---
title: Can I Get Life Insurance With a Pre-Existing Medical Condition in Australia?
description: Can you get life insurance with a pre-existing condition? Understand exclusions, premium loadings and insurer pre-assessments before applying in Australia.
image: https://www.jicinsurance.com.au/hubfs/Life%20Insurance%20With%20Pre-Existing%20Conditions.png
---

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# Can I Get Life Insurance With a Pre-Existing Medical Condition in Australia?

[By \- Alex Jorgensen,](https://www.jicinsurance.com.au/jic-insurance-blog/author/alex-jorgensen)  Oct 05, 2026

![Life insurance with pre-existing conditions](https://www.jicinsurance.com.au/hubfs/Life%20Insurance%20With%20Pre-Existing%20Conditions.png)

Yes, life insurance may be available in Australia if you have a pre-existing medical condition. Depending on the insurer, cover type and medical history, an application may be accepted on standard terms, offered with a premium loading or exclusion, or declined. Having a condition does not automatically tell you the outcome. \[[1](https://www.aia.com.au/en/financial-wellbeing/knowledge-hub/making-plans/what-to-expect-when-you-apply-for-life-insurance), [2](https://adviser.tal.com.au/faqs)\]

An insurer pre-assessment can help clarify its likely approach before a full application. It is an initial indication based on the information supplied, not an approval or a guarantee of the final terms. \[[3](https://www.aia.com.au/content/dam/au/en/tailored-protection/adviser-docs/underwriting-pre-assessment-form.pdf)\]

This article focuses on applying for life cover and explains where the treatment of medical conditions can differ for total and permanent disability (TPD), trauma and income protection insurance. 

## What counts as a pre-existing medical condition?

In everyday terms, this means a health condition or medical history that exists before applying for cover. An insurer’s questions may also cover earlier symptoms, treatment, medication and investigations. The wording of those questions and any policy definition matters; a condition does not become irrelevant simply because treatment has finished. \[[1](https://www.aia.com.au/en/financial-wellbeing/knowledge-hub/making-plans/what-to-expect-when-you-apply-for-life-insurance), [4](https://direct.zurich.com.au/info/education-hub/how-does-life-insurance-underwriting-work)\]

For example, an insurer may ask about a previous injury, a condition managed with medication or an ongoing investigation. Answer the questions asked rather than deciding for yourself which parts of your history will matter.

You can [**compare life insurance options**](https://www.jicinsurance.com.au/life-insurance-quotes-online) and ask about the information needed to explore a pre-assessment. 

## What can happen when an insurer assesses your application?

Underwriting is the insurer’s assessment of whether it can offer cover, and at what price and on what terms. Potential outcomes include the following. The options available depend on the product and insurer. \[[1](https://www.aia.com.au/en/financial-wellbeing/knowledge-hub/making-plans/what-to-expect-when-you-apply-for-life-insurance), [2](https://adviser.tal.com.au/faqs), [4](https://direct.zurich.com.au/info/education-hub/how-does-life-insurance-underwriting-work)\]

| **Possible outcome** | **What it means** |
| --- | --- |
| Standard terms | The insurer offers its usual terms without an additional restriction or loading for the disclosed condition. Normal policy terms still apply. |
| Premium loading | An additional premium is charged for the assessed risk. A loading does not, by itself, describe what is excluded. |
| Exclusion | Specified claims are outside the cover. The exact wording and the benefit it applies to need to be checked. |
| Further information or postponement | More evidence may be needed, or a decision may be deferred. This is different from an offer of cover. \[[5](https://adviser.tal.com.au/-/media/tal/files/product-and-marketing-hub/pds-and-essential-docs/talr0153-ap-data-capture-form.pdf)\] |
| Decline | The insurer does not offer some or all of the cover requested. |

A policy may have more than one change to its terms. Different benefits in the same application can also have different outcomes. \[[2](https://adviser.tal.com.au/faqs)\]

## What is the difference between a loading and an exclusion?

**A loading changes the cost; an exclusion limits what can be claimed.** Paying a higher premium does not automatically remove an exclusion, and being accepted for insurance does not necessarily mean your existing condition is covered. \[[2](https://adviser.tal.com.au/faqs), [4](https://direct.zurich.com.au/info/education-hub/how-does-life-insurance-underwriting-work)\]

Check whether the proposed terms apply to life cover, TPD, trauma, income protection or more than one benefit. An exclusion on one benefit should not be assumed to apply identically to the others.

