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Income protection with pre-existing conditions

You can get income protection even if you have a pre-existing medical condition – though it could cost you more or an exclusion may be applied.

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What you need to know

  • A pre-existing condition is a health condition that has been diagnosed or is being investigated by a medical professional.
  • You could face higher premiums in order to cover the condition. An insurer may see you as posing a greater risk of making a claim.
  • An exclusion may be applied to your cover, meaning you cannot make a claim for the condition. Or, you may have to serve a qualifying period, after which time the illness would become a claimable event.

If you suffer from a pre-existing condition, it's still possible to take out income protection. Each insurer will have its own rules about which conditions it will and won't cover, so if your application gets knocked back by one, it doesn't necessarily mean you can't get covered by another provider.

How to get income protection if you have a pre-existing medical condition

Number 1

Apply for cover and disclose details involving your pre-existing conditions

You can do this either with an adviser or directly with the insurer, depending on how you choose to take out cover.

Number 2

Accept a greater premium, waiting period or exclusions on your policy

If an insurer accepts your application for income protection, you may pay higher premiums due to the increased risk that you are exposing them to. This added risk may result in you having to serve a longer waiting period, such as 60 or 90 days. Or, your insurer may impose exclusions on your policy (when claims arise from your pre-existing conditions).

Number 3

Look for another policy

Try another income protection brand if you don't succeed with your first application.

Number 4

Find out what rules your condition is subject to

Make sure you understand what happens when you make a claim relating to your pre-existing condition. We explain this below.

Does income protection cover pre-existing conditions?

Yes, you can get income protection if you have a pre-existing condition. In most cases, you will have to do one of the following:

dollar

Pay more

Some income protection insurance providers will cover you for the pre-existing condition but there will be a loading – this is an increase to the cost of your premiums.

Accept an exclusion

In some cases, if you have a more serious pre-existing condition, such as lung cancer, the insurer might cover you but not for any claims related to your pre-existing condition.

Finder survey: Have Australians from different states lied on their income protection insurance policy?

ResponseWAVICSAQLDNSW
I've never lied on an insurance policy7.21%10.96%9.88%10.45%11.14%
I've lied on a past policy2.7%
I lied on my current policy0.9%0.45%0.56%
Source: Finder survey by Pure Profile of 1110 Australians, December 2023
Data for ACT, NT, TAS not shown due to insufficient sample size. Some other states may also be excluded for this reason.

Income protection calculator: How much cover you could get

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Get quotes from insurers that will review pre-existing conditions

1 - 3 of 3
Name Product Pre-existing Conditions Cover Maximum Monthly Benefit Maximum % of Income Covered Maximum Benefit Period Sum Insured
TAL Accelerated Protection Income Protection
May require a medical test and to disclose details of your medical history before you’re approved for life insurance.
$30,000
Up to 70%
Up to
Age 65
$1,305 million
Get up to 70% of your income covered with flexible short and long term benefit periods.
NobleOak Income Protection
May require a medical test and details of your medical records to be able to tailor your cover.
$30,000
Up to 70%
Up to
Age 65
$65 million
With NobleOak, you can lock in a policy with a benefit period covering you up to the age of 65. Cover limits may go as high as $30,000.
Insuranceline Income Protection (Pre-existing conditions)
Offers tailored cover for your needs.
$10,000
Up to 75%
Up to
5 years
Data not available
Get a $100 bonus gift card after 2 months. T&Cs apply.
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What is a pre-existing medical condition?

While the definition of a pre-existing condition can vary, it generally refers to the following:

  • A health condition that was diagnosed or investigated by a medical practitioner
  • The appearance of certain symptoms leading to a diagnosis
  • A condition that occurred prior to the commencement or reinstatement of your insurance policy

Financial adviser Brenton Tong on income protection for pre-existing conditions

Brenton Tong

Why is it difficult to get income protection with a pre-existing condition?

"There are many things that could knock you out of the workplace for a time, so insurance companies will be very cautious to offer income protection insurance to anyone with a difficult medical background.

If you could imagine the types of things that would stop you from working for 6-12 months – a car accident, a fall on the sports field, chronic fatigue, glandular fever, long COVID, the list goes on. This is especially difficult for those that have a history of mental health issues – even minor."

