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If you want to take out life insurance or disability insurance, you usually have to fill out a health declaration. This contains a series of questions about your health. After you have completed the statement, a medical adviser will assess your health situation. This results in advice to the insurer on whether it can accept you and if so, under what conditions. On this page you will find all the information about how that process works exactly.

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1. Before you start

Insurance helps you deal with risks and uncertainties, such as incapacity for work or the moment when you die. The benefit you then receive is offset by a premium that you have to pay.

For the amount of the premium, your insurer must know how likely it is that you will become incapacitated for work or die during the term of the insurance. That is why a good risk assessment is extremely important.

To assess this risk as accurately as possible, information is needed about your health and lifestyle. The insurer usually uses a health certificate. By completing these, you give the medical adviser, who gives advice to the insurer, insight into your health. Based on this advice, the insurer decides whether to accept your application. And at what premium. For this, the medical adviser must have the same knowledge about your health as you do in advance.

Sometimes the medical adviser asks for additional information from treating physicians or information from further medical examination. This is only allowed if you give permission for it yourself.

What about my privacy?

When filling in the health statement, you reveal a lot of personal information. It is important that the insurer handles this carefully. All kinds of rules apply to this. All people involved in the medical assessment have a duty of confidentiality. Your health certificate and any other (medical) information will be included in a medical file. This is kept under the responsibility of the medical adviser. Employees of the insurer who are not under the responsibility of the medical adviser are not allowed to look at your medical file. And of course, your personal information may not be shared with third parties without your permission.

2. While filling in

The health declaration is an extensive form with many questions. You really have to take some time to fill it in. This way you give a good insight into your health now and in the past. And also in your lifestyle, for example whether you smoke or drink a lot of alcohol.

This insight is necessary to be able to make a good assessment of the risks. Because health risks can occur in all kinds of areas, you will be asked many questions in order to give a clear picture. There are simply many complaints, illnesses and conditions that can have an impact on your risk of disability or premature death. For example, a very extensive overview is given of diseases and disorders that you could have or have had. This ensures that you don't forget or overlook anything.

Events from long ago
We understand that it can be very difficult to give all the information about your health, especially if it was a long time ago. Nevertheless, it is important that you fill in the statement as completely and correctly as possible. Events from long ago can also affect your health in the future, and therefore the risk you want to insure. And that also applies to things that you may find less relevant, or that happened a long time ago. The examples below show that it can be difficult to properly assess which information is or is not important to report in the health statement. Therefore, if you are in doubt, it is best to fill in as much as possible. Or contact the medical adviser or medical team to discuss.

Careful and complete
It is therefore important to complete the health declaration as completely and as carefully as possible. That can mean that you have to write down a lot. For each complaint, illness or condition that you report, you must fill in additional information in the appendix of the health statement. This can be about the treatment you have had or the medication you are taking, for example. Fill all this in carefully, because this way you avoid having to answer additional questions and the acceptance process is not delayed. You will then be told as soon as possible by the insurer whether he can insure you, under what conditions and at what premium. So be complete when filling in, it is better to give too much information than too little. Only if you have had cancer and have recovered from it, in some cases you do not have to report it after a number of years. You can read which cases these are in the health statement and the explanation of it.

Risk factors
All kinds of data can affect your life expectancy or the risk of becoming disabled. Of course, a certain disease or condition does not necessarily mean that this risk is more likely to occur, but the combination with other factors, such as your lifestyle, can lead to negative effects. The medical adviser wants to be able to see the whole picture and therefore asks you for all this information. A complaint such as back pain can have an underlying cause that does affect your life expectancy, for example. Questions about these types of complaints help ensure that nothing is overlooked.

"I broke my knee fifteen years ago"

An example of disability insurance...

You broke your knee when you were twenty. Since the fracture has healed, you have never really had any problems with it again. You are now 35 years old. You might think that this is not important enough to fill out on your disability insurance health declaration. Nevertheless, this information is very relevant. There is an increased risk of premature wear. This can increase the risk of disability, especially if you perform physically demanding work.

What are the consequences if I do not complete the health declaration?

It is very important that you fill in the health declaration as completely as possible. After all, the information is necessary for the insurance you want to take out. If you do not complete the statement completely, it can have major consequences, for you or for your next of kin.

