Life Insurance and Pre-existing Conditions

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What counts as a pre-existing medical condition for life insurance?

Can I get life insurance if I have a pre-existing condition?

Do pre-existing conditions mean I’ll pay more for life insurance?

What’s life insurance underwriting?

Is life insurance worth it if I have a pre-existing condition?

Where can I find and compare life insurance?

Long story short

You may have a pre-existing condition if you’ve ever had long-term treatment for an illness or injury

Insurers’ definitions of a pre-existing condition can vary, so you may like to double-check with them.

A pre-existing condition may mean you pay higher premiums

It might not always mean you can’t get life insurance.

The underwriting process helps life insurers decide whether they’ll cover you

You might be asked about your health and lifestyle, and to have a medical exam.

What counts as a pre-existing medical condition for life insurance?

In the life insurance industry, a pre-existing medical condition is usually defined as any illness or injury for which you’ve been treated over an extended period. This could include any conditions you currently have, or one that you have required treatment for in the past, even if it was successfully treated. It could be right now, recently, or way back when. 

Of course, life insurers can set their own definitions on this front. Therefore, you may need to talk specifics with an insurer to understand whether you have a pre-existing condition according to their rules. Our partner Lifebroker work with customers to help them understand how any pre-existing medical conditions could impact their eligibility for life insurance, or how much they’ll need to pay.  

While it will depend on the insurer’s definition, some conditions that tend to be viewed as pre-existing include: 

• arthritis
• asthma
• cancer
• depression
• diabetes
• heart disease
• high blood pressure
• high cholesterol
• kidney or liver disease
• musculoskeletal conditions
• mental health conditions (including anxiety and depression)
• sleep apnoea
• strokes. 

Can I get life insurance if I have a pre-existing condition?

‘Better late than never’ could easily be a life insurer’s motto. After all, simply having a pre-existing condition won’t necessarily exclude you from purchasing life insurance.   

You have a responsibility to let an insurer know about any pre-existing conditions. They’ll factor these into their risk assessment. As part of this, they might consider your condition’s severity and how well you’ve been managing it. 

Based on their assessment, the insurer may then: 

• ask for more information about you and your condition to make their decision
• cover you with no changes to the policy
• include cover for your pre-existing condition, but require you to pay a loading (meaning you’d pay a higher premium than if you don’t have the medical condition)
• exclude the pre-existing condition from your policy (meaning you wouldn’t be covered for anything related to the condition, but will still be covered for unrelated situations)
• let you know they cannot cover you at all. 

If you strike out with life insurance through a broker, you might find cover elsewhere. For instance, you may be able to get some level of cover through your superannuation or employer. This cover may still exclude your pre-existing condition, and it may not be as much as you’d like, but it might help you avoid going without entirely. 

Are there any pre-existing conditions that aren’t covered?

Yes, sometimes. Coverage for pre-existing conditions varies significantly between insurers and policies, with some conditions potentially excluded or subject to waiting periods or additional premiums. Whether or not you can be covered for your pre-existing condition will depend on a range of factors including the type and severity of your pre-existing condition, how it’s managed, and your overall health.

Some policies may exclude certain pre-existing conditions entirely, while others might provide coverage with specific terms or limitations. The key is understanding your policy’s Product Disclosure Statement (PDS) and being completely up-front about any pre-existing conditions during the application process. If you don’t tell your insurers about a known pre-existing condition, this could result in your claim being rejected down the track or even your policy being cancelled altogether.

What if I’m not aware I have a pre-existing condition?

If you genuinely weren’t aware of a health condition when applying for life insurance, your insurer will assess whether your lack of awareness was reasonable based on the circumstances and information available to you at the time you took out your policy. 

They will likely consider factors such as: 

• Whether you had any symptoms that might have prompted investigation
• Your access to medical advice or health checks
• Whether a reasonable person in your situation would have been aware of potential health concerns
• The timing of when the condition was eventually discovered. 

Each insurer has a different process for evaluating these kinds of situations, and the outcomes will vary depending on your specific policy terms and the nature of your condition. The most important thing is to always answer all questions honestly based on what you knew at the time. 

Helpful tip

Remember, a pre-existing condition needs to be exactly that: pre-existing. So, if you develop a medical condition after you’ve purchased your life insurance, your cover won’t change. You actually don’t even need to let your insurer know that anything’s different. 

However, if you were to change policies or amend the terms of your existing policy (like increasing your level of cover), then this condition would fall into the pre-existing category. As a result, you’d need to be upfront about it when on the hunt for fresh cover. 

Adrian Bennett

General Manager for General Insurance

Do pre-existing conditions mean I’ll pay more for life insurance?

Often, yes. A pre-existing condition could mean you’re more likely to make a claim on your life insurance. To help manage this higher level of risk, an insurer may choose to offer you cover but with an added loading (additional cost) to your premium.  

As a result, you might like to compare cover options before settling on a policy. You may find another insurer is happy to cover you without a loading. Another option customers consider is possibly tweaking their policy’s coverage, like the insured amount, which could help rein in premiums if a loading is unavoidable. 

What’s life insurance underwriting?

When you apply for life insurance, you may need to complete an application. This application helps the insurer understand your personal risk factors. 

An application might mean extra paperwork for everyone involved, but policies with a less thorough application process, or that entirely skip this step, may come with more exclusions around pre-existing conditions. If you’re after more tailored cover, you may need to be prepared to submit an application for the life insurer to better understand your circumstances and underwrite your policy accordingly.

Is life insurance worth it if I have a pre-existing condition?

Well, it depends on your own health and personal situation. What may be worthwhile to one person may hold less value for another. It all comes down to individual circumstances, concerns, and wants.  

With this in mind, you might like to think about whether you’d be able to financially support yourself and your family if you couldn’t work for a time. Similarly, would your family be able to enjoy their current lifestyle if, sadly, you were no longer there? 

Importantly, life insurance may offer you cover if you’re injured or in an accident. You might never need to make a life insurance claim related to your pre-existing condition; instead, you might rely on it when something unfortunate happens totally out of nowhere. 

Where can I find and compare life insurance?

Pre-existing conditions can make life a little more complicated, from remembering to take your medication to following a strict care regimen. And while it’s true that they may impact your life insurance, they might not immediately disqualify you from coverage, either. 

If you’re interested in seeing what cover may be out there for you, given your pre-existing conditions – or you want to purchase a policy before you potentially develop any down the track – iSelect’s online comparison tool makes things easy. Simply share a few details and you can compare a range of life insurance options from different providers side-by-side in a matter of minutes.