Life Insurance with Pre-Existing Conditions in Australia
A pre-existing condition is any injury, illness, or condition you were diagnosed with and treated for before you apply for life insurance. Typically, a pre-existing condition won’t prevent you from applying for cover; however, it may require underwriting so the insurer can assess your situation as best it can. Understanding how your pre-existing condition affects your life insurance can help you get the right cover for your circumstances.
Can you get life insurance with a pre-existing condition?
Yes, you’ll generally still be able to apply for life insurance if you have a pre-existing condition. Typically, insurers assess each application individually, so the details of your condition, how well it’s managed and whether it poses an ongoing risk will all factor into your application.
Depending on how the insurer assesses your application, you may be able to apply for cover with a premium loading added to your policy. Alternatively, your policy may include exclusions or more restrictive terms. Comparing multiple life insurance brands may give you a better indication of which options may be right for you.
What is considered a pre-existing medical condition?
In Australia, insurers typically define a pre-existing condition as any health condition, injury, or illness you’ve experienced, been diagnosed with, or been treated for before applying for a life insurance policy. It’s important to fully disclose everything, including any conditions you have been treated for successfully.
Although each insurer may define a pre-existing condition differently, the general rule is that anything that may affect your ability to work or threaten your life is a pre-existing condition. To understand your insurer’s definition of a pre-existing condition, you should read your Product Disclosure Statement(PDS).
Common examples of pre-existing conditions
- Asthma
- Arthritis
- Diabetes
- Cancer
- High blood pressure
- High BMI
- High cholesterol
- Heart disease
- Kidney or liver disease
- Melanoma
- Mental health conditions (including depression and anxiety)
- Musculoskeletal conditions
- Stroke
- Sleep apnoea
- Any other conditions diagnosed by a medical practitioner
How are pre-existing conditions assessed when you apply?
If you have a pre-existing condition and apply for life insurance, the insurer will assess your situation through a process called underwriting. During underwriting, they review your application and decide whether to issue your policy and, if so, how much your premium will be.
During underwriting, you may be asked to provide the insurer with the following information:
- Your family medical history
- Your personal medical history
- Lifestyle factors, like your BMI and your smoking status
- Your job and other risk factors
- Any existing cover you have and your insurance history
What can happen after your medical history is assessed?
After underwriting, the insurer will generally provide you with a result. The exact phrasing may vary by the insurer; however, general outcomes include:
| Outcome | Writer should explain |
|---|---|
| Your policy is accepted with Standard terms | The insurer will offer you a policy without any additional exclusions or loadings. |
| Your policy is accepted with a premium loading | The insurer may offer you cover; however, they add an additional premium to your policy based on their findings. |
| Your application is accepted with an exclusion or special terms. | In certain cases, the insurer may offer you cover; however, they may exclude certain conditions or circumstances. In these cases, they may also choose to add other terms to your policy. |
| Your policy may be deferred. | The insurer may delay a final decision on your policy. |
| Your application is declined | After assessing your circumstances, the insurer may decide not to offer you the cover you applied for. |
How does the life insurance application process work with a pre-existing condition?
The process for applying for life insurance with a pre-existing condition is similar to any other application. Typically, you’ll start with a phone application. If the insurer needs more information, your application goes to underwriting, which can take several weeks depending on how quickly they process your information.
If your application is accepted, you will receive your policy documents. They’ll include more information about your cover, the premiums you need to pay, and any exclusions that may apply. Read your Policy Disclosure Statement to fully understand your coverage.
What is a life insurance pre-assessment?
A life insurance pre-assessment is a good way to see your options if you have a more complicated medical history. A pre-assessment is an informal way for you to see which insurance brands are more likely to offer you favourable terms and conditions after they anonymously assess your data.
After you request a pre-assessment, you may also be able to get an indication if you should expect any loadings or exclusions to be added to your policy.
Benefits of requesting a pre-assessment
- No impact on your history: Results are not recorded as a formal application.
- Better preparation: You gain insight into how insurers assess your risk.
- More choices that suit your requirements: Helps you identify which insurers may offer the best terms.
