Key takeaways
- You can still apply for a medical card, life or critical illness insurance in Malaysia with diabetes or high blood pressure; the insurer may accept you normally, charge an extra premium, exclude the condition or decline.
- On a medical card, a condition you had, or had symptoms of, before the cover started is a pre-existing illness and is not covered, but other illnesses (after the 30-day wait) and accidental injuries are.
- Bank Negara Malaysia limits pre-existing exclusions to conditions you could reasonably have known about, and an insurer that rejects a claim on that ground must prove you knew.
- Under Schedule 9 of the Financial Services Act 2013, a deliberate or reckless misstatement on the application lets the insurer avoid the policy and refuse all claims; a careless one can mean a reduced claim or changed terms.
- For a new medical card, the insurer must give its decision in writing within 14 calendar days of receiving your complete information (BNM policy document on medical and health insurance).
- NHMS 2023 found that 15.6% of adults in Malaysia have diabetes and 29.2% have high blood pressure, but only 9.7% and 17.3% of adults know they have it.
Can I still buy insurance if I have diabetes or high blood pressure?
Yes, you can apply. Having diabetes or high blood pressure does not stop you from applying for a medical card, life insurance or critical illness cover in Malaysia. What it changes is the answer you get back. Every application goes through underwriting: the insurer reads your health answers, may ask for medical reports or a check-up, and then decides on what terms it can cover you. Great Eastern's product disclosure sheets say this plainly: the premium and policy terms "may vary depending on the underwriting requirements of the Company", and the company "may determine the terms of acceptance based on declaration made by you", including an extra premium for each benefit applied for.
These conditions are very common. The Ministry of Health's National Health and Morbidity Survey 2023 found:
| Condition (adults in Malaysia) | Have it | Know they have it |
|---|---|---|
| Diabetes | 15.6% | 9.7% |
| High blood pressure | 29.2% | 17.3% |
| High cholesterol | 33.3% | 15.2% |
I often see clients who only find out at a company health screening that their sugar or blood pressure is "a bit high", and then worry that it is too late for insurance. It is not too late to apply. It simply means the application needs more care.
The four answers an insurer can give
| Underwriting decision | What it means for you |
|---|---|
| Accepted at standard terms | Same premium and terms as a healthy applicant; the policy works as the brochure describes. |
| Accepted with an extra premium (loading) | You pay more for the same cover. The amount is shown in your offer or sales illustration. |
| Accepted with an exclusion | The policy is issued, but claims caused by the named condition (and, depending on the wording, its complications) are not paid. |
| Declined | The insurer will not cover you for that benefit and lets you know its decision. You can still apply for other types of cover. |
These can be combined, for example an extra premium on the life cover and an exclusion on the medical card. An insurer also cannot turn you down for a medical card only because someone else did: Bank Negara Malaysia's policy document on medical and health insurance says it must not refuse a risk "solely on the basis of a refusal by another" insurer without assessing it under its own underwriting rules.
What counts as a pre-existing condition on a medical card?
This is where most of the confusion starts. Great Eastern's Smart Health Protector product disclosure sheet lists under "What is not covered": "Medical conditions that you had, or had symptoms of, before buying the plan (i.e. pre-existing illness)". Bank Negara's policy document narrows this. An exclusion may only apply to a condition that existed before the cover started and that you could reasonably have been aware of, which means one where:
- you had received, or are receiving, treatment;
- medical advice, diagnosis, care or treatment had been recommended;
- clear and distinct symptoms were evident; or
- its existence would have been apparent to a reasonable person.
If the insurer rejects a claim as pre-existing, it is the insurer that must prove you knew, or should reasonably have known. The Life Insurance Association of Malaysia's consumer guide adds a practical point: if you had consulted a doctor for any pain or discomfort, that is treated as a symptom.
