Modern U.S. life / SI / mortgage-protection underwriting knowledge — actuarial decision framing for software.
Knowledge priority 9/10Not legacy dump tree
Actuarial software-knowledge disclaimer:
These pages synthesize typical U.S. life / simplified-issue / final-expense / mortgage-protection
underwriting logic used industry-wide (2024–2026 field guides, carrier appetites, reinsurance mortality framing).
They are not any single carrier’s filed rates, not advice to applicants,
and not the legacy 2022 database dump. Use them to design interview schemas and carrier-ruleset APIs.
Actuarial view
Diabetes mortality is driven by type, age at onset, control (A1C), treatment intensity, and complications. Actuaries treat A1C as a durable mortality signal; build and tobacco interact strongly.
Primary risk drivers
Type 1 vs Type 2
Age at diagnosis
Insulin use
A1C trend
Nephropathy / retinopathy / neuropathy
Build + tobacco interaction
CAD/stroke combination
Life (full / accelerated)
Map drivers → rate class / flat extra / postpone / decline. Labs & Rx history refine.
Mortgage / FE SI
Well-controlled T2 without complications is commonly mortgage-SI eligible. Insulin + neuropathy or diabetes+heart is the knock-out zone.
Health insurance
A1C, Rx, and complication staging dominate medical underwriting—life tree is only a screen.
Recommended interview logic (software schema)
Diagnosed with diabetes or prediabetes?
No
Continue
Prediabetes only
Often Standard/Preferred if labs OK
Type 2
Most SI/FE volume
Type 1 / LADA
Specialty UW; many SI decline or grade
Age at diagnosis
50+ (T2)
Favorable for level FE if controlled
40–49 (T2)
Watch insulin & complications
Under 40 or childhood
Express often decline
Treatment
Diet / non-insulin only
Best SI path
Insulin
Units, onset, complications decide Level vs Graded vs Decline
Insulin + complications
Usually decline Level SI
Control (fully UW / best evidence)
A1C consistently under 7.0–7.5
Most favorable
A1C 7.5–8.5
Standard / modest table at favorable carriers
A1C over 8.5–9.0 or rising
Heavy rate / decline
Unknown (phone SI)
Rely on Rx history & complication knockouts
Complications?
None
Continue
Neuropathy / retinopathy
Level only if carrier allows; else Graded/Decline
Nephropathy / reduced eGFR
Often decline Level
Amputation from disease / PVD with diabetes
Classic Express decline combo
Typical decision patterns
Profile
Traditional / Express-style
FE / Mortgage SI path
T2, onset 50+, oral only, no complications, average build
STANDARD / SI LEVEL
Good mortgage SI candidate
T2 + insulin, controlled, no complications
SI Level at appetites / else Graded
Shop carrier guide
Diabetes + CAD or stroke
DECLINE many Express
FE Graded or GI
Diabetes + high build + tobacco
DECLINE Express pattern
Stacking rules
T1 poorly controlled / young onset
Specialty or decline
GI fallback
Software implementation note
Fields: dm_type, onset_age, on_insulin, a1c_band, complications[]. Combine with build_class and tobacco.