A life insurance policy offers the best deal to someone who is young and healthy and has no pre-existing medical conditions. However, it’s more common that you’d think for people to have some form of pre-existing medical ailment, irrespective of their age. If you are one of them and are wondering if it’s possible for you to get a life insurance cover, the short answer is yes. Let’s explore the possibility of being approved for a life insurance policy with a pre-existing medical condition.
What is a pre-existing medical condition?
According to the Insurance Regulatory and Development Authority of India (IRDAI), a pre-existing disease means ‘any condition, ailment or injury or related condition(s) for which there were signs or symptoms, and / or were diagnosed, and / or for which medical advice / treatment was received within 48 months prior to the first policy issued by the insurer and renewed continuously thereafter.’
However, not all types of medical conditions are of the same severity or carry the same risk. Hence, the decision of the insurer is based on several other factors.
Factors that are considered by the insurer
- Whether the illness is terminal
One of the important considerations for pre-existing conditions is whether it is a terminal illness or not. For example, someone with an illness such as cancer or AIDs may be denied a life insurance policy by most insurers. However, for other ailments that are not terminal, the insurer may provide a life insurance policy with a comparatively higher premium.
- How controlled the condition is
There are several nuances to medical ailments, and a condition may not impact everybody in the same way. For instance, in case of a pre-existing condition like diabetes, there will be various factors to determine how controlled or manageable the condition is. This includes whether it is type 1 or type 2 diabetes, if the person is overweight or has high cholesterol, if they take insulin, at what age were they diagnosed, etc. Depending on how controlled the condition is, it will be easier to get a life insurance policy.
- What your treatment course is
The insurer will want to know what the prognosis is, which means what is the prescribed course of treatment for the pre-existing condition. This is to ascertain if the treatment is working to either keep the condition controlled or improving it. So, the insurer may want to know the number and type of medications you take, how regularly you visit the doctor, what tests you need to get done, if any, etc.
- If there are any other risk factors
This could either mean your lifestyle habits such smoking, drinking alcohol, consuming tobacco, etc. or if they are any other associated health conditions. For instance, chronic heart disease can sometimes lead to issues with the liver.
Would I have to pay a higher premium?
Yes, you will have to pay a higher premium if you have a pre-existing medical condition. Think about it, what is life insurance? It’s a policy that guarantees a sum assured in case of the policyholder’s demise during the policy term. The element of risk is higher when the policyholder is vulnerable due to their pre-existing medical conditions.
The amount by which the premium will increase would depend on various factors, including the ones highlighted above, as well as the insurance company. You can use an online life insurance premium calculator to gain clarity. Alternatively, you can also speak directly with the insurance company to understand their policies.
Things to keep in mind
Depending on the type of life insurance policy you want to opt for – whether it includes health cover or not – and depending on your age, you may have to undergo a medical test. Either way, when you are filling out the proposal form, you will have to disclose if you have any pre-existing conditions. It’s best to be transparent here, even if you think your condition isn’t serious.
That’s because misrepresentation or non-disclosure of material information like this is one of the common reasons for rejection of claims. The whole point of getting a life insurance policy will be void in such a case. Hence, have an honest discussion with your insurer and figure out what kind of life insurance policy can work out for you.