Insurance with diabetes in NZ: Health, life and other cover options

Sample insurance premiums with diabetes

Premiums for someone with diabetes are quoted individually, so there is no price list to read off. One panel insurer structures loadings as either a percentage added to the premium payable, or a dollar amount charged per $1,000 of cover.

Sample life insurance premiums with diabetes, illustrative loading bands based on one panel insurer's published scale.

NOTE: Indicative only. Generated in November 2026

See Policywise's guide to life insurance cost for how these loadings compare to standard premiums.

Getting health insurance if you have diabetes

You can apply for health insurance with diabetes in New Zealand, and most providers on Policywise's panel assess the condition individually, though a couple of plans use a blanket pre-existing rule instead.

The usual result is cover that works normally for everything else, with diabetes itself either excluded or subject to a stand-down period (a waiting period before cover for that condition begins).

Having pre-existing conditions doesn't mean you can't get cover at all, or that these health issues will be automatically excluded from your policy. Insurers generally won't cover a pre-existing condition unless they've specifically agreed to, and if they do agree, you'll probably pay a higher premium to reflect the risk instead.

Pre-existing-condition definitions are not standardised across the market, so the same diabetes diagnosis can be treated differently from one insurer to the next.

See Policywise's guides to health insurance and pre-existing conditions and diabetes in New Zealand.

What to look for in health cover when you have diabetes

No single plan is best for everyone with diabetes, because the benefits that matter here sit in the detail rather than the headline. What is worth comparing is how a plan handles medicines Pharmac does not fund, how much specialist and diagnostic cover it carries, and what you pay per claim; Policywise's compare health insurance NZ tool compares these features across insurers.

• Non-Pharmac medicine cover. Some providers tie this to an accepted hospital claim, so read the trigger, not just the limit. See Policywise's guide to non-pharmac approved drugs.
• Specialist and diagnostic cover. Annual limits range from a few thousand dollars to unlimited specialist consultations on some plans, and a few tie the benefit to an approved surgical claim rather than paying it standalone.
• What you pay per claim. Plans use different models for this: a per-claim excess chosen from $0 up to several thousand dollars, or a fixed co-payment percentage instead.
• Equipment. Some providers exclude insulin pumps and monitoring equipment as appliances.

How health insurers assess diabetes

Health insurers assess diabetes from a medical declaration you complete at application, then decide whether to cover the condition, exclude it, or apply a waiting period before covering it. Most providers on Policywise's panel do this individually, with a couple of plans applying a blanket pre-existing rule instead.

What underwriters ask for

One panel insurer's health declaration asks you to name diabetes and fill in the details, alongside other glandular disorders such as gout and thyroid conditions. Its form asks for:

• When you were diagnosed, and how long you have had it.
• Your most recent episode, investigation, or change of treatment.
• Current medication.

Possible outcomes

Four outcomes are documented for a health application with diabetes: standard rates with the condition covered, acceptance with a premium loading, acceptance with diabetes excluded, or acceptance with a stand-down before it is covered. Two of the five health insurers on the panel describe no loading mechanism at all.

Diagnosed with diabetes after getting health insurance?

A diabetes diagnosis made after your health policy started is generally covered by that policy. Pre-existing condition clauses are anchored to the date your cover began, so a condition that first arises afterwards is not caught by them.

Changing insurer afterwards is the bigger risk, though seven of the eight providers on Policywise's panel impose no ongoing duty to report a change in health on the cover you already hold.

Is diabetes covered under health insurance?

Diabetes is covered under health insurance when it develops after your policy starts. If you already had it at application, the usual position is an exclusion. This isn't universal, though: some plans apply a waiting period instead, and one plan covers pre-existing conditions in full from day one with no health declaration at all.

A health policy pays for private treatment such as specialist care and complications; it does not cover routine day-to-day management, most of which is publicly funded.

For example:

• A diabetes eye check costs you nothing, five years after a type 1 diagnosis and from diagnosis for type 2.
• Pharmac funds continuous glucose monitors for type 1 (and some other types) but not type 2; insulin pump funding depends on a diabetes team's clinical assessment rather than diagnosis type.