Specified illnesses and the 120-day wait
Separately from the pre-existing rule, a new medical card has waiting periods. On Smart Health Protector, illness is covered after 30 days, and "specified illnesses (e.g. hypertension, diabetes)" only after 120 days, while injuries from an accident are not subject to the 30-day wait. So if high blood pressure is first diagnosed in the second month of a new policy, it falls inside the 120-day window and is not covered. My medical card waiting period guide explains how the days are counted.
How each type of cover treats diabetes or high blood pressure
| Type of cover | How a condition you already have is treated | Where it is written |
|---|---|---|
| Medical card | Pre-existing illness is excluded; hypertension and diabetes are specified illnesses with a 120-day wait. Other illnesses (after 30 days) and accidental injuries stay covered. | Smart Health Protector PDS and brochure |
| Critical illness | "Pre-existing illness" is a major exclusion, and the insurer may charge an extra premium for each benefit. | GREAT Early VantageCare 2 PDS |
| Whole life (death and TPD) | The major exclusions listed are suicide in the first policy year and self-inflicted TPD; premium and terms depend on underwriting. | GREAT MaxiProtector PDS |
| Personal accident | Pays for accidental injury, disablement and death; common exclusions include "pre-existing physical defect or infirmity". | insuranceinfo.com.my |
| MediAsas (base plan, national launch January 2027) | Fully underwritten: you declare your health, and claims for pre-existing conditions follow the exclusions and terms set when the cover is issued. | BNM MediAsas pilot FAQ (29 July 2026) |
Because each plan handles your condition differently, an exclusion or a decline on one type of cover does not mean the same answer on the others.
What happens if I do not declare diabetes or high blood pressure?
Some people are tempted to leave out a "mild" diagnosis to get a cleaner offer. Please do not. Under Schedule 9 of the Financial Services Act 2013, you must take reasonable care not to misrepresent anything when you answer the insurer's questions, and you must also disclose any other matter you know is relevant to its decision. What happens later depends on how the mistake was made:
| Type of misstatement | What the insurer can do |
|---|---|
| Deliberate or reckless (you knew it was untrue, or did not care) | Avoid the policy and refuse all claims (paragraph 15) |
| Careless or innocent, and the insurer would not have covered you on any terms | Avoid the policy and refuse all claims, but return the premiums paid (paragraph 16(2)) |
| Careless or innocent, and the insurer would have covered you on different terms | Treat the policy as if it had those terms, for example with an exclusion (paragraph 16(3)) |
| Careless or innocent, and the insurer would have charged a higher premium | Reduce the claim in proportion (paragraph 16(4)) |
Life insurance has one extra protection: once a life policy has been in force for more than two years, the insurer can only avoid it over a statement on a material matter that was made fraudulently (paragraph 13).
This is not a theoretical risk. In a case from the Ombudsman for Financial Services published on insuranceinfo.com.my, a guarantee letter for a hospital admission was declined after the takaful operator found hypertension and a heart valve condition, diagnosed before the application, that had not been declared. The certificate was voided, no cash value was refunded, and the ombudsman ruled for the operator. The policyholder said he had told the agent; the agent said he had not. Whatever you say to anyone, make sure it is written in the form, and check the copy of your application when the policy arrives.
The Deputy Finance Minister told Parliament in July 2026 that Bank Negara is considering a "no look back" policy that would stop insurers rejecting claims over conditions a policyholder unintentionally failed to disclose, The Star reported. It is still under consideration, so do not rely on it. If a claim has already been rejected, see my guide to appealing a rejected claim.
This is general information, not legal advice.
How to apply with diabetes or high blood pressure, step by step
- Collect your records first. When you were diagnosed, the medicines and doses you take, your latest blood test and blood pressure readings, and any hospital admissions or complications. Letters from your clinic or specialist show the underwriter that the condition is being followed up.
- Do not cancel any policy you already have. A new plan is a new application with new terms. Keep the old one until the new one is issued and you have read it.