- Confidence to apply: You can move forward knowing what to expect.
What should you tell the insurance brand about your medical history?
Being honest and upfront with the life insurance brand is very important. When applying for life insurance, you have a duty to take reasonable care not to make a misrepresentation and should fully disclose all relevant details. If you don’t, then you may face serious consequences. These may include the insurer avoiding your cover, which means they’ll treat your policy as though it never existed; they could vary the amount you’re covered for, or they may even vary the terms of your cover.
Can different life insurance policies have different terms?
Yes, each type of life cover comes with its own set of terms, features and benefits. If you are concerned about how your medical history might affect your life insurance application, it may be a good idea to compare quotes from several leading life insurance brands. At Life Insurance Direct, one of our specialist life insurance brokers can help you compare options and request a pre-assessment so you can make an informed decision about your coverage.
Frequently Asked Questions and Answers
Does a pre-existing condition always mean higher premiums?
Not necessarily. With a pre-existing condition, one possible underwriting outcome is that the insurer applies a loading to your policy. However, insurers generally assess each application individually, so it’s worth requesting a pre-assessment to better understand your options.Can a past or resolved medical condition still affect life insurance?
Yes, generally your past medical conditions will affect your life insurance applications, the premiums you may pay, and the terms of your policy. Life Insurance providers assess your full medical history, and this may include conditions for which you have been successfully treated.What medical conditions can cause a life insurance application to be declined?
If you have a high-risk medical condition, as defined by your specific insurance provider, your life insurance application may be denied. Although these generally vary by insurance provider, high-risk conditions may include certain types of aggressive cancer.Can seniors get life insurance with pre-existing conditions?
Yes, if you are a senior with a pre-existing condition, you may still be able to apply for life insurance. Insurers generally consider several factors when assessing your eligibility. These typically include your age, medical history, overall health, and other lifestyle factors. Request a quote below to see what may be available.Can you get life insurance through super if you have a pre-existing condition?
Yes, you may be able to get life insurance through your super if you have a pre-existing condition. You may be able to get default life insurance without a medical; however, it’s very important to read your fund’s Product Disclosure Statement to understand its exclusions and rules for pre-existing conditions. It’s also important to remember that taking out life insurance through your super has several pros and cons.
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My father is 54 and has been diagnosed with Brain Cancer. The doctors have given him 10 years max to live. Is there any form of Life/Death cover that he could purchase to be able to leave some money to his wife and young family (second marriage) when he dies.
Hi Louise,
I’m sorry to hear about your father’s diagnosis.
Because each insurer has its own underwriting guidelines, your father might want to request a pre-assessment to see whether an insurer might provide him with coverage and on which terms and condition. Please give us a call on 1300 135 205 for assistance.
I’m a young 28-year-old healthy person, with the exception of one pre-diagnoses heart condition. I’m trying to get trauma cover or something to help if I’m sick or injured and can’t work. I work from home in a white-collar profession, yet I can’t get insurance, why?
It’s not my fault I have a heart condition. I’m fine otherwise! I don’t drink or smoke.
Hi Mel,
You might want to first do a pre-assessment. This is done anonymously, to determine how an insurer might view your risk. Contact us directly on 1300 135 205 and a specialist will help you with the process.
Seeing as you’re looking for protection against illnesses and injuries that would prevent you from working, you might also want to consider income protection insurance.
Good morning. I’m a 42-year-old woman, married with 2 kids (10 and 11) both by c- section. My BMI would be in the 40s somewhere, but I am walking for exercise most days now.
I have high blood pressure for past 5yrs approx. but it is well maintained. I have life insurance in New Zealand, but I’ve moved back to Australia.
I would like to get a policy here so can stop sending money back. What are my chances without paying through the roof?
Hi Lisa,
Every life insurance company use different underwriting guidelines. One might provide you cover with a high loading, while another might offer a small premium increase.
It’s best to compare leading life insurance companies against one another to find the one that offers affordable premiums, but also quality cover.
Start comparing policies side-by-side online by filling in the quote form above and applying or for immediate assistance, please give us a call on 1300 135 205 and request that a pre-assessment be done for you.
