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Finding the Right Life Insurance with Pre-Existing Conditions

Navigating the life insurance landscape can be tricky, especially with pre-existing conditions like diabetes, heart disease, or cancer. These conditions add layers of complexity to the application process, often leaving applicants wondering where they stand. But it’s not all doom and gloom.
Fact Checked

Updated: 06 September 2024

Yet, having a pre-existing condition doesn’t mean you’re out of options. In fact, there may be an option available which suits your unique situation. The key is understanding your condition’s impact and exploring the market thoroughly to find an option that suits your requirements. 

Key facts

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What Is a Pre-Existing Condition?

A pre-existing condition is generally recognised as any illness, injury, or medical condition that was present before the start of your life insurance policy. This definition can vary between insurers, but it typically depends on medical attention or treatment received for the condition rather than just a formal diagnosis. Whether the condition was previously treated or is ongoing, it’s the insurer’s medical assessment that ultimately determines its status as a pre-existing​ condition.

Examples of pre-existing conditions often include, but are not limited to:

  • Asthma
  • Cancer
  • Depression or other mental health conditions
  • Diabetes
  • Heart disease
  • High blood pressure
  • Sleep Apnea
  • Stroke

Effect on Life Insurance

The impact of pre-existing medical conditions on life insurance policies can differ depending on various factors. Some insurers may cover these conditions under standard terms, while others might require additional medical information or impose specific exclusions or higher premiums based on the risk assessment. In certain scenarios, insurers might not offer coverage depending on the nature and severity of the condition​.

How to Get Life Insurance With a Pre-Existing Condition

Finding affordable life insurance with pre-existing conditions may require some extra work and diligence on your part. You’ll generally be required to give your insurer all the details they need to review your application. Expect to honestly answer questions about your health, lifestyle, family history, and BMI.

Should I disclose my pre-existing medical condition?

Yes, you should disclose your pre-existing medical condition when applying for life insurance. Being upfront ensures that your coverage accurately reflects your needs and protects you from potential claim denials down the line. The key is honesty, by fully disclosing your health information, you’re building a trust-based relationship with your insurer, which ultimately safeguards your future.

Loadings and Exclusions in Life Insurance Policies

Loadings
Loadings are additional costs applied to your insurance premium, often due to pre-existing medical conditions. This increase helps ensure broader access to coverage, even for those who might assume their medical history makes them ineligible. The loading is typically a percentage or $ per mille ($1,000) and is determined by the likelihood of a future claim, as indicated by the information provided in your application, making insurance more inclusive yet tailored to individual risk profiles.
Exclusions
Exclusions in your policy may relate to hazardous hobbies, pre-existing medical conditions, risky travel plans, or dangerous occupations. These exclusions are designed to clarify that no claims can be made for incidents related to these specific risks. For instance, with a high speed racing exclusion, any claim due to injury, disability, or death occurring during this activity would not be covered, ensuring that policyholders are clear on the boundaries of their coverage.

What to do if my application is denied?

If your life insurance application is declined due to a pre-existing condition, when approaching an alternative insurer be sure to disclosure the previous decline / loading / exclusion as part of the application process as this previous application forms part of your insurance history.. To avoid rejection, consider pre-assessing your eligibility. Consulting a specialist life insurance broker who understands insurers’ risk appetites can also be beneficial. 

Special considerations for Seniors

Seniors face distinct challenges when looking for life insurance, as age and health issues play a crucial role. The severity of a pre-existing condition and advanced age can restrict policy options and elevate premiums. Seniors need to understand how these factors influence their insurance opportunities.

Insurer policies towards seniors vary significantly, with some offering more lenient terms or specialising in certain conditions. Shopping around is key to finding a policy that best suits an older applicant’s needs. Exploring the market thoroughly ensures seniors can secure the most favourable coverage available.

Frequently Asked Questions and Answers

If you didn’t disclose a pre-existing medical condition when applying for life insurance, there’s a high chance it won’t be covered. Insurers rely on the information you provide to assess risk and determine your coverage. If they discover that you failed to disclose a condition, they could deny your claim, reduce the payout, or even cancel your policy. Honesty is crucial to ensure you’re fully protected when you need it most.

Mental health conditions, including depression, are assessed by insurers based on severity, treatment history, and overall impact on your lifestyle. These factors can influence your policy terms, potentially leading to adjusted premiums or specific exclusions.

Yes, individuals with pre-existing conditions can access various insurance products, including income protection. However, terms might vary, with some insurers offering modified coverage or adjusting premiums based on the risk associated with the condition.

Insurers consider heart conditions seriously due to their potential impact on life expectancy. They’ll look at the condition’s severity, treatment success, and lifestyle changes. This assessment can affect policy availability and cost.

Obesity and associated health risks are significant factors for life insurance providers, as they can increase the likelihood of various diseases. Based on the assessed level of risk, insurers might require a higher premium or impose certain restrictions.

Yes, a history of cancer can influence your life insurance options. Insurers evaluate the type of cancer, treatment success, remission duration, and any ongoing health impacts. Depending on these factors, you may face higher premiums, specific policy exclusions, or, in some cases, difficulty obtaining coverage. It’s crucial to provide comprehensive health information to find the most suitable policy.

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Specialist

Russell is the founder and CEO of Life Insurance Direct and has been quoted in The Sydney Morning Herald, The Age, Independent Financial Adviser, Risk Adviser, Adviservoice, and Insurancenews. Russell has over 15 years’ experience in the Australian life insurance & financial services sector and is instrumental in driving the latest innovations in our insuretech platform.

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