Getting Life Insurance with a Pre-Existing Condition | 7 Steps to Qualify
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- 7 Steps to getting Life Insurance with a Pre-Existing Condition
- What counts as a pre-existing condition
- Income protection with pre-existing conditions
- How underwriting works in Australia
- Possible outcomes of underwriting
- What happens if I don’t disclose a pre-existing condition?
- Managing cost without weakening cover terms
7 Steps to getting Life Insurance with a Pre-Existing Condition
If you have a pre-existing medical condition, there are several steps that can help you secure suitable cover. Being transparent with your medical history is critical, as insurers will need this information to make an informed decision. The process may seem complex, but with the right support it becomes more manageable.
1. Speak to a specialist
The first step is to disclose your full medical history to one of our insurance specialists. This includes information about diagnosed conditions, treatments, outcomes, and your current health status. While insurers technically only need details that may affect their decision, providing as much information as possible gives your specialist the best chance of finding a suitable policy. If you are unsure whether something is relevant, it is always safer to disclose it.
2. Request a pre-assessment
If your medical history is complicated, you may want to opt for an anonymous pre-assessment. This involves sharing your details with multiple insurers without lodging a formal application, allowing you to see how they might assess your risk. Pre-assessments are often useful for those with health conditions, high-risk occupations, or unusual financial circumstances. It’s a discreet way to gauge insurer attitudes before making a formal commitment.
Benefits of a pre-assessment
A pre-assessment gives you insight into how insurers may view your risk, without it affecting your insurance history. The more accurate and detailed the information you provide, the more reliable the results will be.
Key benefits include:
- 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.
3. Review the outcome
Once the pre-assessment is complete, you can compare the responses from different insurers. This helps you decide whether to proceed with a formal application and which company is likely to offer the best terms. Having this knowledge upfront gives you greater confidence when moving forward.
4. Lodge a formal application
When you are ready to apply, your specialist will submit a full application to the insurer who provided the most favourable indicative outcome. This includes all relevant medical and personal information. Many insurers may also request further details such as financial statements if you are self-employed and applying for income protection.
5. Provide additional information
After receiving your application, the insurer may require further evidence to complete their assessment. This could include GP reports, specialist letters, blood tests, or a medical examination. You will be asked to sign a medical authority form so the insurer can access the necessary records.
6. Underwriting process
With all information gathered, your application enters underwriting. This is where the insurer carefully evaluates your health, lifestyle, and medical history to determine your level of risk. Underwriting ensures that the final terms of your policy are consistent with the insurers risk appetite based on your individual circumstances.
7. Insurer’s decision
Once underwriting is complete, the insurer will provide one of four outcomes: acceptance at standard rates, acceptance with a loading (higher premium), acceptance with exclusions, or a decline. If you are unhappy with the decision, you may be able to ask when the outcome is reviewable or explore alternatives with another insurer. It’s important to remember that insurers often share similar views (as they use the same reinsures) on certain conditions, but shopping around with other insurers / brands can still make a difference as they may have different risk profiles for certain conditions .
What counts as a pre-existing condition
Insurers in Australia typically define a pre-existing condition as any health issue you have had prior to taking out the policy. This can range from chronic illnesses to past injuries, depending on what’s disclosed in your application. Even conditions that are stable or fully recovered may still be assessed during underwriting.
Common examples of pre-existing conditions
- Heart disease
- High blood pressure
- Arrhythmia
- Stroke
- Cancer
- Melanoma
- Diabetes
- Thyroid disorders
- High cholesterol
- High BMI
- Asthma
- Sleep apnoea
- Chronic obstructive pulmonary disease (COPD)
- Musculoskeletal conditions
- Arthritis
- Chronic back pain
- Mental health conditions (including anxiety and depression)
- Kidney or liver disease
- Epilepsy
- Multiple sclerosis
- Parkinson’s disease
- Any other conditions diagnosed by a medical practitioner/professional
Can you get cover with a pre-existing condition?
Yes, many Australians with pre-existing conditions are still able to obtain life insurance. The level of cover and cost will depend on the details of the condition, how it has been managed, and whether it poses an ongoing risk. While some conditions may only attract a premium loading, others may be subject to exclusions or more restrictive terms. Comparing multiple providers is the best way to find out what cover is realistically available for your situation.
Income protection with pre-existing conditions
Income protection insurance can provide a vital safety net by replacing part of your income if illness or injury stops you from working. For Australians with pre-existing conditions, insurers may apply loadings or exclusions, particularly if the condition increases the risk of long-term time off work. However, exclusions usually apply only to that specific condition, meaning you could still claim for other unrelated illnesses or injuries. Alternatively, the exclusion or increase in premium may be reviewable after a certain period of time elapsing after being symptom or treatment free from the injury or illness..
