Life Insurance Medical Tests: Requirements, Thresholds & What to Expect (2026)
IMFL Advisory Team
29 min read
Complete guide to life insurance medical testing in Australia. Coverage thresholds, test types, preparation tips, and how test results affect your premiums.
Get personalized insurance quotes from Australia's leading providers in just 2 minutes.
Introduction
Applying for life insurance can feel invasive. You're asked detailed questions about your health, lifestyle, family history, and habits—and for larger coverage amounts, you may be required to undergo medical testing. Understanding when medical tests are required, what's tested, and how results affect your application helps you prepare and potentially secure better premiums.
In Australia, life insurance medical requirements vary by:
Coverage amount (sum insured)
Your age
Type of cover (life, TPD, trauma, income protection)
Health history disclosed in your application
Occupation and lifestyle risks
Most applicants seeking standard coverage amounts ($250k-$750k) and under age 50 won't need medical exams—just a detailed health questionnaire. However, if you're seeking higher coverage, are older, or have disclosed health conditions, insurers may require medical evidence to assess your risk accurately.
This comprehensive guide explains life insurance medical testing requirements across Australian insurers, coverage thresholds that trigger testing, what to expect during medical exams, how to prepare, and how test results affect your premiums.
Important: This is general information only and does not take into account your individual circumstances. Medical requirements vary between insurers and are subject to change. Always consult the insurer's current medical requirements schedule.
When Are Medical Tests Required?
Coverage Amount Thresholds
Australian insurers use automatic acceptance limits based on coverage amount and age. Below these limits, applications can be approved without medical exams (assuming no significant health issues disclosed).
General thresholds (approximate across major insurers):
Ages 18-39:
Up to $1,000,000-$1,500,000: No medical exam typically required
Above $1,500,000: Medical exam required
Ages 40-49:
Up to $750,000-$1,000,000: No medical exam typically required
Above $1,000,000: Medical exam required
Ages 50-59:
Up to $500,000-$750,000: No medical exam typically required
Above $750,000: Medical exam required
Ages 60+:
Up to $250,000-$500,000: No medical exam typically required
Above $500,000: Medical exam required
These are indicative thresholds. Actual limits vary by:
Type of cover (TPD and trauma have lower thresholds than life insurance)
Health conditions disclosed in application
Detailed Threshold Comparison by Insurer
Medical Exam Requirements by Age and Coverage Amount
Age Range
AIA
TAL
Zurich
NobleOak
ClearView
18-29
Up to $2m no exam
Up to $1.5m no exam
Up to $1.5m no exam
Up to $1m no exam
Up to $1.5m no exam
30-39
Up to $1.5m no exam
Up to $1.5m no exam
Up to $1.25m no exam
Up to $1m no exam
Up to $1.25m no exam
40-49
Up to $1m no exam
Up to $1m no exam
Up to $750k no exam
Up to $500k no exam
Up to $1m no exam
50-59
Up to $500k no exam
Up to $750k no exam
Up to $500k no exam
Up to $300k no exam
Up to $500k no exam
60-69
Up to $300k no exam
Up to $500k no exam
Up to $300k no exam
Up to $200k no exam
Up to $300k no exam
Indicative thresholds for life insurance only. Lower thresholds apply to TPD, trauma, and income protection. Actual requirements depend on health history, occupation, and insurer guidelines. Subject to change.
Important notes:
Thresholds are cumulative: If you have $500k life cover + $500k TPD cover, insurers consider this $1 million total coverage when determining medical requirements
Disclosed conditions override thresholds: Even if you're under automatic acceptance limits, disclosing significant health issues (diabetes, heart disease, cancer history) triggers medical evidence requirements regardless of coverage amount
Medical tests may be required even below automatic acceptance limits if you disclose:
✅ Cardiovascular conditions: High blood pressure, high cholesterol, previous heart attack, chest pain
✅ Metabolic conditions: Diabetes (Type 1 or 2), obesity (BMI >35), thyroid disorders
✅ Respiratory conditions: Asthma requiring daily medication, COPD, sleep apnea
✅ Neurological conditions: Epilepsy, multiple sclerosis, Parkinson's disease, previous stroke
✅ Cancer history: Any cancer diagnosis, even if treated and in remission
✅ Mental health: Depression requiring hospitalization, bipolar disorder, suicide attempts
✅ Kidney or liver disease: Chronic conditions affecting organ function
✅ Family history: First-degree relatives with heart disease, cancer, or stroke before age 60
The golden rule: Insurers assess risk based on information you provide. Full disclosure ensures accurate assessment and protects your claim entitlement. Non-disclosure can result in claim denial.
