What's the risk? Access to insurance for people living with health conditions

Insurance Life insurance Health advocacy Consumer protection
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What's the risk? (report) 896.25 KB

Legal Aid NSW conducted the Health Conditions and Insurance Project to better understand the experience of people living with health conditions who access general and life insurance products. The project included a survey of 281 people, a literature review, consultation with consumer and industry representatives, and analysis of case law, legislation and codes of practice. Survey participants reported difficulty obtaining appropriate insurance, particularly life and travel insurance, and also reported challenges when making claims. Some of these people perceived their treatment as discriminatory, but most people experiencing problems with insurance did not take any legal or other action.

It is unlawful to discriminate against a person because of their disability, although there are exceptions for decisions based on actuarial or statistical data on which it is reasonable for the insurer to rely. This report recommends that the insurance industry, government and consumer advocates should work together to:

  • prevent unlawful discrimination, and
  • ensure that, if unlawful discrimination does occur, people with health conditions are empowered to assert their rights.

Key findings of the survey:

Two thirds of survey participants reported difficulty in obtaining insurance because:

  • the insurer refused to sell them a policy that covered their health conditions
  • they were charged an extra premium because of their health conditions
  • the insurer refused to sell them a policy at all, or
  • they were not able to find products that suited their needs.

Some survey participants reported that:

  • they did not receive reasons for the decision to refuse cover
  • they purchased insurance but did not receive a product disclosure statement (PDS), or the PDS was confusing
  • the medical assessment process was inappropriate, or
  • they perceived that they were being discriminated against.

Survey participants reported the following challenges when making claims:

  • being discouraged from making a claim
  • having their claim denied because of their health condition
  • not being given information that the insurer relied upon to refuse the claim, not being given information about complaints processes, and not being given the decision in writing
  • onerous procedural requirements for making a claim, including multiple forms and repetitive requests for information, and
  • negative attitudes of some medical professionals towards insurance claims


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