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What is a Pre-Existing Medical Condition?

In our latest guide, our team of independent insurance experts explain what a pre-existing medical condition is and how to find the best and cheapest insurance for people with medical conditions.

People with health issues are often put off from buying the cover that they need, assuming that it will be too expensive or not available. Generally, this isn’t true, and many insurance companies can now provide affordable cover for people with medical conditions.

The most recent research from the Office for National Statistics (ONS) revealed that almost half of the UK’s population has an ongoing medical condition (45.7% of men and 50.1% of women). This research found that the most common long-term medical conditions in the UK are:

Every insurance company will view pre-existing conditions differently, and some can be considerably cheaper than others. Many consumers find it useful to speak to a pre-existing conditions insurance expert for advice. An experienced insurance broker will know which company is the best fit for your situation, your budget, and the type of policy that you need.

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60-Second Summary – What is a Pre-Existing Medical Condition?

When you’re applying for a new insurance policy, you might hear the term ‘pre-existing medical condition’, but not everyone understands what this means. A pre-existing medical condition is any medical condition that you have been diagnosed with, experienced symptoms of, or been treated for before buying an insurance policy.

With almost 50% of people in the UK having some form of medical condition, insurance companies have gotten better at providing fairly priced cover for people with health issues. Certain insurance companies will work better for certain people though, so it is worth getting proper advice before applying for your policy.

  • The Association of British Insurers defines a pre-existing medical condition as any condition that you have or have had in the past. If you have been diagnosed with, experienced symptoms of, or had treatment for a medical condition, an insurance company would class this condition as ‘pre-existing’.
  • Most personal protection policies will ask questions about your medical history during the application process. Depending on the type of cover, you could be asked about conditions from within the last 5 years, conditions you have ‘ever had’, or about your family medical history.
  • Life insurance for pre-existing conditions is often available and will pay out if you die because of your medical condition or anything related to it. This can provide your loved ones with financial security during an extremely difficult time.
  • Policies like critical illness cover and income protection can be available if you have medical conditions, but this will depend on the specific condition and symptoms that you have. A medical insurance expert will be able to explain your best and cheapest options for cover if you are unsure.
  • Health insurance for pre-existing conditions can help with the cost of private treatment for any new medical issues, and you can buy policies for individuals, couples, and families.
  • It can be even more important to buy travel insurance with medical conditions in case you experience a medical emergency while you are away. A travel insurance expert can help you find a policy with a suitable level of medical cover to give you peace of mind.

A pre-existing medical condition is a medical condition that you already have or have had in the past. It is described as ‘pre-existing’ because you had this condition before the start of your insurance application.

If you buy an insurance policy and then develop a medical condition, this condition won’t be classed as pre-existing as it is a new diagnosis. Policies like life insurance should cover any new conditions that develop during your policy term.

With specific types of insurance (e.g. critical illness cover or health insurance), your policy won’t pay out for every potential medical problem. It’s a good idea to read your policy documents carefully, to understand when you can claim and if there is anything that you can’t claim for (a ‘policy exclusion’).

Common exclusions will include things like pre-existing conditions, or conditions that are related to your pre-existing condition. An example of this is if you had diabetes and complications from this led to a stroke (due to vessel damage from high blood sugar). If related conditions are excluded, your policy may not pay out for your stroke.

It’s extremely common to have some form of medical condition in the UK, with this recent Sky News report revealing that 1 in 5 adults will be living with serious illnesses by 2040.

Health: One in five adults in England will be living with major diseases by 2040, say researchers

The Association of British Insurers defines a pre-existing medical condition as:

 ‘Any health condition you have now or have had in the past; have been diagnosed with or are waiting for a diagnosis of; have been treated for or are having treatment for before the start date of any health insurance or income replacement insurance cover.’

