Autoimmune conditions and insurance underwriting

There is no single autoimmune rating. Underwriting manuals contain separate entries for each diagnosis, and the terms available for one bear little relation to another. That makes precision on the application important — a general description will simply generate a request for the specialist letter that would have answered the question in the first place.

Across the category, what underwriters look for is the same: how active the condition has been, what treatment is in place, whether treatment has escalated, and whether work has been affected. Where a condition is stable on unchanged treatment with regular specialist review and no work absence, the terms available are considerably better than where the record shows flares, escalation or admissions.

Expect the underwriter to want clinical documentation early and to make little progress without it.

• The specific diagnosis, when it was made and by whom.
• What organs or systems are recorded as involved.
• Current medication, including any immune-modifying treatment, and any recent changes.
• How often flares occur and how severe the record shows them to be.
• Any hospital admissions, and when.
• Frequency of specialist review and the date of the most recent one.
• Whether any time off work has been required.

Evidence commonly requested

• A specialist report, which is usually the central document.
• Full GP notes.
• Recent laboratory results.

What underwriters look at over time is stability: unchanged treatment, a low rate of flares, no admissions, regular specialist review and an unbroken work record. A recent specialist letter confirming a stable position is the single most useful document in this category. A recent change of treatment commonly produces a deferral rather than an adverse decision.

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

• That the specific diagnosis, not the category, decides the outcome — be precise on the form.
• That a recent treatment change often produces a short deferral.
• Whether an exclusion offered names the condition or extends to a whole body system.
• That income protection terms may be far more restrictive than life cover terms on the same file.
• That the specialist report will usually decide the assessment, so it is worth obtaining early.

Every New Zealand insurer writes applications involving an autoimmune condition 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.

• Appetite differs by specific diagnosis and by insurer, and none of it is published.
• An adviser can pre-assess anonymously so testing the market creates no decline record.
• Getting the specialist letter into the file at the outset can halve the time an application takes.
• Where income protection is unavailable, an adviser can assemble what protection other benefits provide.

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.