Buyer's Guide · May 2026

Do I need a medical exam for life insurance in Ireland?

Q: How long does mortgage protection underwriting take in Ireland?

For straightforward cases (declaration only), cover is typically in force within 24–48 hours. If a Permanent Medical Attendants Report (PMA) is required, allow 2–4 weeks. Nurse exam cases take 4–6 weeks. Plan your mortgage timeline accordingly — do not leave the application until the week before drawdown.

Q: Can a declared condition be covered without a medical exam?

Yes — many declared conditions are accepted at standard or rated terms on the basis of the declaration alone, without a PMA. Well-controlled hypertension, mild anxiety managed without medication, and a single previous minor procedure may all fall within Tier 1 depending on the insurer's underwriting guide.

Q: Can I be declined life insurance in Ireland?

Yes, though it is uncommon for mortgage protection. Declinature is most likely where there is a significant undisclosed condition, a very high BMI, or active serious illness. The Consumer Insurance Contracts Act 2019 requires insurers to give reasons for declinature.

Q: What happens if the insurer asks for a medical and I have not had a GP check-up in years?

The insurer sends the PMA request to your registered GP with your consent. If your GP has no recent records, they will note that in the report. The insurer will typically request a blood test or nurse exam to establish a baseline rather than declining cover.

Q: Does taking out a higher sum assured always trigger a medical?

Not necessarily — it depends on your age and health. A 35-year-old non-smoker in standard health can typically get €600,000–€750,000 of cover with a declaration only across some of the five Irish life offices. Over those thresholds, or for older applicants, further evidence is standard.

Most applicants get same-day cover with no medical exam — here is what triggers each level of underwriting.

By Donal Milmo-Penny QFA FLIA · May 2026

The 40-word answer

Most Irish life insurance applicants under 40 with no declared medical history and sums under €500,000 get same-day cover based on a declaration only — no exam required. A Permanent Medical Attendants Report (PMA), nurse exam, or full medical is triggered by declared conditions, family history, larger sums, or older age at application.

The four tiers of medical underwriting in Ireland

Understanding which tier applies to your profile is the most important practical step before applying — it lets you plan your mortgage timeline correctly.

Tier 1 — Declaration only (same-day cover)

The standard case. An applicant completes the online application, answers the medical declaration questions honestly, and the insurer issues cover the same day. No medical report, no exam, no waiting.

·Age at application: typically under 40 (some offices extend to 45)
·Sum assured: typically under €500,000 (some offices up to €750,000 for straightforward cases)
·No declared medical conditions, surgery, or ongoing medication beyond routine
·No significant family history (parents deceased before 60 from hereditary conditions)
·Non-smoker or declared smoker without additional risk factors
·BMI within the normal range (typically BMI 18–30 for automatic acceptance)

Tier 2 — Permanent Medical Attendants Report (PMA / PMAR)

A PMA is requested from your registered GP, covering your medical history, current medications, any diagnoses, and recent consultations. PMAs typically take 2–4 weeks to arrive. The insurer pays the GP fee directly in most cases.

·Declared conditions: hypertension, elevated cholesterol, anxiety or depression treated with medication, Type 2 diabetes, previous surgery
·Significant family history: parent or sibling with heart disease, cancer, or stroke before age 60
·Sums assured between €500,000 and €750,000 for applicants aged 40–50
·BMI between 30 and 35 (depending on insurer threshold)
·Any conditions flagged in the declaration that the insurer's underwriter needs more detail on

Tier 3 — Paramedical / nurse exam

Carried out at your home or workplace at the insurer's expense. Typically includes blood pressure, height/weight, blood sample (full blood count, lipid profile, HbA1c, liver function), ECG for older applicants, and urinalysis. Takes 1–3 weeks to organise and report. Triggered by sums over €750,000, applicants aged over 50, or complex health history.

Tier 4 — Full consultant medical

A full medical examination by a named consultant, usually for sums over €2 million or complex cases. Rare for standard mortgage protection.

How underwriting thresholds compare across the five offices

Requirement	Royal London	Aviva	Zurich	Irish Life	New Ireland
Declaration-only upper limit (age <40)	€750k	€500k	€500k	€600k	€500k
Nurse exam triggers from	€1.5m+	€750k+	€750k+	€1m+	€750k+
Non-smoker definition	12 mths nicotine-free	12 mths nicotine-free	12 mths nicotine-free	12 mths nicotine-free	12 mths nicotine-free

Indicative as at May 2026. Confirm current thresholds with your broker at the time of application.

Practical tips for avoiding delays

Apply at least 6 weeks before your mortgage drawdown date if there is any declared condition or family history.
For straightforward cases (under 40, no conditions, under €500k), 1–2 weeks is usually sufficient.
Complete the medical declaration with full accuracy — partial information triggers back-and-forth queries that cause delay.
Inform your GP that a PMA request from an insurer is likely; many GPs have a 2–3 week response time.
Use a broker who proactively chases the underwriter and GP surgery — passive processing adds unnecessary weeks.

Frequently asked

How long does mortgage protection underwriting take in Ireland?

For straightforward cases (declaration only), cover is typically in force within 24–48 hours. If a Permanent Medical Attendants Report (PMA) is required, allow 2–4 weeks. Nurse exam cases take 4–6 weeks. Plan your mortgage timeline accordingly — do not leave the application until the week before drawdown.

Can a declared condition be covered without a medical exam?

Yes — many declared conditions are accepted at standard or rated terms on the basis of the declaration alone, without a PMA. Well-controlled hypertension, mild anxiety managed without medication, and a single previous minor procedure may all fall within Tier 1 depending on the insurer's underwriting guide.

Can I be declined life insurance in Ireland?

Yes, though it is uncommon for mortgage protection. Declinature is most likely where there is a significant undisclosed condition, a very high BMI, or active serious illness. The Consumer Insurance Contracts Act 2019 requires insurers to give reasons for declinature.

What happens if the insurer asks for a medical and I have not had a GP check-up in years?

The insurer sends the PMA request to your registered GP with your consent. If your GP has no recent records, they will note that in the report. The insurer will typically request a blood test or nurse exam to establish a baseline rather than declining cover.

Does taking out a higher sum assured always trigger a medical?

Not necessarily — it depends on your age and health. A 35-year-old non-smoker in standard health can typically get €600,000–€750,000 of cover with a declaration only across some of the five Irish life offices. Over those thresholds, or for older applicants, further evidence is standard.

About the author

Donal Milmo-Penny QFA FLIA — Research Lead, mylife.ie. Qualified Financial Adviser and Fellow of the Life Insurance Association. Former Chairman of PIBA and Director of Brokers Ireland.

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This article provides general information only and does not constitute personal financial, tax, or legal advice. mylife.ie is a trading name of SMP Financial Ltd, regulated by the Central Bank of Ireland as an insurance intermediary (C42382). Telephone 01 662 9133.