Pre-Existing Conditions and Life Insurance NZ (2026): Diabetes, High Blood Pressure, BMI and More

Diabetes, high blood pressure or a high BMI rarely mean no cover — they usually mean a loading, an exclusion, or a different insurer. Here is how NZ insurers underwrite life, trauma and TPD with a pre-existing condition, and why two insurers can reach opposite answers on the same person.

A health history rarely closes the door on life insurance in New Zealand. Far more often it changes the terms — a premium loading, an exclusion on one condition, or simply a different insurer saying yes where another said no. With about 323,000 New Zealanders living with diabetes ¹, at least one in four adults with high blood pressure ³, and roughly one in three living with obesity ⁵, pre-existing conditions are part of everyday underwriting, not an exception. This guide explains how life, trauma and total and permanent disability (TPD) cover treats them, and why shopping the case matters.

TL;DR: A pre-existing condition usually means a loaded premium, a targeted exclusion, or a decline — not the end of the conversation. Because insurers weight risk factors differently, someone declined by one NZ insurer can be accepted by another ⁸. Around 323,000 New Zealanders live with diabetes ¹, so conditions like this are routine to underwrite. Cover always depends on the policy terms and your disclosure.

How do pre-existing conditions affect life, trauma and TPD cover?

When you apply for personal risk cover, the insurer underwrites you — it assesses your health, history and risk factors against its published criteria and reaches one of four outcomes: standard terms, a loading, an exclusion, or a decline ⁷. A pre-existing condition is simply a health issue you already have, or have had, when you apply.

The key point for life-risk cover is that the answer is rarely all-or-nothing. The four outcomes work like this:

• Standard terms — cover at the normal price, the condition judged minor or well managed.
• Loading — cover is offered, but at a higher premium to reflect the added risk (often quoted as a percentage, for example "+50%").
• Exclusion — the policy is issued, but claims relating to that specific condition are not covered, while everything else is.
• Decline — the insurer will not offer that cover type at all.

These outcomes also vary by product type. Life cover (paid on death or terminal illness) tends to be the most forgiving, because many chronic conditions raise long-term risk modestly rather than dramatically. Trauma cover (a lump sum on a defined serious illness such as cancer, heart attack or stroke) and TPD cover (a lump sum if you can no longer work) are usually underwritten more tightly, because the condition you disclose may be directly linked to the events those policies pay on. So it is common to be offered standard or lightly loaded life cover, while the same condition draws an exclusion on trauma.

Whatever the outcome, whether a claim is ultimately paid depends on the terms, conditions, exclusions and underwriting of the specific policy, and on your disclosure. This is a summary only — always read the policy wording or product disclosure statement.

How do insurers treat diabetes, high blood pressure and high BMI?

These three are among the most common factors NZ underwriters see, and each is judged on detail rather than the label alone.

Diabetes. Underwriters separate type 1 from type 2, and weigh how well it is controlled — typically your HbA1c readings, how long you have had it, whether you use insulin, and whether there are complications (eyes, kidneys, nerves, heart). Well-controlled type 2 diabetes with no complications often attracts a moderate life loading and may still get trauma cover with a diabetes-related exclusion. Diabetes is also a rising factor: prevalence is projected to climb from around 268,000 (2015–19) to over 500,000 by 2040–44 — an increase of roughly 87% ² — which is why insurers treat it as a meaningful long-term risk.

High blood pressure (hypertension). At least one in four NZ adults has high blood pressure ³, and at least one in five may have it undiagnosed ⁴. Treated, controlled hypertension with no related damage is frequently accepted at or near standard terms. Higher or poorly controlled readings, or hypertension alongside other factors, push toward a loading.

High BMI. Body mass index (BMI) of 25 or over is classed as overweight and 30 or over as obese ⁶; about one in three NZ adults lives with obesity ⁵. BMI is a frequent loading or decline driver because it correlates with other risks. A modestly raised BMI alone is often a small loading; a very high BMI, especially combined with high blood pressure or diabetes, has a larger effect because the risks compound.

The common thread is that underwriters do not price a label — they price the detail and the combination. A single, well-managed condition is treated very differently from several risk factors stacked together.

What outcome should I expect by condition — loading, exclusion or decline?

The table below shows typical directions only. It is not a quote, and your actual terms depend on the full medical picture, the insurer, and your disclosure. Outcomes vary by insurer for the same risk profile ⁷⁸.

Figure: Common pre-existing conditions and likely life-cover outcomes (NZ). Source: NZ insurer underwriting guides ⁷⁸.

Two things are worth holding onto. First, an exclusion is not the same as a decline — you can still hold valuable cover for everything outside the excluded condition. Second, terms can be reviewed later; if your health improves, it can be worth asking the insurer to reassess a loading or exclusion.

Why does one insurer say no and another say yes?

This is the part that surprises people most. Two insurers can look at the same person and reach opposite answers — one declines, the other offers cover, sometimes at standard terms.

The reason is that each insurer sets its own underwriting criteria and weights risk factors differently, based on its own claims experience, reinsurance arrangements and appetite for particular conditions ⁷. One insurer may be cautious about diabetes but relaxed about BMI; another may be the reverse. The Financial Services Council, the industry body, makes the same point at a market level: outcomes vary by insurer for the same risk profile ⁸.

For someone with a pre-existing condition, this is the single most useful thing to understand. A decline from one insurer is not a verdict on whether you are insurable — it reflects that one company's appetite. The practical response is to place the application where it is most likely to succeed, rather than apply blind and collect declines (each of which then has to be disclosed to the next insurer). This is exactly where working through an adviser earns its keep, and we cover the mechanics in how insurers underwrite a life insurance application.

What can I do to improve my terms before applying?

