Heart conditions and insurance underwriting

Cardiac underwriting is detailed because insurers have a great deal of claims data and a great deal of clinical information to work with. Where a heart condition has been investigated, there is usually a specialist report, an imaging result and a treatment record — and underwriters would far rather assess those than a summary written by an applicant.

The pattern across the market is that recent events are deferred and older, stable, well-documented histories are rated. An application made a few months after a significant cardiac event is very likely to be postponed to a review date rather than refused. That is a timing decision, and it is worth understanding as such rather than reading it as a rejection.

The follow-up questions are among the longest in any application.

• The exact diagnosis, the date, and the clinician who made it.
• What investigations were done and what they showed.
• What treatment or procedure was carried out, and when.
• Current medication and whether it has changed.
• Frequency of specialist review and the date of the most recent one.
• Whether you have returned to full normal activity and to work.
• Other cardiovascular factors — blood pressure, cholesterol, build, smoking, family history.

Evidence commonly requested

• A cardiologist’s report, usually the most recent one.
• Investigation results and any procedure record.
• Full GP notes rather than a summary.
• Occasionally a further cardiac test arranged and paid for by the insurer.

What tends to improve the position over time is the passage of time itself, combined with a documented return to normal activity, a settled medication regime, no further events or admissions, and a recent specialist letter confirming a stable position. Insurers also read the surrounding risk factors as part of the same assessment, so changes recorded in build or smoking status are relevant to how the file is viewed.

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

• That a deferral after a recent event is normal and usually converts to an offer later.
• Whether an exclusion is written narrowly to the diagnosis or broadly across the cardiovascular system.
• That trauma cover and life cover will be answered differently, sometimes very differently.
• That a specialist letter in the file at the outset changes the tone of the assessment.
• That any existing cover you already hold is now extremely valuable and should not be cancelled.

Every New Zealand insurer writes applications with a cardiac 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.

• Cardiac appetite is one of the most variable things in the New Zealand market and moves with reinsurance treaties.
• An adviser can pre-assess anonymously so that testing several insurers does not create a decline record.
• Assembling the cardiology report and investigation results before applying materially improves the process.
• Where trauma cover is unavailable, an adviser can look at what a life or TPD structure can achieve instead.
• An adviser can advise on when to apply — sometimes waiting for a scheduled review is worth several months.

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.