Life insurance with pre-existing conditions

It's possible to get life insurance that covers pre-existing conditions - although it might cost you a bit more.

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Pre-existing conditions can affect your ability to get life insurance and the premium you have to pay. When buying life cover, it's super important to let your insurer know if you have a pre-existing condition. Not doing so is likely to invalidate your policy when the time comes to claim.

What is a pre-existing condition?

A pre-existing medical condition is a medical condition you have or have had prior to buying life insurance or income protection. Essentially, it's any health issue that could affect your life expectancy and health or ability to work.

If you die or suffer a severe illness as a result of a pre-existing condition, your claim can be refused if it's listed as an exclusion on your life insurance policy.

Some common pre-existing conditions examples are:

  • Heart disease
  • High blood pressure
  • Cancer
  • Kidney or liver disease
  • Depression
  • Diabetes
  • sleep apnoea
  • Musculoskeletal conditions.

Life insurance with pre-existing medical conditions: two options

  1. Compare insurers who uses an underwriter upfront during your application

  2. Compare your options with an adviser, by getting in touch with them directly.

Compare life insurance brands who may underwrite your condition upfront

Name Product Maximum cover Maximum Entry Age Fully Underwritten? Terminal Illness Benefit Optional Extras
NobleOak Term Life Insurance (Pre-existing conditions)
TPD cover, Trauma cover
  • Cover for pre-existing conditions is assessed on a case by case basis during the application process.
  • You may be subject to an increase in premiums or a specific exclusion.
  • Medibank Life Insurance (Pre-existing conditions)
    TPD cover, Trauma cover
  • When applying, you are asked to sign a declaration confirming that you have provided all relevant details about your health and any pre-existing conditions.
  • The information you disclose about your pre-existing condition will determine the coverage you may receive, including claims.
  • InsuranceLine Life Cover (Pre-existing conditions)
    Trauma cover
  • Pre-existing conditions cover assessed on a case by case basis.
  • You must disclose during your application and may need to speak to someone on the phone about your condition.
  • Maximum cover available may be less due to condition.
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    What's considered a pre-existing medical condition?

    When it comes to life insurance, a pre-existing medical condition is usually a medical condition that occurs before the commencement of your policy where:

    • A medical professional has provided you advice or treatment for the condition or
    • You have experienced symptoms of a condition and are reasonably expected to seek advice or treatment

    Definitions vary, brand to brand

    If you have a pre-existing medical condition and are trying to purchase a new insurance policy it’s important to be aware that the language used to qualify a condition as pre-existing:

    1. Can vary from brand to brand.
    2. Can be interpreted incorrectly by the policyholder

    Why do some life insurers exclude pre-existing conditions?

    A brands will do this to minimise it's risk. This is because a pre-existing condition can highly increase the chances of you making a claim in the eyes of some providers.

    What types of information about my medical history will I need to disclose?

    When purchasing an insurance plan with a pre-existing medical condition or illness, you will need to disclose personal information. The required information can vary depending on the condition and brand.

    1. Information about specific conditions

    The conditions listed below will specific information to be disclosed:

    • Asthma, sleeping disorders
    • High cholesterol, blood pressure, diabetes or high blood sugar
    • Skin problems such as cancers, moles or tumors
    • Depression or anxiety
    • Serious disorders like cancer, epilepsy, heart conditions, anemia, kidney or bladder disease or thyroid conditions.
    • Female specific conditions like breast cancer
    • Male specific conditions like prostate cancer

    2. General medical information

    Other information may require you to disclose if you have been in the hospital, seen a doctor for a condition, have been prescribed medication in the 5 years before the insurance application or any of the following.

    1. If you made a previous claim because of an illness.
    2. If you have had symptoms which made you seek medical advice or a professional health practitioner and are awaiting tests or medical treatment or are taking prescriptions drugs.
    3. If you have had to miss work because of the condition.
    4. The contact information of the doctor or specialist may be required.

