LIFE COVER WITH A HEALTH CONDITION
Life Insurance When You Have a Health Condition
Get a clear view of your options for life cover, what your existing cover provides and what an application would involve. We help you review the policies you already hold and prepare any new application carefully and accurately.
Our Financial Advice Team Is Here to Help You
We Can Help You
- Work out the cover that suits your situation, and what an application would ask
- Apply for life cover with your health history set out accurately and in full
- Explain what a premium loading or an exclusion actually means
- Read the exclusion wording so you know what a policy still covers
- Look at increasing the cover inside your fund, and what that involves
- Establish what your existing life cover would pay today
- Confirm whether default cover in your fund still stands
- Consider suitable cover for a partner as part of the household’s protection plan
- Review a policy before anything is cancelled or replaced
- Lodge a claim on cover you already hold, and stay with it
Who We Help
- People living with cancer and wanting to see exactly what a current policy would pay
- Adults with an autoimmune condition looking at protection for the years ahead
- Households managing diabetes and wanting cover priced on the current facts
- Anyone with a heart condition weighing up whether to apply again
- People managing asthma and wondering how much it affects an application
- Anyone managing depression or anxiety wanting to know what an exclusion would mean
- Partners and carers looking at protection for the whole household
- Super fund members with insurance attached they would like explained
- People whose application was declined and wanting to know what happens from here
What we advise on
Getting the Right Cover, Step by Step
What a Health Condition Means for Cover
We can explain how an insurer looks at a health history, and what the possible answers are.
Underwriting is how an insurer assesses an application and decides whether to offer cover, on what terms and at what price. Possible outcomes include standard terms, a higher premium, an exclusion, a request to apply again later, or a decline.
Here is what the process actually involves:
- The possible outcomes of an application, from standard terms through to a decline
- A premium loading, which is a percentage added to the standard premium for higher assessed risk
- An exclusion, which limits cover for specified conditions, events or related claims according to its wording
- A deferral, where an insurer asks to look at the file again after a stated period
- The duty to take reasonable care not to make a misrepresentation when answering questions
- Evidence an insurer asks for, from questionnaires to a report from your treating doctor
- The terms and status of cover already in force, including any health assessment when it began
- Whether default cover inside super is available without medical checks, and the eligibility rules and conditions attached
Conditions People Ask Us About
We can tell you what an insurer is likely to ask about the condition you are living with.
Insurers assess health conditions differently, and their approach can change over time. The details matter: the diagnosis, treatment, time since treatment and your current health. Two people with the same condition can be offered quite different terms.
The conditions we are asked about most often:
- Cancer, where the type, the stage at diagnosis and the time since treatment are assessed
- Autoimmune conditions such as lupus, coeliac disease, multiple sclerosis and Crohn’s disease
- Diabetes, where an insurer looks at the type, the control and any complications
- Heart conditions and high blood pressure, where readings, treatment and stability all count
- Asthma, where severity, medication and any hospital admissions are what an insurer asks about
- Mental health conditions, where an exclusion is one possible outcome and worth understanding
- A condition being investigated but not yet diagnosed, and what the timing means
- Conditions in remission, and the evidence an insurer looks for before offering terms
Applying With a Health History
We’ll prepare the application with you, so your history is set out accurately and in full.
When answering a consumer insurance application, you have a duty to take reasonable care not to make a misrepresentation. We help you understand the questions and provide accurate information. This matters for the insurer’s assessment and any later claim, although it doesn’t guarantee a claim will be accepted.
The work we do together on an application:
- The duty to take reasonable care not to make a misrepresentation, in force since October 2021
- Questions answered against your records rather than from memory, with dates and treatment
- Reports an insurer asks your treating doctor for, and what a report usually contains
- A personal statement covering symptoms, tests and treatment, written while detail is to hand
- The ban on requesting or using adverse genetic test results in life insurance underwriting from 8 October 2026, including the rules for results volunteered with consent
- The difference between a clinical diagnosis, which stays relevant, and a genetic test result
- Timing an application around treatment, where an insurer would rather look again later
- What happens to an application if your health changes between lodging and a decision
Loadings, Exclusions and Deferrals
We can explain exactly what an offer with a loading or an exclusion would mean for you.
An offer isn’t always a plain yes or no. A loading increases the premium, an exclusion limits cover according to its wording, and a deferral means the insurer may consider the application again later. Whether terms can be reviewed depends on the policy and insurer, so it’s worth checking at the start.
