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I have a pre-existing medical condition: Can I still get insurance?

It’s one of the questions that our SHARE advisers hear the most: Can I still get insurance if I have a pre-existing medical condition? Will my condition(s) be covered?

Your medical history – including any health issues you currently have or have had in the past – is one of the key things that insurers look at when assessing your insurance application. But contrary to popular belief, pre-existing conditions aren’t always ‘uncoverable’.

Here are some key things to know, according to our SHARE advisers.

Your circumstances are unique

Each time you apply for a new policy, the insurer will assess your circumstances. Depending on your risk factors, they will decide whether to provide cover or not, and if any special conditions should be attached to your policy – like higher premiums or specific exclusions.

This process is called underwriting, and it can be:

  • Partial, where fewer questions are asked (e.g., online-only covers)
  • Full, which involves a more comprehensive, detailed assessment and ensures that your cover is tailored to your specific situation.

As insurance advisers, we provide advice on fully-underwritten policies and are here to guide you through the application process.

The reality is, everyone is different and has unique insurance needs. By asking a number of health, occupation and lifestyle questions upfront, a fully underwritten policy allows the insurer to properly tailor your cover.

This in turns means there is more certainty for you at claim time, compared to partly underwritten policies. Plus, full underwriting is also the most appropriate option if you have pre-existing or past medical conditions… Read on to learn more.

Are pre-existing medical conditions always excluded?

It’s important to note that pre-existing health conditions aren’t always excluded, nor do they necessarily result in higher premiums. And once again, the detail makes all the difference.

While online-only covers usually may contain automatic ‘blanket exclusions’ for pre-existing conditions, by applying for fully-underwritten insurance through an adviser, you may find that not all medical conditions will affect your application. And even if they did, a complete exclusion may not necessarily be the case.

Depending on your situation, the insurer may add a ‘stand-down’ period for your condition, cover the condition by increasing your premiums, or exclude it (either for a limited time or permanently).

Get in touch to learn more – we can help you explore your options.

Beware of ‘unwitting non-disclosure’

Whenever applying for insurance, online or with an adviser, it’s always important to fully disclose any health conditions you may have or have had in the past.

Some may seem irrelevant; others may have happened so long ago that you barely even remember them. But keep this in mind: if you don’t tell the insurer about them (no matter if intentionally or not), you’ll be putting yourself at risk of a claim denial in the future.

Our SHARE advisers can help you avoid unwitting non-disclosure, by guiding you through the paperwork and asking you as many questions as possible.

Can I review my exclusions and premium loadings?

Have any exclusions or higher premiums been applied to your policy? In some cases, you may be able to get them reviewed down the track.

Smoker premiums are a good example of this. If you were a smoker when you applied, your insurer will have added a ‘smoker premium’ loading to your policy. But if you quit smoking for good at least 12 months ago, you can ask your insurer to remove review the loading.

Of course, no one is the same, and providers reassess loadings and exclusions on a case-by-case basis. That’s why we recommend regular insurance reviews with a SHARE adviser: we can help you check where you stand and liaise with the insurer on your behalf.

Get in touch

If you’re unsure how your medical condition may affect your insurability, please don’t hesitate to contact us. Our SHARE advisers are here to answer your questions. Disclaimer: Please note that the content provided in this article is intended as an overview and as general information only. While care is taken to ensure accuracy and reliability, the information provided is subject to continuous change and may not reflect current developments or address your situation. Before making any decisions based on the information provided in this article, please use your discretion and seek independent guidance.