Life insurance in Ireland with a pre-existing condition — what to disclose and how it is priced

The disclosure duty has changed — and the change matters

Before December 2019, an Irish life insurance applicant owed the insurer a duty of “utmost good faith” — an open-ended obligation to volunteer anything that might be material to the insurer’s assessment, whether or not the question had been asked. The duty was wide, ambiguous, and — in claim disputes — routinely produced bad outcomes for consumers who had answered the questions on the form correctly but had not volunteered additional information they did not know was relevant.

The Consumer Insurance Contracts Act 2019 replaced that duty. Section 16 of the Act sets the current Irish standard: the consumer is required to answer the specific questions the insurer asks, honestly and with reasonable care. The duty now runs to the questions actually asked. If the application form does not ask about a particular fact, the consumer is not required to volunteer it. That is a meaningful protection — but it places a corresponding obligation on the consumer to answer the questions that are asked fully, accurately, and the first time.

The four possible underwriting outcomes

An Irish life insurance application that discloses a pre-existing condition produces one of four outcomes:

1. Standard rates. The condition is well-controlled, stable, or far enough in the past that the underwriter assesses no additional mortality risk. Premium is the standard rate for the age and sum assured.
2. Loaded premium. The underwriter assesses some additional mortality risk and applies a percentage loading on the standard premium — commonly +25%, +50%, +75% or +100% ("double"), occasionally higher. The cover is otherwise standard.
3. Exclusion. The cover is issued at standard or loaded rates, but with one or more named conditions excluded — i.e. the policy will not pay if death or serious illness is caused by that excluded condition. Common on serious illness cover; less common on life cover.
4. Decline. The underwriter is unable to offer cover. The application is declined. The decline does not, on its own, prevent the applicant applying to a different office — each office underwrites independently, and some offices will accept risk that another office declines.

The five Irish life offices do not underwrite identically on identical disclosures. The order of competitiveness changes by condition class — the most competitive office on diabetes is not the most competitive office on a cardiac history, and neither is necessarily the most competitive on a mental health disclosure, as the underwriting guide sets out. Comparing across all five offices is the only reliable way to find the best outcome for a specific case.

Diabetes — type, control and complications

Diabetes is one of the most commonly disclosed pre-existing conditions on Irish life applications. Underwriting is driven by three variables: the type of diabetes (type 1 or type 2), the control (HbA1c results over time, current medication, episodes of hypoglycaemia or hyperglycaemia), and the complications (retinopathy, nephropathy, neuropathy, cardiovascular disease).

Type 2 diabetes, well-controlled (HbA1c consistently under 53 mmol/mol, no complications, diagnosed at an older age) is commonly offered at loadings between +25% and +75% on life cover at most Irish offices. Type 2 with poorer control or with early complications typically attracts higher loadings (+100% to +200%) or selective declines.

Type 1 diabetes is materially more difficult to underwrite. Some Irish offices will offer life cover at loadings of +100% upward depending on age at diagnosis, current control and complications. Type 1 diagnosed in childhood with long-standing complications can attract decline outcomes at some offices and acceptance with high loading at others. The competitive spread on type 1 diabetes is the largest of any major chronic-condition underwriting class in the Irish market.

Cardiovascular history — the most consequential disclosure

Cardiovascular disclosures — hypertension, raised cholesterol, family history, prior cardiac events, current cardiac medication — are the single most consequential category on Irish life applications. Cardiovascular disease is the leading cause of death in Ireland; the underwriting reflects that.

Well-controlled hypertension (current readings within target on stable medication, no end-organ damage) is commonly offered at standard rates or with a small loading (+25%) at most Irish offices. Raised cholesterol, treated and controlled, similarly. The combination of hypertension and raised cholesterol, or either with a strong family history of premature cardiac disease, raises the loading materially.

Prior myocardial infarction, prior coronary intervention (angioplasty, stenting, bypass surgery), or a confirmed cardiomyopathy diagnosis typically results in selective declines on life cover from one or more Irish offices, with the offices that do offer cover applying loadings of +100% upward and frequently combining the loading with serious illness exclusions for cardiac conditions. Time elapsed since the event matters — a cardiac event five years ago underwrites differently than the same event in the last twelve months.

Cancer history — type, stage and time elapsed

Underwriting of a cancer history depends on three variables: the type of cancer (the underlying tumour biology), the stage and grade at diagnosis, and the time elapsed since completion of treatment with no evidence of recurrence. The five-year disease-free mark is a common watershed in Irish underwriting practice; the ten-year mark is another.

Low-stage, low-grade cancers fully treated more than five years ago — early-stage prostate cancer, low-grade breast cancer with clean margins, early-stage melanoma at appropriate Breslow depth — are commonly offered at standard rates or small loadings on life cover at multiple Irish offices. Higher-stage or higher-grade cancers, or any cancer within the first two to three years of treatment, typically attract material loadings or selective declines. Active or recently treated cancer (still on treatment, or in immediate post-treatment surveillance) is rarely offered life cover by any Irish office at this stage — the underwriting decision typically waits until the post-treatment disease-free interval is sufficient.

