Elevated liver enzymes-commonly ALT, AST, GGT, and alkaline phosphatase-signal hepatic inflammation or injury from conditions such as fatty liver, alcohol use, medications, or viral hepatitis. Underwriters evaluate degree of elevation, persistence, and accompanying labs (bilirubin, ultrasound) to gauge severity. Mild transient elevations may be acceptable, while significant or chronic abnormalities can result in ratings, exclusions, or postponement pending evaluation.

When liver enzymes are high, advisors request follow-up labs, ultrasound reports, and physician notes. Underwriters look for stabilization, abstinence if alcohol-related, and treatment of fatty liver or hepatitis. Timing an exam after improved labs can materially improve the offer. Persistent elevation often leads to ratings and periodic monitoring requirements.