The useful comparison is the final premium together with the policy wording, cover amount and any special terms. An initial quote may not include changes made after underwriting.

### A hypothetical comparison

Imagine two offers for the same type and amount of cover: one includes an exclusion for a specified condition; the other has a higher premium and no equivalent specific exclusion. These are different offers, even if the headline cover amount matches. Other exclusions and policy definitions still need to be checked.

This illustrates how terms can differ; it is not a prediction that either offer will be available for a particular condition. Deciding which offer, if any, suits your circumstances requires a personal assessment.

## Why can insurers assess the same medical history differently?

Insurers do not all use the same underwriting approach. Your diagnosis, treatment, current symptoms and the type of benefit being requested can affect the assessment. One insurer’s response is not a reliable prediction of another insurer’s decision. That is the practical reason to explore likely terms before treating the first response as the only possible outcome. \[[4](https://direct.zurich.com.au/info/education-hub/how-does-life-insurance-underwriting-work), [6](https://www.aia.com.au/en/adviser/business-growth-hub/adviser-news/supporting-your-clients-through-underwriting), [11](https://www.aia.com.au/en/adviser/business-growth-hub/adviser-news/5d-smarter-way-to-risk-profile)\]

## How does a life insurance pre-assessment work?

A pre-assessment is an initial enquiry to an insurer’s underwriting team. An authorised representative can outline relevant information and ask how the insurer is likely to assess the proposed cover. Insurers provide adviser channels for these enquiries, although their processes and information requirements vary. \[[6](https://www.aia.com.au/en/adviser/business-growth-hub/adviser-news/supporting-your-clients-through-underwriting)\]

Useful questions include:

- Could this history affect the premium or result in a specific exclusion?
- Would the likely terms differ between the benefits being considered?
- What medical information would be needed for a full assessment?
- Is further investigation or treatment likely to affect when a decision can be made?

A pre-assessment can help you understand the next step. It does not put cover in place. The insurer still needs the completed application and any required evidence, and its final decision may differ. Information supplied at pre-assessment must also be answered accurately in the formal application. \[[3](https://www.aia.com.au/content/dam/au/en/tailored-protection/adviser-docs/underwriting-pre-assessment-form.pdf)\]

## What information can help an insurer understand your condition?

A clear medical history gives the underwriter more to work with than a diagnosis alone. Depending on the questions asked, useful details can include: \[[5](https://adviser.tal.com.au/-/media/tal/files/product-and-marketing-hub/pds-and-essential-docs/talr0153-ap-data-capture-form.pdf), [11](https://www.aia.com.au/en/adviser/business-growth-hub/adviser-news/5d-smarter-way-to-risk-profile)\]

- When the condition or symptoms began and when they last occurred.
- Treatment received, current medication and your response to treatment.
- Recent test results and any outstanding investigations or referrals.
- Effects on work or daily activities, and any time away from work.
- Contact details for your treating doctor or specialist.

The insurer may request reports or tests; you do not need to assume every application requires a medical examination. For preparation, see [**information needed to apply for life insurance**](https://www.jicinsurance.com.au/jic-insurance-blog/what-information-do-you-need-to-apply-for-life-insurance) and [**medical examinations for life insurance**](https://www.jicinsurance.com.au/jic-insurance-blog/does-life-insurance-require-medical-exam). \[[1](https://www.aia.com.au/en/financial-wellbeing/knowledge-hub/making-plans/what-to-expect-when-you-apply-for-life-insurance), [5](https://adviser.tal.com.au/-/media/tal/files/product-and-marketing-hub/pds-and-essential-docs/talr0153-ap-data-capture-form.pdf)\]

## What if you have several medical conditions?

Several conditions can make an assessment more complex and may limit the terms available. Counting diagnoses or exclusions alone is not a reliable way to predict the result. The insurer needs to consider the complete medical history and the cover requested.

A useful pre-assessment therefore presents the relevant conditions together. Ask how the combination affects the likely offer, rather than assuming each condition will be assessed separately and the results simply added together.

