Life Insurance with Pre-Existing Conditions in NZ: What You Need to Know
One of the most common questions New Zealanders ask about life insurance is whether they can get cover if they have a pre-existing medical condition. The short answer is: yes, in most cases you can. But the terms, cost, and scope of that cover will depend on the nature of your condition, how well it is managed, and which insurer you apply with.
This guide explains how the underwriting process works in New Zealand, what outcomes you can expect for common conditions, and how to give yourself the best chance of a favourable result.
What Counts as a Pre-Existing Condition?
A pre-existing condition is any medical condition, illness, injury or symptom you have experienced, been diagnosed with, or received treatment for before applying for insurance in New Zealand, including symptoms with no formal diagnosis. Insurers ask about your full medical history, so a cancer treated and resolved five years ago still counts and must be disclosed.
Common examples include:
- Chronic conditions: Diabetes (Type 1 and Type 2), asthma, high blood pressure, high cholesterol, arthritis
- Serious illnesses: Cancer (current or historical), heart disease, stroke, kidney disease
- Mental health conditions: Depression, anxiety, bipolar disorder, PTSD
- Musculoskeletal issues: Chronic back pain, disc problems, joint conditions
- Other: Sleep apnoea, epilepsy, Crohn's disease, ulcerative colitis, autoimmune conditions
Insurers are interested in your full medical history, not just current conditions. A cancer that was treated and resolved five years ago is still a pre-existing condition that must be disclosed.
How Underwriting Works in New Zealand
New Zealand life insurers assess every application through underwriting, a five-stage process covering the application form, detailed medical disclosure, GP or specialist reports, additional testing where needed, and the underwriting decision. Disclosure typically covers the last five years in detail, and larger sums insured commonly trigger more extensive medical testing.
The application process
- Application form. You complete a detailed questionnaire covering your medical history, lifestyle, occupation, hobbies, and family medical history.
- Medical disclosure. You are asked about every condition you have been treated for, every medication you take, every specialist you have seen, and any symptoms you have experienced. This typically covers the last five years in detail, with broader questions about your lifetime medical history.
- GP or specialist reports. The insurer may request reports from your GP or specialists to verify and expand on what you have disclosed. This is standard practice for more complex conditions.
- Additional testing. Depending on the sum insured and your medical profile, the insurer may request blood tests, an ECG, or other medical examinations. The larger the sum insured, the more likely the insurer is to ask for them. Each insurer sets its own thresholds, so ask your adviser what applies to the cover you are seeking.
- Underwriting decision. Based on all the information gathered, the underwriter makes a decision. This can take anywhere from a few days for straightforward applications to several weeks for complex medical histories.
Possible outcomes
The underwriter will arrive at one of the following decisions:
| Outcome | What it means |
|---|---|
| Standard terms | You are accepted at normal premium rates with no restrictions. Your condition is not considered a material risk. |
| Loading | You are accepted, but your premium is increased by a set percentage (for example, +50% or +100%) to reflect the higher risk. Loadings can be permanent or reviewed after a set period. |
| Exclusion | You are accepted at standard or loaded rates, but claims related to your specific condition are excluded. For example, cover is provided but any claim arising from your heart condition is not covered. |
| Deferral | The insurer delays their decision, typically requesting that you reapply after a set period (for example, two years after completing cancer treatment). |
| Decline | The insurer determines that the risk is too high and does not offer cover. This does not necessarily mean you cannot get cover elsewhere, as different insurers have different risk appetites. |
It is important to understand that a decline from one insurer does not mean all insurers will decline you. Underwriting guidelines vary between companies, and a licensed financial adviser can help identify which insurer is most likely to offer favourable terms for your specific situation.
Condition-by-Condition Guide
New Zealand insurers assess each pre-existing condition on its own terms: well-controlled Type 2 diabetes is often accepted with a loading of 25% to 100%, Type 1 diabetes with 75% to 150% or more, most cancers require two to five years of remission before cover is considered, and controlled high blood pressure often attracts only a 15% to 50% loading.