When you still need to tell your health insurer

The duty to disclose does not run continuously. It re-attaches at specific events, and on one panel insurer's health cover there are five: upgrading your plan, adding a member, adding a member and upgrading together, transferring to another policy and upgrading, and leaving a workplace scheme.

The window for leaving a workplace scheme is short: members changing employers have 30 days to ask about keeping cover for conditions that developed while covered. On that insurer, where a change needed a fresh declaration, the cut-off becomes that date, so a diagnosis can become newly pre-existing.

Reviewing your medical cover after a diagnosis

A diagnosis is a reason to read your policy, not to replace it. Conditions that developed while you were covered are generally covered by that insurer, and a new insurer would probably treat them as pre-existing and could decline related claims. So start with what you already hold.

• It's worth checking what your plan pays for specialist consultations, imaging, and medicines Pharmac does not fund.
• It's worth checking the certificate for whether a diagnosis needs reporting, rather than assuming.

Talk to a Policywise adviser if you'd rather have it reviewed for you.

Getting life insurance if you have diabetes

Yes, you can get life insurance with diabetes in New Zealand, usually with a premium loading, an exclusion, or a deferral. The six life insurers on Policywise's panel each assess diabetes individually instead of declining it on the diagnosis alone.

For the basics, see Policywise's what is life insurance guide.

No published New Zealand figure exists for how often diabetes leads to a decline or a loading, so treat any band below as a shape, not a quote.

See Policywise's guide to life insurance and pre-existing conditions.

How life insurers assess diabetes

At least one panel insurer assesses diabetes by type first, then by how well controlled it is, how long you have had it, and whether complications have appeared. On that insurer's criteria, type 1 and type 2 are treated differently, and gestational diabetes and pre-diabetes are each handled on their own terms rather than folded in with type 2.

Indicative terms from the one panel provider that publishes them:

What underwriters ask for

One insurer's published approach is to want evidence of control over time rather than a diagnosis date, and it publishes its full evidence list as follows:

• The type of diabetes, your age at diagnosis, and how long you have had it.
• How well controlled it is, best evidenced by HbA1c (a blood test showing average blood glucose over roughly the past three months) results.
• Treatment compliance and any complications such as retinopathy, kidney impairment, or nerve damage.
• Cardiovascular markers such as high blood pressure and high cholesterol.

Possible outcomes

A life application with diabetes usually ends in one of four outcomes: standard rates, a premium loading, an exclusion for diabetes and its complications, or a deferral until better evidence is available. Four panel insurers' own policy wordings document a loading as an outcome, a fifth publishes detailed diabetes-specific figures in its underwriting guidance, and exclusion is documented just as often.

An exclusion can be permanent or set for a fixed period, and a deferral is a wait rather than a refusal. 12 months is the published figure for a recent type 2 diagnosis.

Diagnosed with diabetes after getting life insurance?

A diabetes diagnosis after your life policy started does not change that policy. The duty of disclosure attaches when you apply and at renewal, not continuously, and at least one panel insurer promises in its wording not to change the premium on an existing cover because your health changed.

Separately, the law limits how far back a misstatement in the original application can be held against you. A life policy cannot be avoided for a statement in the proposal unless it was substantially incorrect and material, and was made fraudulently or within three years before the avoidance or the death, whichever comes first.

When you still need to tell your life insurer

On life cover, the trigger is a new application, not a new diagnosis. Panel insurers document disclosure duties attaching when you apply for cover, when you reinstate a policy that has lapsed, when you move to a new insurer, and when you increase cover outside a guaranteed-insurability facility (a set future-cover increase that doesn't need new medical evidence).

Switching is the trigger that costs people the most. A new insurer takes your whole medical history into account, which can mean exclusions, a higher premium, or losing cover you already had.

Reviewing your life cover after a diagnosis

Start by checking what the life cover you already hold does for you, because a diagnosis can trigger a benefit rather than a problem. Most trauma products on Policywise's panel name severe diabetes as a covered condition, and several pay a partial benefit on a new adult-onset type 1 diagnosis alone.

The "Trauma (critical illness) cover" section below has the detail.

• It's worth reading the diabetes definition in your trauma policy, and the severity thresholds it sets, before assuming there is nothing to claim.
• It's also worth checking for a special events or future insurability option. Some providers' versions let you increase cover without new medical evidence, though any existing loading carries through.