## What needs checking if you already have cover?

Existing insurance may have terms you cannot obtain again after a change in health. Before changing or cancelling it, check the proposed replacement’s acceptance, commencement date, exclusions and other conditions. A quote or favourable pre-assessment is not confirmation of replacement cover. \[[5](https://adviser.tal.com.au/-/media/tal/files/product-and-marketing-hub/pds-and-essential-docs/talr0153-ap-data-capture-form.pdf), [7](https://moneysmart.gov.au/how-life-insurance-works/insurance-through-super)\]

Default insurance through super may sometimes be available without individual medical checks, but eligibility and pre-existing condition rules still matter. Additional cover may require assessment. Read the relevant fund documents instead of assuming that cover through super includes every existing condition. \[[7](https://moneysmart.gov.au/how-life-insurance-works/insurance-through-super)\]

For more detail, see [**switching life insurance providers**](https://www.jicinsurance.com.au/jic-insurance-blog/can-i-switch-life-insurance-providers). Personal advice may be useful where retaining or replacing cover depends on your circumstances.

## Answering health questions accurately

For consumer insurance contracts, there is a duty to take reasonable care not to make a misrepresentation. In practical terms, answer the insurer’s questions carefully, honestly and completely, and ask for clarification if a question is unclear. \[[8](https://www.asic.gov.au/about-asic/news-centre/find-a-media-release/2022-releases/22-241mr-asic-review-finds-room-for-improvement-remains-with-life-insurance-claims-handling), [9](https://advisers.zurich.com.au/resources/change-navigator/duty-to-take-reasonable-care)\]

Check any application prepared with help from someone else. Follow the insurer’s instructions about reporting changes before cover starts. Inaccurate answers can affect the policy or a later claim; a pre-assessment does not replace these responsibilities. \[[9](https://advisers.zurich.com.au/resources/change-navigator/duty-to-take-reasonable-care)\]

 

##### Founder’s note

My view is that a medical condition is a reason to understand the available terms before applying, rather than assume you cannot get cover. Insurers do not all use the same playbook, and the difference between an exclusion and a loading can materially change what you are comparing.

That is where a pre-assessment can be useful. Your authorised representative can speak with underwriting teams about their likely approach, so the conversation starts with what may be available and on what terms. The final decision still rests with the insurer after a full assessment.

## Frequently asked questions

### Does a pre-existing condition always mean a higher premium?

No. Standard terms may be available. The outcome depends on the condition, the insurer’s assessment and the benefit requested; a loading or exclusion is not automatic. \[[1](https://www.aia.com.au/en/financial-wellbeing/knowledge-hub/making-plans/what-to-expect-when-you-apply-for-life-insurance), [2](https://adviser.tal.com.au/faqs)\]

### If one insurer declines me, will every insurer decline me?

Not necessarily. Underwriting approaches differ, but another insurer’s acceptance is not guaranteed. Explain previous decisions accurately wherever an application asks about them. \[[3](https://www.aia.com.au/content/dam/au/en/tailored-protection/adviser-docs/underwriting-pre-assessment-form.pdf), [5](https://adviser.tal.com.au/-/media/tal/files/product-and-marketing-hub/pds-and-essential-docs/talr0153-ap-data-capture-form.pdf), [6](https://www.aia.com.au/en/adviser/business-growth-hub/adviser-news/supporting-your-clients-through-underwriting)\]

### Does a loading mean my condition is covered?

A loading means an additional premium applies. It does not replace the need to check exclusions, benefit definitions and your policy schedule before assuming a claim involving that condition would be payable. \[[2](https://adviser.tal.com.au/faqs), [4](https://direct.zurich.com.au/info/education-hub/how-does-life-insurance-underwriting-work)\]

### Is a pre-assessment a formal insurance application?

No. It is an initial enquiry based on limited information. It does not bind the insurer, guarantee final terms or establish cover. A full application and assessment are still required. \[[3](https://www.aia.com.au/content/dam/au/en/tailored-protection/adviser-docs/underwriting-pre-assessment-form.pdf)\]

### Can an exclusion or loading be reviewed later?

Sometimes. An insurer may allow a review, depending on the term and its requirements. TAL, for example, describes processes for reviewing medical exclusions and loadings. A review does not guarantee removal or a lower premium. \[[10](https://adviser.tal.com.au/latest-news/review-of-medical-exclusions)\]

### Can I get cover without a medical examination?

Possibly. An insurer may assess an application from the answers and available evidence, or request further reports or tests. No examination does not mean there are no health questions or exclusions. \[[1](https://www.aia.com.au/en/financial-wellbeing/knowledge-hub/making-plans/what-to-expect-when-you-apply-for-life-insurance), [4](https://direct.zurich.com.au/info/education-hub/how-does-life-insurance-underwriting-work)\]

## Compare life insurance with a pre-existing medical condition

When comparing life insurance with pre-existing medical conditions, look at the proposed terms alongside the premium. An exclusion, loading or different outcome across benefits can change what an offer means.

