Life Insurance With Health Problems or a Previous Decline
A health condition doesn't automatically mean you can't get life insurance. Whether your health history is fairly straightforward, you've already been offered a higher-than-expected premium or you have been declined, the details matter—and so does choosing the right insurance company for your situation.
A Health Condition Doesn't Tell the Whole Story
Two people can have the same health condition and receive very different life insurance offers. That's because an insurance company isn't just looking at the name of a diagnosis. They may also consider when it was diagnosed, how severe it is, how it's being treated, whether it's well controlled, and whether there are other health concerns that change the overall picture.
Something as common as high blood pressure, diabetes or sleep apnea may be viewed very differently depending on the details. Even a history of cancer or heart disease doesn't automatically tell us what your options will be.
That's why I don't like making assumptions about whether someone can qualify based on a diagnosis alone. The better place to start is understanding your health history and what an insurance company is likely to see when it reviews your application.
What Matters During the Approval Process
The process an insurance company uses to evaluate your application is called underwriting. Depending on your health history, the company may look at several pieces of information to understand not just what you've been diagnosed with, but what that diagnosis means today.
When It Happened
A recent diagnosis, surgery or hospitalization may be viewed differently than something that happened years ago.
Severity
The same condition can range from relatively minor to much more serious. The specifics matter.
Treatment & Follow-Up
Insurance companies may look at medications, procedures, follow-up care and whether you're following your doctor's recommendations.
How Well It's Controlled
Current readings, lab results, symptoms and whether the condition has remained stable can all help tell the story.
Other Health Factors
Weight, tobacco use, other diagnoses and complications can affect how an insurance company views the overall picture.
Your Medical Records
Sometimes what's written in a medical record raises questions that aren't obvious from the diagnosis itself. When something doesn't match your actual history, it may need to be understood or clarified.
┃Your Health History
Diagnosis, treatment, medications, control, timing and the overall picture.
┃How a Company Views It
Insurance companies have their own underwriting guidelines and may evaluate the same history differently.
┃Possible Results
The company may offer its best rates, a higher premium, postpone a decision or decline coverage.
The Insurance Company Matters Too
Insurance companies don't all look at health conditions exactly the same way. One company may be more comfortable with a particular medical history than another, which can affect whether you're approved and what you're asked to pay.
That's one reason I don't believe the best place to start is simply finding the company with the lowest advertised price. A great rate doesn't do much good if that company isn't a good fit for your health history.
Sometimes the solution is choosing a different insurance company. Other times, the better approach is understanding what is causing the concern in the first place. Medical records can contain old diagnoses, incomplete information or details that need additional context before an insurance company has the full picture.
The goal isn't to find a company that will overlook your health. It's to understand your situation well enough to find the company and approval process that make sense for you.
Understand the Situation Before You Apply
Finding the right life insurance when health is involved starts with understanding the details. Sometimes the situation is straightforward. Other times, a little work before submitting an application can make a meaningful difference.
1
Understand
We'll talk through your health, medications, treatment and anything else that may affect your application. If you've already applied, we'll also want to understand what happened and why.
2
Evaluate
Depending on the situation, I may research how different insurance companies are likely to view your history, ask additional questions or determine whether medical records or other information may help clarify the case.
3
Compare & Decide
Once we understand the situation, we can decide which insurance company and approval process make the most sense—or whether there is a reason to wait before applying.
When the Medical Record Told the Wrong Story
Initial decision: Decline
After additional review: Approved with Standard Rates
A client recently applied for life insurance and her medical records raised several serious concerns. Most importantly, her medical records showed a history of cancer. The insurance company ultimately declined the application based on what it believed was an undisclosed cancer history.
There was one major problem: the client had never been diagnosed with cancer.
Instead of immediately moving on to another insurance company, we went back through the concerns the underwriter had identified. The records also referenced several blood abnormalities the client didn't recognize as ongoing medical conditions, along with questions about a gastrointestinal procedure that had been ordered, but never completed.
The client and I worked with her doctor to obtain a letter addressing the various concerns. The physician confirmed that she had never been diagnosed with cancer. The blood abnormalities were traced back to a hospitalization years earlier, had resolved and had not recurred. The doctor also clarified that her gastrointestinal symptoms had resolved and explained why the recommended procedure had not been completed.
We submitted these additional details to the underwriter and asked the insurance company to reconsider her application. After another review by its medical department, the company changed the decision from a decline to an approval with Standard rates.
The goal wasn't to get the insurance company to overlook her health history. It was to make sure its decision was based on an accurate understanding of that history.
Start With What You Know
You don't need to gather every medical record before we have a conversation. Most of the time, we can start with what you already know about your health and ask additional questions from there.