To put this in simple terms, an insurance company will class a medical condition as pre-existing if one of the following applies:

  • You have experienced symptoms or received treatment within the last five years
  • You have experienced symptoms or received treatment in the past
  • You are currently receiving medical treatment for this condition (ongoing medical conditions)

It’s also important to be aware of the difference between an acute medical condition and a chronic medical condition. For policies like health insurance, only acute medical conditions will be covered, so it is best to understand what this means.

It’s also important to note that you don’t always need to have had a formal diagnosis for a condition or symptom to be classed as pre-existing. This is why you might be asked if you’ve experienced ‘symptoms of’ a condition, rather than being asked if you’ve been ‘diagnosed with’ a condition.

How far back do pre-existing conditions go?

For most personal insurance policies, you will be asked if you have experienced symptoms of specific medical conditions within the last five years.

There will be exceptions to this though, especially with policies like life insurance or critical illness cover. With these policies, you can be asked if you’ve ever experienced symptoms of or been diagnosed with certain serious conditions (e.g. cancer).

You may also be asked about your family medical history, and if your close family members (e.g. parents or siblings) have been diagnosed with specific conditions.

This isn’t anything to worry about, and it’s a standard part of an insurance application process. The answers to these questions will help an insurance company to determine what they think your risk of claiming on your policy is. Declaring a medical condition or family history doesn’t automatically mean that you can’t get the cover that you need.

While it might be tempting to hide a diagnosis from your insurer, this can mean that your policy is invalid and won’t pay out. It is always best to answer any questions that are asked as honestly as you can. Insurance companies will understand that you might not remember every detail, especially if it has been several years since a diagnosis or course of treatment.

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During your insurance application, you will be asked various questions about your health and lifestyle. It is important to declare any relevant medical information that you are asked for, or you risk there being issues when you need to claim.

The insurance company will ask questions about your medical history, to help them to decide if they can or can’t offer the cover that you need. The application process can differ between insurance companies and between different types of insurance policies.

A particular medical condition could be a problem for one insurance company, and another company may not even ask about it. It all comes down to the insurance companies that you apply to and how their processes and policies work.

If you are worried that your health might impact your ability to get insurance, it’s worth getting some advice from an experienced insurance expert.

When it comes to medical conditions, UK insurance companies will view some conditions as being more serious than others. Examples of serious medical conditions include cancer, stroke, and brain tumours.

If you have a common condition like asthma and experience mild symptoms, this will be viewed as less serious than if you have a condition that has a major impact on your health and lifestyle (e.g. multiple sclerosis).

Having a serious medical condition doesn’t mean that you won’t be able to get insurance, but it can make it even more important to get advice before you apply. A medical insurance specialist will be able to explain your best options for cover and which insurance companies will be most suitable for the policy that you need.

Most people in the UK are familiar with the financial journalist Martin Lewis, who is often asked for advice on topics like finance and insurance during TV and radio interviews.

Martin Lewis’ Guide to Life Insurance – Inheritance Tax | This Morning

In an interview on ITV’s This Morning, Martin Lewis commented that life insurance will always ‘cost a lot more’ for someone who has medical conditions. This isn’t necessarily true, and you shouldn’t let comments like this put you off from applying for the cover that you need.

Policies like life insurance, health insurance, and travel insurance can be reasonably priced if you apply to the right insurance companies.

Martin Lewis was likely referring to situations where somebody with a serious health condition has tried to apply for life insurance through a standard, mainstream insurance company. In cases like this, a specialist company would likely be able to offer a lower price.

People with less serious conditions can often get cover for a standard price or a very minimal price increase. Even people with serious or long-term conditions can buy cover that isn’t ridiculously expensive if they apply with the help of a specialist insurance broker.

Life insurance is often available for people with pre-existing medical conditions and can be more affordable than you would imagine. The key to finding the best and cheapest life insurance quotes is to speak to a medical conditions life insurance expert.

The application process can sometimes take slightly longer, as you may need to submit extra medical evidence, but this isn’t anything to worry about. Extra evidence like a GP report can ensure that your policy is valid, so your loved ones are less likely to experience issues when they need to claim.

