Insurance with Heart Conditions in NZ: Your Options Explained
Heart disease is the second leading cause of death in New Zealand, behind cancer. According to the Heart Foundation, cardiovascular disease accounts for approximately 33% of all deaths in New Zealand each year, claiming around 9,000 lives annually. An estimated 180,000 New Zealanders are living with a diagnosed heart condition, and many more have undiagnosed risk factors like high blood pressure or elevated cholesterol.
If you are one of these people, you have probably wondered whether you can still get insurance. The answer, in most cases, is yes. But the type of cover available, the cost, and any restrictions will depend on your specific condition, how well it is managed, and which insurer you apply with.
This guide explains how NZ insurers view different heart conditions, what outcomes you can realistically expect, and how to give yourself the best possible chance of getting meaningful cover.
Heart Disease in New Zealand: The Numbers
Cardiovascular disease accounts for approximately 33% of all deaths in New Zealand each year, claiming around 9,000 lives, and an estimated 180,000 New Zealanders live with a diagnosed heart condition. Around 8,000 heart attacks occur annually, one in five adults has high blood pressure, and heart failure affects an estimated 80,000 New Zealanders.
- Approximately 9,000 New Zealanders die from cardiovascular disease each year
- Around 8,000 heart attacks occur in NZ annually, with survival rates improving significantly over the past two decades
- One in five adult New Zealanders has high blood pressure, making it one of the most common conditions disclosed on insurance applications
- Maori and Pacific peoples experience higher rates of cardiovascular disease and at younger ages than the general population
- Heart failure affects an estimated 80,000 New Zealanders, a number expected to grow as the population ages
These statistics matter for insurance because they shape how insurers assess cardiac-related risk. Heart conditions are among the most common reasons for modified underwriting terms in New Zealand, but they are also among the most well-understood by underwriters. This means the process, while sometimes slower, follows well-established guidelines.
Types of Heart Conditions and How Insurers View Them
New Zealand insurers grade heart conditions by severity, from well-controlled high blood pressure and cholesterol, which often attract standard terms or a modest loading, through arrhythmias and valve conditions assessed on their specific type, to heart attack, which usually requires 12 to 24 months of stable recovery, and heart failure, which is the hardest to insure.
High blood pressure (hypertension)
High blood pressure is the most common cardiac-related condition disclosed on insurance applications. Because it is so prevalent and well-understood, most insurers have straightforward guidelines for it.
If your blood pressure is well-controlled with medication and you have no complications (such as kidney damage or left ventricular hypertrophy), you can often get cover at standard terms or with a modest loading. The key factors insurers look at are your current readings, whether your levels have been stable over time, any organ damage, and your overall cardiovascular risk profile (including cholesterol, weight, smoking status, and family history).
High cholesterol (dyslipidaemia)
Similar to high blood pressure, high cholesterol on its own is typically manageable from an underwriting perspective. Well-controlled cholesterol with statins and good overall health often results in standard or near-standard terms. It becomes more significant when combined with other risk factors.
Arrhythmias (irregular heartbeat)
Arrhythmias cover a wide range of conditions, from benign palpitations to serious rhythm disorders. The underwriting outcome depends heavily on the specific type:
- Atrial fibrillation (AF): The most common sustained arrhythmia. If well-managed with medication and your stroke risk is low, cover is usually available with a loading or exclusion. Persistent or poorly controlled AF is harder to insure.
- Supraventricular tachycardia (SVT): Generally considered lower risk, especially if treated successfully with ablation. Standard or mildly loaded terms are common after successful treatment.
- Ventricular arrhythmias: More serious, as they can be life-threatening. If you have a defibrillator (ICD), expect significant loadings, exclusions, or potential declines depending on the underlying cause.