The decisions we work through together:
- A loading expressed as a percentage of the standard premium, and the cost of it over time
- The scope of an exclusion, including related conditions or events it may also affect
- A deferral, and what an insurer would want to see before looking at the file again
- Whether the contract allows terms to be reviewed on fresh medical evidence later
- The cover still worth holding when the terms offered are not the terms you wanted
- Partial cover accepted now, against waiting for terms that may never improve
- Whether a later application has to disclose a previous decline, and how to answer
- Whether the amount of cover and premium are affordable, with a plan to review them over time
Life Cover Inside Your Super
We can check what the insurance in your fund provides, and what conditions came attached to it.
Your super fund may provide life and TPD cover without medical checks, subject to eligibility and policy conditions. We check whether cover is active, any limited cover or pre-existing condition terms, and what could cause it to end. Inactivity, an account closure, insufficient funds or policy age limits may affect cover.
We’ll go through your fund with you and set out:
- Eligibility for default life and TPD cover, including age and balance requirements
- Whether cover is available without medical checks, and any conditions that limit it
- Pre-existing condition and limited cover terms, set out in the product disclosure statement
- The 16-month inactivity rule and whether you’ve elected to keep insurance on an inactive account
- What a rollover, account closure or insufficient balance could mean for existing cover
- Whether an increase requires medical assessment or qualifies under a specific policy option
- Whether a second fund is worth keeping open purely for the insurance attached to it
- Trauma cover, which has not been available inside super for policies written since 2014
The Cover You Already Hold
We’ll review the benefits and conditions of your existing policies before recommending a change.
Cover taken out before a diagnosis may have terms that are valuable to keep. A replacement may require a fresh health assessment and could offer different terms. Before recommending cancellation, we compare the existing and proposed cover and confirm any replacement, including its conditions and start date, in writing.
Together, we’ll go through:
- Every policy in force, listed with its sum insured, benefits and relevant conditions
- Existing terms agreed before a diagnosis that may be difficult to obtain in a new application
- Any replacement confirmed in writing, with its start date and conditions checked before existing cover is cancelled
- Premiums still being paid, and whether a policy has quietly lapsed for non-payment
- A lapsed policy, and whether reinstatement is available or a new application is needed
- Cover attached to an employer, which commonly ends when the job ends
- The terminal illness benefit sitting inside a life policy already in your name
- Whether existing cover can be increased without a fresh health assessment
Cover for Your Partner and Family
We can look at cover for the whole household, not only for the person who was diagnosed.
We can review the protection needs of each partner and the household as a whole. Cover for a partner may help protect the household if something happens to that partner; it doesn’t replace cover for the person with a health condition. Children, caring responsibilities and policy ownership also shape the plan.
What we look at across the household:
- Whether suitable cover is available for a partner and what needs it would address
- The income your household relies on now, which may not be the income it relied on before
- Ownership of each policy, and who would receive a benefit at the time it is paid
- Beneficiary nominations and policy ownership considered alongside your will, with your solicitor’s input
- Protection for a partner who has stopped paid work to provide care
- Children in the household, and what a benefit would need to fund for them
- Existing cover in both names, reviewed together rather than one policy at a time
- Early access to super, decided by the fund or the ATO, and what it can be used for
The Terminal Illness Benefit
We’ll explain how a terminal illness benefit is claimed, and what the certificates have to say.
A life policy may allow an early payment if its terminal illness definition is met, and the insurer’s requirements are set by the policy. For cover inside super, releasing the money also involves separate super rules: two registered medical practitioners must certify an illness or injury likely to result in death within 24 months, at least one a relevant specialist, with both certificates within their certification periods.
What we establish with you:
- Wording in your own contract, which can differ from a policy issued years earlier
- The medical certification required by your policy and, separately, by super release rules
- The 24 month period in the super rules, and what happens once that period ends
- Cover outside super, where the insurer assesses the claim under the policy terms
- A benefit paid from super, released as a lump sum once the fund is satisfied
- The tax treatment of a lump sum released on a terminal medical condition
- What remains payable to your beneficiaries after an early payment is made
- Documents the fund and the insurer each need, and the order to send them in
Claiming on Cover You Hold
We’ll lodge the claim with you and stay with it, from the first form to the decision.