- Answer every health question fully. If you are not sure whether something counts, declare it and attach the report. Bank Negara requires insurers and their agents to use plain language and to help you meet your duty of disclosure.
- Go for the check-up or send the reports if asked. Insurers set out when they need more information or medical investigation reports before they decide.
- Wait for the written decision. For a new medical card, the insurer must tell you within 14 calendar days of receiving your complete information.
- Read the offer carefully. Check the exact wording of any exclusion and the amount of any extra premium. You can accept it or say no.
- Use the 15-day free-look period. According to Great Eastern's PDS, if the policy does not suit you, you can cancel within 15 days and the premium is refunded, less any medical examination fee incurred.
One more habit that helps: keep a simple folder with your diagnosis letter, a list of medicines and your yearly check-up results. The same folder makes hospital admissions and claims smoother later.
Diagnosed after you bought your medical card? Keep it
This is the part I most want readers to know. If your medical card started before you were diagnosed, the diabetes or high blood pressure is not pre-existing for that policy. Bank Negara's policy document says an insurer cannot terminate a medical policy during the period of cover, and cannot refuse to renew it only because you made a claim. Deputy Finance Minister Liew Chin Tong said the same in Parliament in July 2026: insurers cannot cancel a policy or refuse renewal just because the policyholder made a claim or was diagnosed with an ailment after taking up the cover.
What the insurer may do at renewal is change the terms after a fair underwriting assessment, or add a loading for an individual with past claims. That loading cannot exceed 25% of the premium before the claims (above that, the insurer must review the rates of the whole portfolio), the practice must be disclosed in the PDS, and you must be told in writing at least 30 days before the policy anniversary if the terms change.
Worked example: keep the old card or switch?
Every fact here is assumed for illustration and is not a real case: a 52-year-old has had a medical card since age 45, was diagnosed with type 2 diabetes at 50, and now sees a new plan with a higher limit.
| What happens (assumed) | Keep the existing card | Cancel it and buy a new card now |
|---|---|---|
| Admitted to hospital because of diabetes | Claimable under the policy terms, because the diabetes started after the cover | Pre-existing illness: not covered |
| Admitted for dengue | Claimable | Claimable once the 30-day waiting period has passed |
| Injured in an accident | Claimable | Claimable; injuries have no 30-day wait |
| Heart or kidney problem linked to diabetes | Claimable under the policy terms | May be excluded if the exclusion covers complications |
A Great Eastern campaign FAQ for existing customers shows how wide that last row can be: it lists "diabetes and its complications" diagnosed, disclosed or claimed before the new policy starts as not covered, and carries existing health loadings and exclusions onto the new rider. If you want more cover, ask what the new plan would exclude before you cancel anything, and keep the old card until you have compared the exact wording. If it is your parents who are in this situation, my guide to medical cards for parents over 60 covers the age side too.
How I can help before you apply
I am Lulu Loke, a Great Eastern Life Planning Advisor in Kuala Lumpur and Selangor for 13 years. This is my own guide, not a Great Eastern website. With so many adults in Malaysia on blood pressure or diabetes medication, this is one of the most common questions in a policy review. I work with families in Seri Kembangan, Serdang, Puchong, Cheras and across KL, and I explain things in Mandarin, English or Cantonese. Before you apply, I can:
- look at the policies you already have, from any insurer, and tell you what they already cover for your condition, before you cancel or replace anything;
- go through the health questions with you so every answer is complete, and list the reports worth attaching;
- explain the underwriting decision when it comes back, including any extra premium or exclusion wording, so you can decide calmly;
- help with hospital admissions and claims later, which is when an accurate application really pays off.
I cannot promise that an insurer will accept you, or on what terms; that is the underwriter's decision. What I can do is make sure your application is accurate and complete. Start with a free policy review, or WhatsApp me at 016-914 0086 with your age, the condition and roughly when it was diagnosed. No hard selling: take your time.