Types of Medical Tests Required
1. Blood Tests (Most Common)
Standard blood panel tests:
Lipid profile (cholesterol):
Total cholesterol
LDL cholesterol ("bad" cholesterol)
HDL cholesterol ("good" cholesterol)
Triglycerides
Cholesterol ratio (total/HDL)
Purpose: Assess cardiovascular disease risk. High cholesterol increases risk of heart attack and stroke.
Impact on premiums:
Total cholesterol >6.5 mmol/L: May result in premium loading
LDL >4.0 mmol/L: Increased risk assessment
HDL <1.0 mmol/L: Adverse indicator
Optimal: Total <5.5, LDL <3.0, HDL >1.0
Glucose tests:
Fasting glucose (blood sugar after 8-12 hour fast)
Different cover types have different risk profiles, resulting in varying medical requirements.
Medical Exam Thresholds by Cover Type (Age 40)
Cover Type
No Exam Required
Blood/Urine Test
Full Medical Exam + ECG
Notes
Life Insurance
Up to $1,000,000
$1m - $2m
Above $2m
Highest automatic limits
TPD (Own Occupation)
Up to $500,000
$500k - $1m
Above $1m
Lower limits due to higher claim rates
TPD (Any Occupation)
Up to $750,000
$750k - $1.5m
Above $1.5m
Slightly higher than Own Occupation
Trauma Insurance
Up to $500,000
$500k - $1m
Above $1m
Lower limits due to high claim frequency
Income Protection
Up to $10,000/month
$10k-$20k/month
Above $20k/month
Based on monthly benefit amount
Indicative thresholds for a 40-year-old with standard occupation and no disclosed health conditions. Actual requirements vary by insurer. Ages 50+ have lower thresholds; ages under 35 have higher thresholds.
Why TPD and trauma have lower thresholds:
Higher claim rates: TPD claims occur at approximately 3-4x the rate of death claims
Trauma claims common: Approximately 1 in 5 people experience a trauma condition before age 65
Disability assessment complexity: TPD requires assessing functional ability, not just mortality risk
Income protection thresholds:
Based on monthly benefit amount, not total payout
Insurers assess income continuity risk differently than lump sum risk
Longer benefit periods (to age 65) may require more stringent medical evidence than shorter periods (2 years)
What Happens During a Medical Exam
Scheduling Your Exam
Once the insurer requests a medical exam:
Notification: Insurer contacts you (usually within 3-7 days of application submission) to arrange medical exam
Provider arranged: Insurer contracts with medical service providers (e.g., Hooper Medical, ExamOne, MedLab)
Appointment booking: Provider contacts you to schedule appointment
Location options: Your home, workplace, local clinic, or provider's office
Timing: Usually within 1-2 weeks of request
Important: Medical exam appointments are typically free—the insurer pays all costs.
Pre-Exam Requirements
Fasting requirements:
8-12 hours fasting before blood test (for accurate glucose and lipid measurements)
Water is allowed (and encouraged)
No food, coffee, tea, juice, or other beverages
Take regular medications unless instructed otherwise
Scheduling tips:
Morning appointments are best (easier to fast overnight)
Avoid scheduling during illness (reschedule if unwell)
Get good sleep the night before (affects blood pressure)
What to bring:
Photo identification (driver's license or passport)
List of current medications
Medical history details (if not already provided)
Contact information for your GP
During the Exam (30-45 minutes)
Step 1: Identity verification
Photo ID checked
Confirm personal details
Step 2: Medical history review
Nurse/examiner asks detailed health questions
Verifies information from application
Asks about:
Current medications
Recent doctor visits
Family medical history
Lifestyle (exercise, diet, alcohol, smoking)
Step 3: Physical measurements
Height (without shoes)
Weight (light clothing)
Waist circumference
Blood pressure (seated, both arms)
Pulse rate
Step 4: Blood sample
Venipuncture (needle in arm vein)
2-4 vials collected
Tests for cholesterol, glucose, liver, kidney function, etc.
