The reality is many of us -- both young and old -- live with reoccurring medical conditions.
Pre-existing medical conditions, including but not limited to heart conditions or sleep apnoea, can impact the amount you pay for your life insurance.
Depending on the type of pre-existing condition, the condition can also impact the type of cover that is available to you.
Here's what you need to know about getting life insurance with a pre-existing medical condition.
A pre-existing medical condition generally is any condition that existed prior to you taking out life insurance.
Different insurers have different guidelines for pre-existing conditions and how they’re evaluated during the application process.
Comparing life insurance with our ten life insurance providers is one way to make sure you are able to find the appropriate insurer based on pre-existing conditions.
What is a pre-existing medical condition?
A pre-existing medical condition is generally any condition you’ve been diagnosed with or treated for by a medical provider or specialist before taking out life insurance.
This could be a medical condition you need ongoing treatment for, or one you’ve been treated for in the past.
It’s important to remember that every insurer has their own definition of what a pre-existing condition is and what’s considered a pre-existing condition under one policy might not be under another.
On top of that, many insurers consider pre-existing conditions on a case-by-case basis.
This means they might look at things like:
What your condition is
Your history of symptoms
How long you’ve been treated for your condition
How long ago you stopped receiving treatment, if applicable
The outcome of your treatment.
What are examples of pre-existing conditions?
Any condition that existed prior to you taking out life insurance, you’re being treated for, or have been treated for in the past, could potentially be classified as a pre-existing condition.
Some examples include:
High or low blood pressure or high cholesterol
Diabetes or high blood sugar
Depression, anxiety or other psychological conditions
Cancer or a stroke
Ongoing disorders like epilepsy or heart conditions
Kidney, liver or bladder disease
Again though, this all depends on the insurer.
Different life insurance policies include different guidelines for pre-existing conditions and how they’re assessed.
Does life insurance cover pre-existing conditions in Australia?
There are several ways life insurers in Australia assess pre-existing conditions:
They might offer special terms, including loadings and/or exclusions for cover if you have a pre-existing condition.
They might cover you if treatment or symptoms for a pre-existing condition stopped at a specific point in the past – for example, five years ago.
They might cover some pre-existing conditions but not others.
They might not cover a pre-existing conditions at all, even if you have not experienced symptoms for a long time.
Let’s say you went through a tough time a few years back and had six counselling sessions with a psychologist over a three-month period.
Since then, you’ve been feeling much better and haven’t needed any further treatment for symptoms of depression.
In this case, an insurer might agree to cover you because your condition was treated successfully, because treatment stopped a while ago or because they didn’t require you to disclose that information in your application.
Alternatively, they might cover you but exclude you from making a claim related to your mental health.
What do I have to disclose about my medical history?
As a general rule of thumb, you have to take reasonable care not to make a misrepresentation with respect to any pre-existing condition, if an insurer asks.
If you don’t, you could invalidate your policy and be knocked back if you try to make a claim.
Exactly what’s asked of you will depend on the insurer and the type of life insurance you’re after.
Typically, group life insurers (the kind of life insurance you get automatically through your super) ask very little, and may not require you to disclose your medical history at all.
If you buy directly through an insurer, you’ll typically be asked some general questions about your medical history.
Retail insurers (the kind you’ll find at Compare Club) ask different questions which depend on their underwriting and policy.
The process can vary, but you may get some very specific questions.
Although retail life insurance sometimes comes with more scrutiny, it can also increase the likelihood of your claim being accepted.
Retail claims pay out at a rate of 96.4%, while direct life insurance claims pay out at a rate of 90%.
More FAQs about life insurance with pre-existing conditions
What are common exclusions on life insurance policies?
You might find an insurer that will cover your pre-existing condition, but there are some common exclusions that most policies don’t cover:
Self-inflicted injuries – claims based on a self inflicted act that causes injury is generally excluded.
Criminal activity – claims based on an injury or death that happened while committing a criminal activity.
Term life insurance exclusions
Suicide – claims for death resulting from suicide within the first 13 months of the commencement of the policy.
Unsafe travel – claims that arise from travel to countries with a “Do Not Travel” warning or active war zones.
Some trauma events such as a heart attack, stroke and cancer could be excluded for the first 90 days of the policy.
Uncomplicated pregnancy-related conditions such as morning sickness could be excluded from income protection policies.
What types of tests will I need to undergo?
It depends on what the insurer requires when they assess you.
They may ask for multiple tests on none at all.
For example, you may get asked to undertake a BMR (Brief Medical Report), which may include blood tests and a comprehensive medical history questionnaire.
The insurer may also require access to a PMAR (Personal Medical Attendance Report, which is medical records from your GP if the insurer needs more information).
However, if you’re a young, healthy person, for example, you may not be asked to undergo any tests at all.
Do I need to let my insurer know if my condition changes?
In some cases, yes.
However, retail life insurance policies are often the exception to the rule.
They are what’s known as ‘guaranteed renewable’, meaning your cover will be renewed regardless of changes to your health.
Can I get life insurance if I have cancer?
This depends on the nature of your condition and the insurer’s terms.
When reviewing your application, an insurer will typically consider:
The exact diagnosis
The type of cancer
When it was diagnosed
How you’re being treated
Whether you’re in remission
Whether the cancer has spread to other organs or parts of the body.
As you might expect, life insurance is more readily available if you’re in remission.
The longer you’ve been in remission, the more options you may have.
Can I get life insurance if I’m over 60 and have a pre-existing condition?
Yes you can.
However, cover will depend on your condition.
Your age also has an impact on your ability to get cover based on your level of risk.
If you're over 50 and want to know if you can get life insurance, read our guide.
Where can I find the best life insurance if I have a pre-existing condition?
It can be tricky to know where to find life insurance with pre-existing medical conditions.
However, that shouldn’t prevent you from getting the right cover to protect you and your loved ones.
Comparing life insurance with our Compare Club specialists is one way to make sure you know what can be covered for.Compare & Save
The information contained in this guide is of general nature only and has been prepared without taking into consideration your objectives, needs and financial situation. As such, it is important that you consider the appropriateness of any advice and the relevant product disclosure statement (PDS) before proceeding. Check with a financial professional before making any decisions.