Heart attack (myocardial infarction)
A previous heart attack is one of the more challenging cardiac conditions for insurance purposes. However, it does not mean cover is impossible. The outcome depends on:
- How long ago the event occurred (more time equals better prospects)
- The severity and extent of damage to the heart muscle
- Whether you have had successful intervention (stenting, bypass surgery)
- Your current cardiac function (ejection fraction)
- Lifestyle changes since the event (smoking cessation, exercise, diet)
- Whether you have had any further cardiac events
Most insurers want to see at least 12 to 24 months of stable recovery before they will consider an application after a heart attack, and many prefer longer. Cover may be available with significant loadings and/or cardiac exclusions.
Heart valve conditions
Heart valve disorders range from mild (a minor valve prolapse picked up incidentally) to severe (requiring valve replacement surgery). Mild mitral valve prolapse without regurgitation is often insurable at standard or lightly loaded terms. More significant valve disease, particularly if it requires surgery or ongoing monitoring, will result in heavier loadings, exclusions, or deferrals.
Congenital heart conditions
Congenital (present from birth) heart conditions vary enormously in severity. A small atrial septal defect (ASD) that was repaired in childhood and has no ongoing issues may be insurable at near-standard terms. Complex congenital heart disease with ongoing cardiac limitations is much harder to insure and may result in declines for some cover types.
Heart failure
Heart failure is among the most difficult cardiac conditions to insure. Because it indicates the heart is not pumping effectively, insurers view it as a high ongoing risk. Cover may be limited to funeral or guaranteed acceptance products, or may not be available at all for life and income protection insurance.
Underwriting Outcomes by Condition Type
Underwriting outcomes in New Zealand differ sharply by cardiac condition. Controlled high blood pressure and successfully treated SVT usually attract standard terms or a small loading, well-managed atrial fibrillation a loading of 25% to 75%, and a heart attack more than two years ago a loading of 50% to 150% or more with a cardiac exclusion common.
| Condition | Life Insurance | Income Protection | Trauma Cover | Health Insurance |
|---|---|---|---|---|
| High blood pressure (controlled, no complications) | Standard or small loading | Standard or small loading | Standard or small loading | Usually available, possible cardiac exclusion |
| High cholesterol (controlled) | Usually standard | Usually standard | Usually standard | Usually available |
| Atrial fibrillation (well-managed) | Loading (25% to 75%) | Loading or exclusion | Loading or cardiac exclusion | Available with cardiac exclusion |
| SVT (successfully treated) | Standard or small loading | Standard or small loading | Standard or small loading | Usually available |
| Heart attack (2+ years ago, good recovery) | Loading (50% to 150%+) | Cardiac exclusion common | Cardiac exclusion or decline | Cardiac exclusion typical |
| Heart attack (less than 2 years ago) | Deferral or decline | Deferral or decline | Decline likely | Cardiac exclusion |
| Mild valve condition | Standard to moderate loading | Standard to moderate loading | Standard to loading | Usually available |
| Severe valve disease / replacement | Significant loading or decline | Exclusion or decline | Exclusion or decline | Cardiac exclusion |
| Congenital (repaired, no ongoing issues) | Standard to moderate loading | Standard to moderate loading | Standard to loading | Usually available |
| Complex congenital heart disease | Case-by-case, possible decline | Exclusion or decline | Exclusion or decline | Cardiac exclusion |
| Heart failure | Decline likely | Decline likely | Decline likely | Cardiac exclusion or decline |
Important: These are indicative outcomes based on general industry practice. Your actual result may be better or worse depending on your full medical history, lifestyle, and which insurer you apply with. An licensed financial adviser can help you understand what to expect for your specific situation.
What Cover Can You Typically Get?
New Zealanders with a heart condition can usually still get life insurance with a loading, which for a prior heart attack can run 50% to 200% above standard rates, health insurance with a cardiac exclusion, and funeral or guaranteed acceptance cover. Income protection without exclusions, trauma cover for cardiac events, and standard terms are much harder to obtain.
Cover that is often available
- Life insurance with a loading. Many people with heart conditions can get life insurance, though premiums may be higher. For well-controlled hypertension or cholesterol, the loading may be modest. For more serious conditions like a prior heart attack, the loading can be substantial (50% to 200% above standard rates).