1. If the insurance has not yet started...
If, when assessing your health statement, the medical adviser suspects that you have not provided certain information, this information will still be requested from you. This means that your application will be delayed and it will therefore take longer before you can actually take out the insurance.

2. If the insurance has already started...
It can also happen that the medical adviser only discovers that you have not included all the information when you file a claim. For example, because you have not completed the health declaration completely or incorrectly. You have then violated the duty of disclosure . The insurer will then have to determine whether this has consequences. There are several options, such as:

  • The insurer stops the insurance
  • The insurer does not provide a payment in the event of death or disability
  • The insurer requests a refund

If you have deliberately provided incorrect information, you can end up in the fraud registers of insurers, making it more difficult for you to take out insurance.
In short, when filling in, be:

  • complete
  • Open and honest
  • Not afraid to tick yes

If you still have questions or doubts, contact the medical adviser or the medical team.

Health Data Review Committee
If, after the death of the insured, the insurer suspects that health data was concealed when the life insurance policy was taken out, it can ask the independent Health Data Review Committee to conduct an investigation. The court will rule on the question of whether health data were provided incorrectly and/or incompletely when applying for the insurance. This concerns health data at the time of the application that were important for the assessment of the risk to be insured, and that have to do with the ultimate cause of death. The decision of the committee is communicated to both the insurer and the next of kin and is binding on the insurer.

Why do I have to report for my term life insurance that I have ever had back pain? That won't kill me sooner, will I?

Hereditary predisposition

Can the medical adviser ask about a hereditary predisposition to a certain disease or condition? That depends on the amount for which you want to take out insurance.

Above the question limit
If you take out insurance above the question limit , you may be asked questions about the risk of a hereditary disease of yourself or your family or about the results of previously performed genetic testing (a chromosomal or DNA test). If it is known that you have a hereditary predisposition to a disease, you must report it, even if you do not (yet) have this disease.

Below the question limit
If the amount is below the question limit, the medical adviser may not ask about a hereditary predisposition. If it is known that you do have a hereditary predisposition to a disease, but you do not (yet) have this disease, you do not have to tell them. Even if you had contact with your GP or a specialist about a possible genetic test, you do not have to report it. Have you undergone surgery or other preventive treatment as a precaution but no complaints or symptoms of this disease? Then you do not have to report this operation or treatment. However, if a doctor has seen during a genetic test that you have a hereditary predisposition and you already have complaints or symptoms, you must report this.

You can read more information about heredity in this joint brochure of the Erfocentrum and the Association.

3. After completing

Once you have completed the health statement, it will be assessed. It may be that the medical adviser does this himself, but someone from his or her team can also do that. Or it happens automatically. In all cases, it is done according to the instructions and rules of the medical adviser. The medical advice then goes to the insurer.

The final decision about the insurance is not made by the medical adviser, but by the insurer. You can get this advice first, so before it goes to the insurer. This can be useful, for example if you suspect that the insurer will not accept you. If the medical adviser does indeed advise negatively, you can ensure that this is not forwarded to the insurer. This is called 'blocking right'. You can then withdraw your application. The insurer will not reject your application. You can read how you can make use of this on the explanation of the health statement.

Please note: a rejection of your application never has consequences for applications to other insurers. An insurer may never ask whether you have previously been refused because of your health. An insurer will also not pass on a rejection to another insurer.'

It is also important to know that insurers all have their own criteria for determining whether or not they want to insure someone, and at what premium and conditions. So it is certainly not the case that you have nowhere to go if you have been rejected by one insurer. It can therefore be useful to request quotes from several insurers.

Request additional information
The medical adviser bases the advice on the completed health statement. Sometimes the information entered in the health statement is not sufficient to properly assess your health. The medical adviser then has several options. He can request additional information from one of your doctors. For example, with your general practitioner or medical specialist. Your (written) permission is always required first. It is not allowed to request more information than is necessary to assess your health situation. The medical adviser may also decide that a medical examination is necessary. In some cases, this is a general health check-up; In other cases, the medical examiner will examine you for specific conditions. The medical examiner is never the same as your own doctor and is also not part of the medical team that advises the insurer. The inspection is part of the acceptance procedure. If you refuse, you cannot take out the insurance. Here you can read more about the medical examination.

