Already Have a Health Condition? You Still Have Options

Nobody gets through life without a few things on their medical record. By the time most people come to buy insurance they already have some history. What matters is knowing how to buy the right product so that history costs you as little as possible.

The mistake people make

Here is the thinking I hear a lot: I already have a condition, I wish I had bought cover earlier, and now anything I buy will just exclude it — so what is the point? I won’t bother.

That is badly wrong. Having a history is a fact. Having no options is not.

Disclosing a health history properly

First and non-negotiably: you disclose it to the insurer, whether or not there are medical records in New Zealand. Leaving something out can produce a dispute at claim time, a declined claim, or in serious cases the whole policy being cancelled. I have written separately about the four ways insurers handle an undisclosed condition.

The skill is in how a history is disclosed: never concealing anything, always factual, but described in a way that protects your interests as far as the facts allow. That part takes an adviser who knows the underwriting well.

It often goes better than people expect

A pre-existing condition is not automatically excluded, and sometimes you can negotiate a review down the track — typically along the lines of three years with no symptoms and no treatment being grounds to have the exclusion removed.

Some insurers are also more relaxed about older history. A condition from more than ten years ago that has fully resolved may not be excluded at all.

What if the condition is ongoing?

If you have a chronic condition that has not resolved and you want it covered, that is not impossible either. There are policies in New Zealand that cover pre-existing conditions, at a higher premium. Whether that is the right choice for you depends on your circumstances, which is exactly why an adviser needs the full picture of your history and what you need before recommending anything.

The four routes to covering a pre-existing condition

These are, as far as I know, the only four in New Zealand.

1. Group cover through an employer

Usually Southern Cross. Sometimes the employer pays all or part of the premium, sometimes staff pay it themselves. Setting the premium aside, the significant thing about group cover is that it covers pre-existing conditions, and it covers them immediately.

Not every company can offer it — there are minimum participation numbers — so this is luck rather than planning. But if you are starting a new job, the company has group cover, and you need a pre-existing condition covered, join within the first three months.

2. Southern Cross UltraCare

A strong product for pre-existing conditions. The advantage is that the great majority of pre-existing conditions come into cover after three years, and it also covers GP visits and other day-to-day items. The drawbacks are the price, and that Southern Cross products do not include a voluntary overseas treatment benefit.

3. nib’s three-year pre-existing condition promotions

Run from time to time rather than permanently, so again a matter of timing. If one is running and you need a pre-existing condition covered, take it — the premium is the normal price and most pre-existing conditions become claimable after three years.

4. nib Easy Health

nib’s standing pre-existing conditions product, available all the time rather than as a promotion. Most pre-existing conditions come into cover after three years, and it is cheaper than UltraCare. The limitation is that it is base cover only — specialists and diagnostics are not covered.

Where to start

If you have a condition and want to know which of these fits, send me the details. Which route makes sense depends on your history, your employer, your budget and what you most want covered.

Need advice on disclosing a health history? Get in touch with Cornerstone Insurance.

Phone: +64 211 280 727 Email: amy.tao@cornerstonefs.co.nz WeChat: Amytaoingrace