Agent Playbook: Documentation and Client Scripts to Ensure Application Accuracy and Reduce Post-Sale Claims

A complete agent playbook for U.S. life insurance agents focused on underwriting, application accuracy, beneficiaries, and denial prevention. This is an ultimate-guide level resource with step‑by‑step procedures, ready‑to‑use scripts, checklists, and documentation templates that lower the risk of contestability, reduce post‑sale claims and disputes, and preserve trust with clients and carriers.

Key goals:

Prevent application errors and misrepresentation exposures
Improve speed and quality of underwriting decisions
Protect beneficiaries and reduce claim disputes post‑mortem
Build defensible documentation for audits and litigation

Quick facts you must internalize

Most life policies include a contestability period (commonly two years) during which insurers may investigate and rescind on proof of a material misrepresentation. Regulators require insurers to show proof of materiality rather than denying claims simply because death occurred within two years. (dfs.ny.gov)
Industry underwriting now relies heavily on digital data sources (MIB, Rx history, MVRs) and accelerated underwriting workflows; agents must be precise in disclosures because these systems flag discrepancies quickly. (munichre.com)

Table of contents

Why this playbook matters
Anatomy of an application and critical fields
What underwriters pull and how they use evidence
Document-first workflow: step-by-step for agents
Scripts: point‑of‑sale, teleunderwriting & follow‑up
Templates & checklists (downloadable-ready formats)
Common mistakes, real examples, and how to rewrite
Beneficiary designations: traps and best practices
Post-issue audits, monitoring, and corrections
Legal/regulatory notes & how to respond to contestability
Related resources and references

Table of Contents

Why this playbook matters

A single omission or ambiguous answer on an application can create a contestable claim, rate change, or even a rescission—impacting families when they most need certainty. Insurers are increasingly automated and data‑driven: the Medical Information Bureau (MIB), prescription history, electronic health records, and motor vehicle/driving records are common evidence inputs that underwriters use to validate applications. Agents who document accurately and follow clear client scripts drastically reduce the chance of post‑sale denials. (mib.com)

High‑leverage reasons for accurate applications

Protect beneficiaries from delayed payments or denials during contestability. (dfs.ny.gov)
Avoid legal exposure for the agent and the broker‑dealer (material misrepresentation claims).
Reduce re‑underwriting or amendments after issue (rates, exclusions).
Increase client satisfaction and referral potential.

Anatomy of a life insurance application — fields agents cannot let slide

High‑risk fields: these are the answers underwriters scrutinize first and often verify via third‑party sources.

Full legal name (matching government ID and medical records)
Social Security number (for MIB & consumer reports)
Date of birth and age (benefit adjustments if incorrect)
Tobacco use and nicotine history (very common cause of reclassification)
Prescription medications (brand/generic, dosage, indication)
Medical history details (diagnoses, dates, hospitalizations, procedures)
Family history where requested (e.g., premature cardiac disease)
Hazardous avocations and travel (aviation, diving, foreign residences)
Alcohol/drug history, DUIs (dates and outcomes)
Income / net worth / ownership (for business policies; insurable interest)
Beneficiary name(s), relationship, and percentage splits
Policy ownership (owner vs insured) and any irrevocable beneficiary

Why these matter: misalignment between application answers and MIB, APS, Rx history, or medical records triggers investigations and can become the basis for a material misrepresentation finding within contestability. (mib.com)

What underwriters pull and how they use evidence

Underwriters use a layered evidence model. Knowing these layers lets you proactively collect and clarify before submission.

