For related reading: • How Life Insurance Underwriting Really Works • How Medical Exams Affect Your Term Life Insurance Rates • How Term Life Insurance Premiums Are Calculated
What Is an APS (Attending Physician Statement)? An APS is a copy of your medical records sent directly from your doctor to the insurance company. It’s used when underwriters need clarity, confirmation, or more detail beyond what an exam or questionnaire provides.
Insurers typically request an APS when: • You’ve taken medications for chronic conditions • Your medical exam shows elevated results • You report past surgeries or health issues • Your prescription history reveals long-term use • There are inconsistencies in your application It’s one of the most influential pieces of your underwriting file.
What Life Insurance Companies Look for in Your Doctor’s Records Insurers examine many parts of your medical history — some obvious, others less so. Here’s exactly what they review:
1. Diagnosed Medical Conditions Underwriters look for conditions that influence longevity risk, such as: • High blood pressure • High cholesterol • Diabetes or prediabetes • Depression, anxiety, or other mental health diagnoses • Respiratory issues (asthma, COPD) • Heart disease markers • Cancer history • Autoimmune disorders They want to understand: • Severity • Treatment • Control/stability • Future prognosis A well-managed condition may not hurt your rate class as much as people expect.
2. Vital Signs & Trends Over Time A single high blood pressure reading during a medical exam may not disqualify you — but a trend documented in your medical records might. Insurers evaluate patterns such as: • Repeated elevated BP readings • Gradually increasing cholesterol • Rising BMI • A1C trending upward • Recurring respiratory issues Long-term patterns matter more than one-off results.
3. Medications Prescribed (Even Years Ago) Prescription history is cross-checked with your medical exam and application. Insurers look at: • What medications you’re taking • Dosage and frequency • Duration of prescriptions • Whether conditions appear “controlled” or not • Whether diagnoses match medications For example: If you report “slightly elevated cholesterol,” but your doctor prescribed statins, underwriting will categorize the condition as treatment-required, not “mild.”
4. Doctor Notes About Your Lifestyle This part surprises most applicants. Doctor visit notes often include references to: • Drinking frequency (“patient reports 2–3 drinks nightly”) • Exercise habits • Weight gain or loss • Smoking or vaping history • Stress levels • Compliance with medical advice Even casual comments noted by your physician may show up in your underwriting file.
5. Mental Health History Insurers give special attention to: • Diagnoses of anxiety or depression • Hospitalizations • Suicide risk indicators • Medications (SSRIs, benzodiazepines) • Long-term therapy notes Important: Well-managed anxiety or depression often still qualifies for Preferred or Standard rates.
6. Past Surgeries & Hospitalizations Insurers don’t just look at what happened — they look at long-term implications, such as: • Recovery status • Residual symptoms • Recurrence risk • Ongoing medications A resolved surgery with no complications may have zero impact on your rate.
7. Missed Appointments & Follow-up Gaps This is one of the most overlooked risk factors. If your doctor notes: • “Patient did not return for follow-up,” • “Non-compliant with medication,” • “Missed recommended testing,” Insurers may consider this unmanaged risk, which can raise your premium.
8. Notes on Smoking, Vaping, or Nicotine Use Even occasional or former nicotine use can appear in your APS: • Social smoking • Vaping • Cigar use • Nicotine replacement products If your urine test shows nicotine but your APS contradicts your application, underwriting always defaults to smoker rates.
How APS Information Affects Your Rate Class
Preferred Plus or Preferred • Clean history • No chronic health issues • Ideal vitals • No risk markers
Standard • Controlled conditions • Some fluctuations in vitals • Normal BMI or slightly elevated • Moderate alcohol use
Substandard / Table Rated • Uncontrolled conditions • High BMI • Significant diagnoses • Poor medication compliance • Concerning doctor notes Your APS is often the deciding factor between these categories.
What Happens If Your Doctor’s Records Conflict With Your Application? If the APS contradicts your application or medical exam, the insurer always follows the most conservative, risk-averse interpretation. Common conflicts include: • Undisclosed medications • Inaccurate smoking status • Underreported alcohol use • Conditions not listed on the application Underwriters see discrepancies as red flags.
Can You See Your APS Before It’s Sent? Yes — you have the legal right to request your medical records at any time. Reviewing your records before applying can prevent surprises and help you prepare answers proactively.
How to Improve Your Underwriting Results (Based on Your Doctor’s Notes)
1. Manage health conditions consistently Stability looks better to insurers than perfection.
2. Follow your doctor’s recommendations Compliance shows lower long-term risk.
3. Update old medical records if you’ve improved Doctors often forget to remove outdated notes.
4. Avoid nicotine entirely before applying Even replacement products can delay preferred approval.
5. Lose a small amount of weight A BMI improvement of even 2–3 points can move you into a higher rate class.
6. Address minor issues before your exam Treat high BP or cholesterol early — underwriting rewards control.
Final Thoughts: Your Doctor’s Records Tell a Big Part of Your Insurance Story Your application and exam matter — but your doctor’s records often matter even more. Understanding what’s inside your APS gives you a major advantage, helping you secure better rates and a smoother underwriting experience. Knowledge is power when applying for life insurance.
Recommended Next Read • How Life Insurance Underwriting Really Works: Inside the 2026 Process