Incidentally, it is also possible that you are asked to participate in a medical examination because you have applied for insurance for a very high amount. You can read about it here.

It pays to request several quotes

Medical advice
The medical adviser will assess your health situation. Based on this, advice to the insurer follows. Usually the advice will be that someone can be insured at a normal premium and normal conditions. In that case, we speak of the standard premium. That is the premium that the insurer charges for people with an average risk. But sometimes the medical adviser estimates the risk to be higher. Then there will be a different advice to the insurer. The advice is, for example: offer insurance with restrictive conditions. Or a higher premium. Or sometimes even: don't offer insurance at all. If you are informed about this decision, it will always include an explanation from the medical adviser. In such a case, it is wise to request several quotes.

When your health changes...
After completing the health declaration, changes can of course occur in your health situation. What do you do then? Imagine that you get complaints after you have completed the health statement and sent it to the medical adviser. It is important that you report this to the insurer. If you don't, you may face the same consequences as if you did not complete the health declaration completely. However, if you get the complaints after you have already been accepted for the insurance, this will no longer affect your insurance. You do not have to report this.

'We look at health in the longer term'

Max Hendriks has been a medical adviser for almost thirty years. What does he like about his job? "That it is always about customisation, every file is different."

"The big challenge for a medical adviser is to come to personal medical advice on the basis of all kinds of different data," says Max. "In doing so, we have to take into account both the interests of the insurer and those of the customer."


What do you pay attention to as a medical adviser when assessing a health statement?
"The medical adviser pays attention to all matters that may have consequences for someone's health. But don't worry too much about this: it is certainly not the case that you cannot take out insurance if your health is not so good, or if you have had complaints in the past. If you think about it, everyone will have to deal with a certain complaint, illness or condition at some point in his or her life. Therefore, do not be afraid when filling in the statement. The vast majority of people can simply take out insurance. In some cases, the insurer will set different conditions."

Is a medical adviser actually independent? He works for the insurer, doesn't he?
"The medical adviser is paid by the insurer. He is employed or hired. However, that does not mean that it is not objective. A medical adviser is first and foremost a doctor. And that means that he has to comply with many laws, rules and codes. For example, medical disciplinary law also applies to the medical adviser. The law and the self-regulation of insurers also state that the doctor must work independently."

Why do you sometimes have to pay a higher premium, while the treating specialist says that you have nothing wrong any more?
"There is an important difference between a treating physician (such as a medical specialist) and an assessing physician (such as a medical adviser to an insurer). They look at you in a completely different way, so to speak. The attending physician usually looks specifically at your illness and the treatment options. The assessing physician looks at the whole picture. This also concerns, for example, the possible long-term consequences of treatment. And what risks there are for the insurer. It is very important that the assessing physician compares your situation with large groups of other people who do not have the condition. He or she then comes to an advice to the insurer on the basis of, among other things, guidelines, results of scientific research and statistical data."

What is the best thing to do if I have a question about filling in the health declaration?
"If you are unsure about your answer when filling in the statement, or perhaps do not fully understand the question, it is best to contact the medical adviser or the medical team of the insurer directly. Then you can discuss it, so that you can continue filling it in. That is better than giving the wrong or incomplete answer. On the insurer's website, where the health declaration is also located, you will find the direct telephone number or email address."

If you want to know whether you have to fill in something or not, how can you discuss? Then the insurer knows, right?
"Information that we are not allowed to have, we are not allowed to use for medical advice. So we ignore that. And you can, if the medical advice is there, also request it, and see whether that health information has been used or not."

If you are unsure about your answer when filling in the statement, or perhaps do not fully understand the question, it is best to contact the medical adviser immediately

Download the information in this clear brochure

All information about completing the health declaration, as it can be read on this web page, can also be found in a brochure that can be downloaded here.

The 'questions and answers' below can also be downloaded as a text document .

Questions and answers

  • Yes, that is possible. Dutch life insurers consider HIV to be a chronic condition, which can often simply be insured.

  • No, it does not have to mean that in the case of private funeral, life or disability insurance. This is because this type of insurance is not based on a 'double obligation', as is the case with health insurance. There, everyone is obliged to insure themselves and the insurers are obliged to accept everyone as an insured. This does not apply to private life or disability insurance.

