Evidence of Insurability
Evidence of insurability (EOI) is proof that a person qualifies for insurance coverage based on their health status, typically required for late enrollees, increased coverage, or certain life events.
Get personalized explanations
🎬 Video Explanation
💡
Exam Tip
EOI = proof of health status. Required for late enrollment, coverage increases, or if previously declined.
What is Evidence of Insurability?
Evidence of insurability is proof that an individual meets health requirements to qualify for insurance coverage. It may involve medical questionnaires, physical exams, or medical records review.
When EOI Is Required
| Situation | EOI Required? |
|---|---|
| Initial Open Enrollment | Usually not |
| Late Enrollment | Usually yes |
| Increase Coverage | Often yes (above guarantee issue amount) |
| Decline Then Re-enroll | Usually yes |
| Qualifying Life Event | Usually not |
Types of EOI
| Type | Description |
|---|---|
| Short Form | Brief health questionnaire |
| Long Form | Detailed medical history |
| Medical Exam | Physical, blood work, EKG |
| APS | Attending Physician Statement |
Guarantee Issue vs. EOI
| Feature | Guarantee Issue | EOI Required |
|---|---|---|
| Health Questions | None | Yes |
| Medical Exam | None | Maybe |
| Denial Possible | No | Yes |
| Coverage Amount | Limited | Higher available |
Common EOI Situations
| Insurance Type | When EOI May Be Required |
|---|---|
| Group Life | Coverage over certain multiple of salary |
| Group Disability | Coverage over threshold amount |
| Individual Life | Always required |
| Health (Outside OE) | May be required |