Diabetes
Diabetes is one of the most common pre-existing conditions New Zealanders face when applying for life insurance. The outcome depends heavily on the type of diabetes and how well it is controlled.
Type 2 diabetes (well-controlled):
- Often accepted with a premium loading of 25% to 100%
- Insurers want to see stable HbA1c levels (ideally under 7%), regular monitoring, and no complications
- If you manage your condition through diet, exercise, and/or oral medication, your chances are better than if you require insulin
Type 1 diabetes:
- More challenging, but cover is still possible
- Expect higher loadings (75% to 150% or more)
- Insurers focus on HbA1c control, frequency of hypoglycaemic episodes, and whether complications have developed (eye, kidney, nerve damage)
Type 2 diabetes (poorly controlled or with complications):
- May result in deferral or decline
- Complications such as retinopathy, nephropathy, or neuropathy significantly increase the risk assessment
Cancer history
Whether you can get life insurance after cancer depends on the type of cancer, the stage at diagnosis, the treatment received, and how long you have been in remission.
General guidelines:
- Most insurers require a minimum period of remission before they will consider cover. This is typically two to five years after completing treatment, depending on the cancer type and stage.
- Early-stage cancers (such as Stage 1 melanoma or localised prostate cancer) may be considered sooner.
- Late-stage or aggressive cancers may require five or more years of remission, and some may result in permanent decline.
Likely outcomes by cancer type:
| Cancer type | Typical minimum remission period | Likely outcome |
|---|---|---|
| Basal cell carcinoma (skin) | Often immediate or short | Standard terms or small loading |
| Early-stage melanoma | 2 to 3 years | Loading or exclusion |
| Breast cancer (Stage 1) | 2 to 5 years | Loading, possibly with cancer exclusion |
| Breast cancer (Stage 2 to 3) | 5+ years | Higher loading or exclusion |
| Prostate cancer (early, localised) | 2 to 3 years | Loading or exclusion |
| Bowel cancer (early stage) | 3 to 5 years | Loading or exclusion |
| Leukaemia / lymphoma | 5+ years | Case by case, higher loading or decline |
| Lung cancer | 5+ years | Decline or very high loading |
These are general guides. Every case is assessed individually based on pathology reports, treatment details, and follow-up results.
Heart disease
Heart disease covers a broad range of conditions, from high blood pressure and high cholesterol through to heart attacks, angina, and heart failure. The underwriting outcome depends on the severity and how well the condition is managed.
High blood pressure (hypertension):
- If controlled with medication and no organ damage, often accepted at standard terms or with a small loading (15% to 50%)
- Uncontrolled hypertension or hypertension with complications (stroke, kidney damage) may result in higher loadings or exclusion
High cholesterol:
- Generally well-regarded if managed with statins and lifestyle measures
- Unlikely to result in decline on its own
Heart attack (myocardial infarction):
- Typically requires a minimum recovery period of 6 to 12 months
- Expect significant loadings (50% to 150%) and possible cardiac exclusions
- Single uncomplicated events with good recovery and ongoing management have better outcomes
Angina, arrhythmia, heart failure:
- More complex conditions with variable outcomes
- Stable, well-managed cases may receive cover with exclusions and loadings
- Severe or unstable cases may be declined
Mental health conditions
Mental health is an area where NZ insurers have evolved significantly. Having a history of depression or anxiety does not automatically prevent you from getting life insurance. However, the underwriting approach is detailed and condition-specific.
Depression and anxiety (mild to moderate):
- If you have had one or two episodes that were treated successfully and you are stable (no current medication or on stable long-term medication), most insurers will offer cover
- Expect standard terms or a small loading
- Some insurers may apply a mental health exclusion to trauma or income protection cover, even if life cover is offered at standard terms
Severe or recurrent depression:
- Multiple hospitalisations, suicide attempts, or ongoing treatment with multiple medications may result in deferral, exclusion, or decline
- The more recent and severe the episodes, the more cautious the underwriter
Bipolar disorder:
- Cover is possible but challenging
- Expect significant loadings or exclusions, particularly for trauma and income protection
- Stability over several years with consistent treatment improves outcomes
PTSD and other conditions:
- Assessed case by case
- Duration, trigger, treatment, and current stability are the key factors
Which Conditions Affect Eligibility Most?
