Don't leave yourself unprotected. Find out if you're eligible for life cover with your pre-existing medical condition.
With so many different insurance companies and policies available on the Australian market, it is much easier than it was in the past to get life insurance or income protection if you have a pre-existing medical condition. Increased competition between insurers has meant that insurers have become more flexible in who they are now willing to cover. Depending on the condition, the insurer will either;
- Automatically cover the condition
- Request additional information about the nature of the condition
- Exclude the condition from being covered
General conditions to understand in order to get cover
The definition of what a pre-existing condition is may vary from provider to provider, however, it is generally defined as any illness or injury that you have been receiving medical attention for a prolonged period of time. Some of these pre-existing conditions include heart diseases, asthma, and diabetes. You are required to disclose details of any pre-existing conditions at the time of application, failure to do so may result in your claim being rejected.
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- Can I Get Life Insurance if I have a Pre-Existing Medical Condition?
- How Do Life Insurance Companies Treat Medical Conditions in Australia?
- What Type of Information Might an Insurance Provider Ask During Your Policy Application?
- How Does an Insurance Company Find Out About Pre-Existing Medical Conditions?
- Debunking Life Insurance Myths about Pre-existing Conditions
- Important Steps Before Choosing a Life Insurance Provider
- Comparing Life Insurance Policies if You Have Pre-existing Medical Condition
- Do I Have to Disclose My Previous Health Conditions to the Life Insurance Provider?
- Meeting with an Insurance Provider
Can I get life insurance if I have a pre-existing medical condition?
Different insurance providers will have different conditions around their treatment of pre-existing medical conditions. Generally, there will be a;
- a) set of conditions that the insurer will automatically cover
- b) set of conditions that will require further information around the nature of the condition and current treatment being received
- c) set of conditions that the insurance provider
Based on the conditions above, an insurer is likely to either;
- a) accept the application and apply a premium loading
- b) accept the application and exclude certain conditions from cover
- c) reject the application
If it is not clear from the information on the insurance providers website or in their PDS how your condition will be treated, it is always best to contact the insurer directly to clarify where your condition falls before submitting your application.Back to top
How do life insurance companies treat medical conditions in Australia?
If a claim for an insurance benefit relates to a pre-existing condition that has not been fully disclosed before the policy commencement date or the date of any increase or reinstatement, the benefit will not be paid.
While definitions may vary among providers, generally a pre-existing condition is defined as, in relation to a claim for an insured benefit, the;
- a) condition was diagnosed or investigated by the insurer;
- b) symptoms leading to a diagnosis first appeared; or
- c) event leading to the claim occurred;
Prior to the effective date of commencement, reinstatement of insurance benefit or improvement of the insurance benefit. This includes circumstances or symptoms that the policyholder was aware of, or should have been aware of.
What type of Information might an insurance provider ask during your policy application?
An insurance provider may request the following details while reviewing your policy;
- Family medical history: Details of any medical conditions suffered by immediate family (i.e. mother, father and siblings) including mental disorders, diabetes, cancers, heart disease
- Medical history: Details of any medical examination, consultations, procedures or medications (including stimulants or sedatives taken within the last five years.
- Lifestyle: Likelihood of being exposed to the HIV virus.
If you are not sure of any of the details listed above, you should contact your doctor or family members to clarify.Back to top
How does an insurance company find out about pre-existing medical conditions?
Each year the insurance industry is filled with horror stories of claims not being paid because the policyholder did not disclose information about a pre-existing condition. In the event of a claim, an insurance provider will take rigorous steps to review the policyholders medical history. They will take the necessary steps to look over the claimants medical history and contact medical professionals that they had consulted over the years.
If it is found that the claimant did not disclose details about their or an immediate family members medical history, the claim may be rejected if the condition is found to have impacted the claim.Back to top
Debunking life insurance myths about pre-existing conditions
There are some common myths surrounding the treatment of pre-existing conditions by life insurance providers that may lead to some people neglecting to even apply for cover. Below are some of these myths;
- I am uninsurable: This is the biggest and most popular myth of them all. People who have had pre-existing conditions are led to believe that if you have diabetes or heart disease, you cannot obtain life insurance. However, the insurance industry is continuously developing its products in order to meet the different demands of their clients.
- I have a special condition that is uninsurable: Here’s a fact – insurance providers may offer similar insurance products, but that does not mean that they have similar features, cover, and limitations. If your medical condition is rejected by one insurance provider, it does not mean that other providers will do the same. Nowadays, there is a great deal of insurance companies that specialise in providing life insurance for people with high-risk jobs and/or pre-existing conditions.
- I need to undergo a rigorous medical examination: Another myth that causes a lot of people to shy away from getting life insurance. Just thinking about the series of medical tests you have to go through is enough to discourage even the healthiest person. On the contrary, if you have a previous health condition but you see your doctor regularly, take the prescribed medication properly, and have your doctor’s medical report to attest to that, you don’t need to subject yourself to another medical exam.
Important steps before choosing a life insurance provider
- Identify what type of cover you need: Before shopping around, it helps when you sit down first and list the things you want included in a policy. This includes the type of policy and the length of cover you need since this will affect the cost of your premiums.
- Shop around: Don't limit yourself to one provider and take the time to see what is available on the market.
- Ask the help of an insurance specialist: If you have difficulty sorting through the different policies, you can always engage the services of an insurance adviser. A good insurance adviser is someone who is in contact with a large network of insurance providers so that he will be able to give you lots of options and quotes from different insurance companies. Insurance consultants can use their knowledge of the market to help you find insurers that are willing to provide cover for your condition.
- Take the necessary steps required during the policy application: It is important to take the necessary steps that are prescribed by your insurance provider during the application process. Provide all necessary documentation and answer all questions related to your condition as truthfully as you can.
Comparing life insurance policies if you have pre-existing medical condition
There are some key components of your policy to look out for if you have a pre-existing medical condition and are looking to take out cover. This includes:
- Any exclusions and restrictions: This is a very important area to look at if you have previous health conditions, as you need to see whether there are any restrictions with regards to the cover based on your previous health conditions. Your condition may be automatically covered or you may need to undertake additional underwriting.
- The cost of the cover: Depending on the previous health conditions that you have suffered from, the cost of your life insurance cover can increase dramatically. In order to get the best deal possible you need to make sure you compare quotes from a number of insurance providers