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Gatekeeper to Promise-keeper: A Fresh Look at the Familiar Problem of Life Underinsurance

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Industry discussions about closing the life insurance coverage gap can follow a numbingly familiar pattern: Carriers begin by wondering why so many consumers fail to understand the value of life insurance and conclude by calling for greater financial education.

As RGA’s chief medical director for U.S. Mortality Markets, I appreciate the industry's frustration with the failure to attract applicants, yet as a neurologist, I’ve been trained to look at problems from the inside-out, as well as the outside-in.

Let me suggest that our best yield will be to look inward – to challenge our assumptions about the consumer and to assume equal responsibility for making a life insurance purchase a more compelling proposition. RGA is seeking to do just this through our participation in Help Protect Our Families in partnership with seven U.S. life insurance trade associations, numerous life insurers, and other financial security professionals. The goal of this industry-wide initiative is to think differently and explore new methods to raise awareness about the value of life insurance and address America’s steadily growing financial protection gap.

The problem of underinsurance poses a very real danger to the financial and physical health of families and communities. Just 54% of all Americans have life insurance coverage, a notable decline from 63% just a decade ago, according to the LIMRA 2020 Insurance Barometer Study. There are 60 million uninsured and underinsured households with an average life insurance gap of $200,000.2 And yet, year after year it seems, the mortality protection gap widens as life insurance growth lags.

Addressing this discrepancy requires that we bust common consumer myths about insurance, but at the same time, insurers need to break through with a positive case for insurance:

Myth one: Underwriting is a gate designed to keep out applicants.

Underwriters are not gatekeepers, but promise-keepers, focused on keeping coverage sustainable so that insurers can continue to earn trust and fulfill responsibilities for generations to come.

Far too many individuals don’t even bother applying for life insurance because they believe pre-existing conditions would disqualify them or make coverage prohibitively expensive. When asked why they did not buy insurance, 63% of underinsured respondents1 to a recent LIMRA survey deemed coverage too expensive. Yet, when asked how much the cost of insurance would be, most consumers estimated costs that were triple the actual rates.

What is behind this disconnect? The misunderstanding may stem from a false belief that life insurance is designed for an exclusive group; the opposite is true. Life insurance is based on the idea of pooling or spreading risk among the largest possible population to minimize costs from any one event. Insurers could not survive by keeping those who want insurance from getting it. On a practical and actuarial level, this means that we are continually striving to understand that next medical advance or uncover the newest technologies and data sources to identify unserved markets and make more attractive offers. For example, many diabetics might consider themselves un-insurable but coverage has been steadily improving due to advances in treatment and care that have markedly reduced mortality and morbidity risks for well-controlled cases.

As an industry, we have an opportunity to draw attention to these new product designs and rapid scientific advances that are empowering carriers to help more people. We also can be more transparent about the process of underwriting.

Myth two: Life insurance is a luxury, not a necessity.

Life insurance protects the future.   

A disturbingly large proportion of the U.S. population lives on the financial edge, just one emergency away from insolvency. In a 2020 LIMRA Insurance Barometer Survey, 44% of families believed they would face financial hardship if the primary wage earner died within 6 months; for 28%, it would be within just one month.3

The global recession caused by COVID-19 has only exaggerated these challenges – and we must realize that this financial fragility has implications for the well-being of individuals and society. In medicine, we often refer to the “social determinants” of health. This is the idea that conditions in the places where people live, work, and play affect a wide range of health and quality-of life-risks and outcomes. Life insurance, or its lack, is part of these social determinants and can play an essential role in these outcomes. Consider how the grief of losing a loved one can be magnified by severe financial stressors caused when the household must make up for the lack of an income, which might include forgoing education, skipping bills, and even deferring preventive healthcare. This can fuel a downward cycle, where individuals who do not pursue life insurance leave families unprotected and even less capable of adequately transferring wealth to future generations. And as financial resources continue to decline, long-term inequities in health and wealth widen.

Life insurance can serve as a break on this downward cycle. It offers the income replacement that can pay for education, health care, and much more. As an industry, we can do more to make the case that a life policy may be a financial product, but it is also a societal good. Our business is to protect the future.

3. Myth three: Life insurance is about your death.

Life insurance is about the lives of your loved ones.

Based on Google searches, U.S. interest in life insurance is at its highest level it has been in the past 5 years. The reason for that is clear. Six in 10 Americans say they have a heightened awareness of the importance of life insurance due to COVID-19.4 The threat of death, or severe illness, from a pandemic has a way of re-focusing the mind on priorities like health and well-being. But will this sudden surge in interest persist once the immediate health crisis ends?

One perception that fuels the protection gap is that a life policy is only valuable upon death – and all of us want to use the products we purchase during our lives. As an industry, we must do more to nurture relationships with insureds to highlight the value of policy ownership today. For the un/underinsured, we must change the narrative to bust the myths for those who see life insurance as a luxury, as not intended for them, or as unattainable.

Within every myth, there is a kernel of truth and an opportunity for change. The novel coronavirus has forced many of us to confront our own vulnerability to loss and to think more seriously about planning for our family’s protection. All of us are susceptible to disease, joblessness, and family changes, but we don’t have to be made more fragile by these crises. Yet for too many, life insurance is perceived as out-of-reach.

It is time for us, within the industry, to consider how to make our products more approachable and appealing. Learn more about Help Protect our Families and consider joining our mythbusting mission.   


  1. Understanding Life — The Impact of Consumer Knowledge on Life Insurance Ownership (2019), LIMRA
  2. Turn Up the Volume: $12 Trillion Sound Opportunities (2017), LIMRA
  3. 2020 Insurance Barometer Study, LIMRA and Life Happens
  4. LIMRA Quarterly Consumer Sentiment Study, October 2020

The Author

  • Dr. Dave Rengachary
    Senior Vice President and 
    Chief Medical Director

    U.S. Mortality Markets
    Send email >


The novel coronavirus has forced many of us to confront our own vulnerability to loss and to think more seriously about planning for our family’s protection, according to RGA's Dr. Dave Rengachary. He calls on the industry to consider how to make insurance products more approachable and appealing to close the protection gap. Learn more about Help Protect our Families.   
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