How do pre-existing conditions affect life insurance applications?

Life insurance helps families of the deceased recover from the loss of a loved one. The financial assistance it provides can support the living expenses of those who are left behind.

Getting insured is a highly recommended practice that everyone should consider. However, getting insurance coverage when you are suffering or have suffered from a specific health condition may prove to be a big challenge. This so-called ‘pre-existing conditions’ will surely make it difficult to look for an insurance company that will grant you a policy.

What is a pre-existing condition


A pre-existing condition is a health problem that has been treated by a specialist before you apply for a health insurance. Usually, these conditions have an effect on your overall health, your ability to work, or even your mortality. Because of the increased risk involved, said conditions are often excluded in life insurance policies. Death caused by any of these exclusions will prevent your family from making a claim.

Here are the usual pre-existing conditions insurance companies exclude from coverage:

-          Sleep apnea

-          Stroke

-          Weight issues

-          Cancer

-          Heart disease

-          Diabetes

-          High blood pressure

-          Melanoma

-          Kidney disease

-          Blood disease

-          Cardiovascular issues

The definition of a pre-existing condition varies per insurer. Some insurers stop treating a pre-existing condition as something that still persists when it has been successfully cured by a past operation. If there are no ongoing consultations or tests to monitor the recurrence of the condition, then the individual may be considered as someone who has fully recovered from said illness.

Certain insurance companies allow coverage on pre-existing conditions as long as the applicant has stopped visiting their doctor for a number of years or months to consult about the illness. Insurers see this as a sign that the individual has now a lower risk of making a claim due to said condition.

Still, some insurers consider a pre-existing condition as is, whether it has been treated or not. Even if you haven’t visited your doctor or had treatment for the said condition for the past 20 years or more, it will still be excluded from the insurance coverage.

Many Australians think that it’s impossible to get a life insurance when they have any of the pre-existing conditions listed above. It may be challenging but not impossible at all. You’ll just have to spend more effort in looking for an insurer since you’ll be considered by many as a high-risk individual.

Getting insured despite having a pre-existing condition


It’s always best to tell your insurer about any pre-existing medical condition you have. Aside from being a requirement in the application process, being honest with your insurer will help both parties come up with a solution to get you a better policy.

When applying for a life insurance, you have to disclose all the details about your health or any pre-existing condition you have. When we say all that means starting from the day you were born up to the day you apply for insurance coverage.

You’ll be giving your family a hard time in claiming the insurance in case you fail to disclose pre-existing conditions. You’ll be wasting a lot of resources on a policy that can’t be claimed because of your own error.

After assessing your situation, there are 4 ways the insurer may proceed with your application:

1)      Declined.

In extreme cases, insurance companies will defer from giving approving your policy application when they ascertain that you’re a high-risk individual.

2)      Exclusions will be applied.

Even if you haven’t consulted your doctor for years to check on your health condition, the insurer will still consider the possibility of its recurrence. They’ll still cover you, though, except when the cause for the claim is the excluded medical condition.

3)      Accepted but with additional loading.

You’ll be paying extra to cover the pre-existing conditions you have. They may charge you with a bigger loading fee or a higher premium just to cover your pre-existing condition.

4)      Accepted with full coverage.

The insurer believes you’ve fully recovered from the condition.

In some cases, you may have to undergo certain medical tests to confirm your condition. There are life insurance providers in Australia that don’t require a medical examination before you’re granted coverage. You can look for these kinds of insurer to avoid further complications.

As with all insurance policies, life insurance premiums will depend on your health risk level. The bigger the medical problems you have, the harder it is to get insured. And if you do get insured, you’ll be paying a higher premium than other people. The additional cost will depend on the pre-existing condition you have and how prone you are to making a claim based on said illnesses.



Points to remember when applying for a life insurance


Pre-existing conditions will usually limit the policy choices available to you. If you had cancer or another disease with similar gravity, you’ll find it difficult to obtain critical illness coverage.

Although it may be more challenging to find insurers who will grant you a policy, you shouldn’t grab the first one that you encounter. It’s highly recommended to still do due diligence and read the fine print to make sure you’re getting the best deal.

You can conduct a pre-assessment when shopping for a life insurance policy in Australia. It’s a way to determine what an insurer can offer, given your circumstances while maintaining your anonymity at the same time. To do this, simply fill out the company’s application form and attach all required health documents. Black out your name on all the documents and forms to make it anonymous and unbinding.

A special case in life insurance applications is finding an insurer that will accept a senior citizen with pre-existing conditions. Typically, insurance companies impose an age limit of 50, with some extending coverage up to those who are already 75 years old. There are only a few companies who offer this kind of policy.



Obtaining a life insurance policy can be difficult when you have a pre-existing condition that affects your risk level. Even though you’ve been completely treated for the said condition, insurers may still have doubts about your overall health status. This results in a higher chance of getting your application declined or having to pay a premium loading to cover the increased risk.

Pre-existing conditions are often excluded in life insurance policies, so make sure you read the fine print before you sign it. If getting a life insurance doesn’t work out as planned, an accidental death policy may be a good alternative.

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