    However, these insurances do involve solidarity between people with similar risks. Insured persons therefore pay a premium that matches the underlying risk that the insurer takes over from them. Because this risk can vary from person to individual, there may also be a difference in the premium someone pays.

  • Asking people with an increased risk of a higher premium does not have to be in conflict with the legislation. The Equal Treatment on the Grounds of Disability or Chronic Illness Act (Wgbh/cz) provides that insurers may make indirect distinctions. Indirect discrimination occurs when a claim or course of action initially appears neutral, but nevertheless affects people with a disability or chronic illness in a roundabout way. Insurers may indirectly discriminate, if this is objectively justified by a legitimate aim, and the means for that purpose are appropriate and necessary. Charging a higher premium to people with an increased risk is therefore permitted, provided that the distinction made falls within the framework of this law. The supervision of this law is entrusted to the Netherlands Institute for Human Rights (CRM).

  • Medical information is stored in a protected manner and stored in a digitally secure file at the medical part of the policy, under the responsibility of the medical adviser. The medical data can only be accessed by the medical team. If the application does not go through, the data will be destroyed after a certain period of time.

  • No, this is not allowed. Data about a person's health is sensitive. The General Data Protection Regulation therefore stipulates that these are so-called 'special personal data'. And that, for example, health insurers may only use this data if special conditions are met. Health insurers perform a number of (statutory) tasks for which they need information about their insured. For these purposes, they are allowed by law to process personal data, including medical data. This includes data that is necessary to be able to process claims. Sharing medical data with other insurers is not one of the tasks for which health insurers may use this medical data.

  • Insurers are not allowed to ask just anything. Legal limits have been set on the possibilities of collecting information through medical examinations. This is laid down in the Medical Examinations Act (Wmk) and the Insurance Inspections Protocol that the Dutch Association of Insurers drew up in consultation with the Dutch Patient Federation and the KPMG doctors' organisation.

    The Wmk seeks a balance between the interest of insurers in having access to information for the risk assessment on the one hand and the protection of the privacy of the insured on the other. For example, the health questions must be as specific as possible and cooperation in genetic testing is not a condition for taking out insurance, for example. Customers also do not have to report the result of previously performed genetic testing below the question limit. It is prohibited to conduct research for the purpose of an insurance inspection in which the interest of the insurer does not outweigh the risks for the insured.

    The legal limits have been translated into the model health declarations of the Dutch Association of Insurers. Insurers may ask the questions included in these model statements. They are free to ask less, but they are not allowed to ask more questions than are stated in those model statements.

  • The premium charged by insurers is based on the risk that someone runs of, for example, becoming disabled or dying earlier. It is therefore very important for insurers that the medical adviser has insight into all the (medical) information needed for a good risk assessment. This also concerns (medical) information from the past or information that is not important according to the treating physician. After all, that information can influence the risk that the customer wants to insure.

    If the customer no longer had to provide that information, or to a much lesser extent, the insurance would become especially popular with those who know that they need the insurance the most. This is called antiselection. Due to anti-selection, insurers will probably have to pay out more often and more. This in turn causes higher premiums, making the insurance less accessible. That doesn't help anyone.

  • With insurance, customers can insure themselves against an uncertain event, such as disability or the moment of death. The customer pays a premium for this. To determine the amount of the premium, it is important that the insurer knows how likely it is that the uncertain event will occur. A good risk assessment is therefore extremely important for the insurer.

    This risk assessment based on the (health) risk profile of the customer is done by, or under the responsibility of, a medical adviser. A health certificate is usually used for this. This document contains questions about health. The customer will be asked to fill in this form. If the answers from the health certificate give cause to do so, this information may be supplemented with information from treating physicians and/or information from further medical examination.

  • Each insurer has its own underwriting policy. That is why it can be useful to request a quote from various providers. If another insurer previously rejected your application because of your health, you do not have to report this when you apply for a new one.

    Read the explanation that you will receive in the event of a rejection. It can also be useful to check whether the medical adviser has a correct picture. Or see if the coverage can be adjusted.