Primary evidence sources underwriters use

Paramed/medical exam results (vitals, specimens)
Attending Physician Statements (APS) if complexity exists. APS requests are common for chronic or complex conditions and can cause long delays. (havenlife.com)
Medical Information Bureau (MIB) Insurance Activity Index and consumer file (coded alerts of past disclosures or prior applications). MIB flags do not contain full records but will prompt verification. (mib.com)
Prescription databases and pharmacy records (Rx history is a staple of accelerated underwriting). (munichre.com)
Motor Vehicle Reports (MVRs), criminal records, and public data for hazardous activities or driving incidents
Electronic health records (EHR) or consolidated medical records (growing use via EHR services)
Prior life applications and underwriting history (declines, withdrawals)

What triggers an APS or deeper pull

Significant or recent diagnoses (cancer, cardiac events, diabetes with complications)
Conflicting statements (client says “no hospitalization” but paramed or MIB shows admissions)
Unusual Rx patterns (opioids, insulin starts, many psych meds)
High face amounts or older ages where a full medical history is expected

Practical agent tip: if you know a client has a complex history, proactively explain to them why physician records may be needed and request permission to inform their doctor that an APS request will be coming. That reduces delay and improves cooperation. (policyadvisor.com)

Document‑first workflow: step‑by‑step for agents (the core playbook)

Follow this workflow on every new case. Treat the application like a legal affidavit—accurate, dated, and corroborated.

Pre‑meeting intake (phone/email)
- Send a short pre‑application questionnaire to capture medications, major diagnoses, surgeries, and risky hobbies. Ask clients to gather a 12‑month pharmacy list and recent medical summaries.
- Confirm identity documents they will use (driver’s license, passport).
Point‑of‑sale interview (in person or video)
- Use scripted language (see Scripts section) so you and client use the same words. Record the call with permission where allowed; otherwise take time‑stamped notes and email a summary to the client for verification.
- Read critical fields aloud and ask the client to confirm each item. If using e‑app, require the client to review the answers on screen and sign each section.
Authorizations and e‑signatures
- Obtain HIPAA/medical authorizations and MIB consent at point‑of‑sale. Explain they authorize the insurer to access prior insurance activity and records.
- If the client is reluctant, document the refusal and the reason, and escalate to the underwriting contact at carrier (some carriers accept alternative evidence).
File evidence pack before submission
- Attach the client‑signed pharmacy list, list of specialists and dates, and a one‑page medical summary written in the client’s words (date‑stamped). This helps underwriters reconcile discrepancies and reduces the chance of drawing an APS.
- If the client is high‑risk or has recent tests, consider uploading a release for specific doctor records proactively.
Submission & immediate post‑submission follow‑up
- After submitting, email the client a copy of the submission summary and list of items the carrier may request (APS, labs).
- Set calendar reminders: 7 days, 14 days, 30 days for underwriting updates. Proactive agent follow‑up reduces delays and shows good faith.
Record retention and audit trail
- Save recordings (where legal), signed authorizations, the pre‑application questionnaire, and the client confirmation email in a folder tied to the case ID. Keep these for a minimum of 7 years or per state regulation.

Why this reduces denials: the combination of signed declarative statements, contemporaneous notes, and supporting Rx/doctor lists reduces ambiguity when carriers run MIB/Rx checks and improves your ability to rebut allegations of misrepresentation if a question arises. (mib.com)

Scripts: exactly what to say (point‑of‑sale, teleunderwriting and follow‑up)

Below are field‑tested scripts agents can use verbatim. Always record with consent or summarize and send to the client immediately.

Point‑of‑sale script (in person / video)

Agent: “I’m going to read aloud the information we’re entering on the application. Please stop me at any point to correct or elaborate. After we finish, I’ll email a one‑page summary so you can review it and confirm.”
Critical confirmation prompts:
- “Have you used any tobacco, nicotine pouches, vaping, or nicotine replacement in the last 12 months?”
- “List every prescription you’ve taken in the last 12 months, and the reason—for example, ‘Lisinopril 10 mg for blood pressure.’”
- “Have you been seen in the emergency room, hospitalized, or had surgery in the last 5 years? What were the dates and doctor names?”
- “Do you have any activities we need to disclose like pilot duties, night racing, or professional diving?”

Teleunderwriting script (short, accurate answers)

Teleunderwriter: “This call will be recorded to ensure accuracy. Do I have your permission to record?”
Teleunderwriter: “Please confirm your legal name and date of birth exactly as on your driver’s license.”
Teleunderwriter: “Do you smoke or use nicotine products? If yes, what and when did you last use?”
If Rx mismatch: “Our prescription records indicate [drug]. Did your physician prescribe this? What is the diagnosis and date it started?”