Diabetes and other types of cover: Trauma, disability, income, mortgage, funeral, and group insurance

Diabetes lands differently on each product. On trauma cover, it is a named insurable event. On income protection, mortgage protection, and disability cover, it is typically a loading, exclusion, or deferral set at underwriting that bites only on diabetes-caused claims. On workplace cover, it may not be underwritten at all.

Trauma (critical illness) cover

Trauma insurance is the product where diabetes is most likely to pay out rather than be carved out. Severe diabetes is a named covered condition on six of the seven panel insurers selling trauma cover, and a new adult-onset type 1 diagnosis triggers a partial payment on four of them.

See Policywise's critical illness vs disability comparison for how trauma cover differs from income protection and TPD.

If you already hold it, the question is whether a complication has reached the severity the definition requires. If you are buying after a diagnosis, expect diabetes to be excluded, which still leaves the cover working for cancer, heart attack, and stroke.

Total and permanent disability (TPD) cover

No panel TPD wording names diabetes. Total and permanent disability cover is triggered by a functional test, so what matters is what you can and cannot do rather than what caused it. Severe complications of diabetes can reach those tests.

One common formulation of the non-occupational test (the fallback test used alongside the primary occupational test) covers irreversible loss of sight in both eyes, total loss of use of both hands or feet (or one of each), or an inability to perform at least two activities of daily living unaided.

Apply after a diagnosis and any exclusion goes on your schedule; a diagnosis on cover you already hold changes nothing.

Income protection

No panel income protection wording names diabetes. An exclusion is applied at underwriting, and because the disability test is generic, it bites only on claims caused by diabetes. A diagnosis on cover you already hold does not disturb it.

Income protection matters more with diabetes than people expect, because ACC income protection cover works differently: ACC covers accidents and not illness. Personal injury generally excludes anything caused wholly or substantially by a gradual process, disease, or infection, subject to narrow exceptions mainly covering work-related illness and injury arising from treatment, so ACC won't step in if diabetes causes a long absence from work.

Not every health insurer sells income protection, so compare wider than yours. See Policywise's income protection vs TPD comparison for how this differs from TPD cover.

Mortgage protection

Mortgage protection is underwritten no more lightly than life cover. On the three panel products, diabetes is assessed at application under the same policy-wide pre-existing test, and any exclusion is recorded on your schedule rather than written into the wording.

The monthly repayment benefit uses a generic total disability test, so a severe complication that meets it triggers the benefit like any other disabling illness. If you already hold the cover, a later diagnosis does not disturb it.

Funeral cover

Funeral cover is one of the few products sometimes sold without individual underwriting, alongside a non-underwritten health plan and scheme-wide automatic acceptance on some group covers, which is why it can stay open to someone a life insurer has declined or heavily loaded.

At least one panel insurer offers guaranteed acceptance within a set age band, with no medicals and no health questions, though its own stand-down for a non-accidental death runs 24 months.

That is not a market norm, and it carries two catches. Many funeral policies in the market generally pay out in the first 12 months only if the death was accidental, and as you age, the premiums paid can exceed the payout.

If you already hold funeral cover, a later diagnosis does not affect it. Policywise's position is that a standalone funeral policy is rarely the right first answer; its guide sets out the alternatives.

Group and workplace cover with diabetes

Group and workplace cover is the option a diabetes diagnosis is least likely to spoil, because many group schemes skip individual underwriting. Two panel life insurers admit eligible employees up to an automatic acceptance level with no medical underwriting, gated on being at work rather than on health history.

Those schemes typically need 10 or more lives, and above the acceptance level, at least one of them provides only interim accident-only cover while underwriting runs.

Policywise's published position is that pre-existing conditions are covered instantly from five or more staff for health insurance, and from 15 for life, trauma, and income protection. A scheme admitting members without medical underwriting is worth checking if you've been declined or loaded individually.

See what group income protection and group trauma cover would add first.

How to get better terms with diabetes

The thing most within your control is the quality of the evidence you hand the underwriter. A New Zealand annual diabetes review closely overlaps with what some insurers' evidence requests ask for, so it's worth asking your GP for the results before you apply.

