Health and underwriting
Medical exams and tests in underwriting
Most applications never involve a needle. Whether yours does is decided by a grid of age and sum insured, plus whatever your answers happen to trigger — not by how healthy you look.
Last reviewed 4 September 2026 · Written and checked by the Best Life Insurance editorial team · How we get paid
In short
- Medical evidence requirements are set by an age and sum-insured grid that every insurer publishes internally.
- Below the thresholds, your answers plus possibly a GP report are the whole assessment.
- The common tests are a nurse visit with height, weight, blood pressure and bloods, sometimes a urine sample.
- The insurer arranges and pays for anything it requires. You do not pay for underwriting evidence.
- Results occasionally uncover something you did not know about. What happens next is governed by the insurer’s process, and you are entitled to your results.
- Nicotine and cotinine testing is routine, and a non-smoker declaration that fails a cotinine test is treated as non-disclosure.
What this is, plainly
Insurers buy medical evidence in proportion to the risk. A 28-year-old applying for $300,000 of life cover with a clean history is cheap to insure and cheap to be wrong about, so the insurer accepts the application on your answers alone. A 55-year-old applying for $2 million is a different proposition, and the insurer will pay for a nurse, a blood panel and possibly a report from a specialist before it commits.
The trigger is mechanical. Each insurer runs a table of age bands against sum-insured bands, and where you land in that table decides what evidence is ordered. It is not a judgement about you, and asking for slightly less cover can sometimes drop you under a threshold — which is a legitimate thing to discuss with an adviser if you want to avoid a full medical, though it is rarely worth buying less cover than you need to avoid a blood test.
Separately, your answers can trigger evidence on their own. Disclose a blood pressure medication and the insurer will want recent readings. Disclose a family history of bowel cancer and it may want to know when you last had a screening colonoscopy. This kind of targeted evidence is far more common than a full medical.
What is usually required, and when
| Evidence | What it involves | Typically triggered by |
|---|---|---|
| No evidence | Your answers only | Younger applicants, modest sums insured, clean history |
| GP report (PMAR) | The insurer writes to your doctor for a summary or full notes | A disclosed condition, or older applicants |
| Nurse visit | Height, weight, blood pressure, sometimes a blood sample, at home or at work | Crossing an age and sum-insured threshold |
| Blood and urine panel | Lipids, glucose or HbA1c, liver and kidney markers, cotinine, sometimes HIV | Larger sums insured, or a disclosed condition |
| Full medical | An examination by a doctor | Very large sums insured, or an unusual history |
| Specialist report | A letter from the consultant already treating you | A significant or recent condition under specialist care |
Indicative only. Every insurer sets its own grid and its own triggers, and these change.
The nurse visit
This is the most common in-person requirement. A contracted nurse comes to your home or workplace at a time you choose, takes about twenty to thirty minutes, and measures height, weight, waist and blood pressure. If bloods are required they are taken at the same visit. You may be asked to fast beforehand, which the booking will tell you. The nurse does not make any assessment; they collect and send.
What the bloods usually cover
A standard underwriting panel looks at cholesterol and lipids, blood sugar or HbA1c, liver and kidney function, and a cotinine test that detects nicotine. Larger cases may add HIV and hepatitis screening. You consent to each of these, and the insurer must tell you what it is testing for.
Not sure what cover you actually need?
That is the question an adviser is there to answer. Tell us your situation and a licensed New Zealand adviser will compare the market and come back with a written recommendation — including where you can cut cover you do not need.
No cost to you and no obligation. General information only — not personalised financial advice.
What to watch for
These are the details that decide whether the cover does what you expected. Read them before you compare on price.
- Whether the insurer pays for the evidence it requires. It should — you are never asked to fund underwriting tests.
- Whether the requirement is a nurse visit or a full doctor’s medical, because the wait for the latter is longer.
- That a cotinine test will detect vaping and nicotine pouches, not only cigarettes.
- That fasting instructions matter — an unfasted glucose result can trigger a repeat test and weeks of delay.
- Your right to receive a copy of your own results, and to have anything unexpected explained by your GP rather than an underwriter.
Where an adviser makes a difference
Every New Zealand insurer writes medical underwriting 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.
- Evidence grids differ. The same sum insured can require a nurse visit at one insurer and nothing at another.
- An adviser knows which insurers currently require the least intrusive evidence for your age and cover amount.
- Where a full medical is unavoidable, an adviser sequences it so it is done once and the report is used with the right insurer.
- If a result comes back borderline, an adviser can arrange a repeat or a specialist letter before the underwriter forms a view.
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.
What happens if you get in touch
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
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
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
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
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.
Frequently asked questions
Do I have to have a medical to get life insurance in New Zealand?
Usually not. Most applications are assessed on your answers, sometimes with a report from your GP. In-person evidence is triggered by crossing an age and sum-insured threshold or by something you disclosed, not by default. Larger amounts of cover at older ages are the cases most likely to require a nurse visit or a full medical.
Who pays for insurance medical tests?
The insurer. If it requires a nurse visit, bloods, a GP report or a specialist report as part of assessing your application, it arranges and pays for it. You should never be invoiced for underwriting evidence, though you may need to take time off work for an appointment.
What do insurance blood tests check for?
A typical underwriting panel covers cholesterol and lipids, blood glucose or HbA1c, liver and kidney function, and cotinine to verify nicotine status. Larger cases may add HIV and hepatitis testing. You consent to the specific tests, and you can ask for the list before agreeing.
Can I get life insurance without any health questions at all?
There are products sold on that basis, mainly funeral and accidental death cover. What you give up is significant: waiting periods before natural-cause death is covered, small maximum sums insured, and a much higher price per dollar of cover. For most people a fully underwritten policy is far better value, even with a loading.
What happens if I fail a cotinine test after declaring I am a non-smoker?
The application is reassessed at smoker rates, and the insurer will treat the original declaration as a disclosure issue. Because smoker premiums are dramatically higher, the temptation is real and the consequence is severe — a policy issued on a false non-smoker declaration is vulnerable at claim time. Declare accurately and apply for the non-smoker rate later once you meet the insurer’s definition.
How long is a medical report valid for?
Insurers generally treat evidence as current for a limited window, often around six months, after which it may need repeating. If your application stalls for months while other information is gathered, ask whether the tests already done will still be accepted or will have to be redone.