Pre-existing conditions carry different weight in New Zealand underwriting, ranging from low impact conditions such as controlled high cholesterol, mild asthma and treated basal cell skin cancers, through moderate impact conditions like controlled Type 2 diabetes and resolved mild depression, to very high impact histories including recent cancer treatment, severe heart disease and organ transplant.
| Impact level | Conditions |
|---|---|
| Low impact | Controlled high cholesterol, mild asthma, treated skin cancers (basal cell), resolved minor injuries, hay fever |
| Moderate impact | Controlled Type 2 diabetes, treated high blood pressure, mild to moderate depression/anxiety (resolved), early-stage cancers in remission (2+ years), sleep apnoea |
| High impact | Type 1 diabetes, heart attack history, recurrent or severe depression, mid-stage cancers in remission, Crohn's disease, epilepsy |
| Very high impact | Recent cancer treatment, severe heart disease, multiple mental health hospitalisations, organ transplant history, HIV/AIDS, motor neurone disease |
The key principle is that well-managed, stable conditions fare far better than poorly controlled or recently treated ones. Insurers reward evidence of ongoing management and medical compliance.
Loadings, Exclusions, and Declines Explained
A loading is an extra percentage charged on top of the standard premium and can be permanent, temporary for a set period such as five years, or reducing over time. An exclusion instead removes claims arising from a specific condition, and a decline means no cover is offered, though other New Zealand insurers may still accept you.
Loadings
A loading is an extra charge on top of the standard premium. It is expressed as a percentage of that standard premium, so a +75% loading means you pay 75% more than someone with an identical profile and no loading. The condition-by-condition ranges set out above show how much that percentage can vary.
Loadings can be:
- Permanent: Applied for the life of the policy
- Temporary: Applied for a set period (for example, five years), after which the insurer reviews your condition and may remove the loading if your health has remained stable
- Reducing: Some insurers reduce the loading over time as you demonstrate ongoing good health
Exclusions
An exclusion removes a specific condition (or conditions related to it) from your cover. You are insured for everything else, but if you make a claim that arises from the excluded condition, it will not be paid.
For example, if you have a history of back problems and your policy has a spinal exclusion, a claim for back surgery would not be covered. However, a claim for cancer or a heart attack would still be paid.
Exclusions are common for:
- Musculoskeletal conditions (back, knees, hips)
- Mental health (particularly on income protection and trauma policies)
- Specific organs or body systems related to prior treatment
Declines
A decline means the insurer will not offer you any cover. If you are declined:
- It does not mean you are uninsurable. Different insurers have different guidelines.
- A licensed financial adviser can approach other insurers on your behalf, presenting your case in the most favourable light.
- Group life insurance (through an employer) may be an alternative, as these schemes often provide automatic cover without individual underwriting.
- You can reapply in the future if your condition improves or more time passes since treatment.
Your Disclosure Obligations
Full and honest disclosure is the single most important step when applying for life insurance in New Zealand with a pre-existing condition. Under New Zealand insurance law you must disclose all information a reasonable person would consider relevant to the insurer's decision, covering every diagnosis, symptom, medication, specialist visit, hospital admission and mental health treatment.
What you must disclose
You must disclose everything the insurer asks about. This includes:
- All conditions you have been diagnosed with
- All symptoms you have experienced, even if you did not receive a formal diagnosis
- All medications you take or have taken
- All specialists, hospital visits, and medical tests
- Any mental health treatment, counselling, or therapy
- Family history of serious illness (if asked)
The duty of disclosure
Under New Zealand insurance law, you have a duty to disclose all information that a reasonable person would consider relevant to the insurer's decision. This applies at the time of application and at any subsequent policy variation.
Insurers ask specific questions, and your obligation is to answer them honestly and completely. If you are unsure whether something is relevant, disclose it. Let the underwriter decide whether it matters.
What Happens If You Do Not Disclose?
