When you apply for medically underwritten cover, the insurer underwrites you — assesses your health, history and lifestyle to decide the terms. Understanding this process helps you get the best outcome and, crucially, protects your future claim.
What underwriting can result in
- Standard terms: accepted at the normal premium.
- A loading: accepted, but at a higher premium to reflect higher risk.
- An exclusion: accepted, but a specific condition or activity isn’t covered.
- Deferral or decline: the insurer waits for more information or can’t offer cover — but you find this out up front, not at claim time.
Why honest disclosure matters
You have a duty to take reasonable care not to make a misrepresentation when you apply. Disclosing a pre-existing condition honestly means the insurer assesses it now and sets clear terms — so the claim can’t be disputed later on the basis of something you didn’t mention. Non-disclosure is one of the most common reasons a claim is reduced or denied.
Frequently asked questions
What counts as a pre-existing condition?
Broadly, a health condition or symptom you had before applying (or before default cover started). Insurers assess these through underwriting on personal policies, or may limit cover for them under default policies.
Will a pre-existing condition mean I’m declined?
Not necessarily - the common outcomes are standard terms, a premium loading, or an exclusion for that condition. Outright decline is less common, and you find out up front.
What happens if I don’t disclose something?
You have a duty to take reasonable care not to misrepresent your health. Non-disclosure is a leading reason claims are reduced or denied, so honest disclosure at application actually protects your claim.
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