Our team of experts has written a full Life Insurance with Pre-existing Conditions guide to explain more about how to apply for life insurance with medical conditions.

Regardless of your medical history, the cost of life insurance is always going to vary based on things like your age, smoker status, and the amount of cover that you need.

It’s a common myth that people who have medical conditions will have to pay extremely high prices for their insurance policies. This generally isn’t the case, and most people will still be able to get affordable cover.

Our team of independent insurance experts have put together the tables below, to demonstrate the potential difference in life insurance prices for people with different types of medical conditions. For these examples, we have used diabetes, overweight, MS, and depression (mental health), as our experts often speak to people with these conditions.

Level term life insurance – £150,000, covered up to age 90

Person’s ageNo medical conditionsDiabetes life insurancePrice difference (%)
Age 20£9.28 (Guardian)£9.41 (Vitality)1.4%
Age 25£11.59 (Guardian)£11.75 (Vitality)1.3%
Age 30£14.95 (Guardian)£15.98 (Vitality)6.8%
Age 35£20.78 (Vitality)£20.78 (Vitality)0%
Age 40£23.40 (Vitality)£23.40 (Vitality)0%
Age 45£31.12 (Vitality)£31.12 (Vitality)0%
Age 50£40.51 (Vitality)£40.51 (Vitality)0%
Age 55£57.48 (Vitality)£57.48 (Vitality)0%
Note: In this example, the customer type 2 diabetes, was diagnosed in July 2018, has good control of symptoms and does not take insulin.

Person’s ageNo medical conditionsOverweight life insurancePrice difference (%)
Age 20£9.28 (Guardian)£9.28 (Guardian)0%
Age 25£11.59 (Guardian)£11.59 (Guardian)0%
Age 30£14.95 (Guardian)£14.95 (Guardian)0%
Age 35£20.78 (Vitality)£20.86 (Guardian)0.4%
Age 40£23.40 (Vitality)£30.22 (Guardian)29%
Age 45£31.12 (Vitality)£38.85 (Guardian)25%
Age 50£40.51 (Vitality)£56.10 (Zurich)38.5%
Age 55£57.48 (Vitality)£76.35 (Guardian)33%
Note: For this example, the customer’s height was 5’10” and weight was 90kg (BMI score of 28.4)

Person’s ageNo medical conditionsMS life insurancePrice difference (%)
Age 20£9.28 (Guardian)£27.35 (Vitality)194%
Age 25£11.59 (Guardian)£34.31 (Vitality)196%
Age 30£14.95 (Guardian)£46.23 (Vitality)209%
Age 35£20.78 (Vitality)£60.61 (Vitality)191%
Age 40£23.40 (Vitality)£57.60 (LV=)146%
Age 45£31.12 (Vitality)£70.28 (LV=)125%
Age 50£40.51 (Vitality)£82.85 (LV=)104.5%
Age 55£57.48 (Vitality)£118.59 (LV=)106%
Note: In this example, the customer has primary progressive MS and first experienced symptoms in July 2018, with mild/moderate symptoms.

Person’s ageNo medical conditionsDepression life insurancePrice difference (%)
Age 20£9.28 (Guardian)£9.41 (Vitality)1.4%
Age 25£11.59 (Guardian)£11.75 (Vitality)1.3%
Age 30£14.95 (Guardian)£15.98 (Vitality)6.8%
Age 35£20.78 (Vitality)£20.78 (Vitality)0%
Age 40£23.40 (Vitality)£23.40 (Vitality)0%
Age 45£31.12 (Vitality)£31.12 (Vitality)0%
Age 50£40.51 (Vitality)£40.51 (Vitality)0%
Age 55£57.48 (Vitality)£118.59 (LV=)106%
Note: In this example, the customer first experienced symptoms in July 2018, takes antidepressants, and has experienced 2 or 3 episodes of symptoms.