Step 5: Urine sample
Collect urine specimen in sterile container
Tests for protein, glucose, drugs
Step 6: ECG (if required)
Electrodes placed on chest, arms, legs
Lie still while machine records heart rhythm
Takes 5-10 minutes
Non-invasive and painless
Step 7: Completion
Examiner may provide preliminary results (blood pressure, pulse)
Formal lab results sent directly to insurer
You typically receive copy of results
After the Exam
Results timeline:
Lab processes blood/urine: 3-5 business days
Results sent to insurer: 5-7 business days
Insurer reviews results: 1-2 weeks
Total time from exam to decision: 2-3 weeks
Possible outcomes:
✅ Standard acceptance:
Test results within normal ranges
No premium loading
Policy issued at quoted premiums
⚠️ Acceptance with loading:
Test results show elevated risk (e.g., high cholesterol, high blood pressure)
Premium increased by X% loading
You can accept loaded premium or decline
⚠️ Exclusion:
Specific condition excluded from coverage
E.g., liver disease excluded from trauma cover
Life and other covers proceed without exclusion
🔍 Further evidence required:
Results show abnormalities requiring investigation
Insurer requests GP report, specialist reports, or additional tests
Timeline extends 4-8 weeks
❌ Decline:
Test results show unacceptable risk
Application declined
You may apply with another insurer (different underwriting criteria)
How to Prepare for Your Life Insurance Medical Exam
Your test results directly impact your premiums. Poor preparation can result in artificially elevated readings, leading to unnecessary premium loadings. Follow these evidence-based strategies to optimize your results.
7 Days Before Your Exam
✅ Hydrate consistently:
Drink 2-3 liters of water daily
Proper hydration improves blood pressure readings and makes blood draws easier
Avoid energy drinks and excessive caffeine
✅ Reduce sodium intake:
Limit processed foods (chips, fast food, canned soups)
Excess sodium elevates blood pressure
Aim for <2,300 mg sodium daily
✅ Increase physical activity:
30 minutes of moderate exercise daily
Improves blood pressure and glucose metabolism
Don't overdo it—exhaustion can elevate readings
✅ Moderate alcohol consumption:
Limit to 1-2 standard drinks per day
Excessive alcohol increases liver enzymes and blood pressure
Avoid binge drinking completely
❌ Avoid crash dieting:
Extreme calorie restriction can affect blood sugar and lipid readings
Maintain normal, healthy eating patterns
48 Hours Before Your Exam
✅ Avoid strenuous exercise:
Heavy workouts elevate creatinine (kidney marker) and liver enzymes
Rest or light activity only for 2 days before exam
✅ Get adequate sleep:
7-9 hours per night
Sleep deprivation increases blood pressure and cortisol
Affects glucose metabolism
❌ No alcohol:
Abstain completely 48 hours before exam
Alcohol elevates liver enzymes (GGT, ALT, AST)
Can take 48+ hours for liver markers to normalize
❌ Avoid high-fat foods:
Heavy, greasy meals affect lipid measurements
Can cause triglycerides to spike
Stick to lean proteins, vegetables, whole grains
12 Hours Before Your Exam (Fasting Period)
✅ Begin fasting:
No food after dinner (at least 8-12 hours before appointment)
Water is allowed and encouraged
Take regular medications with water (unless instructed otherwise)
❌ No coffee or tea:
Caffeine can increase blood pressure and heart rate
Affects glucose measurements
❌ No smoking:
Nicotine increases blood pressure and heart rate
If you're a smoker, don't quit just before the exam (withdrawal affects readings and cotinine test will be positive)—be honest about smoking status
❌ No chewing gum:
Can affect glucose readings
Some gums contain sugar
Morning of Your Exam
✅ Drink water:
1-2 glasses upon waking
Helps with blood draw (fuller veins)
Improves blood pressure readings
✅ Wear comfortable, loose clothing:
Short-sleeved shirt for easy blood pressure cuff access
Loose pants if ECG required (electrodes on legs)
✅ Arrive relaxed:
Leave early to avoid rushing
Stress and anxiety elevate blood pressure
Practice deep breathing in waiting room
❌ Don't exercise:
Skip morning workout
Even light exercise elevates heart rate
❌ Don't use cold medications:
Decongestants increase blood pressure
Reschedule exam if you're unwell
During the Exam
✅ Relax during blood pressure measurement:
Sit quietly for 5 minutes before measurement
Keep both feet flat on floor
Don't talk during measurement
Breathe normally
✅ Be honest about anxiety:
Tell examiner if you're nervous (common and normal)
They may allow you to relax longer before measuring
"White coat hypertension" is recognized—insurer may request home blood pressure monitoring instead of loading premiums based on single elevated reading
✅ Request a second measurement:
If first blood pressure reading is high, politely ask for another reading after 5 minutes rest
Insurers typically use the lowest reading if multiple measurements taken
What NOT to Do
❌ Don't lie about health conditions:
Non-disclosure detected through medical tests or insurer requests for GP records
Results in application decline and potentially affects future applications
❌ Don't try to "game" tests:
E.g., taking medication to temporarily lower blood pressure or cholesterol
Insurers review medication lists and test results for consistency
Long-term management is what matters, not one-time results
❌ Don't refuse tests:
Refusing required medical tests results in automatic application decline
❌ Don't delay taking regular medications:
Continue prescribed medications unless doctor advises otherwise
Stopping blood pressure or diabetes medication before exam creates dangerous false readings
How Test Results Affect Your Premiums
Medical test results directly influence underwriting decisions. Understanding how insurers interpret results helps you anticipate premium impacts.