Post‑submission client email (template)

Subject: Application submitted for [Client Name] — Please verify
Body (short): “We submitted your application to [Carrier]. Attached is the exact content we sent. Please reply ‘I confirm’ or indicate corrections. If you get a request for medical records from your doctor, please sign and return or let me know and I will follow up.”

Agent escalation script for APS requests

Agent to client: “The carrier has requested records from Dr. [Name]. Many doctors take 2–3 weeks; I’ll call and ask the office to prioritize the release. If you prefer, I can email a HIPAA authorization to you so you can sign and speed the release.”
Agent to doctor’s office: “This is [Agent Name] for [Client]. We have a signed HIPAA waiver authorizing a life insurance Attending Physician Statement. The carrier is [Carrier], case [ID]. Can you confirm an estimated turnaround time and if we need to provide anything further?”

Use these scripts to create templates in your CRM and train staff.

Underwriting paths compared — quick reference table

Underwriting Path	Evidence Typically Required	Typical Turnaround	Best for	Agent action to reduce risk
Full medical (FUW)	Paramed exam, labs, APS if flagged, Rx, MIB, MVR	2–6 weeks	Complex health history, high face amounts	Collect full med list, pre‑authorize APS, upload records
Accelerated underwriting (AUW)	Rx, MIB, MVR, e‑app analytics; may skip fluids	24–72 hours to 2 weeks	Healthy applicants under carrier thresholds	Ensure accurate Rx, confirm no undisclosed events; pre‑emptively document recent doctor visits. (genre.com)
Simplified issue (no exam)	Short health questionnaire, Rx & MIB checks	Same day to 1 week	Applicants seeking quick coverage with modest limits	Carefully review yes/no items; explain that omissions trigger investigations
Guaranteed issue	No health Qs	Immediate	High‑risk applicants, senior guarantees	Explain limitations/exclusions and suicide timeframe

Common application mistakes (and exact prevention steps)

Top mistakes and stopgaps

Vague medical answers (e.g., “heart issues” vs. “CABG on 3/15/2019 by Dr. X”)
- Prevention: insist on dates, doctor names, and medication names/doses. Provide a fillable template for the client to list meds with indication and start dates.
Omitting prescription medications (leading to Rx mismatches)
- Prevention: have clients produce a 12‑month pharmacy printout or a signed Rx list. Agents: store that printout in the file.
Misstating tobacco status (intentional or accidental)
- Prevention: clarify nicotine definitions and ask about any nicotine product use, including vaping and patches; confirm last use date.
Incorrect beneficiary ownership vs. policy owner mismatch
- Prevention: go through beneficiary and owner fields line‑by‑line and email a confirmation of ownership and beneficiaries.
Inconsistent dates across documents (e.g., application vs. medical examiner forms)
- Prevention: before submitting, cross‑check every date field and produce a one‑page checklist signed by the client.
Not collecting HIPAA/medical release at point of sale
- Prevention: make HIPAA release a hard stop in your CRM; applications without it should not be submitted unless carrier allows alternative.
Not documenting agent advice on risk activities (client told agent but not disclosed)
- Prevention: document the conversation and insist the client sign off that high‑risk activities were disclosed and will be presented accurately on the application.

Most denials are reversible with documentation. If a denial cites “material misrepresentation,” your contemporaneous file (signed notes, email confirmations, recorded scripts) is the agent’s greatest defense. (life-insurance-lawyer.com)

Rewriting an application after a mistake: best practices

If you or the client discover an error after submission but before issue:

Immediately notify the underwriter and request a corrections packet or re‑submission. Do not falsify dates or backdate information.
Have the client sign a corrected answers form or an addendum explicitly stating the error, the correction, date discovered, and the client’s initials.
Document the chain of custody: who prepared the original, who provided the correction, and when it was submitted.
If the policy has already issued and you discover a material error, contact legal/compliance at carrier and seek guidance; many carriers will allow endorsement or re‑underwriting rather than rescission when corrected promptly.