JIC Insurance can help you compare options and understand general product features and the application process. You can [**compare cover through JIC Insurane**](https://www.jicinsurance.com.au/quote-tool) and ask about exploring an insurer pre-assessment.

JIC Insurance provides general advice and does not recommend which policy is suitable for your personal circumstances. For advice about the type or amount of cover, ownership or replacing an existing policy, [**speak with a JIC financial adviser**](https://www.jicwealth.com.au/).

##### About the author

Alex Jorgensen is the Founder of Jorgensen Investment Company (JIC), with over 10 years of experience in financial services. He has built multiple businesses across life insurance, lending, and financial advice, focusing on creating simple, structured solutions that help clients make confident financial decisions. Alex is a registered provider on the official [ASIC Financial Advisers Register](https://moneysmart.gov.au/financial-advice/financial-advisers-register#!id=001238139). You can verify his independent client reviews on [Adviser Ratings](https://www.adviserratings.com.au/adviser/1238139/Alex-Jorgensen) or connect with him via [LinkedIn](https://www.linkedin.com/in/alex-jorgensen-160856198/). Alex Jorgensen is a registered financial adviser for JIC Wealth AR # 001238139 under AFSL JIC Adviser Network AFSL # 562451. 

#### General Advice Warning

This article contains general information and does not take into account your objectives, financial situation or needs. Consider whether it is appropriate for your circumstances and read the relevant Product Disclosure Statement, policy schedule, special terms, Target Market Determination and Financial Services Guide before making a decision. Acceptance, premiums and terms are subject to the insurer’s assessment. JIC Insurance Pty Ltd is a Corporate Authorised Representative (1310905) of JIC Adviser Network Pty Ltd (AFSL 562451).

## Sources

Sources checked on 5 October 2026. Insurer material describes its own processes; policy terms and underwriting requirements can change. The pre-assessment form is cited for process principles, not as a current application form or a universal underwriting guide.

1\. AIA Australia — [What to expect when you apply for life insurance](https://www.aia.com.au/en/financial-wellbeing/knowledge-hub/making-plans/what-to-expect-when-you-apply-for-life-insurance)

2\. TAL — [Frequently asked questions — application outcomes](https://adviser.tal.com.au/faqs)

3\. AIA Australia — [Underwriting pre-assessment form — indicative and non-binding status; evidence requirements](https://www.aia.com.au/content/dam/au/en/tailored-protection/adviser-docs/underwriting-pre-assessment-form.pdf)

4\. Zurich Australia — [How does life insurance underwriting work](https://direct.zurich.com.au/info/education-hub/how-does-life-insurance-underwriting-work)

5\. TAL — [Accelerated Protection Data Capture Form — insurance declined or modified](https://adviser.tal.com.au/-/media/tal/files/product-and-marketing-hub/pds-and-essential-docs/talr0153-ap-data-capture-form.pdf)

6\. AIA Australia — [Supporting your clients through underwriting](https://www.aia.com.au/en/adviser/business-growth-hub/adviser-news/supporting-your-clients-through-underwriting)

7\. ASIC MoneySmart — [Insurance through super](https://moneysmart.gov.au/how-life-insurance-works/insurance-through-super)

8\. ASIC — [22-241MR — life insurance claims handling review; background on the duty to take reasonable care](https://www.asic.gov.au/about-asic/news-centre/find-a-media-release/2022-releases/22-241mr-asic-review-finds-room-for-improvement-remains-with-life-insurance-claims-handling)

9\. Zurich Australia — [Duty to take reasonable care](https://advisers.zurich.com.au/resources/change-navigator/duty-to-take-reasonable-care)

10\. TAL — [Reviews of medical exclusions can now be done on a short form](https://adviser.tal.com.au/latest-news/review-of-medical-exclusions)

11\. AIA Australia — [Underwriting guide to the 5 Ds — medical history detail](https://www.aia.com.au/en/adviser/business-growth-hub/adviser-news/5d-smarter-way-to-risk-profile)

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