    What types questions should I be prepared to answer in regards to my condition?

    An example of the types of questions you could be asked for specific conditions include:

    *Mental health conditions can include: Depression, anxiety, panic or phobia disorder, alcohol or substance abuse, schizophrenia, eating disorders, manic depressive or bipolar disorder, post-traumatic stress disorder, ADD or ADHD or the possibility for other mental health conditions.

    Will I need to inform my insurer of any changes to my condition?

    You will need to disclose any changes in circumstances before your insurer accepts to provide you with cover. Once they have accepted your condition and have chosen to provide you with cover, you will need to disclose any changes if you:

    • Have not applied for cover yet
    • Extend cover
    • Vary your life insurance
    • Reinstate a life insurance contract

    Life insurance and medical tests

    As part of your life insurance application you may be required to undergo medical screening. Medical screenings are particularly common among older applicants and for those wanting to cover a large sum. Based on your test results, your life insurance provider looks for indicators of diseases or illnesses such as:

    • Heart disease. In Australia, coronary heart disease kills more people than any other disease and in 2013 accounted for 13% of all deaths in Australia (Heart Foundation). As part of your medical screening your blood pressure is used to determine your cholesterol level as high cholesterol is an indicator of coronary artery disease. Then, depending on your age and medical history, you may need to have an electrocardiogram to check for an irregular heartbeat.
    • HIV. HIV is the virus that has the potential to become AIDS. If you have contracted HIV, antibodies or antigens will have developed in response to the virus and will be present in your blood.
    • Diabetes. If you have chronic diabetes you are more likely to suffer a heart attack, kidney disease, stroke and many other health conditions. Your blood and urine may be tested for unusually high glucose levels, which can be an indicator that your body is not processing sugars properly.
    • Kidney disease. Kidney disease can lead to kidney failure and if you don't receive dialysis or a transplant the disease can be fatal. Your blood will be checked for high levels of blood urea nitrogen and your urine for high levels of creatinine, protein and red blood cells.
    • Liver disease. Liver disease can develop into liver cancer, or cause gastrointestinal bleeding. Your blood will be screened as part of a life insurance assessment, for sighs of a high bilirubin level or elevated levels of the enzymes which normally appear in liver cells.
    • Cancer. Some forms of cancer can be identified through blood and urine tests. Blood cancers such as leukaemia can be identified in your blood, and bladder or kidney cancer can be identified in your urine. The levels of prostate specific antigen can also indicate prostate cancer.

    What types of tests will I need to undergo

    When applying for life insurance, you may undergo one of the following types of medical tests:

    • A check up. This type of medical test can usually be undertaken at your own GP’s office or completed by a medical nurse. This check up will record your weight and height, and may include a blood pressure and urine test.
    • A check up and a blood test. In this instance you have the same tests as above, but your doctor or nurse will also take some blood to see whether you are HIV positive, or if you have illnesses such as Hepatitis. The insurer may also request a cholesterol reading.
    • Personal medical attendant report. This is a detailed medical history report completed by your regular GP, which is sent off to your insurer.

    Are these types of medical test necessary?

    Medical tests are not required for all types of life insurance, although submitting to a test can mean lower premiums as the insurer can better tailor your coverage. This is because the insurer wants the most accurate information possible about your health, and blood tests and medical examinations can provide this information.

    What else is assessed during the underwriting process?