- Health insurance with a cardiac exclusion. Most health insurers will offer cover that excludes claims related to your heart condition. This means you are covered for everything else (cancer treatment, surgical procedures, specialist consultations) but not for cardiac-related hospital stays or procedures.
- Funeral cover or guaranteed acceptance products. These are available regardless of health status, though they typically offer lower benefit amounts and higher premiums relative to the cover provided.
Cover that is harder to get
- Income protection without exclusions. If your heart condition could reasonably prevent you from working, insurers are cautious about providing full income protection. You may get cover with a cardiac exclusion, but unrestricted income protection is harder after a significant cardiac event.
- Trauma cover for cardiac events. This is often the most restricted. Since trauma cover pays a lump sum on diagnosis of conditions like heart attack or heart surgery, an insurer is unlikely to cover you for the very condition you already have. However, you may be able to get trauma cover that excludes cardiac conditions but covers everything else (cancer, stroke, etc.).
- Standard terms on any product. Unless your condition is very mild or fully resolved, standard terms (no loading, no exclusion) are uncommon for significant heart conditions.
How to Apply: Getting the Best Outcome
Applying with a heart condition in New Zealand requires more preparation than a standard application. Gather cardiologist reports, cardiac test results from the last 6 to 12 months, GP notes and a full medication list, demonstrate six to twelve months of documented stability, disclose every diagnosis and symptom, and work with a licensed financial adviser.
1. Gather your medical documentation
Before you start the application process, collect:
- Cardiologist reports and letters. Recent correspondence from your specialist that summarises your diagnosis, treatment, current status, and prognosis. This is the single most important document for your application.
- Test results. Echocardiograms, stress tests, angiograms, Holter monitor results, and any other cardiac investigations. Recent results (within the last 6 to 12 months) carry more weight.
- GP notes. A summary of your condition management, medication list, and any relevant blood test results (cholesterol levels, HbA1c if diabetic, kidney function).
- Medication list. A complete list of all medications you take, including dosages.
Having this documentation ready can significantly speed up the underwriting process. Without it, the insurer will request it from your doctors, which can add weeks or months to the timeline.
2. Demonstrate stability and positive management
Insurers want to see that your condition is stable and well-managed. Evidence of the following works in your favour:
- Consistent medication compliance
- Regular specialist follow-up appointments
- Stable or improving test results over time
- Lifestyle modifications (smoking cessation, regular exercise, healthy weight, reduced alcohol intake)
- No recent hospitalisations or cardiac events
If you have recently made positive changes, such as quitting smoking or losing weight, it can help to have a period of documented stability before applying. Six to twelve months of demonstrated improvement strengthens your application.
3. Disclose everything
Full disclosure is essential. Under New Zealand insurance law, you have a duty to disclose all material information to the insurer. For heart conditions, this means every diagnosis, every test, every symptom, and every medication.
Non-disclosure can void your policy entirely, even if the condition you failed to disclose is unrelated to a future claim. It is always better to disclose and receive modified terms than to risk having a claim declined years later because of incomplete disclosure.
4. Work with a licensed financial adviser
This is where the process differs most from applying on your own. An experienced adviser can:
- Assess your situation before applying. They can give you a realistic expectation of likely outcomes based on their experience with similar cases.
- Select the right insurer. Different insurers have different appetites for cardiac risk. Some are more lenient on hypertension, others may be more willing to consider post-heart-attack applications. An adviser knows which insurer to approach first.
- Pre-assess with underwriters. Many advisers can submit a pre-assessment (sometimes called an indicative assessment) to one or more insurers before lodging a formal application. This means you can find out the likely outcome without creating a formal application record.
- Present your case effectively. An adviser can package your medical information, highlight positive factors, and present your application in the most favourable light.
- Negotiate terms. If the initial offer includes heavy loadings or broad exclusions, an adviser can sometimes negotiate better terms by providing additional information or requesting a review.
At QuoteHub, we connect New Zealanders with licensed advisers who have experience handling applications with pre-existing conditions, including heart conditions. Get in touch for a free, no-obligation assessment of your cover options.