The more accurately we understand your history, the better we can evaluate which insurance company and approval process may make sense before you apply.
Helpful Things to Know
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Your diagnosis and approximately when it began
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Medications you're currently taking
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Recent surgeries, hospitalizations or major procedures
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How the condition is being treated and how well it's controlled
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Any upcoming tests, procedures or follow-up appointments
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What happened if you've previously applied for life insurance
Don't know every detail? That's okay. We can figure out what's actually important as we go.
Questions You May Have About Your Health & Life Insurance
Can I get life insurance with a pre-existing health condition?
Usually, yes.
Having a health condition doesn't automatically prevent you from getting life insurance. The result can depend on the condition, how severe it is, when it was diagnosed, how it's being treated, how well it's controlled and which insurance company reviews your application.
Some conditions may have little effect on the offer, while others can result in a higher premium, a postponed decision or a decline. The details matter more than simply having a diagnosis.
Even when traditional coverage isn't available, there may be other products or strategies we can consider. A health problem doesn't necessarily mean we've run out of options.
What should I do if I've already been declined for life insurance?
Start by finding out why you were declined before submitting another application.
Sometimes the health history itself is the issue. Other times, the insurance company may not be a good fit for your particular history, the timing may be poor, or information in the application or medical records may need clarification.
A previous decline doesn't necessarily mean every insurance company will make the same decision, but I generally want to understand what happened before deciding what to do next.
If you don't already know the reason, call the insurance company directly and ask them to send you a letter explaining the specific reason or reasons that influenced their decision.
What if I was approved, but the premium is much higher than I expected?
Before accepting the offer or immediately applying somewhere else, it's worth understanding why the premium increased.
The reason may be a health condition, lab result, medical record, medication or another factor discovered during the approval process. Once we understand what affected the offer, we can evaluate whether the price is reasonable for your situation or whether another option is worth considering.
My first step is usually to identify exactly what caused the higher premium. If that isn't clear, you can ask the insurance company for a written explanation of the factors that influenced its offer.
Will I have to take a medical exam?
Not always.
Some applications can be approved without an exam, while others may require an exam, medical records, labs or additional information depending on your age, health history, amount of coverage and the insurance company's requirements.
Having a health condition doesn't automatically mean you should avoid medical underwriting. Sometimes providing more information can actually help an insurance company understand your situation more accurately and may even lead to a lower premium.
Do my medications affect whether I can get life insurance?
They can.
Insurance companies may consider the medications you're taking, what they're treating, how long you've taken them and how well the underlying condition is controlled.
A prescription by itself doesn't necessarily determine the outcome. It's usually considered along with the rest of your health history.
It's important to discuss prescriptions you've filled in the past several years, even if you no longer take them. This helps us make better decisions before applying and can help avoid surprises or delays during the approval process.
Should I wait to apply if I was recently diagnosed, had surgery or still have testing scheduled?
Sometimes waiting to apply is the best strategy.
A recent diagnosis, surgery, hospitalization, pending test or unresolved medical evaluation can make it difficult for an insurance company to determine the long-term picture.
That doesn't mean you should automatically wait. It means we should understand what's happening before deciding whether applying now or later makes more sense.
Sometimes we may stagger the strategy—putting some protection in place now while we wait for an opportunity to improve or add to that coverage later.
Can I get life insurance after cancer, a heart attack or another serious health problem?
Many times yes.
Serious health conditions don't automatically mean permanent ineligibility. Insurance companies may consider the type and severity of the condition, treatment, time since the event, current health, recurrence or complications and ongoing follow-up.
These are situations where the details and the insurance company can make a significant difference.
For example, some types of cancer may have little or no impact after treatment, while others may require a waiting period before traditional coverage becomes available. The type of cancer, stage, treatment and time since treatment can all matter.
If my health has changed, can I keep the life insurance I already have?
Yes, and sometimes that is exactly what you need to do.
Developing a health problem after an existing life insurance policy is already in force generally doesn't cause the insurance company to re-underwrite that policy simply because your health changed.
Before replacing or giving up existing coverage, it's especially important to understand what you already have. Your existing policy may have been issued when you were younger or healthier and could be difficult or more expensive to replace today.
Your existing policy may also include options that allow you to extend or change the coverage without going through medical underwriting again. That's one reason I want to understand what you already have before considering a replacement.
Kevin Woolley
Founder | Woolley & Woolley Insurance Group
Ready to Start the Conversation?
Whether you're just starting to look for life insurance or you've already received an offer or been declined, I'm happy to take a look at your situation. We'll start with your health history, what you're trying to accomplish and any steps that you've already taken.
From there, we can figure out what makes sense before you apply—or what may be worth another look if you already have.