Can you get income protection with a pre-existing condition?

Yes, usually, though rarely on the same terms as someone with a clean health history. The answer also changes depending on which insurer you ask.

Income protection is often the most heavily underwritten of the three main protection products. Life cover primarily asks whether a condition could shorten your life. Income protection asks a different and much broader question: could it stop you working? A bad back may have little effect on life cover but can matter heavily for income protection.

The practical consequences are three:

1. The usual answer is an exclusion, not a price rise: cover is offered, but claims arising from your condition are not paid.
2. Exclusions are often reviewable, and can be removed after a settled period. Almost nobody is told this, and you have to ask.
3. Insurers disagree with each other sharply: one insurer's decline is genuinely not the market's answer. We can show this with published figures below.

One more thing to know before the detail. There are two entirely different ways a policy can deal with a condition you already have: full medical underwriting, which decides your personal terms before you buy, and a moratorium, which excludes it automatically and then lifts that exclusion after a set clear period. Most of this guide covers the first. The second is explained here, and it is often the faster route.

Everything here is drawn from publicly available underwriting guides published by five UK insurers, plus eight accident and sickness policy wordings, dated between August 2025 and August 2026. These are indications of how each insurer generally assesses a condition. They are not binding, not quotations, and not a decision on your application.

Contents

1. Why income protection is underwritten more strictly for pre-existing conditions
2. Income protection underwriting outcomes
3. Income protection exclusions for pre-existing conditions
4. Why shopping around matters for pre-existing conditions
5. Common pre-existing conditions and income protection
6. Mental health and income protection
7. Back pain and income protection
8. Weight and BMI for income protection
9. Diabetes and income protection
10. How to improve your income protection underwriting terms
11. Do you need a medical for income protection?
12. Family history, genetic tests and income protection
13. Occupation, hobbies and income protection
14. What to do if income protection is declined
15. Full medical underwriting vs a moratorium
16. How Eleos can help with income protection and pre-existing illness

Why income protection is underwritten more strictly for pre-existing conditions

You do not have to take this on trust. One insurer publishes its weight-based decisions for life cover, critical illness and income protection in the same document, so the comparison is exact.

Here is that insurer's grid for someone aged 17 to 29:

Royal London, Protection: BMI, effective 29 June 2026. "Age attained" basis.

At a BMI of 39, a 28-year-old can buy life cover at a 125% loading but cannot buy income protection from that insurer at any price. It is the same person, on the same day, assessed by the same company.

The insurers say why themselves. One writes that back pain is "the leading cause of disability, so a history of back pain is significant for income protection". The same guide notes that mental health conditions are "one of the leading causes of disability claims", and that excess weight "puts additional strain on the joints, which is particularly significant for disability benefits".

   LIFE COVER              asks:  will this shorten your life?
   CRITICAL ILLNESS        asks:  will this cause a listed serious illness?
   INCOME PROTECTION       asks:  will this stop you working, for any reason,
                                  at any age, for weeks or for decades?

The third question is much wider. Conditions that are irrelevant to the first two (a recurring back problem, a period of anxiety, a knee that plays up) sit right at the centre of it.

Income protection underwriting outcomes

Every underwriter works to roughly the same menu.

Two of those can arrive together: a loading and an exclusion.

Loadings are usually bounded: one insurer states that its range runs from a minimum of +50% to a maximum of +150%, and that "usually, a maximum of three exclusions will be applied before we are unable to offer cover." Another writes that "we would always prefer to add a loading or exclusion to a policy than not offer cover." Beyond a certain risk, an insurer stops pricing and steps away, which is precisely why a different insurer, with a different appetite, is worth asking.

Note one asymmetry. Exclusions are essentially never applied to life cover: one guide says so outright, that "exclusions are not applied to life cover, but are commonly applied to critical illness and disability cover." If you have only ever bought life insurance, the exclusion mechanic will be unfamiliar.

Income protection exclusions for pre-existing conditions

An exclusion is a carve-out. Everything else is covered normally.

If you have had recurring lower back pain and an insurer applies a spine exclusion, you are still covered for a heart attack, cancer, a broken leg, pneumonia and a mental health absence: every cause of incapacity except the excluded one. That is a materially better outcome than no policy, and it is how most people with a health history end up insured.

Exclusions vary in width:

Ask for the exact wording before you accept. A knee exclusion and an "arthritis" exclusion are not the same product. Eleos also explains the wider question of what income protection covers, including common exclusions.

