The short answer
Most people with a health condition can get life cover. A decline is the least likely outcome of the four, and it is not the same as being uninsurable.
What varies is the terms. You might be offered cover at the standard price, at a higher price, with something specific excluded, or asked to come back later. Those are four genuinely different answers and most people have never had the difference explained.
Insurers also disagree with each other, more than you would expect, on the same set of facts. That disagreement is the whole reason a broker exists on a case like this.
The four answers, and what each one means
Almost every page on this subject uses these words without defining them. They are not interchangeable and the difference matters.
Standard terms. You are offered cover at the ordinary price for your age. This happens more often than people expect, particularly where a condition is well controlled and has been stable for a while.
A loading. You are offered full cover, but the premium is higher. Nothing is carved out. If you claim, you are paid in full. You are simply paying more for the same protection. This is the most common outcome for a managed condition.
An exclusion. You are offered cover at the ordinary price, but one specific thing is carved out. Everything else is covered normally. The wording of the exclusion is what matters here, and it is worth reading rather than skimming, because a narrow exclusion and a broad one can look similar at a glance.
A postponement. Not a no. The insurer wants more time, usually because something is recent, or a test result is pending, or treatment has just changed. They will tell you when to come back.
A decline is the fifth possibility and it is the rarest. Even then it means one insurer said no on their criteria, not that nobody will cover you.
Why two insurers reach different answers about the same person
This is the bit that surprises people, and it is worth understanding because it changes what you do next.
Insurers do not share one rulebook. Each builds its own underwriting approach from its own claims experience, its own reinsurance arrangements and its own appetite for particular conditions at a particular time. Those things change.
So one insurer may have deep experience of a condition and price it comfortably. Another may have less, and price it cautiously or not at all. Same person, same medical history, genuinely different answers, at broadly similar prices.
We are deliberately not publishing a table of which insurer accepts what. Those positions change without notice, and a table that is right today is quietly wrong in six months. Anyone publishing one is either updating it constantly or misleading you.
What is actually being assessed
Not the diagnosis label. That is the thing most people assume and it is the thing that causes the most unnecessary worry.
Underwriting is mostly interested in stability and recent history. How long since diagnosis. Whether it is controlled. Whether treatment has changed recently. Whether there have been hospital admissions or complications. Whether any tests are outstanding.
Which is why two people with the same condition on paper can be offered very different terms. Someone diagnosed eight years ago, stable on the same treatment, with no complications, is a straightforward case. Someone diagnosed four months ago whose medication changed last week is not, yet, and postponement may be the sensible answer for them rather than a bad one.
The practical implication is a hopeful one. Time and stability tend to improve the answer. If you were declined or loaded heavily a few years ago, that decision was about you then.
Most people have more than one thing
Every guide on this subject discusses one condition in isolation. Real applications rarely look like that.
A real person turns up with a higher BMI, and something they take for blood pressure, and a course of antidepressants they finished four years ago. Each of those on its own is ordinary. Together they are a case that needs putting to the right insurer in the right order, because insurers combine factors differently and some combinations matter much more to one than another.
This is the situation where a comparison form does worst and a human does best. A form asks whether you have condition X. It cannot ask the follow-up question that turns a loading into standard terms.
What to have ready before you apply
Collecting this first is the single most useful thing you can do, because it means one conversation instead of four.
- What you have been diagnosed with, and roughly when
- Current medication, doses, and when it last changed
- Your most recent relevant test results if you have them, and their dates
- Any hospital admissions, procedures or complications, with dates
- Whether anything is outstanding, such as a referral, a scan or a follow-up
- Your GP practice name and address
- Height and weight
- Alcohol and smoking history, honestly, including vaping and anything you stopped recently
Dates matter more than you would think. “About four years ago” and “March 2022” are different quality answers, and the second one gets you a firmer response.
Three things not to do
Do not guess on the form. If you are unsure of a date or a dose, say you are unsure. An honest approximation flagged as an approximation is fine. A confident wrong answer is the thing that causes problems later.
Do not leave anything out because you think it is minor. The things people omit are almost never the things that would have changed the price. They are, however, exactly the things that cause a claim to be examined closely.
Do not apply to several insurers at once to see who says yes. Applications are recorded. A trail of declines makes the next application harder, and it is entirely avoidable by asking first and applying once.
Where to start
Get your dates and your medication list together, then have one conversation before anybody submits anything.
The useful part of that conversation is not the quote. It is working out which insurer is likely to look at your particular history most favourably, and applying there once, with everything presented properly, rather than finding out by trial and error.
If the answer does come back as a loading or an exclusion, it is worth knowing that both are usually reviewable later. Terms set when something was new often are not the terms available once it has been stable for years.