We understand that making a claim can come during a difficult time. Eligibility depends on the policy’s definitions, exclusions and other conditions. We help you understand those requirements and gather the evidence, while the insurer assesses the claim.
Together, we’ll work through:
- The TPD definition your policy uses, which may depend on your occupation and work status
- Whether trauma cover includes the diagnosed condition and its required severity, survival period or other conditions
- The income protection definition, waiting period and other requirements for benefits to begin
- Medical evidence the insurer requires, and who is responsible for providing each part
- Claims across more than one policy, where a single event can trigger several
- How a benefit is taxed once paid, which differs by cover and by where it is held
- The fund trustee and the insurer as two separate decisions on cover held inside super
- What happens if a claim is declined, and where that decision can be reviewed
Your Life Cover, Worked Through Together
An Application Prepared Properly
Help to answer the insurer’s questions carefully and accurately.
Terms You Understand Before Signing
A loading or an exclusion explained in full, so the offer is a real choice.
A Realistic Path to Cover
What is open to you now, and what an application would need to set out.
The Cover Inside Your Fund Confirmed
Default insurance identified in writing, along with any conditions attached to it.
A Clear Picture of What You Hold
Existing policies and fund cover reviewed, with what each provides and its conditions explained.
Protection Across the Household
Each partner’s needs considered as part of the household’s protection plan.
Keeping Cover Affordable
Options considered to help maintain suitable cover as costs and circumstances change.
Support Through a Claim
The claim lodged with you, and somebody alongside you until a decision arrives.
Proactive, Holistic, and Experienced Financial Planning
A diagnosis changes a lot of things. Protecting the people who depend on you can still be part of the plan. Depending on your circumstances, cover may be available on standard terms or with an adjustment, and understanding your options is a useful first step. We can explain what an application would involve before anything is formally submitted. There’s no cost for the initial conversation, and you decide whether to go further.
The people you’re doing this for are the reason it’s worth asking. Somebody who wouldn’t be left to manage alone, children whose lives can stay steady, a household that keeps its options. We’ll go at whatever pace suits you, we’ll carry as much of the paperwork as we can, and we’ll keep you informed about where things stand. There’s no rush from our end, and nothing is decided before you’re ready.
Every financial decision impacts the next
Your Financial Life Is Connected
Great advice starts with understanding the bigger picture. Every stage of life presents new opportunities and challenges, from buying property and changing careers to growing your family, planning for retirement and protecting what matters most. At Ryker, we help connect every piece of your financial world into one clear strategy.
Your
Wealth
- Property & Investing
- Career & Income
- Tax Strategy
- Insurance & Protecting Your Family
- Super & SMSF
- Wealth & Investments
- Life Events & Changes
- Business & Wealth
- Legacy & Future Wealth
- Retirement Planning
Frequently Asked Questions
We’re invested in your long-term success. What we do is personal, and we take it personally.
Your financial decisions connect, so we consider the parts of your financial life that are relevant to the advice you need:
- Property & Investing
- Career & Income
- Tax Strategy
- Insurance & Protecting Your Family
- Super & SMSF
- Wealth & Investments
- Life Events & Changes
- Business & Wealth
- Legacy & Future Wealth
- Retirement Planning
This is how we help you make decisions today with your longer-term goals in view.
Everybody’s situation is different, so we listen first, understand what matters to you and explain your options clearly before we make a recommendation.
A health condition doesn’t necessarily rule out life cover. Whether cover is available, and on what terms, depends on your circumstances and the insurer’s assessment.
Possible outcomes include standard terms, a higher premium, an exclusion, a request to apply again later, or a decline. The insurer considers details such as the diagnosis, treatment and your current health. We can explain likely questions and possible outcomes before you apply, but the insurer makes the final decision.
We start by reviewing cover you already hold, including inside super. We check whether it’s active and what its terms provide before considering a new application.
It depends on the type and stage of cancer, treatment, current health and the time since treatment.
An insurer may consider an application, ask to assess it again later or decline cover, and its approach can change over time.
While treatment is recent, the more useful work is usually the cover already in your name: what a life policy would pay, whether a trauma or TPD claim is available now, and what the terminal illness benefit does. That conversation can happen whenever you’re ready for it, and there’s no rush from our end.
These conditions don’t necessarily rule out cover. Availability and terms depend on the condition, your circumstances and the insurer.