• HbA1c results, ideally a run of them rather than one. A target under 53 mmol/mol suits most adults with type 2 diabetes.
• A cardiovascular risk assessment, lipid levels, and renal and liver function tests.
• Up-to-date retinal photoscreening and a recent foot examination, kept current: one insurer's guide treats blood tests as valid for about 12 months, with abnormal results needing to be repeated.

Most panel providers underwrite diabetes case by case; a couple of plans use no medical underwriting at all. One insurer saying no does not settle the question: underwriting guides are published as guidelines only, with each application given individual consideration.

The comparison above shows real divergence between insurers too, with five of eight panel providers documenting a loading as an outcome and two documenting none at all. A previous avoidance or cancellation of cover is itself material information you have to disclose on a later application.

Being up front is not the same as being stuck with it, and your adviser can tell you how a given insurer underwrites diabetes before you apply.

Can a loading or exclusion be removed later?

Sometimes. Health cover commonly reviews exclusions by the passage of time. Life cover generally does not, and only one of the six life providers on Policywise's panel publishes a review process at all.

On the health side, three of the five health-selling panel providers document a review path. The mechanisms are:

• An automatic rule after three years of continuous cover, though on at least one plan a diabetes-related cardiovascular exclusion can be permanent and never clear, regardless of that rule.
• A review period printed on the certificate.
• A five-year window on lump-sum products.
• Time-limited exclusions that simply expire.

On the life side, the one published process asks for a full application so the risk can be reconsidered, and the insurer says that if the risk has reduced, it will decrease or remove the loading.

Separately, at least one health insurer lets you ask for an excluded pre-existing condition to be reconsidered once you're no longer experiencing it or needing ongoing care for it; where an insurer agrees to cover a pre-existing condition, a higher premium will probably apply to reflect the added risk.

Better control gives you something to argue with. Type 2 diabetes can sometimes be put into remission for at least five years through weight loss, a low-calorie diet, or bariatric surgery. There is no cure for type 1.

Improved control is not portable, though. It's worth asking your existing insurer for a review rather than re-applying elsewhere, because a new policy can exclude your diabetes as pre-existing and bring a fresh qualifying period.

Will your claim be paid if you have diabetes?

Yes, provided diabetes was disclosed, any resulting exclusion or loading doesn't rule the claim out, and the policy's own definition is met. Non-disclosure can lead to a declined claim, and so can a definition your diagnosis does not reach.

For type 2 diabetes, and for type 1 diagnosed before age 30, a trauma claim needs the specified complications at the stated severity, though the number and the complications required vary by provider, from one of four complications on most products to two of three on one provider's wording. A first-ever type 1 diagnosis after age 30 is itself a named trigger on several panel products.

See how insurers would handle this claim in Policywise's insurance claim guide.

Non-disclosure is a real but bounded problem. About 10% of complaints to the ombudsman involve it, and pre-existing medical conditions are the most commonly undisclosed thing.

The legal test is whether the statement would have influenced a prudent insurer's judgement in setting the premium or in deciding whether to take or continue the risk on substantially the same terms.

Two decided New Zealand cases illustrate how this can play out. In the first, a life application omitted six conditions, including diabetes and high cholesterol, two of which independent underwriters found material; the insurer made a reduced payment plus $10,000 in goodwill, which the ombudsman found fair.

In the second, an undisclosed raised HbA1c led the insurer to avoid the policy, before the ombudsman obtained three independent underwriting opinions and the insurer reinstated it, paying $66,560 with a retrospective 50% loading.

The current law does not distinguish innocent from deliberate non-disclosure, which the ombudsman calls harsh. That changes on 15 November 2027, when the Contracts of Insurance Act 2024 requires only that a consumer took reasonable care not to misrepresent, replacing the current duty to proactively disclose everything material.

The other way a claim fails has nothing to do with disclosure: the clinical thresholds in a trauma definition simply aren't reached. In one decided case (not a diabetes claim), the clinical criteria in the definition weren't met, and the complaint was not upheld.

The same logic would apply to diabetes, where the thresholds cover retinopathy, neuropathy, kidney impairment, and gangrene requiring surgery at stated severities.

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