The part almost nobody is told

Many exclusions are temporary, but only if you go back and ask:

One insurer sets this out plainly: where an exclusion is applied, it adds a review date to the policy, "usually one to three years after it goes on cover. If they have no recurrences of the excluded condition during this time, they can contact us and we will review whether the exclusion can be removed."

Another applies the same logic in specific places. An exclusion after an abnormal cervical smear is removed following a normal smear, and a hazardous-hobby exclusion is reviewable once there has been no more than one accident or injury in three years.

   YEAR 0     Policy starts with an exclusion and a review date
   YEAR 1-3   No recurrence of the condition
   THEN       YOU contact the insurer and ask for a review
              ────────────────────────────────────────────
              Nothing happens automatically. Diarise it.

Put the review date in your calendar the day the policy is issued: this is the single most valuable, least-known thing on this page.

Why shopping around matters for pre-existing conditions

This is the claim everyone makes and few people evidence. Here is the evidence.

Below is the BMI at which each of four insurers stops offering income protection, taken from their published grids:

Worked example one: a 28-year-old with a BMI of 39 and no other conditions:

Worked example two: a 45-year-old with a BMI of 41:

Notice that the generous insurer swaps between the two examples. There is no "best insurer for weight", only a best insurer for that weight at that age. The same is true across most conditions.

One more detail sounds trivial and is not. Insurers round BMI differently: two round at 0.50, and one rounds to the nearest whole number and names the exact online calculator its underwriters use, warning that other calculators "may round calculations differently." At a band edge, one decimal place is the difference between standard rates and a loading.

Common pre-existing conditions and income protection

How the same condition can land on life cover versus income protection, drawn from two insurers' published guides:

Two patterns are worth pulling out.

Well-controlled conditions are frequently standard: blood pressure, cholesterol, mild asthma and fully investigated IBS are routinely accepted at ordinary rates on income protection. Control and compliance are what the underwriter is reading, not the diagnosis alone.

Cardiovascular and neurological events are where income protection stops: angina, heart attack, stroke and multiple sclerosis are priceable for life cover and generally unavailable for income protection across the guides reviewed.

Mental health and income protection

The widespread belief is that any mental health history means an automatic exclusion. Across four insurers' published positions, that is not true.

Two of the four leave a genuine route to standard terms.

That second route is a lever you can pull, and it is covered in detail below. One insurer states that mild depression, anxiety or stress is "likely to lead to an exclusion on a temporary basis", but that "on higher deferred periods (13 weeks plus), it may be possible to offer standard terms depending on individual circumstances."

What underwriters are actually assessing

Not the label. The published question lists are consistent across insurers:

• Time since diagnosis, and time since the last symptoms
• Treatment, past and present, including counselling
• Whether there was ever inpatient or hospital treatment
• Time off work
• Frequency of episodes, where an "episode" typically means symptoms severe enough to prompt a GP visit, a change in medication, additional counselling or a referral
• Any self-harm, suicide attempts or suicidal thoughts, with dates

Time off work is doing a lot of the work in that list: two people with the same diagnosis and very different absence records will get very different answers.

Where the limits are

The published hard limits are broadly consistent: a suicide attempt within the last year, recurrent attempts or self-harm within the last two years, suicidal thoughts within the last year, and current or past alcohol or drug misuse alongside the condition. One insurer cannot cover bipolar disorder, manic depression, schizophrenia or borderline personality disorder at all. Others assess these individually rather than listing them as automatic declines, which is another reason a single answer is not the market's answer.

A note on how you disclose

One insurer offers a choice: disclose your mental health history through online questioning, or by tele-interview with a nurse. Another notes it has "underwriters who are trained to deal with the sensitive nature of these calls." If typing it into a form feels wrong, ask whether a conversation is available. The outcome is assessed the same way; the experience is not.

Back pain and income protection

Back pain deserves its own section because it is the sharpest example of the whole principle.

Across two insurers' published guides, back pain is standard rates for life cover at every severity: mild, moderate and severe alike. For income protection:

What tips a mild case from "standard" to "exclusion" is published:

• Recurrent episodes, or recent symptoms
• More than a week off work in the last two years: one insurer names this exact threshold as triggering a minimum of an exclusion
• Symptoms within the last five years, which is another insurer's threshold
• Whether your job is manual or sedentary

If there is a known underlying cause, such as a disc problem or sciatica, the assessment is based on that rather than on the symptom alone.

