Life insurers utilize many sources of information to assess mortality risk, with applicants’ permission, and underwriting requirements continue to change as the insurance ecosystem evolves with the introduction of new and novel risk stratifiers. Nonetheless, in many markets, the insurance history and physical examination remains a key element of the risk assessment process. This revised chapter provides historical insight into the value of the physical examination and key findings which remain relevant today and can assist underwriters and insurance medical directors arrive at an accurate and fair decision.