, take it. If the gap is tiny, enjoy the speed.

Your one-evening lookback checklist

1. Write a med summary with stop dates
2. List clinics and last visit dates for the past 2–3 years
3. Note any tickets or DUI with month/year
4. Jot your nicotine timeline with a real quit date
5. Gather any easy wins: CPAP report, home BP log, last labs you know
6. Decide a monthly range that fits
7. Ask for apples-to-apples quotes from 2–3 carriers, both no-exam and exam, plus the next face tier ($500k vs $450k; $1M vs $900k)

You’ll be ready for any lookback with facts that match.

Copy-paste scripts

Clinician summary request
“Could you write a brief note for life insurance underwriting? Please list diagnosis, current status, meds with doses, last visit date, any recent labs or imaging if relevant, and a line that I’m stable with routine follow-up.”

Records desk nudge
“My insurer requested records for underwriting. Could you share your standard turnaround and confirm when the request will be fulfilled?”

Underwriting context
“Here is context for the Rx item you flagged: [drug], short course after [procedure] in [month/year], discontinued. Current meds listed below with stop dates.”

Reconsideration
“Please reconsider application #[number]. Attached: clinician summary, CPAP compliance, and BP log. These address the items noted in your review.”

How I keep lookbacks from slowing you down

• Pre-screen that captures meds, stop dates, and doctor names
• Carrier picks that fit your health profile and underwriting rules
• Same-spec quotes, both paths, with the next face tier checked
• Tight cover letter so underwriters don’t have to guess
• Fast responses to data hits with short, dated context
• If needed, a targeted APS or a quick exam to lift the class

Clean info plus the right carrier is the easiest path to a fair “yes.”