Non-disclosure is one of the most common reasons life insurance claims are denied in New Zealand, and an insurer that discovers an undisclosed pre-existing condition at claim time can take one of three actions: voiding the policy and refunding premiums, reducing the claim payment, or applying retrospective exclusions or loadings.
- Void the policy entirely. The insurer treats the policy as though it never existed and refunds your premiums. No claim is paid.
- Reduce the claim. The insurer pays a reduced amount based on what they would have offered had they known about the condition.
- Apply retrospective exclusions or loadings. The insurer adjusts the policy to reflect what they would have offered with full disclosure.
The consequences of non-disclosure can be devastating for your family at the exact moment they need financial support. There is no scenario in which hiding a condition works in your favour. If the condition was going to result in a decline, at least you know upfront and can explore alternatives. If it results in a loading or exclusion, you still have meaningful cover for everything else.
Innocent non-disclosure
If you genuinely did not know about a condition at the time of application (for example, an undiagnosed cancer), this is generally treated differently. Insurers must act fairly, and the Financial Markets Authority (FMA) oversees this. However, if you had symptoms you did not mention or test results you overlooked, the insurer may still dispute the claim.
Insurer Approaches in New Zealand
New Zealand insurers take meaningfully different approaches to pre-existing conditions, with AIA, Partners Life, Fidelity Life, Chubb Life, Southern Cross and Asteron Life each applying their own guidelines. Partners Life often offers terms where others decline, while Chubb Life's simplified underwriting guide, updated in May 2025, raised non-medical limits and reduced mandatory tests.
| Insurer | General approach to pre-existing conditions |
|---|---|
| AIA | Flexible underwriting with a wide range of loading and exclusion options. AIA Vitality programme rewards healthy behaviour, which can help with ongoing premiums. Strong for complex cases. |
| Partners Life | Known for competitive underwriting. Often willing to offer terms where other insurers may decline. Good option for applicants with moderate-risk conditions. |
| Fidelity Life | Flexible approach, particularly for income protection. Offers multiple product structures that can accommodate different risk profiles. |
| Chubb Life | Simplified underwriting guide (updated May 2025) with higher non-medical limits and fewer mandatory tests. Good for streamlined applications. Trauma cover for homemakers up to $1M. |
| Southern Cross | Primarily health insurance, but group life schemes can provide cover without individual underwriting. Useful alternative if individual cover is declined. |
| Asteron Life | Comprehensive underwriting with competitive terms for well-managed conditions. |
A licensed financial adviser will know which insurers are currently most receptive to specific conditions and can target your application accordingly. This is one of the most valuable things an adviser does: matching your medical profile to the right insurer.
Tips for Applying with a Pre-Existing Condition
Applicants with a pre-existing condition get the best outcome in New Zealand by working with a licensed financial adviser, obtaining and checking their GP records for errors, demonstrating good management through regular check-ups and stable test results, applying during a period of stability, disclosing everything, and considering group cover through an employer as a fallback.
1. Work with a licensed financial adviser
This is the single most important step. An adviser who specialises in risk insurance will:
- Know which insurers are most favourable for your condition
- Help you present your medical history in a complete but well-organised way
- Manage the application process and liaise with underwriters on your behalf
- Negotiate on terms if the initial offer includes heavy loadings or broad exclusions
2. Get your medical records in order
Before applying, visit your GP and request a copy of your medical records. Review them for accuracy. If there are errors (for example, a condition that was investigated and ruled out but still appears as a diagnosis), have your GP correct them. Clean, accurate records speed up the underwriting process and reduce the chance of misunderstandings.
3. Demonstrate good management
If you have a chronic condition, show the insurer that you are managing it responsibly:
- Regular GP or specialist check-ups
- Medication compliance
- Stable test results (HbA1c for diabetes, blood pressure readings, cholesterol levels)
- Lifestyle measures (exercise, diet, not smoking)
4. Apply while stable
Timing matters. Apply when your condition is well-controlled and you have a period of stability behind you. Applying immediately after a hospitalisation, medication change, or flare-up is likely to result in a worse outcome.