    During the underwriting process, your insurer will look at various life insurance risk factors, which can generally be broken down into eight risk groups:

    • Your medical history. During your application for life insurance you should let your insurer know of any congenital problems, illnesses or diseases, injuries, psychological issues or any undiagnosed by ongoing symptoms.
    • Your family medical history. Family history is an important indicator for ailments that are known to have familial links such as cancer, depression or congenital heart defects.
    • Your lifestyle. You should inform your insurer if you're a smoker, drinker, or taking any prescription or non-prescription drugs.
    • Your occupation. Your occupation, hours you work, your title, the size of the company you work for are all important factors for insurers.
    • Your financial situation. Your insurer will want to make sure that the amount you're being insured for is both logical and that you will be able to keep up with the required premium repayments.
    • Your participation in hazardous pursuits. Your participation in hazardous pursuits may be assessed depending on both the type of activity and your level of competency.
    • Your location. Your insurer will look at your access to medical facilities and likelihood of natural disasters in the areas you work and live.
    • Your present risk. Contemporary events are current risks that may pose an immediate threat such as civil unrest or natural disasters.

    What about unforeseen medical events?

    If your looking for additional protection that covers you in the event you suffer a serious medical condition, you may also want to consider trauma insurance. Trauma insurance provides a lump sum benefit if you suffer a condition listed on the policy. Some insurers offer cover for more than 50 conditions including: Other conditions that may be covered include:

    • Alzheimers disease
    • Aortic surgery
    • Benign brain tumour
    • Blindness
    • Severe burns
    • Cancer
    • Cardiomyopathy
    • Chronic fatigue syndrome
    • Crohn's disease
    • Coma
    • Coronary artery angiography
    • Coronary bypass surgery
    • Crohn's disease
    • Deafness
    • Dementia
    • Depression
    • Diplegia
    • Hemiplegia
    • Heart attack
    • Heart conditions
    • High blood pressure
    • HIV accidental infection
    • HIV occupational acquired
    • Huntington's disease
    • Kidney failure chronic
    • Loss of limbs or eye
    • Loss of speech
    • Loss of independent existence
    • Lou Gehrig's disease
    • Lung disease
    • Major head trauma
    • Major organ transplant
    • Mental illness
    • Motor neurone disease
    • Multiple sclerosis
    • Musculoskeletal injuries
    • Osteoporosis
    • Out of hospital cardiac arrest
    • Parkinson's disease
    • Peripheral neuropathy
    • Quadriplegia
    • Sleep apnoea
    • Stroke
    • Terminal illness

    Steps to getting cover

    If you do have a pre-existing condition in your medical or family history, don't be daunted by the medical screening life insurers conduct for diseases and health conditions. If you have a pre-existing condition when you apply for life insurance, follow these steps in your application for the greatest chance of success:

    Diseases and health conditions assessed for a life insurance policy will differ between providers so make sure you read the fine print on the inclusions and exclusions of cover, and understand all medical testing procedures for your assessment.

    What are your rights under the Disability Discrimination Act?

    The Disability Discrimination Act of 1992 helps promote the rights of people with disabilities by regulating discrimination of theses people by life insurance companies. The act ensures that people with disabilities are able to gain coverage by making it unlawful for companies to discriminate people with disabilities during the underwriting process. The act does acknowledge that some discrimination is likely to take place as is the nature of underwriting. There are instances where risks associated an individuals disability may be far too high for the insurer to accept the risk. Different providers have different criteria for assessing people with disabilities.

    Some common question that we get about pre-existing medical conditions

    Applying for life insurance when you have a pre-existing condition can be a daunting process, so your questions are answered here:

    Can you take out life insurance if you have a pre-existing condition?

    • Yes, even if you have suffered a disease or disablement in the past, you can still apply for life insurance coverage for protection against a range of future events.

    What sorts of conditions can be covered by life insurance?

    • The illnesses and disabilities covered under your life insurance policy will depend on your insurer, and will be detailed in full in your product disclosure statement.

    What does a life insurance medical exam involve?

    • A medical exam can be as simple as checking your weight and blood pressure, or may also include a blood test, a urine test, or a cholesterol test.

    How should you apply for life insurance if you have a pre-existing condition?

    • It can be useful to compare insurance companies and quotes online, but if you have a specific condition to include on your application, you will receive the most accurate prices and information by calling or visiting the insurer directly.

    1. Report REP 498 Life insurance claims: An industry review, 2016

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