The practical read: if your back has been settled for several years and you have not lost real time at work, standard terms are genuinely on the table. If you had a fortnight off eighteen months ago, expect a spine exclusion, and expect it to be reviewable later.

Weight and BMI for income protection

Weight is assessed on BMI, and it affects income protection more than life cover, as the grid at the top of this guide showed.

The standard bands, where no loading applies, differ by insurer:

Two things people find surprising.

Being underweight is rated too: every grid above rates or declines low BMI as well as high. One guide explains why, noting that underweight "may be secondary to, or symptomatic of, an underlying medical condition, or an eating disorder", with raised risks of infection, falls, fractures and osteoporosis.

Ratings loosen with age: a BMI of 33 is +50% for someone under 30 and standard rates for someone over 50 at one insurer. The loading reflects years of exposure to the complications, so the same number is a bigger problem at 25 than at 55.

Weight also compounds. One guide lists the conditions it raises the risk of, including high blood pressure, heart disease, diabetes, stroke, several cancers, sleep apnoea, gout and osteoarthritis. It notes separately that carrying extra weight "puts additional strain on the joints, which is particularly significant for disability benefits, especially if someone already has arthritis in their weight bearing joints."

Diabetes and income protection

Diabetes produces the widest disagreement in the published guides, which makes it the strongest possible argument against giving up after one refusal.

One insurer covers Type 1 diabetes for income protection, while three do not: if you have Type 1 and were told income protection is unavailable, that statement was true of the insurer who said it, but not of the market.

The conditions attached are strict. That insurer requires diagnosis more than 12 months ago, and all of: HbA1c below 8 (IFCC below 64); no complications other than background retinopathy; compliance with treatment; no time off work in the last five years; non-smoker with no vaping; a BMI attracting no more than a 50% loading; and controlled blood pressure and cholesterol. Anything else is declined. The exclusion applied is broad, covering diabetes and its related complications and conditions.

Type 2 and your HbA1c

Where Type 2 is rated rather than excluded, the number that matters is your most recent HbA1c. One insurer's published income protection grid:

The Exeter, Income First Underwriting Guide, August 2026. Assumes no other risk factors or diabetic complications; ratings also depend on time since diagnosis. Requires a recent HbA1c and a diabetic review within the past 18 months.

Read the columns left to right and the same inversion appears as with BMI. At an HbA1c of 6.5% to 7.4%, someone under 30 starts at +125% and someone in their fifties starts at +75%. Early onset means more years ahead in which complications can develop.

Before applying: get your most recent HbA1c reading and the date of your last diabetic review. At one insurer these are prerequisites, not nice-to-haves.

How to improve your income protection underwriting terms

Most of underwriting is your history, and you cannot change that. Four things you can:

1. The waiting period

Your waiting period (also called the deferred period) is how long you must be off work before benefit starts. Longer waiting periods are cheaper. They can also change the underwriting outcome, which is almost never explained.

Two insurers say so in print:

• Mild depression, anxiety or stress attracts an exclusion on shorter deferred periods, but "on higher deferred periods (13 weeks plus), it may be possible to offer standard terms."
• High-risk activities "will normally be excluded from applications with short deferred periods." A longer waiting period can avoid the carve-out entirely.

Some conditions come with a minimum waiting period attached. One insurer offers Crohn's disease and Type 2 diabetes only on a minimum four-week waiting period.

   4 weeks     Benefit starts sooner. Higher premium, and tighter
               underwriting on some conditions.

   13 weeks+   Longer wait before benefit starts. Lower premium, and a
               genuine route to standard terms on some conditions.

The instinct is to pick the shortest waiting period you can afford. If you have a mental health history, that instinct may be exactly wrong. Check what sick pay your employer provides first. If you get six months at full pay, a 13-week or 26-week wait costs you nothing real and may improve your terms. Eleos also explains how the waiting period affects an income protection policy.

2. Which insurer you apply to

Covered above. It is not marketing: at BMI 39 aged 28, one insurer offers cover at +125% and three decline outright.

3. Time

Almost every guide contains a clock. The recurring threshold is five years symptom-free, with two years appearing for specific triggers:

If you are close to one of these thresholds, waiting a few months before applying can be worth more than anything else on this page. If you are nowhere near one, apply now: cover you have is worth more than better terms you might get later, and the next condition is always unpriced.

4. How accurately you disclose

Every guide asks for the same thing, and one puts it bluntly. Accurate disclosure "will reduce the likelihood of us having to request further medical information or asking them to attend a mini screening", and an application "may take longer to underwrite if there is conflicting evidence between their application form and the GP Report we receive."