As you can see, price increases will depend on the condition itself and can often be minimal and in some cases, there won’t be an increase at all. There are also simple ways to lower the cost of your cover such as reducing your policy term (length of cover) or choosing a cheaper type of policy (e.g. family income benefit).

Prices will usually be lower for younger customers, so it’s best to buy your life insurance as early in life as you can. Unless you opt for increasing cover, your monthly premiums would be fixed at the price for the age that you were when you bought your cover.

Does life insurance cover pre-existing conditions?

Your life insurance policy should cover any pre-existing medical conditions that you have, meaning that it will pay out if you die because of or for reasons related to this condition.

There are some exceptions to this (e.g. guaranteed life insurance), but in most cases, pre-existing conditions will be covered. Our independent life insurance experts can help with life insurance for medical conditions including:

It can be possible to buy critical illness insurance (also known as critical illness cover) when you have a pre-existing medical condition. A critical illness insurance policy will pay out a cash lump sum following a new diagnosis of a serious medical condition.

These policies can pay out £1,000’s to support you and your family while you recover from or adapt to living with your medical condition. Based on research from the Association of British Insurers, the following conditions make up around 80% of all critical illness insurance claims:

Your insurance company will provide you with a set list of medical conditions that your policy covers. A critical illness insurance expert will be able to explain exactly how your policy works and all the conditions that you will be able to claim for.

Does critical illness insurance cover pre-existing conditions?

Critical illness policies will not pay out for any medical conditions that you had before buying your policy. This means that you can’t buy a policy and then claim for a previous diagnosis.

In some cases, you won’t be able to claim for a new diagnosis that is related to a pre-existing condition. If this applies to your critical illness policy, this will be fully explained within your policy documents.

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Most insurance companies in the UK will be willing to sell income protection insurance to customers who have medical conditions. Our independent insurance experts have helped hundreds of income protection customers with conditions such as:

Getting this type of cover can be easier if you don’t experience severe symptoms due to your condition, but it isn’t impossible to get cover with more serious conditions. Insurance companies will usually ask if your condition has prevented you from working in the past, and if it significantly impacts your daily life.

There might be some situations where income protection insurance isn’t available because of your medical condition(s). There will be alternatives that can provide some level of cover (e.g. personal accident insurance), and an insurance expert will be able to explain all your options to you.

Does income protection insurance cover pre-existing conditions?

Your pre-existing condition should be covered by your income protection policy unless it states that it isn’t within your policy documents.

Some insurance companies will offer cover which ‘excludes’ claims for your pre-existing condition. This means that you could claim for sick leave for various reasons, but not if it is related to your pre-existing condition.

People with medical conditions can often buy private health insurance, with prices starting at less than £20 per month. There are a few types of health insurance to choose from including individual cover, as well as policies designed for couples, families, and businesses.

Certain insurance companies will be able to offer cheaper pricing for customers who have pre-existing conditions. Companies like The Exeter work particularly well for people with medical conditions, due to their flexible underwriting and their ability to cover complications of existing conditions.

Our independent health insurance experts have written a full Health Insurance for Pre-existing Conditions guide, which provides further details about how private health insurance works.

Does health insurance cover pre-existing conditions?

While health insurance can be available for people with pre-existing conditions, it won’t usually pay out for treating those conditions. Private health insurance has been designed to help with covering the cost of treating new medical issues. Policies can also help with providing complementary treatment alongside NHS services, for people with chronic conditions. Health insurance policies also provide additional health support by offering additional benefits, like online GP appointments and private prescription services.

Bupa By You health insurance | Understanding pre-existing conditions

This short video from health insurance company Bupa explains how health insurance works for medical conditions in more detail. All health insurance companies will view medical conditions slightly differently, and each one will explain any exclusions for medical conditions within their policy terms and conditions.

For more about health insurance, you can read some of our top health insurance guides for UK customers in 2024.

Travel insurance is another policy where you will be asked about your health and medical history when you apply. You will need to declare any pre-existing conditions that you are asked about to ensure that your policy is valid, and that you receive the right level of cover.

