Insurance and Mental Health in NZ: Anxiety, ADHD and Bipolar
Most New Zealanders with a history of anxiety, depression, ADHD or bipolar disorder can still get life, health and income protection cover, though the terms depend on severity, recency and which insurer assesses the application. Income protection is the product most likely to carry a specific mental health exclusion, while life and trauma cover are usually affected only by a premium loading or a stand-down. Health insurance pays toward ongoing psychiatric treatment instead, and the named yearly limits vary by insurer, from Southern Cross's $600 to $750 a year for psychiatrist consultations to UniMed SmartStay's $1,000 mental health benefit. A licensed adviser can present a full application to the insurer most likely to accept it on reasonable terms.
In short
- Mental health conditions made up 32% of NZ income protection claims in the 12 months to December 2025, behind musculoskeletal injuries at 38%, per MoneyHub's analysis of adviser claims data.
- In 2024/25, 14.3% of NZ adults (about 619,000 people) experienced high or very high psychological distress, per Te Hiringa Mahara's summary of the NZ Health Survey.
- Southern Cross pays up to $750 a year for psychiatrist consultations and up to $3,500 a year toward psychiatric hospitalisation, while UniMed's SmartStay sets a $1,000 a year mental health benefit.
- The Contracts of Insurance Act 2024, which would tighten disclosure rules, received Royal Assent in November 2024 but is not yet in force and will not fully commence until 15 November 2027.
New Zealand insurance runs on disclosure. A past or current mental health condition is one of the most common things applicants disclose, and it does not close the door: it means the insurer needs more information, and the answer differs by product, condition and insurer. This guide describes general underwriting outcomes only; nobody can tell you what your own application will produce before an insurer has actually assessed it.
What NZ insurers ask about a mental health history
Every application asks for a diagnosis, current and past medication, treatment history, any hospitalisation, and whether the condition is currently stable. For ADHD and bipolar disorder specifically, insurers also ask when the diagnosis was made: a childhood ADHD diagnosis managed into adulthood is assessed differently to one made last year, and bipolar disorder's episodic pattern means insurers look closely at how long it has been since the last episode.
| Question area | What insurers want to know |
|---|---|
| Diagnosis and treatment | The condition, who diagnosed it, and any psychologist, psychiatrist or counsellor involved |
| Medication | Current and past medication, dosage and duration |
| Hospitalisation and time off work | Any inpatient admission, and any period away from work |
| Stability | Whether the condition is currently stable, and your last episode |
Most insurers also request a GP report to confirm what you have disclosed, so a gap between your application and your GP's notes is one of the most common reasons a policy is later avoided.
Income protection and mental health exclusions
Income protection is the product most likely to change with a mental health history, because these conditions are already a leading cause of claims: 32% of NZ income protection claims in the 12 months to December 2025, behind musculoskeletal injuries at 38%, based on MoneyHub's review of claims data from a large NZ adviser business.
| Outcome | When it is more likely |
|---|---|
| Standard terms | A single mild episode, resolved years ago, no ongoing treatment |
| Premium loading | A managed, stable condition with consistent treatment |
| Mental health exclusion | Recurring or recent episodes, or an ongoing diagnosis such as bipolar disorder |
| Postponement | Active treatment, a recent episode, or a medication change |
An exclusion is not the same as no cover. A Partners Life Income Cover policy with a mental health exclusion still pays up to 62.5% of your income at application if you cannot work because of a back injury, cancer or any other non-excluded illness. No NZ insurer publishes a fixed percentage loading for a mental health history, and we are not going to invent one: a loading is a percentage set individually once your file has been assessed, not read off a table.
Which health insurance plans cover psychiatric treatment
Health insurance pays toward the cost of psychiatric and psychological treatment itself, and the named yearly limits vary widely by insurer and plan tier. nib's current Ultimate Health policy documents fold psychiatric treatment into the general Non-Surgical Benefit rather than publishing a separate named mental health sub-limit.
| Plan | Psychiatric or mental health benefit | Named limit |
|---|---|---|
| Southern Cross KiwiCare / RegularCare | Psychiatrist consultations | 80% of charges to $600 each claims year |
| Southern Cross Wellbeing One / Two | Psychiatrist consultations | $750 each claims year |
| Southern Cross Wellbeing Plus Options | Clinical psychology | $100 each claims year |
| Southern Cross UltraCare | Psychiatric hospitalisation | $3,500 each claims year, sub-limits apply |
| UniMed SmartStay | Mental health treatment | $1,000 each policy year |
A pre-existing mental health condition complicates a health insurance application the way any pre-existing condition does: expect a question about it, and expect standard terms, an exclusion for that condition, or a stand-down before treatment for it is covered.
ADHD and bipolar disorder: what's different
ADHD's treatment by NZ health insurers changed materially in 2026. In January, families told RNZ they had been blindsided after Southern Cross told paediatricians it was "clarifying" that ADHD and autism fell under its mental health exclusion, cutting off funding some families had previously received (RNZ, 27 January 2026). After clinician and member feedback, Southern Cross reviewed its classification and, in March, reclassified ADHD and autism as neurodevelopmental rather than mental health, so the exclusion no longer applied (RNZ, 4 March 2026). Disputes still surface at provider level: in July a Waikato barrister took Southern Cross to the Disputes Tribunal after it paid only $65 toward his $1,000 ADHD assessment, treating it as a GP visit because the assessing doctor was supervised by, but not yet registered as, a psychiatrist (RNZ, 3 July 2026). For life, trauma and income protection, a stable, managed ADHD diagnosis is generally treated as manageable rather than an automatic barrier.