Blood Pressure Impact
Blood Pressure Premium Loading
Systolic/Diastolic
Classification
Premium Impact
Additional Requirements
<120/80
Optimal
No loading
None
120-129/80-84
Normal
No loading
None
130-139/85-89
High Normal
0-10% loading
May require GP report if other risk factors
140-159/90-99
Stage 1 Hypertension
25-50% loading
GP report, evidence of medication compliance
160-179/100-109
Stage 2 Hypertension
50-100% loading
Specialist report, controlled for 6+ months
≥180/≥110
Stage 3 Hypertension
Decline or 100%+ loading
Cardiology workup, controlled for 12+ months
Premium loadings are indicative and vary by insurer, age, and presence of other risk factors. Well-controlled hypertension with medication compliance receives lower loadings than uncontrolled hypertension.
Key factors insurers consider:
Duration of hypertension: Newly diagnosed vs long-standing
Treatment: Medicated vs unmedicated
Compliance: Regular monitoring and medication adherence
Other risk factors: Smoking, obesity, diabetes, family history compound loading
End-organ damage: Kidney damage or heart disease from hypertension increases loading
Tips to minimize loading:
Ensure blood pressure controlled before applying
Provide evidence of regular monitoring (home BP log)
Show medication compliance (prescription records)
Cholesterol Impact
Cholesterol Premium Loading
Total Cholesterol (mmol/L)
LDL (mmol/L)
HDL (mmol/L)
Premium Impact
<5.5
<3.0
>1.2
No loading
5.5-6.5
3.0-4.0
1.0-1.2
0-25% loading (age-dependent)
6.6-7.5
4.1-5.0
0.8-1.0
25-50% loading
>7.5
>5.0
<0.8
50-100% loading or decline
Premium loadings depend on age, family history, and presence of cardiovascular disease. Treated and controlled high cholesterol receives lower loading than untreated.
Cholesterol ratio matters:
Total cholesterol / HDL ratio >6: Significant risk, higher loading
Total cholesterol / HDL ratio <4: Lower risk, may offset slightly elevated total cholesterol
Triglycerides:
<2.0 mmol/L: Normal, no impact
2.0-5.0 mmol/L: Borderline high, 0-25% loading
>5.0 mmol/L: High, 25-50% loading
Glucose and Diabetes Impact
Glucose/Diabetes Premium Loading
Fasting Glucose (mmol/L)
HbA1c (%)
Classification
Premium Impact
<5.6
<5.7
Normal
No loading
5.6-6.0
5.7-5.9
Slightly elevated
0-10% loading (monitoring required)
6.1-6.9
6.0-6.4
Pre-diabetes
25-50% loading
≥7.0
≥6.5
Diabetes
50-200% loading or decline (depends on control, complications)
Diabetes loadings vary significantly based on type (Type 1 vs Type 2), duration, control (HbA1c levels), complications (kidney, eye, nerve damage), and treatment compliance.
Type 2 Diabetes loading factors:
Well-controlled (HbA1c <7%, no complications):
Premium loading: 50-100%
Evidence required: Diabetic clinic reports, retinal screening, kidney function tests
Moderately controlled (HbA1c 7-8%, minor complications):
Premium loading: 100-200%
May exclude diabetes-related complications from trauma cover
Income protection may be offered with diabetes exclusion
Type 1 Diabetes:
Generally more severe loading (100-300%) or decline
Some specialist insurers (e.g., NobleOak) offer cover with significant loading
Requires extensive medical evidence
BMI and Weight Impact
BMI Premium Loading
BMI Range
Classification
Premium Impact (Life)
Premium Impact (TPD/Trauma)
18.5-24.9
Normal weight
No loading
No loading
25.0-27.9
Overweight
0-10% loading
0-10% loading
28.0-29.9
Overweight
10-25% loading
10-25% loading
30.0-34.9
Obese Class I
25-50% loading
50-75% loading
35.0-39.9
Obese Class II
50-100% loading
75-150% loading or decline
≥40
Obese Class III
100%+ loading or decline
Decline
TPD and trauma loadings are higher than life insurance because obesity increases disability and critical illness risk more than mortality risk. Age, health conditions (diabetes, hypertension), and lifestyle factors compound loading.