Cancer history is one of the underwriting classes on which the competitive spread between offices is widest. The same diagnosis ten years prior, cleanly treated, can produce a standard rate at one Irish office and a +75% loading at another. Whole-of-market comparison is particularly valuable in this class.

Mental health disclosures — depression, anxiety, and the rest

The mental health underwriting picture in the Irish market has changed materially in the last five years. The historic position — default decline or heavy loading on any disclosure — has been replaced at most Irish offices by a graduated underwriting framework that responds to the specific condition, severity, time elapsed and current functional status. Our guide on mental health and life insurance covers this domain in detail. A short summary:

• Mild to moderate depression or anxiety — single episode, fully resolved, no recent treatment, no functional impact — is typically offered at standard rates or with a small loading on life cover.
• Recurrent depression or anxiety — multiple episodes, ongoing medication, or current treatment — typically attracts a +25% to +75% loading on life cover at most Irish offices.
• Significant historic mental health events — hospitalisation, suicide attempt, severe episode — attract higher loadings (+100% upward) and the competitive spread between offices widens materially. Time elapsed is a key variable.
• Active severe mental illness — currently unstable bipolar disorder, recent psychotic episode, active suicidal ideation — is the underwriting class where decline outcomes are most common. Some Irish offices have moved further than others on this class.

BMI, weight and lifestyle disclosures

BMI is asked on every Irish life application. The Irish market standard rates band runs from approximately BMI 18 to BMI 32; outside that band loadings begin and steepen as BMI rises. A BMI of 35 typically attracts a moderate loading; a BMI of 40 attracts a larger loading and begins to interact with co-morbidities (hypertension, diabetes, sleep apnoea) that raise the picture further. Recent weight loss is generally viewed positively; recent rapid weight gain is a question the underwriter may follow up.

Alcohol consumption is asked on every application. Standard rates apply within the Irish low-risk weekly limits (currently 11 standard drinks for women and 17 standard drinks for men, per HSE guidance). Above that threshold, loadings begin. A history of alcohol dependence, residential treatment, or alcohol-related liver disease attracts material loadings and in some cases declines on life cover.

Hazardous pursuits — motor sport, climbing, diving, certain aviation activities — are commonly addressed by exclusion (the policy pays except where death is caused by the named pursuit) rather than by premium loading. The applicant has the choice of accepting the exclusion or paying a loading where the office offers that route.

What complete disclosure actually requires

Disclosure under §16 of the Consumer Insurance Contracts Act 2019 is tested by reference to the questions on the application form. The questions are typically open and require complete answers. The pattern of incomplete disclosure that produces declined claims is consistent:

• Listing some consultations but not all. A question about "any consultations with a GP in the last five years" requires every consultation, not a representative sample.
• Listing some medications but not all. A question about "any medication taken regularly" requires every regular medication, including over-the-counter regulars, including PRN medication used regularly.
• Treating ‘test’ results as non-events. A blood test result outside the normal range, even if no diagnosis was attached, is typically disclosable if asked about. "The GP said it was fine" is not a substitute for disclosing the actual result.
• Forgetting investigations that produced no diagnosis. A scan, an endoscopy, a cardiac investigation that returned normal results is still an investigation, and if asked about, must be disclosed.
• Not disclosing family history when asked. Family history of cancer, cardiac disease, or hereditary conditions is asked specifically and must be answered specifically.

Where the 2025 claims data lands

The 2025 mylife.ie whole-of-market claims report shows the five Irish life offices paying €919.2m in protection claims across 18,200+ individual claims, with life-cover paid rates of 97–99% across the disclosing offices. The 1–3% of life-cover claims that are not paid almost always fail at the application stage — material non-disclosure under §16 of the Consumer Insurance Contracts Act 2019 — not at the claim stage.

Irish Life publicly states that material non-disclosure is the main reason death claims are not paid. New Ireland’s 2024 disclosure showed all three declined death claims that year were on non-disclosure grounds. The 2025 dataset shows the same pattern across the disclosing offices. For an applicant with a pre-existing condition, complete and accurate disclosure is not just a regulatory obligation — it is the single biggest action they can take to ensure the policy they buy will pay when needed.

How mylife.ie approaches pre-existing conditions

mylife.ie is a whole-of-market intermediary regulated by the Central Bank of Ireland (C42382). On applications involving a disclosed pre-existing condition, a QFA-qualified adviser takes the medical history in detail, prompts the applicant on each underwriting question, and submits a complete picture to the chosen office. The recommendation considers all five Irish life offices and weights the comparison toward the offices whose underwriting framework responds most favourably to the specific condition class.

Using a whole-of-market broker does not transfer the legal duty of disclosure — that remains with the consumer under the Act. What it changes is the practical chance of a complete disclosure, a clean underwriting outcome, and a contract that will pay when needed. We do not claim to be the cheapest in every case — we claim to compare every case. Every case reviewed by a QFA.

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