Getting life insurance with a pre-existing medical condition

Can you get life insurance with pre-existing conditions?

Yes, it’s possible to get life insurance even if you have a pre-existing medical condition. However, pre-existing conditions are dealt with on a case-by-case basis by life insurance providers. Your provider will determine the level of cover they’re willing to provide and at what cost, as well as any potential exclusions to the coverage they offer you.

You’ll usually be required to answer additional questions in regards to the pre-existing condition and you may have to undergo a medical examination or share reports about your medical history.

What is a pre-existing medical condition?

A pre-existing medical condition is a condition that you’ve been diagnosed with and treated for before signing up for a new life insurance policy. Life insurance providers typically decide what they consider to be a pre-existing medical condition individually, so not all providers will be the same.

What might be considered a pre-existing medical condition?

Typical conditions, ailments and illnesses that might be considered a pre-existing medical condition include asthma, cancer, depression, diabetes, high blood pressure, heart disease, kidney or liver disease, certain mental health conditions, or previously suffering from a stroke.

It’s important to disclose any such condition at the time you’re seeking a life insurance quote from a potential provider. This is due to reforms in legislation, prompted by the Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry, which came into effect from 5 October 2020, and are now enforceable, meaning you must answer questions relating to pre-existing medical conditions carefully and to the best of your knowledge.

This allows a life insurance provider to consider what sort of cover they’re willing to offer. They will normally ask you some questions about your health, lifestyle, occupation and family medical history when assessing your application. Some insurers may require you to undertake medical examinations and tests, such as blood tests.

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

If you have a pre-existing condition it’s important to disclose it when applying for a life insurance policy. Failure to do so may result in your claims relating to the condition being denied and/or your cover being changed (e.g. your premiums increasing or additional exclusions and waiting periods being put in place).

If you accidentally forget about a condition you later find you should have disclosed, then it’s advised that you contact your provider as soon as possible. That will allow a potential renegotiation of any life insurance cover.

Medical conditions can also vary greatly in severity and their treatment requirements. By giving your insurer a better idea of the extent of your condition you may be offered better value for your policy, either through a reduction in your premiums or more extensive coverage for your condition.

When you disclose a pre-existing condition to your life insurance provider, they will generally do one of several things:

• Amend your policy to prevent it from covering your pre-existing condition or be unable to offer you cover at all. If this is the case, it may be worth comparing your options to find a provider that will cover your condition.

• Automatically provide cover for the condition under your policy.

• Cover your condition at an increased premium.

• Request additional information about the condition before making a decision.

Due to the personalised nature of pre-existing conditions, it’s also important to compare your life insurance options in order to find a policy that offers you good value for your money. You can compare life insurance with Canstar.

It’s also important to read any relevant documents, such as the Product Disclosure Statement (PDS) and Target Market Determination (TMD), for any policy you’re considering.

What if life insurance is declined due to a pre-existing medical condition?

There’s always the risk a provider may decline to offer you cover. That could also make it more difficult for you if you seek cover elsewhere, because you may be asked by other providers if you’ve ever had cover declined.

There may be ways you can get an idea of how likely you are to get cover in advance, to reduce your risk of having an application declined. One way is using the services of an independent financial adviser who has a good knowledge of the various providers offering life insurance and the potential risk they’re prepared to take on.

Potential providers may indicate that, based on the details provided, they would offer life insurance at an increased premium, or they may decline to offer cover. Either way, the decisions are based solely on anonymous information.

If hiring an independent financial adviser isn’t feasible for your financial situation, you could try directly inquiring with life insurance providers. They may give you more information about whether or not they’ll offer you cover, without you having to put in a formal application.

You may find you can still get life insurance cover but that your pre-existing condition is excluded from coverage. Again, that’s why it pays to shop around and compare your options.

How can you get your own pre-assessment of life insurance?

You may be able to get your own pre-assessment from a potential provider by making an anonymous phone call or online enquiry to a provider to outline your pre-existing medical condition. Again, it’s important you be honest about your own health and any family history you think might be relevant to a provider.

You can do this with several different providers to get an idea of what sort of cover they may be prepared to provide, what premium they may charge or an indication as to whether you’d be declined. But note, this is only a guide based on an anonymous pre-assessment. You may get a different result when you apply in person.

Life Insurance Calculator: How much insurance do you need?

Can you get life insurance through your superannuation with a pre-existing condition?

Yes—the Federal Government’s Moneysmart website states that most super funds will accept you for a default level of cover without health checks. It’s important to note, however, that if you want to take out extra cover above the standard level, a medical questionnaire and medical exam might apply.

Check the PDS of your chosen super fund’s life insurance policy carefully to see whether you’ll be covered for any pre-existing medical conditions you may have.