Example language for corrected‑answers addendum (client signs):

“I, [Name], certify that on [date] I stated [incorrect answer]. The correct information is [correct answer]. I understand that the insurer may rely on this information for underwriting.” Have client initial each corrected line.

Good documentation here often prevents a post‑mortem accusation of concealment.

Beneficiaries — how agents prevent disputes and ensure proceeds go to intended recipients

Beneficiary mistakes cause emotional and financial harm, and often lead to litigation and delays.

Checklist for clear beneficiary designations:

Use full legal names, SSN/TIN (if corporate), date of birth, and relationship. Avoid ambiguous identifiers like “my children.”
Specify percent shares that add to 100% (e.g., 50/50) and include contingent beneficiaries.
Ask whether a beneficiary is a minor—if yes, recommend a trust or payable‑on‑death (POD) or custodial arrangement.
Clarify owner vs beneficiary: owners can change beneficiaries unless an irrevocable beneficiary is named. Document any discussions about irrevocable designations.
If community property issues apply (community property states), document spouse consent if proceeds are intended for someone else. (Community property states include AZ, CA, ID, LA, NV, NM, TX, WA, WI.) (nerdwallet.com)

Sample agent script for beneficiary confirmation:

“I need to record your beneficiary exactly as you want the payout to be mailed. Please tell me the full legal name, date of birth, relationship, and percentage. If you wish to name a trust, I need the trust name, date, and trustee.”

Common red flags to escalate to legal counsel

Conflicting beneficiary designations in the file vs. carrier system
Signatures with suspicious alterations or backdated changes
Irrevocable beneficiary disputes tied to divorce agreements
Unclear owner consent where spouse rights may apply

High‑risk applicants: what to collect to get approved

For smokers, diabetics, hazardous job holders, or applicants with DUIs, prepare the following:

Detailed medication list and labs (HbA1c for diabetics, last A1c and date)
Hospital discharge summaries and procedure reports (cardiac cath, stent, CABG)
Specialist notes (cardiologist, oncologist, psychiatrist)
Clear timeline for substance‑use recovery or DUIs (dates, treatment, probation success)
Aviation logs or proof of certifications for pilots (type of flying, hours, commercial vs private)
Work duties and safety controls for hazardous occupations

Providing precise evidence upfront leads to more accurate underwriting and fewer adverse surprises after issue.

Post‑issue audits and monitoring (how agents can maintain policies and protect beneficiaries)

Post‑issue monitoring is not passive. Create a 12‑month check sequence for every new policy:

30 days after issue: confirm policy delivery, beneficiary acceptance, and premium mechanism (EFT set up).
90 days: confirm no open underwriting conditions (APS pending, lab results).
Annual reminder: request clients to update any new medical conditions, prescriptions, or risky activities and remind them to update beneficiaries after major life events.

If carriers conduct post‑issue audits, maintain an “audit folder” with:

Signed one‑page applicant confirmation
Pre‑application questionnaire
Pharmacy list or Rx printouts
HIPAA release
Signed corrected answers addenda (if any)
This reduces carrier friction and preserves your professional record.

What to do if a claim is contested (agent playbook for the post‑mortem)

Gather the full file immediately (application, signed authorizations, scripts, emails).
Request the denial letter and the exact basis for the carrier’s investigation (which records or discrepancies led to the denial).
If the denial is within the contestability period, understand that the insurer must prove materiality. In many jurisdictions carrier must show the misstatement would have changed the underwriting decision. Regulatory guidance cautions against contesting without actual proof. (dfs.ny.gov)
Recommend the beneficiary retain counsel if the denial persists. As agent, your role is documentary and communicative: provide all contemporaneous records and affidavits you control.
If the carrier acted without proper procedure, file a complaint with the state department of insurance.