People with medical conditions should consider applying through a medical travel insurance specialist. A specialist policy will usually provide a much higher level of cover for medical expenses, to protect you against the expensive cost of medical care in foreign countries.

Many policies can provide £1,000,000’s in medical cover, so you won’t be left with unaffordable medical bills for your treatment.

Does travel insurance cover pre-existing conditions?

Travel insurance should cover your pre-existing conditions, provided that you told the insurance company about them when you applied. If you don’t tell the insurer about your condition and then need to claim for something related to it, they would likely refuse to pay out.

All policies will be slightly different, and you will need to assess if the policy will provide enough medical cover for your medical condition. If you need to bring medication or equipment (e.g. walking aids), you should check to see if your policy would cover replacing these if they are damaged or lost/stolen.

The simplest way to find the right insurance policy for someone with medical conditions is by contacting a medical insurance specialist.

You may be able to get cover through mainstream providers or price comparison sites, if your condition is mild and symptoms are minimal. It can however be much cheaper and easier to apply through an experienced broker. People with more serious conditions could save £100’s by applying through an expert, and could even be declined if they apply to the wrong insurers.

Each of the links below will take you to our online forms, where you can request your quote. Our travel insurance link will take you to our trusted travel insurance partners, who specialise in travel insurance for people with pre-existing conditions.

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Is it worth paying for life insurance?

Yes, if you’ve got children or financial dependents then you should have life insurance to protect them if you die. Martin Lewis and the Financial Conduct Authority recommend that you take out life insurance to protect your family and your home. Generally, life insurance premiums start from as little as £5 per month and will be cheaper for younger adults.

Common myths about life insurance:

  • Life insurance won’t pay out (pays out 98% of claims)
  • People with medical conditions can’t have life insurance
  • Life insurance is expensive
  • Savings can be just as effective as life insurance
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Is life insurance worth it? - iam|INSURED

What is the average cost of life insurance per month?

Based on recent research carried out, the average cost of life insurance is approximately £38 per month and the average level of cover is £152,000. Life insurance premiums also vary dramatically from one insurance provider to another and you can reduce your monthly premiums by shopping around.

Fundamentally, life insurance premiums vary depending on your age, health and the amount of cover that you need, starting from as little as £5 per month. You can also get life insurance to protect your family and your home against financial loss if you die.

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Average cost of life insurance - iam|INSURED

What does life insurance cover you for?

Life insurance is a monthly renewable ‘term insurance’ contract that pays out a cash lump sum or regular payments on death to your family or beneficiaries. Policies are most commonly used for family protection or mortgage protection for your loved ones if you die and your household income reduces, plus the additional issues of losing a parent or carer.

Traditional life insurance will not exclude any pre-existing medical conditions and will cover suicide after 12 or 24 months. You can also use life insurance for business protection purposes as well as tax-efficient business life insurance for directors or key people.

What are the disadvantages of life insurance?

The biggest and most common problem that consumers have with life insurance is the cost and the monthly premiums. This is the top reason for policy cancellations and why more people don’t take out life insurance to protect their family.

Another key disadvantage with life insurance is that it holds no investment value, nor can you cash it in. Life insurance works like any other traditional general insurance policy (e.g. car insurance, house insurance, pet insurance etc.), you pay a monthly premium and it will pay out in the event of a claim. Some people decide to use savings instead of taking out life insurance but you need to make sure that you have sufficient savings to cover the costs of death for your family.

Why do I need life insurance?

The fact is that nobody actually ‘needs’ life insurance, but it is strongly recommended that families and couples have cover to protect their loved ones in the event of death. Martin Lewis recommends life insurance and says “this is something that every parent, partner, or person with any other type of dependent needs to consider”.

Life insurance financially protects your loved ones if you die and pays out a cash lump sum to repay your mortgage, pay for school fees, replace lost income, and pay for regular outgoings. Mortgage life insurance is not linked to your mortgage debt so you can use it to pay off some or all of your mortgage.

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