Pre-Existing Conditions and Life Insurance: What You Need to Disclose

The duty of disclosure is one of the most misunderstood aspects of life insurance. Applicants sometimes omit health information because they assume it is old, irrelevant, or minor. Others are not sure what counts as "material." A few deliberately conceal conditions they believe would affect the premium.

All of these approaches create significant risk. A non-disclosed condition can lead to a policy being voided — at exactly the moment the family needs the money most. This guide explains the legal framework, the most commonly disclosed conditions and their underwriting consequences, the "proportionate remedy" that modern law applies, and how to use specialist underwriters for complex health histories.

The Legal Framework: CIDRA and the Insurance Act 2015

Consumer Insurance: CIDRA 2012

For personal (consumer) insurance policies — life insurance, critical illness, income protection taken out by an individual for personal purposes — the Consumer Insurance (Disclosure and Representations) Act 2012 (CIDRA) applies.

Under CIDRA, the applicant must take reasonable care not to make a misrepresentation to the insurer. "Reasonable care" is assessed objectively — would a reasonable person in the applicant's position have considered this information material and disclosed it?

CIDRA replaced the older common law duty of "utmost good faith" (uberrimae fidei), which required the applicant to proactively disclose everything that might conceivably be material, regardless of whether the insurer asked. Under CIDRA, the starting point is the insurer's questions — if the insurer asks a question, answer it honestly and completely. If the insurer does not ask about something specific, the applicant is not automatically obliged to volunteer it (though there are exceptions for facts so clearly material that any reasonable person would know they should be disclosed).

In practice: Most modern life insurance applications are highly detailed. The insurer asks about your height and weight, smoking status, alcohol consumption, family medical history (parents' and siblings' conditions, particularly heart disease, cancer, and diabetes), personal medical history (conditions diagnosed, symptoms under investigation, medications, hospital visits), mental health history, hazardous activities, and overseas travel plans. Answer all questions fully, accurately, and completely.

Business Insurance: Insurance Act 2015

For business insurance policies — key person cover, shareholder protection, relevant life policies taken out by a company — the Insurance Act 2015 applies. The Insurance Act 2015 imposes a "fair presentation of the risk" duty, which is more demanding than CIDRA's "reasonable care" standard.

Under the Insurance Act 2015, the policyholder must disclose every material circumstance known (or that ought to be known) to senior management — not just the specific individuals filling in the form. This creates obligations to investigate and disclose matters that may be within the organisation's knowledge even if not known personally to the form-completer.

For most small business protection policies, the practical difference from CIDRA is modest. But for larger or more complex business insurance arrangements, the Insurance Act 2015's requirements are more onerous.

The Proportionate Remedy: What Happens if You Under-Disclose

Under the old law, any material non-disclosure gave the insurer the right to avoid the policy — cancel it entirely and refund the premiums paid. Even an innocent mistake could result in the policy being void.

CIDRA significantly changed this. The insurer's remedy now depends on the nature of the misrepresentation:

Deliberate or reckless misrepresentation: The insurer can still avoid the policy, decline to return any premiums, and potentially report the matter as fraud.

Innocent or careless misrepresentation: The insurer applies a "proportionate remedy":

• If the insurer would still have issued the policy on the same terms had the disclosure been made → the insurer pays the full claim
• If the insurer would have charged a higher premium → the insurer pays a proportionate claim (the proportion reflecting what the premium would have bought)
• If the insurer would not have issued the policy at all → the insurer can avoid the policy but must return all premiums

For example: an applicant forgets to mention a previous episode of mild anxiety disorder treated five years ago. The insurer would have accepted the policy but with a 25% premium loading for mental health conditions. Under CIDRA, the insurer pays 80% of the claim (the proportion that the actual premium paid represents of the loading premium that should have been charged).

This is fairer than the old regime but still represents a significant reduction in the claim payout. The message remains: disclose fully.

Commonly Disclosed Conditions and Their Underwriting Impact

Mental Health Conditions

Depression and anxiety are among the most common disclosed conditions and the most common causes of income protection claims. Underwriting varies significantly by:

• Severity: A single episode of mild depression treated with a short course of antidepressants, fully resolved, three years ago → standard terms possible for life insurance; possible loading or exclusion for IP
• Recurrence: Multiple episodes, ongoing treatment → premium loading on life; exclusion of mental health conditions from IP (or whole-policy exclusion if severe)
• Recent episodes: A current or very recent episode → likely postponement until remission

IP policies for individuals with a history of mental health conditions require particular care. Mental health claims account for around 30% of all IP claims in the UK — meaning insurers underwrite the mental health risk carefully. An exclusion of mental health conditions from an IP policy is a meaningful limitation.

