If you’re looking to purchase life insurance (also known as term life insurance) and you have a medical condition that significantly impacts how you live, there’s a good chance it will be classified as a pre-existing condition.
While having a pre-existing condition may influence your premium rates or even exclude you from coverage by some providers, the notion that you are uninsurable is a common misconception.
It’s important to note that each insurance provider may have differing policies. Some may not consider a medical condition to be pre-existing if it no longer requires treatment or occurred some time ago (e.g. 10, 15 or 20 years). Then again, some providers may exclude pre-existing conditions from cover altogether.
For this reason, it’s important to determine what different providers take into consideration when it comes to defining a condition as pre-existing for the purposes of the policy, and whether they will pay claims related to the pre-existing condition.
Pre-existing conditions may be classified as any medical conditions you had or currently have before purchasing a life insurance policy. This could be a medical condition that requires ongoing treatment, one that has required treatment in the past or even conditions that have been successfully treated.
Life insurance providers need to know about your medical conditions because it can impact the level of risk posed to them by covering you. For example, someone who has previously had cancer could be seen as a higher risk to insure, since they are more likely to suffer from the same condition or a similar condition further down the line than someone who doesn’t have a pre-existing condition. As a result, they might have to pay a higher premium (or ‘loading’) for the same policy than a person without that condition.
Essentially, any medical condition you currently have or previously had that affects your health and could potentially result in a claim could be classified as pre-existing. Some common examples of pre-existing conditions include:
In some cases, medical conditions you had in the past may not be considered pre-existing under your life insurance policy. These can include conditions that were successfully treated and no longer require medical tests, or conditions that haven’t required treatment for a specific time.
Definitions regarding pre-existing conditions can vary, so it’s always worth reading the relevant Product Disclosure Statement (PDS).
In many cases, you will find certain life insurance policies will cover you even if you have a pre-existing medical condition. However, your provider may increase your premium with a loading as a result to account for the added risk of insuring you.
If you’re looking to get life insurance with your pre-existing condition covered, you may need to provide copies of medical reports or undergo a medical examination to satisfy the underwriting guidelines for the insurer to accurately determine the level of risk involved if they insure you (underwriting refers to the process where an insurer accepts a contract to insure a customer).
Whatever your pre-existing condition may be, a good way to find the most suitable cover for you is to shop around and compare policies, since coverage varies depending on the provider.
To get the most out of your policy, you should make a personal checklist of what conditions you need coverage for. Make sure you include anything that affects the way you live and could potentially impact your ability to work.
Just because one life insurance provider might not cover your pre-existing condition, it doesn’t necessarily mean you’re uninsurable. We offer products from a range of insurance providers, so shop around until you find a policy that’s suitable.
Like with most types of insurance, you are bound by a duty of reasonable care not to make a misrepresentation when taking out a life insurance policy. While having a pre-existing condition may increase your premiums, not disclosing your medical condition can be even more costly. You may have your claim denied if you do not tell your provider the truth about your medical history when you apply, meaning you would have paid premiums for a policy that may not cover you.
The more information you provide, the more your insurance provider can tailor your cover to suit your requirements and potentially save you money on premiums. A pre-assessment can also help your provider gain a better understanding of your current condition and give an early indication of whether they can offer you cover before you complete a full application.
A life insurance pre-assessment is a process that can help you gain a better understanding of what policies may be available to you. This is generally done through an insurance consultant before you purchase a policy to give you an idea of which life insurance policies could cover your condition.
It involves a form that asks questions about your pre-existing conditions, along with your general details (e.g. age, height and weight) and other information regarding your current lifestyle and occupation. This form can usually be filled out over the phone by your insurance consultant. The more information you give, the more comprehensive the pre-assessment can be.
Pre-assessments are not compulsory, but your insurance consultant may request you to complete one if you have a pre-existing condition.
The information you may need to provide can vary between providers but may include the following types of information.
It’s important to note that the results of your pre-assessment aren’t conclusive; rather, they’re a guide to give you an idea of what kind of cover and prices you can get. If you can’t be covered by a standard policy due to your pre-existing condition (or other factors), your life insurance provider may offer a policy with revised terms tailored to your needs. These terms may include:
Gary had a heart condition 10 years ago that required open heart surgery. He still requires medication but lives a healthy lifestyle with a proper diet and regular, low-impact exercise.
While there are other insurance companies that can insure him, Gary’s provider has excluded claims involving heart disease. So, if he died of this cause, his beneficiary would not be able to claim on the policy.
Gary could search for better coverage, by completing a pre-assessment with Compare the Market to get an idea of whether another provider could offer him a new policy that covers death due to heart conditions.
While you may be able to find a life insurance provider that can cover your pre-existing condition, there are some things that many providers will not cover. Common exclusions include:
Other exclusions for specific policies may also include:
You should always read the Product Disclosure Statement (PDS) to understand the exclusions and limits that are applicable to any policy you are considering.
You’ll likely pay more for life insurance with a pre-existing condition, which is known as a loading. However, it’s important to keep in mind that there are a wide variety of other factors that can affect how much you pay for life insurance, including:
Some providers will require you to have a medical exam with a doctor or medical professional if you want to get life insurance, but not all of them will have this requirement. You’ll still need to fill out a medical questionnaire regardless of whether your provider requires an actual medical examination or not.
It’s still possible to get life insurance if you have a pre-existing health condition. You can get life insurance by:
You’ll need to fill out the provider’s questionnaire and tell them about your condition. While you may have to pay a premium loading or face exclusions specifically related to your condition, you can still take out life insurance and get cover for yourself and your family.
If an insurance provider denies your application for life insurance based on their eligibility criteria, you have a couple of options:
You’ll need to disclose a certain amount of information requested by the provider as part of the application process. Failing to give them this information can be seen as a non-disclosure, which can impact your ability to get insurance coverage.
Insurance companies have strict policies to protect customer privacy and sensitive information, so you don’t need to worry about disclosing your information.
Should you develop a health condition after you take out life insurance, you will still be covered. You’ll need to contact your insurance provider to inform them of the diagnosis, and this may affect loadings or condition-related exclusions.
If you recover or are able to reduce the impact of your condition, your premiums may not necessarily decrease. This is because having a medical condition, regardless of whether it was temporary, means you may be at a higher risk of having health complications later in life.
Additionally, life insurance progressively gets more expensive as we age, partly due to the higher likelihood that you’ll need to make a claim as you get older.
Ready to compare your options? Our free life insurance comparison service compares polices from a range of providers to help you find cover. You can compare all the features, benefits and prices of life insurance products in the one place, and all for free!
