What to look for with a pre-existing condition

Most people with a health history assume they are uninsurable, and most of them are wrong. Underwriters accept a great deal — treated conditions that have been stable for years, conditions well controlled on medication, histories that were serious once and are not now. What varies is the terms, and the variation between insurers is larger than almost anyone outside the industry expects.

The reason is reinsurance. New Zealand insurers pass a share of their risk to reinsurers, and reinsurers take different views of the same condition based on their own claims experience. One will take a treated thyroid condition at standard rates; another applies a loading; a third excludes it. None of that is published, and it changes when treaties are renegotiated.

So the useful question is not which insurer is best for pre-existing conditions. It is how to find out, this year, which one will take your history on the best available terms — without doing damage to your record while you look.

1. 1Assemble the facts before anyone asks. Dates of diagnosis, treatments, medication and doses, the most recent test results, and the name of the specialist involved. A history presented clearly gets a better answer than the same history presented vaguely.
2. 2Pre-assess, do not apply. An adviser can put an anonymised summary of your history to several insurers and get indicative terms back. It is not an application, nothing is recorded against you, and no future disclosure obligation is created.
3. 3Understand what a formal application costs you if it goes badly. A decline, a loading or an exclusion is a disclosable event on every future application to any insurer, and it cannot be undone. Never apply blind to the cheapest insurer first.
4. 4Disclose everything, including things you think are irrelevant. Insurers can request your GP notes. A loading you were told about is far better than a claim your family is not paid.
5. 5Read any exclusion carefully rather than accepting the label. An exclusion described in one sentence can be worded broadly or narrowly, and the text is negotiable more often than people assume.
6. 6Ask whether an exclusion or loading can be reviewed later. Where a condition has been stable for years, some insurers will reconsider. There is no automatic right, so ask at the outset.

These are the details that decide whether the cover does what you expected. Read them before you compare on price.

• That applying to several insurers at once, hoping for a better answer, maximises the chance of collecting a decline.
• That an exclusion’s exact wording matters far more than its label — “anything related to” can be very broad.
• That a loading is often better value than an exclusion, because it leaves the cover intact.
• That existing cover should never be cancelled before replacement cover is issued and accepted.
• That a condition your health insurer excludes may still be accepted on life or trauma cover, and the reverse.
• That underwriting decisions age — an answer from three years ago may not be the answer today.

Every New Zealand insurer writes cover with a health history to its own wording, and the words are where the money is. Two policies that look identical on price can pay very differently when it matters. Closing that gap is the entire job of an adviser.

• Pre-assessment across insurers, before any application exists, is the single highest-value service available to someone with a health history.
• An adviser knows how to present a history to an underwriter — what evidence to attach and what context changes a decision.
• Where an exclusion is offered, an adviser can negotiate its wording rather than accepting the first draft.
• An adviser can structure cover across two insurers where one will take a benefit that the other will not.
• If terms are unfavourable everywhere, an adviser will say so and tell you what to do about it, including when to try again.

There are three ways to buy life cover in New Zealand, and they are not equivalent. You can buy direct from one insurer, which means you see one product range and one underwriting appetite. You can buy through your bank, which usually means a single insurer’s product sold under the bank’s brand, often with narrower definitions. Or you can go through an adviser, who quotes several insurers at once and is required to put your interests first.

The premium you pay is the same either way. Insurers build adviser commission into their pricing whether or not an adviser is involved, so going direct does not get you a discount — it just removes the person whose job is to argue your corner at application and at claim time.

• An adviser can see which insurer is currently taking your health history on standard terms, and which one will load or exclude it.
• An adviser can structure cover across two insurers if that produces a better outcome than putting everything with one.
• An adviser handles the underwriting back-and-forth, and is the person who chases the claim when a family is least able to.
• An adviser has to document why the recommendation suits you, which is a written record you can hold them to.

We are a referral service, not an insurer. We do not quote premiums and we do not sell policies. What we do is put you in front of one licensed New Zealand adviser who can compare the market properly.

1. 1

   You tell us what you are looking at

   The form takes about a minute. Nobody asks for your medical history on a web form — that conversation happens with the adviser, properly, and only once you have decided to proceed.

2. 2

   An adviser calls you

   A licensed New Zealand adviser talks through your situation: who depends on you, what you owe, what you already have in place, and what you are actually worried about.

3. 3

   They compare the market

   The adviser quotes across the major insurers, checks which of them will take your health history on the best terms, and puts the options side by side in writing.

4. 4

   You decide, in your own time

   There is no obligation and no cost to you. If the answer is that you already have enough cover, a good adviser will tell you that.