You cannot change your history, but you can influence the picture you present and the order in which things happen. Some practical considerations:

• Get your numbers current. Recent GP results — HbA1c for diabetes, blood-pressure readings, current weight and BMI — let an underwriter assess actual control rather than assume the worst.
• Show that a condition is managed. Evidence of monitoring, medication adherence and stable readings supports better terms than a gap in records.
• Improve what is realistically improvable. Where a condition is influenced by lifestyle, sustained changes that move your readings or BMI can change the outcome over time. This is general information, not medical advice — talk to your GP.
• Do not apply blind to multiple insurers. Each decline or loading generally has to be disclosed on later applications, which can make terms harder to get. A pre-assessment (an informal, no-names enquiry to insurers) tests the likely outcome first.
• Disclose fully and accurately. Non-disclosure is the fastest way to have a future claim challenged. Whether a claim is paid depends partly on what you disclosed, so completeness protects you.

None of this guarantees a particular outcome. It improves the odds and the evidence — and it puts the application in front of the insurer most likely to accept it.

How is this different from health insurance pre-existing rules?

It is easy to assume all insurance treats pre-existing conditions the same way. It does not, and the distinction matters.

Health (medical) insurance generally handles a pre-existing condition by excluding it — the policy covers you for new conditions that arise after it starts, but not for conditions you already had ⁹. Premiums are typically not loaded for the history in the same way; the condition is simply carved out, sometimes with the option of review after a continuous-cover period.

Life, trauma and TPD insurance has the fuller range of outcomes described above — standard terms, a loading, an exclusion, or a decline — because it is priced on the long-term risk of death or a serious health event, not on year-by-year medical costs. So the same diabetes diagnosis might be excluded on a health policy, lightly loaded on life cover, and excluded on trauma cover, all at once.

We cover the health-insurance side in detail in pre-existing conditions and health insurance options. The headline: don't assume that because one insurer or one product type treated your condition a certain way, the rest will follow.

How does an adviser place a hard-to-insure case?

When a case is complicated, the process matters as much as the application itself. An adviser typically works through it like this:

1. Build the full picture. Conditions, dates, readings, medications, specialists and any earlier insurance decisions — the same detail an underwriter will eventually want.

2. Pre-assess before applying. An informal enquiry to several insurers tests likely terms without lodging a formal application, so early declines don't pile up on your record.

3. Place the application with the right insurer. Because appetite varies ⁷⁸, the case goes to the insurer most likely to offer acceptable terms for your particular profile.

4. Manage the underwriting. Chasing GP notes, adding context, and responding to questions so the file is complete and accurate.

5. Review the offer in full. Comparing loadings, exclusions and wording across what's available — not every insurer in the market is shown, and each has its own product disclosure statement to read.

6. Revisit later. If your health improves, asking insurers to reassess a loading or exclusion at review time.

How a loading or exclusion is actually structured is its own topic — see how loadings and exclusions work on NZ cover.

We work with a panel of selected insurers, listed in our disclosure, rather than every provider in the market. We're generally paid by commission from the insurer when you take out a policy through us; this doesn't change the premium you pay, and we manage any conflicts in line with our duty to prioritise your interests — full details are in our disclosure.

Frequently asked questions

Can I get life insurance in NZ if I have diabetes?

Often, yes. Well-controlled type 2 diabetes commonly attracts a moderate loading on life cover, and trauma cover may be offered with a diabetes-related exclusion. Type 1 and poorly controlled diabetes are underwritten more tightly. Outcomes vary by insurer ⁷⁸, and any cover depends on the policy terms and your disclosure.

Will high blood pressure increase my life insurance premium?

It can, but treated and well-controlled hypertension is frequently accepted at or close to standard terms. Higher or poorly controlled readings, or high blood pressure alongside other factors, are more likely to draw a loading. Recent, stable readings from your GP help.

Does a high BMI mean I'll be declined?

Not usually on its own. A modestly raised BMI is often a small loading; a very high BMI can mean a larger loading, an exclusion, or — at the extreme end — a decline, especially when combined with conditions like diabetes or hypertension ⁵⁶. Insurers weigh BMI differently from one another.

What's the difference between a loading and an exclusion?

A loading means you pay a higher premium but are still covered for the condition. An exclusion means the policy is issued and covers everything except claims relating to that specific condition. A decline means that cover type isn't offered at all. Many people with a pre-existing condition end up with a loading or an exclusion rather than a decline.

One insurer declined me — should I give up?

Not necessarily. Because each insurer sets its own criteria and risk appetite, a decline from one doesn't mean you're uninsurable ⁸. The better approach is usually a pre-assessment that tests likely terms across insurers before lodging a formal application, so early declines don't accumulate on your record.

Should I disclose everything, even minor conditions?

Yes. Full, accurate disclosure is what protects a future claim. Whether a claim is paid depends partly on what you told the insurer when you applied, so leaving things out — even minor things — can put cover at risk later. If you're unsure what's relevant, an adviser can help.

This article is general information only and is not personalised financial advice. It does not take into account your particular financial situation, goals or needs. Before acting, consider whether it's right for you and seek advice tailored to your circumstances. Whether a claim is paid depends on the terms, conditions, exclusions, stand-down periods and underwriting of the specific policy, and on your disclosure — always read the policy wording. Craig Smith Business Services Ltd (FSP712931), trading as Smiths Financial, holds a Class 2 licence issued by the Financial Markets Authority to provide financial advice on personal risk insurance, health insurance, general insurance, KiwiSaver and managed funds, and is a member of the Financial Dispute Resolution Service (FDRS). Written by Henry Smith, Financial Adviser; reviewed by Craig Smith, Principal Adviser. Last reviewed 15 February 2026.