The way your application is assessed depends on how stable and well managed your condition is. A pre-assessment can give you an early indication of how insurers might view your risk, helping you find a provider more open to your circumstances. Even with exclusions, income protection can still deliver valuable peace of mind by covering unexpected health issues that could affect your ability to earn an income.
How underwriting works in Australia
In Australia, life insurers use a process called underwriting to assess your application. Underwriting involves reviewing your medical history, lifestyle, and sometimes your occupation to determine risk. This process is designed to ensure that the insurer offers fair and sustainable cover based on your individual circumstances.
What medical evidence will insurers ask for
During underwriting, insurers may request supporting evidence to confirm the stability of your condition. This could include medical reports from your GP, pathology results such as blood tests, or letters from treating specialists. The more complete and up-to-date the information is, the smoother the assessment process will be. If you’re unsure what evidence is required, many comparison services can guide you before you apply.
Possible outcomes of underwriting
Depending on the insurer’s assessment, your application may result in one of several outcomes. The decision is based on your health history, the severity of your condition, and how well it is being managed. Understanding these possibilities upfront helps set realistic expectations before you apply.
- Standard rates – Your policy is accepted with no changes if the insurer considers your condition low risk or stable.
- Loadings – Premiums are increased to reflect a higher risk associated with your condition.
- Exclusions – Certain conditions or causes of claim are not covered under the policy.
Disclosure: what to tell your insurer and why it matters at claim time
Full disclosure is one of the most important parts of the life insurance application process. If you fail to share relevant details, the insurer may deny a future claim even if you’ve paid premiums for years. To avoid this, be open about your health history and provide as much detail as possible.
When applying, disclose information such as:
- Past diagnoses and treatment outcomes.
- Current medications and management plans.
- Specialist reports and GP visits.
- Lifestyle factors like smoking, alcohol use, or high-risk activities.
What happens if I don’t disclose a pre-existing condition?
In Australia, you have a legal duty to take reasonable care when answering health questions on a life insurance application. Failing to disclose a pre-existing condition could result in a denied claim, even after years of paying premiums. Full disclosure ensures your insurer can assess your situation properly and provide clear cover terms. While some conditions may result in higher premiums or exclusions, many pre-existing conditions are fully covered but you must have fully disclosed these, the insurer assessed this and agreed to cover.
Application timeline and what to expect after you apply
The life insurance application process usually begins with a phone application. If additional evidence is needed, underwriting can take several weeks depending on how quickly the further information is processed. If approved, your policy documents will confirm cover, premiums, and any exclusions applied. For more information, you can request a callback from one of our specialists before you commit.
Managing cost without weakening cover terms
There are ways to manage costs even if your policy includes loadings. Comparing multiple insurers can highlight differences in how conditions are treated, sometimes reducing premiums significantly. Choosing an appropriate sum insured and reviewing optional features and benefits can also help balance affordability with adequate protection. Using a comparison tool or speaking with an insurance specialist may also help you identify policies with built-in discounts or wellness rewards.
Frequently Asked Questions and Answers
Do life insurance policies cover pre-existing conditions?
Many insurers can still provide cover if you fully disclose your condition and the insurer accepts it without limitations or exclusions. In most cases, exclusions don’t automatically drop off, you’ll need to request reassessment after a period of time. Re-insurer rules also play a role in determining eligibility and benefit periods. For some conditions, insurers may limit cover (for example, a two-year benefit period for income protection with diabetes).Do any insurance companies cover pre-existing conditions?
Yes, several insurers in Australia consider applications from people with pre-existing conditions, though their approach may differ. Some may be more flexible with conditions like controlled asthma or diabetes, while others may impose loadings or exclusions. Comparing multiple providers can reveal significant differences in outcomes, making it possible to find a more suitable option. For a tailored comparison, you can use an online tool or get advice from a licensed adviser.What illness does life insurance not cover?
Insurers generally assess every condition individually, but certain serious or unstable illnesses may lead to exclusions or declined applications. Examples include late-stage cancers, recent heart attacks, or untreated psychiatric conditions. In these cases, the insurer may either limit cover or exclude claims related to the specific illness. Reviewing the Product Disclosure Statement (PDS) carefully and speaking with a life insurance specialist ensures you know what is and isn’t covered.Who should not buy life insurance?
Most people benefit from having some level of life insurance in place because it provides financial protection when your family needs it most. Even if you do not have dependants, debts, or major financial responsibilities, the unexpected costs of illness or passing away can place a burden on loved ones. Choosing to go without cover means taking on the risk of leaving family or friends to manage those expenses alone. It is usually better to have cover in place than to find yourself or your family unprotected when the worst happens.Can you get life insurance if you’re already sick?
Yes, it is often possible to get life insurance even if you are currently managing an illness, but the terms will depend on the type and severity of your condition. Insurers usually request detailed evidence such as medical reports to assess your current health and treatment plan. In some cases, cover may be offered with exclusions or higher premiums rather than a full decline. To explore your options, you can compare insurers online or request a personalised quote through a specialist.
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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.