Back injuries and insurance underwriting

Ask an underwriter what a back injury means and they will ask which product you are applying for. On life cover, the answer is usually nothing at all — a spine problem is very unlikely to be a cause of death, and it barely registers in the rating. On income protection, the answer is often an exclusion, because back problems are among the most frequent causes of time away from work in the country.

That asymmetry catches people out. Applicants who have had a manageable back problem for years are frequently surprised to be offered full life cover and an income protection policy with the spine written out of it. It is not inconsistent. It is two different products answering two different questions about the same history.

The exclusion is also usually permanent. Insurers review exclusions less readily than loadings, and a spine exclusion applied on income protection tends to stay. That makes the wording, at the moment it is first offered, one of the most consequential things in the whole application.

Expect detailed questions and expect the record to be checked.

• When the injury or first episode occurred, and how.
• What treatment was given — physiotherapy, chiropractic, injections, surgery.
• Whether an ACC claim was made, and when.
• Whether there has been any recurrence, and how often.
• How much time off work was taken, and when the most recent episode was.
• Whether any imaging was done and what it recorded.
• Your occupation, which weighs heavily on income protection.

Evidence commonly requested

• A GP report covering consultations, referrals and treatment.
• Imaging or specialist reports where they exist.
• Occasionally an ACC claim history.

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

• The precise scope of any exclusion offered, including whether it extends to conditions “arising from” the injury.
• That physiotherapy and chiropractic treatment are disclosable, and appear in records.
• That an ACC claim history is a record the insurer can ask about.
• That a spine exclusion on income protection is usually permanent.
• That your occupation interacts with this history more than with almost any other.

Every New Zealand insurer writes income protection applications with a back 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.

• Insurers word spine exclusions very differently, and the difference is worth more than any premium saving.
• An adviser can obtain indicative wordings from several insurers before you commit to one.
• Where a narrow exclusion is achievable, it is usually because someone asked for it with evidence attached.
• An adviser can weigh whether a loading, where offered as an alternative, is better value than the exclusion.
• After a long clear period with no treatment, an adviser can put a review request together.

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.