Hi,
I have Type 2 diabetes.
Is there a loading for it and if so how much?
Many thanks,
Ashok
Hello Ashok.
Whether your life insurance policy will have a loading because of your type 2 diabetes, depends on several factors, for example, how old you were when diagnosed, your current health, your latest HbA1C results and the treatment you are currently receiving.
Please fill in the quote form above so a specialist may assist you in finding affordable coverage or for immediate assistance, call us on 1300 135 205.
My husband has cardiomyopathy. He was diagnosed about 10 years ago. He is on medication and has a check-up once a year.
Since he started on the meds he has been totally fine and has had no episodes. Can he be covered for life Insurance?
Hi Rhonda,
Thank you for asking this important question and I’m happy to hear your husband is doing well.
We specialise in finding cover for customers with a medical history like your husband’s. However, to do so we require some additional information, for example, how old he was when diagnosed with Cardiomyopathy, the symptoms he experiences, whether he’s a smoker etc.
Kindly call us on 1300 135 205 or request a quote and we’ll contact you to obtain the information required to complete a pre-assessment, the results of which should give you a better indication of which companies and policy types meet your husband’s requirements.
I hope we can help you find what you’re looking for.
Hey I have a Knee replacement fitted a number of years ago and not expecting any issues with it. I was wondering if I had an accident (ie feel down stairs and broke my knee replacement) is there any insurance out there that would cover for accident only for pre – existing medical conditions?
Regards
Chris
Hi Chris
While I can’t comment of all insurance policy type’s, however I will be able to comment with the income protection policies we currently have access to from the 10 insurers we use. In general their view is that if you have had a structural issue in the past that was treated by fusion (eg spine fusion), replacement (eg knee replacement) or pinned (where the pins are still present eg broken leg).
Then in general if you were to take out a policy after this medical event now becoming a pre-existing medical condition of this nature, this will generally be excluded from the policy as their general is that as you have had this type of previous condition and treatment it is more likely to reoccur or have related conditions as a result of this.
However each person’s scenario is reviewed on a case by case basis by insurers therefore it would be worth your time completing a pre-assessment to get their actual view based on your particular scenario to be certain.
I am interested in income protection insurance. Here is a short synopsis:
I am an airline pilot currently unable to fulfil my role as a pilot due to being diagnosed in Jan 2016 with an autoimmune disease called Granulomatosis with polyangiitis (Wegener’s disease). I am currently working part time on the ground however it is highly unlikely I will be able to get my medical back to fly again. I am also concerned about not being able to work on the ground either due to the possibility of disease relapses.
If you are able to assist I would greatly appreciate it.
Hi Mark
If you are already suffering from a medical condition that is preventing you from doing your original occupation it would be very difficult to find an insurer willing to cover you for a different occupation for the same condition for full income protection cover. However you may be able to get personal accident insurance that would cover you for accidents that prevent you from being able to work.
If you would like to discuss your situation in detail please and for us to complete a no obligation pre-assessment for full income protection or if you would like personal accident insurance please contact us.
I have been diagnosed with a incidental finding of a small meningioma no treatment is required only follow up scan in 12 months
Hi Sabrina
I would suggest you contact the team on 1300 135 205 to let them know the type and level of cover you are looking for. Please also provide them with any test results you may have had completed for your meningioma and we will be able to complete an anonymous pre-assessment with a number of insurers for you to let you know the best outcome we can find for you.
Hi There,
My husband had Hodgkin’s Lymphoma 15 years ago.
He has had nil re-occurrences and still he can’t get an average life insurance coverage.
What can we do?
Thanks for contacting us Chris with your very relevant question. Life Insurance for cancer survivors can often be difficult to obtain but it is most definitely not impossible. Typically, a Life Insurance Provider looks at the Type of Cancer, Age at Diagnosis, Staging based on a Histology Report and the type of treatment undertaken when they assess life insurance for people who have had cancer. When these factors are considered, the Life Insurer then during the underwriting process decides if the risk to them to insure this person can be considered at standard or normal rates or they may wish to apply a ‘loading’ to the premiums which means they will offer cover but apply a higher premium based on the risk to accept the insurance cover.