How Different Insurers Approach Heart Conditions
New Zealand insurers do not use the same cardiac underwriting guidelines, and the differences are material. Some will consider an application 12 months after a heart attack while others require 24 months or longer, one insurer might apply a 50% loading where another applies 100%, and some review loadings after three to five years while others make them permanent.
Some insurers use more conservative guidelines, applying higher loadings or broader exclusions as standard practice. Others take a more nuanced approach, weighing individual factors more heavily and potentially offering better terms for well-managed conditions.
Key differences between insurers include:
- Waiting periods after events. Some insurers will consider an application 12 months after a heart attack, while others require 24 months or longer.
- Loading levels. For the same condition profile, one insurer might apply a 50% loading where another applies 100%.
- Exclusion scope. Some insurers apply narrow exclusions (for example, "ischaemic heart disease" only), while others apply broader cardiac exclusions that cover a wider range of heart-related conditions.
- Review provisions. Some insurers will review loadings after a set period (for example, three to five years) and may reduce or remove them if your health has remained stable. Others apply permanent loadings.
- Acceptance of specific conditions. Certain insurers are known to be more accommodating for particular conditions. For example, one insurer may have more favourable guidelines for atrial fibrillation, while another may be better for post-surgical valve patients.
This is one of the strongest reasons to use an adviser rather than applying directly. An adviser who regularly handles cardiac applications will know which insurer is most likely to offer the best terms for your specific condition.
Trauma Cover and Future Heart Events
Trauma insurance pays a lump sum on diagnosis of a specified serious condition, including heart attack, coronary artery bypass surgery, heart valve surgery and aortic surgery, so a pre-existing heart condition changes what it covers. New Zealanders with risk factors but no diagnosis can usually get full cardiac cover, while those who have had a heart attack will almost certainly see future cardiac events excluded.
Trauma insurance pays a lump sum upon diagnosis of a specified serious condition, including heart attack, coronary artery bypass surgery, heart valve surgery, and aortic surgery. For someone without a pre-existing heart condition, trauma cover is a valuable protection against the financial impact of a cardiac event.
If you already have a heart condition, the situation is more nuanced:
- If you have risk factors but no diagnosed condition (for example, family history of heart disease but your own health is good), you can typically get full trauma cover including cardiac events. This is actually a strong reason to get trauma cover early, before a condition develops.
- If you have a managed condition like hypertension, trauma cover may be available with a loading but still covering cardiac events. This means if you subsequently have a heart attack, you could still claim.
- If you have had a heart attack or significant cardiac event, future cardiac events will almost certainly be excluded from trauma cover. However, you may be able to get trauma cover that covers non-cardiac conditions like cancer, stroke, or major burns.
Even partial trauma cover has significant value. A policy that excludes cardiac events but covers cancer and stroke still protects you against major financial shocks from those conditions.
Tips for Applicants with Heart Conditions
Applicants with heart conditions in New Zealand do best by applying early while terms are favourable, keeping medical records current, not assuming a decline since modified terms are more common, and allowing four to eight weeks for a decision. Avoid applying to several insurers at once without advice, because every application goes on your insurance record.
- Apply sooner rather than later. If you have risk factors like high blood pressure or high cholesterol, get cover in place now while terms are favourable. Waiting until a more serious condition develops will only make it harder and more expensive.
- Do not assume you will be declined. Many people with heart conditions never apply because they assume they will not be accepted. In practice, outright declines are less common than modified terms (loadings or exclusions). You may be surprised at what is available.
- Keep your medical records current. Regular check-ups and up-to-date test results work in your favour. An insurer is more reassured by a recent echocardiogram showing good heart function than by a report that is three years old.
- Consider a multi-product approach. If you cannot get life insurance at reasonable terms, health insurance with a cardiac exclusion might still be affordable and valuable. Covering what you can is better than covering nothing.
- Be patient with the process. Applications involving heart conditions take longer than straightforward ones. Expect four to eight weeks for a decision, sometimes longer if additional medical reports are needed. This is normal and does not indicate a negative outcome.