5. Disclose everything, but present it well
Full disclosure is non-negotiable, but how you present information matters. An adviser can help frame your medical history in a way that highlights stability and management rather than focusing solely on the condition itself.
6. Consider multiple applications
Your adviser can approach several insurers simultaneously (or sequentially) to find the best terms. This is standard practice and does not negatively affect your chances. Different underwriters genuinely reach different conclusions on the same medical history.
7. Look at group cover as an alternative
If individual cover is unavailable or prohibitively expensive, employer group life schemes often provide automatic cover without individual medical underwriting. The cover amounts may be lower, but it provides a baseline of protection.
Frequently Asked Questions
Can I get life insurance if I have diabetes in New Zealand?
Yes. Well-controlled Type 2 diabetes is regularly accepted with a premium loading. Type 1 diabetes is more complex but cover is still available in many cases. Insurers focus on your HbA1c levels, whether you have any complications, and how consistently you manage the condition.
Will a history of depression prevent me from getting life insurance?
Not necessarily. A single episode of mild to moderate depression that has been treated and resolved is unlikely to prevent you from getting life cover. More severe or recurrent mental health conditions may result in loadings or exclusions, particularly on income protection and trauma cover. Each case is assessed individually.
How long after cancer treatment can I apply for life insurance?
This varies by cancer type and stage. For early-stage, low-risk cancers, some insurers will consider applications two to three years after treatment. For more serious cancers, five or more years of remission is typically required. Your oncologist's reports and follow-up results will be central to the assessment.
What if I have been declined by one insurer?
A decline from one insurer does not mean you cannot get cover. Different insurers have different underwriting guidelines and risk appetites. A licensed financial adviser can identify which insurer is most likely to accept your application and present your case accordingly.
Do I have to tell the insurer about a condition from many years ago?
Yes. If the insurer's application form asks about your medical history (and all of them do), you must disclose all conditions you have been diagnosed with or treated for, regardless of how long ago they occurred. Failure to disclose, even for old conditions, can result in a claim being denied.
Can I get income protection or trauma cover with a pre-existing condition?
Yes, but the underwriting for these products is often stricter than for life cover. Income protection and trauma insurance pay out for a wider range of events, so insurers are more cautious. Expect more exclusions and loadings on these products compared to basic life cover.
Will genetic test results affect my life insurance application?
New Zealand legislation passed in 2025 has given the government power to regulate how insurers use genetic testing results in underwriting. The intent is to prevent discrimination based on genetic predisposition. As of 2026, insurers are moving toward more inclusive practices in this area, but the full regulatory framework is still developing. Currently, you are not required to undergo genetic testing for insurance purposes, and how existing results are used is increasingly restricted.
References
- Financial Markets Authority (FMA), Insurance guidance
- Sorted.org.nz, Life insurance guide
- Insurance Council of New Zealand (ICNZ)
- Insurance & Financial Services Ombudsman (IFSO)
- MoneyHub NZ, Life insurance
- Diabetes New Zealand
- Cancer Society of New Zealand
- Heart Foundation NZ
- Partners Life. "Life Insurance and Pre-Existing Conditions." Accessed March 2026.
- AIA New Zealand. "Applying for Life Insurance with a Medical History." Accessed March 2026.
- Fidelity Life. "Underwriting Guidelines for Advisers." Accessed March 2026.
- Chubb Life NZ. "Essential Underwriting Guide, May 2025." Accessed March 2026.
- Financial Markets Authority (FMA). "Fair Insurance Code and Disclosure Requirements." Accessed March 2026.
- Southern Cross Health Society. "Pre-Existing Conditions and Health Insurance." Accessed March 2026.
- Sorted.org.nz. "Life Insurance Basics." Accessed March 2026.
- Health and Disability Commissioner. "Your Rights When Applying for Insurance." Accessed March 2026.
Disclaimer: This article is for informational purposes only and does not constitute financial advice. QuoteHub connects New Zealanders with licensed financial advisers. Our Financial Services Provider (FSP) number is 712931. Always seek personalised advice from a licensed financial adviser before making insurance decisions.
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