Pulmonary fibrosis is a chronic lung disease characterized by progressive scarring of lung tissue, which impairs the ability to transfer oxygen into the bloodstream. Causes include idiopathic pulmonary fibrosis, autoimmune conditions, environmental exposures, certain medications, and prior radiation. Symptoms often include exertional shortness of breath, dry cough, fatigue, and reduced exercise tolerance. Pulmonary fibrosis is typically diagnosed with imaging, pulmonary function tests, and sometimes lung biopsy. Prognosis varies but can involve significant morbidity and reduced life expectancy, particularly in idiopathic forms. For life insurance underwriting, pulmonary fibrosis is a serious impairment and is frequently uninsurable except in very mild, stable cases.

In underwriting, mention of pulmonary fibrosis prompts rapid escalation to senior underwriters or reinsurers. They review pulmonary function tests, imaging reports, oxygen requirements, six-minute walk tests, and specialist notes. Many cases, especially with progressive disease or oxygen use, result in declines due to high mortality. Advisors who encounter clients with pulmonary fibrosis should be candid about likely outcomes and may explore alternatives such as group coverage, guaranteed issue options, or final expense plans where available. In some situations, older, stable scarring with good functional status may be considered for heavily rated coverage, but this is the exception. Understanding the gravity of pulmonary fibrosis helps advisors manage expectations and avoid repeated unsuccessful applications.