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How Workplace Group Cover Helps You Get Insured Without Medical Questions
•Zebunisso Alimova
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If you have a health history and you have ever been told “no” by an insurer, you know how personal and frustrating underwriting can feel. We get into a practical path that many Kiwis overlook: workplace group scheme insurance, and how it can open the door to cover even when pre-existing conditions would normally trigger exclusions, loadings, deferrals, or declines.
We talk through what group cover often includes, why “automatic acceptance” can be such a big deal, and how it can protect people who might otherwise be uninsurable due to things like diabetes, heart conditions, back injuries, high BMI, or mental health history such as antidepressant use. We also share the reality of what these schemes usually provide: sometimes it is basic life insurance, trauma cover tied to salary, and income protection around 75%, but having something in place can be the difference between stability and chaos when life throws a curveball.
Then we focus on the part most people miss: what happens when you leave the job. A continuation option can let you keep the cover without new terms, but there is often a tight deadline, commonly around 30 days, and if you do not act in time you may lose the chance for good. We also look at why employers should consider offering group insurance as part of a total pay package, including potential family discounts on health insurance and possible tax advantages, and why reviewing your insurance matters because underwriting rules can change over time.
If this hits close to home, subscribe for more straight talk on insurance, share this with your boss or a mate, and leave a review to help other New Zealanders find it. What’s one question you have about group schemes or pre-existing conditions?
If you have lots of pre-existing conditions, but you work for a company and you think, oof, what can I do there? Well, this is the episode for you. Or if you own a company and you've got more than
10 employees, we've got something special for you. This is an episode around the group scheme insurance. So listen up. Hello, Blake.
SPEAKER_00
Hello, Zabanisa.
SPEAKER_01
I just threw this at you. That's okay. And I think this is really, really important. It's always been a little bit of my pet project on the side that I always think about when I come across certain insurance terms that are given to my clients. And let's say I give you an example, a bus driver got diabetes, got heart conditions, sedentary work, you know, so usually they're uninsurable. But I know there is a way around it. And I've discovered there's a way around it if the employees takes out a group scheme cover. And under that group scheme cover, they can actually help their workers to get at least a minimum type of cover, you know, and that it all depends on what sort of group scheme you're doing. But there is a roundabout way, right?
SPEAKER_00
Yeah.
SPEAKER_01
Yeah. So tell me what you know.
SPEAKER_00
So I mean, group group insurance is very common in a lot of companies. It's I guess it's an added incentive to be an employee for
certain companies. And depending on the insurance company, and depending on what uh what insurance product you might be looking at, there's generally what they call an automatic acceptance level where you don't have to apply for, sorry, you don't have to run through medical questions or financial questions to a certain limit. And that's a great way to get people who might have existing terms taken away on a new policy, or someone like you mentioned, your bus drivers or bus driver, not all bus drivers have diabetes.
SPEAKER_01
No, just the ones I came across.
SPEAKER_00
To get them important cover. The beauty of this is if they leave that company, and it each company has its own rules and regulations around how it works, but generically, if you leave that company,
you can take out what's called a continuation option where you continue the cover with no terms, as it was, and you're covered as long as you you'd have to start paying the premiums. So it's a really good way to get cover in place.
SPEAKER_01
Yeah, which is really, really uh cool, but important to remember, usually you get given like 30 days to tick that box. Yeah. If you don't tick that box to continue that cover, then that disappears and can not get that again.
SPEAKER_00
Yeah, and that's actually a really good point as well. If no one's got hold of you from that company, get hold of Ziboniso and myself, because we can actually put those continuations in place for you as long as the coverage is outside of resolution life because it's all locked in there. Yeah. But the the and the reason that I suggest that is giving you the ability to keep important insurance cover, especially at no terms, is important. So as long as someone puts it in place for you, that's the main outcome.
SPEAKER_01
Yeah.
SPEAKER_00
Or the the main goal. Because that protects you.
SPEAKER_01
Yeah. Which is really, really cool because the way I see it, there is a really cool benefit to the employer to do that, because that makes them seen as someone who cares about their workers. It gives instant perks, really, to the people that work there. And also, if you can't afford right now to give them a pay
increase, you could potentially introduce the group scheme as part of their paying package.