Vagueness does not protect you. It triggers a GP report, which delays everything and produces the detail anyway, and non-disclosure is the fastest route to a declined claim years later. Have to hand: dates of diagnosis, dates of last symptoms, current and past treatment, any time off work, and any recent test results.

Do you need a medical for income protection?

Usually not, if you are under 40.

Unlike life cover, where the trigger is the sum assured, income protection evidence limits are set against your monthly benefit, and age drives them hard:

One insurer states the principle directly: under 42, "we will not ask for the routine medical evidence that other insurers might", regardless of the benefit level chosen.

A nurse screening is short and done at home: height, weight, blood pressure and a urine sample. Above higher benefit levels, insurers may add a cotinine test (which checks declared non-smoker status), a blood test, a GP report or a full medical examination.

Under 40, scrutiny comes from the questions, not tests: that is why the answers you give matter more than anything a nurse would measure.

Separately, a high BMI can trigger a screening on its own. One insurer screens anyone with a BMI of 39, and another may request a mini-screen where BMI produces a rating above 75%.

Life cover works on a different trigger: the sum assured rather than the monthly benefit. If that is the product you are weighing up too, see how much life insurance you can get without a medical.

Family history, genetic tests and income protection

Two reassurances that are widely misunderstood.

Predictive genetic tests cannot be used against you: one guide says it plainly, "You do not need to tell us about any predictive genetic test." Another confirms that if such a test is positive, "we won't ask about it and we won't use it if we are told about it." This follows the industry Code on Genetic Testing and Insurance, published by the ABI and available on gov.uk. The single exception in the guides reviewed is Huntington's disease, and only for life cover above £500,000.

A negative predictive test can be volunteered if you choose, and may improve your terms.

The distinction that matters: a predictive test (you have no symptoms, it estimates future risk) cannot count against you. A diagnostic test (it confirms a condition you already have symptoms of) is part of your medical history and must be disclosed.

Family history itself is still assessed, but narrowly:

• One insurer restricts it to first-degree relatives only: "mother, father, brother, sister. You do not need to tell us about adoptive parents, step/half-siblings or other relatives."
• Another only asks about conditions diagnosed before the relative reached 60, and varies the questions by product. It does not ask about a family history of multiple sclerosis for life cover, "because it will not be rated."
• One affected relative often produces no loading. Two is where loading typically begins, and a relative affected young matters more than one affected later in life.

One counter-intuitive point. Where an insurer expects screening for a family condition (bowel, breast or ovarian cancer, polycystic kidney disease, cardiomyopathy), declining the recommended screening can itself cause a decline. Attending is better for your terms, not worse.

Occupation, hobbies and income protection

Occupation

Occupation barely matters for life cover and matters enormously here. One insurer notes that "very few occupations will lead to a loading" on life, but that "occupation is key to determining the premium" on income protection.

Some occupations cannot be covered at all. One insurer's published list includes divers, underground miners, oil rig workers, professional sportspeople, police officers, firefighters (excluding retained), pilots and flight crew, armed forces personnel, certain equestrian professions, merchant mariners, and roles requiring regular medicals to work. Another does not offer income protection to members of the armed forces at all.

Some of the same roles are fine as a second occupation. Retained firefighter, special constable, mountain rescue and part-time lifeboat crew are all accepted without special terms by one insurer.

Hobbies

Here is a table that captures the whole theme of this guide in one place. It shows which pursuits one insurer asks about, by product:

The last two are the giveaway. Competitive horse riding and competitive winter sports are not asked about for life cover or critical illness. They are asked about for income protection, and usually excluded. Not because they might kill you, but because they might break something that stops you working.

A hobby exclusion is usually narrow, and often reviewable later on the same basis as a medical one.

What to do if income protection is declined

A decline from one insurer is a data point, not a verdict. In order:

1. Ask exactly why: "declined" is not a reason. The specific trigger, whether a BMI band, an HbA1c, time off work or months since diagnosis, tells you whether another insurer would see it differently.
2. Ask about a longer waiting period: it can change the answer on some conditions.
3. Ask another insurer: the tables above are the evidence for why this is not a platitude.
4. Ask whether an exclusion is available instead: cover with a carve-out beats no cover.
5. Check the postponement clock: if you are inside a 6 or 12-month window from diagnosis, the answer may simply be not yet.
6. Ask about cover written on a moratorium instead: it handles pre-existing conditions by a completely different method, explained below.

