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Life Insurance with Pre-Existing Medical Conditions

Russell Cain Updated: 29 November 2021

Many Australians assume that life insurance with a pre-existing medical condition is not available, or that premiums will be too expensive. 

However, when comparing life insurance companies that accept pre-existing conditions and working with an insurance broker, you can generally find cover that meets your requirements.

For the purpose of life insurance, a pre-existing medical condition is generally any illness or injury that existed any time before you purchase an insurance policy. While a pre-existing condition, like stroke, heart disease, diabetes or cancer, can make your search for cheap life insurance more complicated, it doesn’t necessarily mean you’ll be denied cover.

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What is a pre-existing medical condition for insurance?

The definition of a pre-existing medical condition is generally any illness or injury for which you have now or in the past received medical advice or treatment, prior to taking out an insurance policy, and that may increase the probability that you will lodge an insurance claim. However, definitions will vary from insurer to insurer.

Examples of pre-existing conditions for life insurance

Does life insurance cover pre-existing conditions in Australia?

Yes, you generally can get life insurance coverage for pre-existing medical conditions. However, it depends on your insurer and some medical factors, for example, date of diagnoses, your past and current treatment, the level and type of cover you’re looking for, as well as your health status, age, BMI and if you’re a smoker.

It’s essential that you compare providers, so you know exactly what’s on offer and who provides the cover you want at a premium you can afford.

Before a life insurance company will offer you coverage, they typically first need to decide whether you are an acceptable risk. Depending on the insurer and their specific underwriting guidelines you could receive one of 4 responses.

Life insurance companies might:

  1. Provide full coverage at standard rates if the insurer defines your condition as successfully treated.
  2. Exclude all pre existing conditions from coverage, even when an illness or injury occurred 20 years ago. Generally, the more recent your condition, the more likely an exclusion will be.
  3. Apply a loading to your policy, to cover the cost of the risk they’re taking on.
  4. Decline cover, because the insurer views you as too high a risk.

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How to get life insurance with pre-existing condition?

Finding affordable life insurance when you have a pre-existing medical condition will usually require more effort. You’ll need to provide the insurer with all the information they require. Questions about your general health, lifestyle, family history and BMI should be answered truthfully and to the best of your knowledge.

Regardless of your health and pre-existing conditions, you should still try to find the best protection you and your loved ones deserve. Use the list below to help you find a life insurance policy with pre existing condition:

The best life insurance for pre-existing medical conditions

There is no one best life insurance company for people with pre-existing conditions. The key is in first doing a pre-assessment, which is an informal way to measure how an insurer might review your risk, without it influencing your insurance history. This way you won’t be penalised for your specific circumstances.

Request an application form from the insurer and attach copies of your medical history. Just remember to black-out your name on all the forms and documents.

Such an assessment is usually anonymous and thus won’t be binding to an insurer. Even though it provides you with the advantage of assessing the way you might be rated, it does not mean you should leave out relevant information in the hopes of getting a better assessment when you do formally apply.

Life insurance for senior with pre-exisiting conditions

Finding life insurance for seniors with a pre-existing medical condition is usually a challenge. Some insurers have a maximum entry age of 50, while others might still accept applicant up to age 75. However, there are life insurance policies available to seniors with pre-existing conditions, it generally just depends on the particular condition and its severity. 

If you’re unable to qualify for a fully underwritten life insurance policy, there are other options, for example, funeral insurance and personal accident cover.

Busting the top 5 myths about life insurance with pre-existing conditions

  1. I can’t get cover with a pre-existing condition
    False. It typically depends on your specific health condition and individual circumstances. You would be surprised at the number of people who have a health condition and was able to obtain adequate insurance coverage. Do not assume that just because you have a pre-existing condition that you cannot get cover. Shop around and ask a specialist for guidance.
  2. My pre-existing condition won’t be covered
    Many clients assume that their pre-existing condition will be excluded from cover. Again, it depends on the insurer, your condition, and the type of benefit you are applying for. For example, diabetes cannot usually be excluded from a policy because it is a condition which affects the entire body.
  3. I must get a medical examination if I have a pre-existing condition
    This is not true and depends on the medical condition and your personal situation. For example, if you have high cholesterol, but you’re able to control it with the right medication, and you have your cholesterol levels checked regularly, a medical exam might not be needed because the insurer can obtain your latest test results from your doctor for free.
  4. My pre-existing condition was 5 years ago; I don’t need to tell the insurer
    Never assume that if a health condition was diagnosed or occurred a long time ago, that you do not have to mention it. You must disclose all relevant health conditions which may affect your application.
  5. I don’t need to tell the insurer every medical condition I have ever had
    You must fully disclose all pre-existing medical conditions which may affect your application. Failing to do so may result in the insurer denying you benefit payments at claim time.

Frequently asked question

  • Is depression a pre-existing medical condition?

    Yes, generally, mental illness like depression and anxiety may be deemed a pre-existing medical condition, but this depends on the insurer. For example, some life insurance companies might offer standard rates if you were diagnosed with mild depression 2 years ago and had fully recovered and do not require any follow-up treatments or medications. Other companies might exclude depression when offering cover.
  • Can I get income protection insurance with a pre-existing condition?

    Whether you can get income protection insurance will depend on the type of health condition you have, when it was diagnosed, whether it has been resolved and your specific occupation type. Keep an eye out for income protection policies that offer accident only protection if full income protection insurance is not available.
  • Can you get life insurance if you have a heart condition?

    Because you are usually at higher risk of future heart-related illnesses, insurers will generally ask for more in-depth information regarding your heart condition and your current health. They may also request additional tests, including blood pressure, an EKG and a cholesterol test. It’s usually best to have a broker help you compare policies to find one offering cover at affordable rates.
  • Is pregnancy seen as a pre-existing medical condition?

    No, for life insurance, pregnancy is generally not seen as a pre-existing health condition and will typically not influence your ability to obtain cover at standard rates. However, generally, a life, trauma, TPD or income protection benefit will not pay out because of a healthy pregnancy, giving birth or having a miscarriage.
  • Can I get life insurance if I have cancer?

    An insurance company will usually review applications on a case-by-case basis. If you’ve recently been diagnosed with cancer and apply for life insurance, the insurer will often decline cover because of the high risk of your claiming. However, if you are a cancer survivor, the insurer will generally review your date of diagnosis, the type and stage of cancer you had, the treatment plan you followed and how long you’ve been in remission.

    Depending on this information you might be provided with cover at an additional premium or cancer might be excluded from coverage altogether.

  • Is obesity defined as a pre-existing medical condition?

    Yes, usually obesity will be viewed as a medical condition that can have a profound negative impact on your health and will likely result in your life cover being more expensive or even being declined.

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