- Review your cover regularly. If you received heavy loadings or exclusions, it is worth reviewing your cover every few years. Your health may improve, new products may become available, and some insurers will reconsider terms after a period of stability.
- Do not apply to multiple insurers simultaneously without advice. Each application goes on your insurance record. Multiple applications (especially if they result in declines) can make future applications harder. An adviser can manage this process strategically.
Get an Assessment of Your Options
If you have a heart condition and want to know what insurance cover is available to you, the best first step is to speak with a licensed financial adviser who has experience with cardiac underwriting.
At QuoteHub, we match you with an adviser who can assess your situation, identify the best insurer for your needs, and guide you through the application process. The initial assessment is free and there is no obligation.
Check your cover options today and find out what is available for your situation.
Frequently Asked Questions
Can I get life insurance after a heart attack in New Zealand?
Yes, in many cases you can. Most insurers will consider applications from people who have had a heart attack, provided there has been a sufficient recovery period (typically 12 to 24 months or longer). You should expect premium loadings and possibly a cardiac exclusion on trauma cover. The terms will depend on the severity of the event, your recovery, current heart function, and overall health. Working with an licensed financial adviser who has experience with cardiac applications will give you the best chance of a favourable outcome.
Will high blood pressure affect my insurance premiums?
It depends on how well your blood pressure is controlled. If your readings are within acceptable ranges (whether managed through medication, lifestyle, or both) and you have no complications, many insurers will offer cover at standard terms or with only a small loading. Uncontrolled or poorly managed hypertension will result in higher loadings or possible deferral until control is established.
Do I have to tell my insurer about a heart condition?
Yes. You have a legal duty to disclose all material medical information when applying for insurance in New Zealand. This includes any diagnosed heart condition, symptoms you have experienced, medications you take, and tests you have had. Failure to disclose can result in your policy being voided or claims being declined, even if the undisclosed condition is unrelated to the claim. Always disclose fully and let the underwriter make their assessment.
What is the difference between a loading and an exclusion?
A loading means your premium is increased by a percentage to reflect the higher risk associated with your condition. You pay more, but you are fully covered. An exclusion means your premium may be standard or close to it, but claims arising from your specific condition are not covered. For example, a cardiac exclusion means the insurer will not pay for claims related to heart disease, but will cover claims for everything else (cancer, accidents, other illnesses). Sometimes both are applied together.
Can I get health insurance with a heart condition?
Yes. Most health insurers in New Zealand will offer cover to people with heart conditions, typically with a cardiac exclusion. This means your health insurance will cover non-cardiac hospital stays, surgery, specialist appointments, and treatments, but will not cover cardiac-related admissions or procedures. This is still valuable cover, as it protects you against the cost of other conditions like cancer treatment, orthopaedic surgery, or other specialist care.
Should I apply directly or through an adviser?
For straightforward applications (such as well-controlled high blood pressure with no other risk factors), applying directly may be fine. For more complex heart conditions, particularly if you have had a cardiac event, surgery, or multiple risk factors, using a licensed financial adviser is strongly recommended. An adviser can pre-assess your application, choose the most suitable insurer, and present your case in the best possible light. This can make a meaningful difference to the outcome.
Financial advice is provided by Craig Smith Business Services Limited, trading as Smiths Insurance & KiwiSaver, a licensed Financial Advice Provider (FSP712931). QuoteHub is a trading name. The information in this article is general in nature and does not constitute personalised financial advice. We recommend speaking with a licensed financial adviser to discuss your individual circumstances. Insurance availability and terms are subject to individual assessment by the insurer.
References
- Financial Markets Authority (FMA), Insurance guidance
- ACC New Zealand
- Sorted.org.nz, Insurance guides
- Insurance & Financial Services Ombudsman (IFSO)
- MoneyHub NZ, Insurance resources
- Cancer Society of New Zealand
- Heart Foundation NZ
- ACC New Zealand, What we cover
Read the full insurance guides
Compare your cover with a licensed NZ adviser · free, no obligation.
Explore related pages: Life Insurance, Income Protection, Health Insurance, Trauma Insurance, Calculators.