SPEAKER_00
That's exactly right, and that's really great points you make. Another, and to further add to that, for example, I know Southern Cross Health Insurance if you're part of a group scheme, generally your family will get a 25% discount off market rates as being part of that group scheme. Some employers might off extend the offer to not just their employees, but they might offer it to their friends and other sorry, their families as well. But that just depends on the company and what they're wanting to take out. But at the minimum, you should get a discount thing associated with a member of a group scheme. So there's some there's a lot of incentives to do it for sure.
SPEAKER_01
Yeah, but I guess the main main main one for me has always been around covering those predisclosed conditions.
Yeah, it's an excellent way to do it. And I don't think a lot of people maybe it's because they don't understand insurance, and I think a lot of people might have just been in a group scheme from day one and not realize that how important and how lucky that is, because they've never had to apply outside of that. The insurance gets let's go, they don't take so they move employees, they don't take it with them. Then they buy a house, they have a family, and all of a sudden insurance is forefront of mind, and then they're excluded for this or excluded for that, or in a worst case, they're deferred or declined because of could be BMI, it could be medical conditions.
SPEAKER_01
Look, for me, it was my back, you know. When I was working in my twenties, I was working at university, and part of my job I had to travel all around New Zealand, all around the world, and I had to do different expos and meet people. And I always had to carry very, very heavy boxes, you know, of materials of the brochures and all sorts. And and I actually injured my back a few times doing that because I didn't know to bend and lift with your knees. So very important. Yeah, very important. And my core muscles were non-existent. Not that I've got much core muscle now. But like my back was one of my biggest uninsurable points in my insurance journey, where I had to prove a lot that hey, now I've had done a lot of work on my back, you know, and it's good now. And can I please get a cover of it?
SPEAKER_00
Did you?
SPEAKER_01
I think so.
SPEAKER_00
That's good. I need to have a look. Lumber spine is one of the biggest exclusions that in mental health. It's very uncommon. Uh it's very common and it's very hard to get them taken off, especially lower back or any back injury.
SPEAKER_01
Yeah. But you're right, mental health was the other one that I've been seeing a lot. Like if any of my clients ever took antidepressants or have been prescribed antidepressants, you know, immediately it's a big red flag for the insurance company. So they might go, actually, I'm not gonna cover you for this. But if you are under the group scheme, then you're covered. And look, those group schemes, again, we're talking different companies might have a different deal with whatever provider sets it up for them. Right. But the ones I've seen in the past is it could be minimum of 200k life cover, for instance, it could be trauma cover of two times of your salary, for instance.
SPEAKER_00
Yeah, life insurance, two or three times your salary. Yeah, that's right. Yeah, and then income protection, 75%.
SPEAKER_01
Yeah.
SPEAKER_00
Yeah. Basic but good.
SPEAKER_01
Basic, but at least it's something rather than nothing.
SPEAKER_00
Exactly. And that's the point, isn't it? Yeah, exactly.
SPEAKER_01
So if you guys are listening to this, and if you working in a small environment or even a big environment, you know, go and talk to your boss, get them to listen to this episode, and uh reach out to us because I feel like this is something that could be so helpful to so many people out there. And employers, there's also, I believe, a tax benefit to that as well. You know, you could actually offset some of your cost by allocating, I mean, you're already paying that anyway, expense somewhere else. So you might as well look after your people.
SPEAKER_00
100%. Yeah. And I guess further to touch on the mental health aspect there is just because you might have if you've got existing insurance, and just because you might have a mental health exclusion,
or maybe there was an increase in premium added when you applied, or maybe you were declined. And that could have been 10 years ago since. That might not be the case now. Medical underwriting with insurers changes all the time. And what was once deemed maybe too major or net or resulted in terms being added might not be the case now, or you might have been symptom free for X amount of years that you don't need those terms on your cover anymore. I guess that gets down another track, but that's make why it's important to review your insurances.
SPEAKER_01
Yeah, exactly. Awesome. Well, Blake, thank you so much for this very, very important topic.