Based on your question, I suspect that you have found that the premiums being offered have been with a ‘loading’ or are higher than you thought? One of the benefits of our service is that we can offer your husband a pre-assessment with up to 11 x Life Insurance Providers that we compare and thus all these Insurers may provide a different outcome in relation to the Life Cover and you can subsequently choose the best for your needs, whether this be the lowest premium or the included features and benefits of a policy. This is a free service for one of our Life Insurance Specialists to conduct the pre-assessment and provide an outcome for you to consider. You are welcome to contact us on 1300 135 205 and we can help you and your husband further in this regard.
Thank You
Hi Team,
I am about to turn 66 and have been retired for afew years. I also take medication for PTSD which is a result of both War Service (Vietnam) and years of working in the emergency services. My previous insurance company has just informed me that my Life Policy has expired and as such they say I can be insured with them if I pay a premium that is absolute extortion! The premium has been increased because of my age to 2 1/2 times what is has been, with NO change in my medical condition. I still need life insurance to protect my family. Is there a company that will provide insurance without the highway robbery?
Hi Alan, Thanks for contacting us and am sorry to hear about those circumstances around the new premium you have been asked to pay to retain your cover. I hope I can provide you with some good information here that will be beneficial to you. I can probably presume that this cover was held inside superannuation and possibly provided by your previous employer in the form of a Group Insurance Product? The reason I say this is that often these types of policies do expire at age 65 or 70.
We can offer a choice of up to 11 x Insurance Providers here and our Life Insurance Specialists can pre-assess your situation with these companies so that you can hopefully find a policy the meets your needs. The Life Insurance Providers will ask questions around the severity of your PTSD but that can be explained to you following the pre-assessment. It does not cost you any money for us to research this for you and to present you with options so that you know where you stand. Please call us on 1300 135 205 and we can start the process for you. Thanks
Hi,
I would like to find out if there are any Insurance Companies that would insure me for both Life Insurance and Income Protection without excessive loading. I am a 52 y.o female. I am a registered nurse who works in an outpatient type setting so no lifting, night shifts etc. Much of my work is either computer/phone related and venepuncture. My BMI is around 40 which seems to be a stumbling block for most insurers much to my irritation. I have normal blood pressure, normal sugar and cholesterol levels and normal liver and thyroid function. I do have generalized anxiety which is well controlled on meds and has been for years. I also have osteoarthritis in my knees and have recently had surgery on one of these (lateral release and tibial tendon transfer). Many years ago I had muscular related back issues but have not had any issues for a couple of decades . Whilst I realize this all sounds terrible I would like it noted that I have not had any sick leave for anxiety issues. Similarly I have not had any time off for osteoarthritis and have only had 6 days off work following the recent surgery. On a family history level. My father died at age 85 having had congestive heart failure for several years which subsequently led to several falls resulting in acquired dementia. My mother is currently living and is 83 and aside from osteoporosis and high cholesterol is well. My paternal grandmother was a large woman like myself and lived to 95. I would be grateful if you could find a company that is prepared to insure me without just looking at their BMI charts and throwing their hands up in the air and saying she is un-insurable and if we do insure her we will tack on an excessive loading. Thanks
Thanks for contacting us Bronwen and your question has plenty of content which is great. I appreciate the effort you have gone to and I can definitely sense the importance that you place on having these covers to protect you and your family. I can see that you have already spoken to one of our Specialists and you have already provided the additional information that we require so thank you. It is important to understand that all Insurers treat each application on a case by case basis but generally when people have pre-existing medical conditions the Insurers will often assess on date of diagnosis, severity of the condition, current treatment and any recent changes to the condition or outcomes. With regards to the Family History information, the Insurers will only look at Family History to immediate first degree blood related family members for example mother, father, brother and sister up to the age of 65, hence this does not extend to Grandparents. I can see that our Life Insurance Specialist has contacted 6 x Insurers to have you pre-assessed at this stage and they will be getting back to you in the next 24 hours to provide some outcomes and discuss your options. Thank You.