The bottom line

"The silver lining with income protection and pre-existing medical conditions is that the insurer is more likely to exclude a medical condition rather than flat out refuse to insure you. This means while you're not covered for your particular ailment, you're still covered for all other events and illnesses."

Brenton Tong is the managing director and senior financial adviser at Financial Spectrum.

Common pre-existing medical conditions that can affect your income protection application

Examples of pre-existing medical conditions include the following:

  • Cancer. If you are a cancer survivor, your insurance provider will want to obtain specific information of the type of cancer it was, the stage when you were diagnosed, the treatments you took and the results of any follow-up checks.
  • Diabetes type I and II. If you suffer from either type I or type II diabetes, you'll be required to undergo a medical examination and can expect to pay a premium loading.
  • Epilepsy. You may pay higher premium rates depending on the type of epilepsy you have: idiopathic, symptomatic or focal.
  • Heart-related conditions. If you have a heart condition, your insurance provider will want to find more information on whether the condition is treated, the response to treatment or if it is malignant.
  • Hepatitis. A declaration of hepatitis on your application will prompt your insurance provider to carry out further investigations. Depending on the type of hepatitis, whether it was a single attack, if you have had a full recovery and it was more than 2 years ago since it occurred, you may be eligible for standard premium rates when you apply for income protection.
  • Mental illness. Mental conditions such as depression, anxiety and bipolar disorder are difficult to assess by insurance providers due to a variety of forms, degrees of severity and their unpredictable nature. A medical attendant’s report will always be required in this case.
  • Sleep apnoea. If you have a history of sleep apnoea, your insurer will request more information on your condition and a detailed medical attendant’s report. In some cases, you may be required to complete a medical examination and a high premium loading may be applicable.

Why do you need to declare pre-existing conditions?

To ensure that your income protection policy is tailored specifically to your needs and condition should they provide you with cover, you need to be upfront and honest about any pre-existing conditions you may have. If you withhold information from your insurance provider, it has the right to deny any claim that may arise as a result of your condition and refuse to provide cover.

With so many different income protection policies available in the Australian market, it isn't easy to determine which cover is most suitable for your needs. If you have a pre-existing condition, you should do the following:

  • Avoid "automatic acceptance" or "no medical examination" policies unless you are after a policy that won't cover your pre-existing condition.
  • Consider speaking to an insurance adviser who can provide tailored recommendations based on your specific needs and requirements. An insurance consultant can minimise the time and effort required in securing an income protection policy, especially if you have a pre-existing medical condition.
  • If you don't want to use an adviser, consider a direct insurer who offers a detailed medical questionnaire upfront. Although it takes longer to get cover, there is less uncertainty at claim time.

Is it possible to apply for income protection with no medical?

You will be required to complete a health check-up with most providers when you apply for income protection. This is to enable your insurance provider to obtain a more accurate depiction of your health and the level of risk that it is exposed to should it provide you with cover. This is standard procedure and isn't something to be feared.

Deepak Gaur's first-hand experience

An example of how a doctor works with an income protection insurer

Let's say I see an applicant with high blood pressure. If the patient's blood pressure isn't well controlled after multiple measurements and they've advised me about the medicine they are prescribed for this medical condition, I would recommend a review of their blood pressure management including their medication. It may be as simple as a patient going to see their GP to have their blood pressure reviewed. If the patient's blood pressure readings are within the normal range, or they normalise after a revision to the dose of their medication, the insurance company may proceed with the policy... but if a person has a past history of a diagnosis, such as cancer, that's an example of where the insurer may request more specific detail.
— Dr Deepak Gaur, the Founder of Pop Up GP, speaking to Finder about insurance medical assessments based on his experience.Read more here.

If you are looking to secure an income protection policy with no medical, you may want to consider the following alternatives:

Income protection from direct providers

Direct life insurance providers in Australia, such as Noble Oak and Zurich, offer income protection policies with competitive premiums with minimal medical underwriting. Even though you still have to go through a medical exam and complete a health questionnaire, there are generally fewer restrictions on the eligibility criteria with direct income protection application.

Learn more

Income protection through super

You can obtain income protection, also known as salary continuance insurance, through your super fund.

You may also already have cover in place through your employer's nominated super fund, so it is best to clarify if this is the case.

Learn more

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