Many Australians delay looking into life insurance because they have a pre-existing medical condition. This may include past surgery, diabetes, high blood pressure, mental health history, cancer history, heart conditions, chronic pain, or ongoing medication. While these conditions can affect an application, they do not automatically mean cover is unavailable.
What insurers assess
When you apply for life insurance, insurers generally assess your health, medical history, occupation, income, lifestyle, pastimes, and any existing insurance. This process is called underwriting. The purpose is to decide whether cover can be offered, what type of cover may be available, and whether any special terms should apply.
For someone with a pre-existing condition, the insurer may ask for extra information. This could include medical reports, test results, details of treatment, medication history, recovery progress, or whether the condition is stable. The more complete the information, the easier it is for the insurer to make a decision.
Loadings and exclusions
A pre-existing condition may result in standard acceptance, a premium loading, an exclusion, a reduced benefit, or in some cases a declined application. A loading means the insurer may offer cover but charge a higher premium due to the additional risk. An exclusion means the policy may not cover claims connected to a specific condition or body part.
For example, someone with a past knee injury may still obtain life cover, but an insurer may exclude certain disability claims linked to that knee. Someone with a well-managed condition may receive different terms compared with someone who has recent symptoms, unstable results, or incomplete medical follow-up.
Disclosure is essential
Disclosure is one of the most important parts of the application. Applicants must take reasonable care not to make a misrepresentation. This means answering questions truthfully, accurately, and completely. Leaving out medical history can create serious problems later, including a claim being delayed, reduced, declined, or the policy being changed.
It is usually better to disclose too much rather than too little. If you are unsure whether something matters, include it or ask before submitting the application.
Alternative strategies
If standard cover is not available, there may still be alternatives. These may include applying with a different insurer, adjusting the cover amount, considering different cover types, accepting a loading, reviewing exclusions, or staging cover over time. In some situations, existing superannuation insurance may also be worth reviewing before applying for new cover.
The key is to understand the options before assuming you cannot be insured.
Final Thoughts
A pre-existing condition does not automatically close the door on life insurance. It simply means the application may need more care, more information, and a realistic understanding of possible outcomes.
Speak with Flatmart to discuss what cover options may be available and what information may help support your application.
Book a life insurance review with Flatmart to discuss available cover options and what information may be needed before applying.
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General Advice Warning: The information provided in this article is of a general nature only and has been prepared without taking into account your individual objectives, financial situation, or needs. Before making any decisions, you should consider the appropriateness of the information and read the relevant Product Disclosure Statements (PDS).
Sources
- AIA Priority Protection PDS (15 Dec 2024) underwriting, duty to take reasonable care, and pre-existing condition wording, pp.4–5 and p.171.
- Zurich Wealth Protection PDS (1 Oct 2024) - application assessment, underwriting, premium loading, special exclusion, and policy schedule terms, pp.68–69.
- OnePath OneCare PDS (1 Oct 2024) - duty to take reasonable care, underwriting questions, and consequences of misrepresentation, p.10.
- Encompass Protection PDS (16 May 2025) - specific exclusions based on individual circumstances including pre-existing medical conditions, pp.73–74.
- NEOS Protection PDS (6 Dec 2024) - application guidance and duty to take reasonable care, p.11.