Hi
My wife is going through a dialysis program. She is lot stronger and energetic ever since she started on it about 2 months ago. She doesn’t have anything major other than that. Does she qualify to hold a life insurance?
Thanks for your question Rakesh. Each Life Insurance company assesses a persons health based on many factors. This can include the severity or frequency of certain medical conditions. The most practical way to approach this for your wife is to make contact with us and we can take her through a pre-assessment on her condition with the Life Insurers and then we will provide further information to both of you before we take her through the application process. You are welcome to contact us on 1300 135 205 and one of our specialists can help you with this.
Hi, my husband has connective tissue disease, he is currently taking medicine and seeing his specialist once a three month. He is 31 this year. Does he qualify to have life insurance cover? Will the cover price be higher than normal?
Hi Lynn
I would need more information to assist you with this question as my brief research has highlighted there are a number of connective tissue conditions therefore please can you provide the following information to assist:
1. Which Connective tissue condition does he have
2. When was it diagnosed
3. What treatment has he had
4. What medication / treatment & dosage is he currently taking
5. Any other medical conditions
6. Is he a smoker / none smoker
Once I have this information I will be able to find out more around the life insurance options that may be available and the potential premiums should the insurers we have access to be able to offer cover to your husband. If you prefer to call us to provide this information please call us on 1300 135 205.
Hi Team
I am looking for a quote for life insurance. I am a 60 year Australia male who has never smoked. My problems is that I have had open heart by-pass surgery. I have fully recovered and have returned to full-time work.
I have a wife and two daughters one 18 yrs and one 14 yrs. Is there any chance of obtaining life insurance at a reasonable cost? or what is the best type of insurance cover to get?
Regards
Paul
Hi Paul
Thank you for your question, in order for me to help you as much as I possibly can in answering your question could you please provide me with the following additional information:
1. Date of the Surgery
2. Diagnosis (That lead to the requirement for Surgery)
3. What Treatment / Surgery was completed – the details of the area / type of treatment.
4. Are you on any type of ongoing treatment?
5. Do you suffer from any other medical conditions?
This information is key for a us to undertake a pre-assessment which is where we informally ask an underwriter from an insurer their views on if they are able to offer cover (and if so on what terms / premium) for someone who has had heart / Bypass surgery.
Once we have this information we will be able to assist further.
Regards
Russell Cain
I have Bipolar2 (Bi polar II) and was diagnosed 10 years ago. I am 56 now and want to know if an insurer would penalise me or disqualify me from taking out a life insurance policy.
Thanks
Hi John
Generally, having Bi polar II (2) alone doesn’t mean you will automatically be disqualified by an insurer for life insurance cover, however your eligibility will generally be based on a number of factors about you and your control of your Bipolar II such as:
• Number of episodes
• Date of last episode
• Response to treatment
• Any hospitalisation
• Suicidal idealisations or attempts
• Any drug or alcohol abuse
For Life or Critical Illness (Trauma) cover it may be possible to get full cover without any additional premiums (loading’s) or exclusions however the number of episodes would have to be very low, with the last episode being a few years + ago and you will need to be responding well to medication and have no other risk factors.
However if this is not the case you may still be possible to get cover however at a higher premium to take into consideration the greater risk posed to the insurer, worst case scenario you may not be able to get full Life or Critical Illness cover, it may have an exclusion or you may only be able to accidental death cover only.
Please note Total & Permanent Disablement cover can be harder to obtain as life insurers generally have tighter eligibility criteria than the above types of cover.
Every persons situation is different and I would suggest talking to a specialist such as us to allow us to get a better understanding of your situation which would allow us to then complete a Pre Assessment (where we take that information about you & your past medical history and anonymously propose your cover / situation to a number of insurance companies to then get their feedback before you lodge a formal application). This gives you an understanding of which insurer may provide you with a better offer or not and can save you a lot of time.
It can also lead to a better outcome as insurers often have different views on certain medical conditions therefore one companies response / view can be very different to another therefore it often pay for people with complex medical situations to engage in a specialist such as us to find an appropriate outcome that works for you.
I hope this helps.