Cardiovascular Conditions

Hypertension (high blood pressure), high cholesterol, previous heart attack or cardiac event, and family history of early cardiovascular disease (father or sibling dying before age 60 from heart disease) all attract underwriting attention.

• Controlled hypertension on medication: Usually insurable at standard or slightly loaded rates for life insurance
• Previous heart attack (over five years ago, fully recovered): Typically insurable with a premium loading; possible CI exclusion for further cardiac events
• Atrial fibrillation (AF): Depends on controlled vs uncontrolled; controlled AF may be standard or loaded; uncontrolled → loaded or declined
• Family history: A single first-degree relative with cardiovascular disease is noted; multiple relatives or early onset → premium loading

Cancer History

Cancer underwriting depends critically on the type of cancer, the stage, the treatment, and the time since completion of treatment:

• Cancer over five years ago with full remission (curative treatment completed): Standard terms possible for some cancers (e.g., early-stage skin cancer (BCC)); other cancers may be accepted with a loading or exclusion even after five years
• Cancer within the last one to five years: Standard terms unlikely; loading, exclusion of further cancer CI claims, or decline depending on type and stage
• Active treatment: Typically declined; applications postponed until treatment is complete and remission confirmed

CI policies for cancer survivors need particular scrutiny: the policy may exclude "further occurrences of the same cancer" or "any cancer" — meaning the CI lump sum is available only for non-cancer conditions. Check the specific exclusion wording carefully.

Diabetes

Type 1 and type 2 diabetes are both disclosable:

• Type 1 diabetes, well controlled: Premium loading for life insurance; loading or exclusion for CI; IP may be available with a loading
• Type 2 diabetes, diet/medication controlled: Possibly standard terms for life if well controlled; loading if not; similar considerations for CI and IP
• Complications: Retinopathy, neuropathy, nephropathy → more significant loading or decline

Mental Health, Diabetes, Cancer, Cardiovascular: The Intersection

Individuals with multiple conditions face compounded underwriting responses. An applicant with controlled hypertension, type 2 diabetes, and a mild depressive episode three years ago may find that each condition individually is insurable with a loading — but the combination may result in a significant overall loading or exclusion.

This is precisely the scenario where specialist underwriters add value.

Specialist Underwriters: The Route for Complex Health Histories

Standard online insurance applications are designed for the broadly healthy majority. They produce automatic declines or postponements for anyone with a moderately complex health history.

Specialist impaired-risk underwriters and markets include:

Specialist insurers: Zurich Insurance's medical special risks team; Legal & General's specialist underwriting team; Scottish Widows' complex cases team

The Lloyd's of London market: Lloyd's underwriters take on risks that standard admitted insurers decline. Bespoke terms — potentially with exclusions, loadings, or defined maximum sum assureds — are available for conditions that standard online systems refuse.

Specialist reinsurers: Most UK life insurers use reinsurers (Munich Re, Swiss Re, Hannover Re, RGA) to manage their risk. For complex cases, the insurer's underwriter will refer to the reinsurer's medical team, whose capacity to accept risk is typically greater than the insurer's standard guidelines.

The key to accessing specialist underwriting is using a specialist broker — an adviser with established relationships with the relevant underwriting teams and experience in presenting complex cases in the format that gets the best result.

Do not attempt to obtain cover for complex pre-existing conditions through an online comparison site or a generalist adviser who does not deal with impaired lives regularly.

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The disclosure requirements described in this guide reflect UK law as at 2026 under CIDRA 2012 and the Insurance Act 2015. Individual policy terms and insurer underwriting practice vary — what one insurer will accept at standard terms, another may decline. The information about specific conditions is general guidance only; underwriting decisions depend on the specific medical facts. Always seek advice from a qualified financial adviser with experience of impaired-life underwriting before applying for life, CI, or IP insurance with a pre-existing condition.

How Global Investments can help

Global Investments has access to specialist underwriting markets, including Lloyd's of London, for clients with complex health histories or pre-existing conditions. We prepare comprehensive cases for specialist underwriters and manage the negotiation of terms on your behalf — maximising the scope and minimising the cost of cover for applicants who would be declined or significantly loaded through standard channels. Contact us for a confidential discussion about your underwriting position.