    For self-employed people who are not accepted for regular disability insurance (AOV) for medical reasons, the private safety net insurance has been developed. No medical assessment is required for this insurance. Starting self-employed persons can apply for the private safety net insurance within fifteen months of starting as an independent entrepreneur.

  • That's right. All customers jointly bring in the money needed for the benefits. You do not know in advance which customers will become incapacitated for work or die during the term of the insurance, and which will not. As a result, there is solidarity, also between people with a higher and lower risk.  Because everyone contributes to the benefits, the premiums for those with an increased risk remain more affordable.
    There is a limit among insured persons with a lower risk to the willingness to contribute to the risks of others. If this limit is exceeded, they will leave the insurance. Then there is less income to pay the benefits of those with an increased risk of. This will increase premiums. To prevent this, insurers must strike a good balance between premiums for people with higher and lower risks.

  • No. Precisely to prevent this, the medical adviser is not allowed to ask questions about heredity if you take out insurance below the question limit. Only if you also have complaints or symptoms of this disease should you report it.

    If you take out insurance above the question limit, this is different. You may also be asked questions about the risk of a hereditary disease of your own or about hereditary diseases in your family. In addition, you may be asked questions about the results of previously performed genetic testing (a chromosomal or DNA test). The medical adviser may therefore require a medical examination.

    The rules on heredity and insurers are laid down in the Moratorium on Genetic Testing. This is part of the Insurance Inspections Protocol. This document describes when insurers may ask questions about heredity. These agreements have been made to prevent people from not having a genetic test carried out because of their insurability.

  • Have you undergone surgery or other preventive treatment as a precaution but no complaints or symptoms of this disease? Then you do not have to report this if you take out insurance for an amount below the question limit. Even if you had an orientation or informative conversation with your GP or a specialist about a possible genetic test, you do not have to report this.

  • An insurer looks at the risk differently than a medical practitioner. From that moment on, a patient who is considered cured falls outside the field of vision of the practitioner. Only when the patient becomes ill again, he or she returns to the practitioner in question.
    The medical adviser must look at the risk in the longer term. Based on its advice, the insurer sets a premium for the entire term of the insurance. Term life insurance or disability insurance for the self-employed usually has a term of decades. In principle, insurers cannot change the premium once the insurance has started. They must therefore take into account all possible outcomes when they determine the premium. So also with the scenario that old conditions, complaints or diseases return (recurrence). Or that the patient has suffered permanent damage as a result of the treatment, which has increased the risk of disability or death.

  • The premium charged by insurers is based on the risk that someone runs of, for example, becoming disabled or dying earlier. Someone with poorer health often also has an increased risk and therefore often pays a little more premium than someone with a lower risk. If the risk is simply too high, the insurer may also decide not to offer someone insurance.

  • It is not allowed to request the entire medical file of a customer in advance, for example from the general practitioner. After all, this file may contain information that the medical adviser is not allowed to request at all. Think, for example, in certain cases, of genetic information. Collecting more medical data or other data than is strictly necessary for the purpose of the medical assessment constitutes an invasion of the individual's privacy and is not permitted.

  • In some cases, the medical adviser may need additional information when assessing the health certificate. This extra information can be requested from the GP, for example. Every doctor has a professional secret. This means that he is not allowed to give medical information about his patients to third parties just like that. A general practitioner or medical specialist may only give information to third parties if they have given written permission for this. This written permission is also called the medical authorisation . The medical adviser needs this authorisation to be able to request information from doctor(s).

  • No, medical examinations are not always allowed. Some types of insurance are subject to a prohibition on examinations, which can be found in Article 4 of the Medical Examinations Act (Wmk). For example, most pension insurance policies prohibit a medical examination.

  • To determine the amount of the premium, it is important that the insurer knows how likely it is that an uncertain event will occur. In order to estimate this probability as accurately as possible, they use medical, statistical and actuarial sources. These are, for example, statistical data from reinsurers, their own figures and experience data, medical publications, the advice of a medical adviser and, of course, the information from the health statement that the customer has filled in himself. These sources differ per insurer and therefore the premiums can also differ. Also, the insurance policies of insurers are not all exactly the same, which can cause differences in premiums.

  • Some of the statistical data used by insurers falls under business-sensitive information. They do not disclose that part for reasons of competition. The insurer will share information from public sources with applicants if requested.

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