One insurer's stated philosophy is worth remembering: "we would always prefer to add a loading or exclusion to a policy than not offer cover." Most underwriters are looking for a way to say yes.

Full medical underwriting vs a moratorium

Everything above describes full medical underwriting: you answer detailed health questions, and the insurer decides your personal terms before you buy.

There is a second method, and if you have a health history it may matter more to you than the first. It is called a moratorium, and it works the other way round. You answer few or no health questions. Instead, the policy automatically excludes any condition you already had, using a definition written into the wording. Then, crucially, that exclusion lifts by itself once you have gone a set period with no symptoms, advice or treatment for it.

Neither is better: they are different trades: full underwriting is slower and asks more of you, but you know precisely what you have bought on day one. A moratorium is fast and asks almost nothing, but you are relying on a general definition rather than a decision about you, and you may not discover where its edges are until you claim. Eleos has a step-by-step guide to making an income protection claim if you want to understand that process too.

The two numbers that define a moratorium

Any moratorium is set by two windows. Both are in the wording, and both vary between policies.

   LOOK-BACK      How far back the policy reaches to call something
                  "pre-existing". Some wordings say 12 months, some 24,
                  and some set no limit at all.

   CLEAR PERIOD   How long you must go symptom-free, advice-free and
                  treatment-free before the condition becomes covered.
                  Commonly 12 or 24 months from the policy start date.

Across eight UK accident and sickness wordings reviewed in August 2026, the clear period was 24 months in seven of them and 12 months in one. The look-back varied more widely: two specified 24 months before the start date, one specified 12 months, and five set no explicit window on the "symptoms you were aware of" limb at all.

That last group is the one to read closely. Where no look-back window is stated, a condition you had years ago can still meet the definition.

What this means in practice

A moratorium is genuinely valuable when full underwriting has gone badly, or when you need cover in place quickly. A condition that an underwriter would exclude permanently may, under a moratorium, become covered after 24 clear months without you doing anything.

But note the mirror image of that. Under full underwriting a personal exclusion is permanent unless you ask for a review. Under a moratorium the exclusion is temporary but automatic. One requires you to act and the other requires you to wait.

Three things to check in any wording before you rely on it:

1. The look-back window, or the absence of one.
2. The clear period, and whether the clock runs from the policy start date or rolls continuously. Some wordings require the clear months to fall immediately following the start date, which is stricter than it first appears.
3. What breaks the run: a single GP visit or repeat prescription for the condition typically restarts it, because the test is not just symptoms but advice and treatment too.

How Eleos can help with income protection and pre-existing illness

A pre-existing illness does not automatically mean you cannot get income protection. The key question is what kind of cover fits your circumstances, and whether you understand how the policy treats your past condition before you buy.

For a quick route to cover: Eleos offers instant-issue accident and sickness income protection online, where you are eligible. The application generally does not involve a medical examination. You can get an income protection quote from Eleos to see what cover may be available to you. Pre-existing conditions are handled on a moratorium basis, so the look-back window and clear period in the policy wording determine when a past condition may become covered. Read those two definitions carefully before relying on the policy.

For a more individual conversation: an Eleos adviser can help you work through your health history, the level of cover, and the waiting period. A pre-existing condition is where general information stops being enough and your diagnosis dates, readings and absence record start to matter.

• We will help you get your own history straight before anything is submitted: dates of diagnosis, date of last symptoms, treatment past and present, and any time off work. That last one is the single most influential item in a disability underwriting decision, and the one people most often under-report.
• We will tell you what to bring: if you have diabetes, that means your most recent HbA1c and the date of your last review. At one insurer those are prerequisites, not extras.
• We will talk through the waiting period properly, including what your employer's sick pay actually covers. As this guide shows, that choice affects your premium and, on some conditions, the terms you are offered.
• We will explain any exclusion in plain English before you accept it: how wide it is, what it actually rules out, and whether it carries a review date you should be diarising.
• We will tell you if waiting is the better move: if you are a few months from a postponement date or a symptom-free threshold, that is worth knowing before you apply, not after.
• We will not treat one insurer's no as the answer: as the tables above show, it frequently is not.

Eleos UK advisers are available during working hours. The quickest way to reach us is a WhatsApp message, and someone will come back to you.

If you want to understand the process before starting, read Eleos's guide to buying income protection.

One thing worth acting on today: underwriting looks at your history as it stands now. Every year you wait, that history gets longer, and the condition you develop next is not yet on it.