Bipolar disorder attracts more cautious underwriting than a single episode of depression, because it is episodic and often lifelong, and insurers weigh the risk of a future episode, not just the most recent one. It is one of the conditions most likely to bring a mental health exclusion on income protection. Life and trauma cover are generally more accessible, since a well-controlled diagnosis with a stable medication regime is more likely to attract standard terms or a loading than a decline. As with any pre-existing condition, a decline from one insurer does not mean every insurer will decline.
Life insurance, trauma cover and what a mental health history costs
Life and trauma insurance are usually affected at the underwriting stage rather than through a blanket exclusion. A single resolved episode from years ago is unlikely to change the premium; an ongoing or recent diagnosis is more likely to bring a loading, and an active crisis is more likely to see the application postponed. To show what a loading sits on top of, indicative, standard monthly premiums for $500,000 of level life cover at age 35, non-smoker, occupation class 1, run from about $25 to $40 a month across insurers including Fidelity Life, AIA, Asteron Life, Partners Life and Chubb Life, based on their published rate cards as at 8 September 2026.
Source: QuoteHub's Premium Index, an indicative range from insurers' published rate cards as at 8 September 2026, with no loadings or exclusions applied. These are not personal quotes, and a mental health-related loading, where one applies, is a percentage added on top at application. For someone declined elsewhere, Momentum Life's Quick Life accepts NZ residents 18 to 65 with no medical questions, trading that for a two-year stand-down on pre-existing conditions, including a prior mental health diagnosis. Insurers that do assess mental health claims can pay well: Asteron Life reported a 97% claims payout rate across life, trauma and income protection claims to 30 June 2024.
The 2026 landscape: disclosure law and dispute rights
New Zealand's insurance disclosure law is mid-reform. The Contracts of Insurance Act 2024 received Royal Assent on 15 November 2024 and would tighten consumers' disclosure duty, but it is not yet in force and will not fully commence until 15 November 2027 at the latest, per the FMA's letter to insurers. Until then, disclosure is still governed by the Insurance Law Reform Act 1977, under which a policy can only be avoided for a misstatement that is both substantially incorrect and material. Southern Cross's ADHD reclassification shows the practical effect: the policy wording did not change, but the diagnostic classification behind it did. If an insurer declines a claim you believe should be covered, the IFSO Scheme and FSCL both provide free, independent dispute resolution.
Getting a better outcome
A licensed adviser who knows how different insurers treat anxiety, depression, ADHD and bipolar disorder can present your file to the insurer most likely to offer reasonable terms. Beyond that: get your GP notes before applying, disclose fully with specific dates and medications, apply once you have had a period of stability, and take an exclusion over no cover, since it still protects you against every other cause of incapacity, and some insurers will review it later.
Frequently Asked Questions
Can I get life insurance in NZ if I have ADHD or bipolar disorder?
In most cases, yes. A stable, managed ADHD diagnosis is generally treated as a manageable risk. Bipolar disorder is assessed more individually, and a well-controlled history with no recent hospitalisation is more likely to attract standard terms or a loading than a decline.
Will a mental health exclusion on income protection stop every claim I make?
No. It removes cover for claims caused by a mental health condition specifically, and still pays out for an unrelated illness or injury, such as a back injury or cancer.
Does health insurance in NZ cover an ADHD assessment?
It depends on the plan and who performs it. Southern Cross now classifies ADHD as neurodevelopmental rather than mental health, but payment can still depend on whether your specific policy recognises the assessing provider, so check before you book.
Do I have to disclose counselling I had years ago?
Yes. Insurers ask about any mental health treatment, including counselling for a specific life event, though a single, time-limited episode is generally viewed differently to a recurring condition.
What happens if my mental health-related claim is declined?
Ask the insurer for a written explanation and escalate through its internal complaints process. If that does not resolve it, the IFSO Scheme or FSCL provide free, independent dispute resolution.
Talk to a Licensed Adviser
A licensed adviser cannot change your medical history, but they can match your circumstances against a panel of NZ insurers, including AIA, Partners Life, Southern Cross and nib, to find the one most likely to say yes on reasonable terms, with no cost or pressure to proceed. Start a free check with a QuoteHub adviser, or read more about life insurance in New Zealand first.
References
- Te Hiringa Mahara, NZ Health Survey 2024/25 mental health and substance use data summary
- RNZ, ADHD and autism treatment not covered by insurer (27 January 2026)
- RNZ, Insurer backtracks on move to exclude ADHD and autism treatment cover (4 March 2026)
- RNZ, Barrister takes health insurer to court over refusal to pay for ADHD diagnosis (3 July 2026)
- MoneyHub via Scoop, Mental health now causes 32% of income protection claims (28 February 2026)
- Financial Markets Authority, letter to insurers on the Contracts of Insurance Act
- New Zealand Legislation, Contracts of Insurance Act 2024
- New Zealand Legislation, Insurance Law Reform Act 1977
- Southern Cross Health Society, Wellbeing plan document
- UniMed, SmartStay plan document
- Asteron Life, Life Insurer of the Year reports 97% claims payout rate
- Insurance and Financial Services Ombudsman (IFSO) Scheme
- Financial Services Complaints Limited (FSCL)
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