Mild-moderate depression/anxiety (controlled, no hospitalization): 0-50% loading
Severe depression, bipolar disorder, schizophrenia: 50-200% loading or decline for TPD and income protection
Hospitalization or suicide attempts within 2-5 years: Likely decline, may reapply after stability demonstrated
Get Your Life Insurance Quote
Compare premiums from all 9 Australian insurers. Answer simple health questions and receive instant quotes online—medical exam only required if needed.
Employer-provided group insurance (limited or no underwriting)
Option 3: Improve health and reapply
Address health issues causing decline
Wait 12-24 months and reapply
Provide evidence of health improvement
Option 4: Seek guaranteed acceptance products
Guaranteed acceptance life insurance (no medical questions)
Significantly higher premiums
Lower coverage limits
Waiting periods before full benefits payable (e.g., 2-3 years)
Alternatives to Traditional Medical Underwriting
Accelerated Underwriting
Some insurers now offer accelerated underwriting using data analytics and third-party data instead of medical exams:
How it works:
Complete detailed online health questionnaire
Insurer accesses data: prescription history, pathology results, hospital records (with your consent)
Algorithm assesses risk
Instant decision for low-risk applicants
Benefits:
Faster approval (minutes to days vs weeks)
No medical exam for most applicants
Convenient online process
Limitations:
Available only for standard-risk applicants with no significant health issues
Lower coverage limits than traditional underwriting
Not all insurers offer accelerated underwriting in Australia yet
Simplified Issue Policies
Simplified issue life insurance requires health questions but no medical exams:
Coverage limits: Typically $50,000-$500,000
Premiums: 10-30% higher than fully underwritten policies
Health questions: Basic questionnaire only
Approval: Fast (1-3 days)
Best for:
Applicants seeking quick coverage
Those who dislike medical exams
Standard health with no major conditions
Guaranteed Issue Policies
No health questions, no medical exams, guaranteed acceptance:
Coverage limits: Typically $10,000-$50,000
Premiums: 50-100% higher than traditional policies
Waiting period: 2-3 years before full death benefit payable (accidental death covered immediately)
Age restrictions: Usually ages 40-80
Best for:
Older applicants declined by traditional insurers
Serious health conditions preventing traditional approval
Funeral expense coverage
Conclusion: Preparing for Success
Life insurance medical tests shouldn't be intimidating—they're simply risk assessment tools that help insurers price your policy accurately. Understanding what's tested, how to prepare, and how results affect premiums empowers you to optimize your application and potentially save thousands in premiums over your policy's lifetime.
Key takeaways:
✅ Medical tests are required above certain coverage thresholds—most applicants under 50 seeking $500k-$1m cover won't need exams
✅ Preparation matters—simple lifestyle modifications before testing can improve results and reduce premiums
✅ Honesty is essential—non-disclosure of health conditions detected through testing results in application decline and jeopardizes future applications
✅ Test results directly impact premiums—elevated blood pressure, cholesterol, glucose, or liver enzymes result in premium loadings or decline
✅ Different insurers, different criteria—one insurer may decline while another accepts with loading; work with a broker to find the best fit
✅ Health improvements pay off—postponing application to address health issues often results in better premiums than applying with current poor health
Before applying:
Get recent health check with your GP
Address any controllable health issues (lose weight, treat high blood pressure, manage diabetes)
Understand your medical history and be prepared to disclose fully
Consider whether your coverage amount truly requires medical testing or if slightly lower coverage avoids testing
During application:
Answer all health questions honestly and completely
Disclose all medications, medical conditions, and family history
Review your results (request copy if not provided)
If loading applied, consider whether additional evidence could reduce loading
If declined, explore alternative insurers or improve health before reapplying
Life insurance provides essential financial protection for your family. Don't let concerns about medical testing prevent you from securing coverage. Most applicants receive standard (non-loaded) premiums, and even those who receive loadings benefit from having coverage in place.
Compare Life Insurance Quotes Online
Answer simple health questions and get instant quotes from all 9 Australian insurers. Medical exam only required if your coverage amount exceeds automatic acceptance limits.