For an autoimmune condition such as lupus, coeliac disease or multiple sclerosis, an insurer looks at the diagnosis, the treatment and how settled things have been. For diabetes, the type, the control and any complications matter most. For asthma, severity and any hospital admissions usually count for more than the diagnosis on its own.
If cover is offered, it may be on standard terms, with a higher premium or with an exclusion. We help you prepare for the information an insurer may request and understand any offer.
A mental health history doesn’t automatically rule out cover.
An insurer may ask about the diagnosis, treatment, current symptoms and any effect on work. Some offers include an exclusion, particularly for income protection or TPD. Its wording matters because it may affect a wider range of related claims than the diagnosis alone.
You can talk through your concerns with us first. We’ll explain what information an application may require and what any exclusion would mean, so you can make an informed choice.
It can be, because many funds provide default cover without individual health checks, subject to eligibility and the fund’s conditions. It’s often the first place we look.
Default cover may carry pre-existing condition or limited cover terms, and an application to increase it may be assessed like any other. Cover may also end if the account becomes inactive and you haven’t elected to keep it, if the balance runs too low or if you change funds.
We check the sum insured, which TPD definition applies, any conditions attached and whether the cover is active. Premiums are generally deducted from your super balance, so we consider the effect on your retirement savings too.
Possibly, and it’s the first thing worth checking.
We check the definitions and conditions in your own policies. A terminal illness benefit depends on the life policy’s definition; cover inside super also involves separate release rules. Trauma, TPD and income protection each have their own eligibility requirements, which we can explain with you.
We’ll read the wording with you, lodge the claim and stay with it. If you’re in the middle of treatment, we’ll carry as much of the paperwork as we can. The insurer makes the decision, and you won’t be waiting on it alone.
Speak with us before cancelling, particularly if your health has changed since the cover began. A replacement may involve a new assessment and different terms.
Depending on the policy, options may include reducing the amount of cover, changing benefits or reviewing how premiums are paid. Moving cover into super or changing the premium structure isn’t always available and may involve a new application or different terms.
Talk to us before you cancel, even if a payment is already late. We can check any urgent deadlines and available options. If replacement cover is proposed, we check its acceptance, start date and conditions before recommending cancellation of existing cover.
Applying online may be convenient, but you still need to understand the questions and the cover being offered.
Advice can help you prepare the application, understand how an insurer may assess your history and compare any terms offered. You still have a duty to take reasonable care not to make a misrepresentation, whichever application channel you use.
We prepare the application with you. Where a question is hard to answer accurately, that’s the moment to ask rather than guess, and you’ll have somebody to ask.
Your accountant and financial adviser bring different expertise to the same decisions. Your accountant can advise on tax reporting, structures and consequences; we help you plan how cashflow, debt, super, investments and protection work towards your goals. We can coordinate before important decisions.
What an accountant does
- Prepares and lodges tax returns, BAS and financial statements
- Advises on tax structures such as companies, trusts and partnerships
- Manages bookkeeping, payroll and ATO compliance
- Provides tax advice on the consequences of a transaction
What a financial adviser does
- Sets a long term strategy across retirement, investing and cash flow
- Builds wealth from early in a working life, starting with cash flow, a first home and super
- Recommends specific super funds, investments and personal insurance
- Operates under an Australian Financial Services Licence, which is required to give personal advice on financial products
- Handles retirement planning, Centrelink and aged care strategy, and estate planning considerations
Professional roles and authorisations matter. We provide financial advice within our authorisations and work with your accountant for specialist tax advice and lodgements.
Where they work together
- Tax position. Your accountant confirms your marginal rate, deductions and carried forward losses, which shapes decisions on super contributions, investment structures and the timing of asset sales.
- Business and entity structures. Your accountant advises on the structure itself and your financial adviser works within it for investments, insurance and succession planning.
- Cash flow. Your accountant’s figures can help us understand what’s available for debt repayment, protection and longer-term goals.
- Before key decisions. We can coordinate with your accountant on contributions, asset sales and other material choices in time to consider relevant tax consequences.
Always, and this is a subject where nearly everybody starts from scratch.
There’s no cost for the initial conversation. Share what you feel comfortable discussing about your health and existing cover. We’ll explain how we can help, what may need checking first and the information we’ll gather together.
Nothing is signed and nothing is lodged at that stage. If the cover already in your name is doing the job, you’ll hear that from us plainly.
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