Legal & regulatory considerations agents must know

Contestability and incontestability periods vary by jurisdiction but commonly last two years. During that period, carriers retain the right to investigate and, upon proof of material misrepresentation, rescind policies. Regulators expect carriers to show actual proof of material misrepresentation—not simply rely on timing of death. (dfs.ny.gov)
MIB and consumer reporting: applicants have the right to request MIB consumer files and correct inaccuracies. Encourage clients to request their MIB report when they suspect prior history that could trigger flags. (consumerfinance.gov)
Data privacy & HIPAA: obtain signed authorizations and note that provider response times vary—document your follow‑ups. APS delays are common; keep clients informed. (havenlife.com)

Real‑world examples (short case studies and lessons)

Case 1 — The missed medication

Scenario: Client omitted an antidepressant on the e‑app. MIB/Rx matched and the carrier rescinded within contestability. Agent had no Rx printout.
Prevention: Always collect a 12‑month pharmacy list and email to client for signature. Maintain the printout in the file.

Case 2 — Beneficiary ambiguity

Scenario: Policy owner wrote “children” as beneficiaries. After death, multiple siblings disputed shares. Payout tied up in probate for 18 months.
Prevention: Insist on explicit names and percentage splits. Recommend trust for complex family structures.

Case 3 — Timely correction prevents rescission

Scenario: Client informed agent of recent hospitalization after submission but before issue. Agent immediately submitted corrected‑answers addendum with client signature and physician note. Carrier re‑underwrote and issued with a rating rather than rescission.
Lesson: Prompt, documented correction is effective.

Training your team: internal SOP & QA checklist (quick reference)

Pre‑submission QA (required): cross‑check name, DOB, SSN, tobacco status, Rx list, beneficiary fields, HIPAA signed.
E‑app confirmation: ensure client signs each page or audio confirms. Record consent.
Evidence collection: pharmacy printout, doctor list, recent labs if applicable.
Post‑submission follow‑up schedule: 7/14/30 days logged tasks.
File backup and retention: encrypted folder, retention policy 7+ years.

Final checklist agents: 12‑point “no surprises” list

Signed HIPAA & MIB consent at point‑of‑sale
Pharmacy printout or signed medication list (12 months)
One‑page client medical summary signed & dated
Full beneficiary details (legal name, DOB, SSN/TIN, % splits)
Owner vs beneficiary confirmation documented
Recordings or written confirmation of teleunderwriting answers
Cross‑checked dates for surgeries, hospitalizations, DUIs
Documented disclosure of hazardous occupations/avocations
APS pre‑authorization when client has complex history
Corrected‑answers addendum when mistakes found pre‑issue
Policy delivery and EFT confirmation within 30 days
Annual beneficiary & medical‑change reminder to client

Selected references and authoritative reads

New York State Department of Financial Services — Circular Letter on Life Insurance Contestability & Unfair Claim Settlement Practices. Regulators require insurers to prove material misrepresentation during contestability. (dfs.ny.gov)
MIB Group — Consumer file and services overview (what MIB is, what it stores, and how insurers use it). Essential reading to understand coded flags and consumer rights. (mib.com)
Gen Re / Industry surveys and Munich Re insights — Accelerated underwriting trends and the common evidence stack (Rx, MIB, MVR) used in AUW. Helpful for agents placing no‑exam/accelerated cases. (genre.com)
Haven Life (and other carrier resources) — Attending Physician Statement (APS) explanations and why APS requests delay decisions. Practical guidance on minimizing APS impact. (havenlife.com)
Life‑Insurance‑Lawyer (practical review) — Top reasons claims are contested/denied and how beneficiaries can respond when claims are disputed. Useful legal perspective on contestability outcomes. (life-insurance-lawyer.com)

Closing: protect clients, protect yourself

Accuracy is not merely bureaucratic—it's the bridge between good advice and the financial protection families expect. Use the workflows, scripts, and checklists in this playbook habitually. Small additions to your process—collecting a pharmacy list, reading answers aloud, capturing an electronic or recorded confirmation—lower risk dramatically and preserve the insurer’s ability to rely on honest, accurate applications.

If you want: I can convert this playbook into

A one‑page agent quick‑reference checklist (PDF)
CRM‑ready email & call templates in text or CSV format
A training deck for onboarding producers and assistants

Which format would you like next?