Key takeaways
- In Malaysia a health condition does not stop you from applying for insurance; underwriting decides between standard terms, an extra premium (loading), an exclusion, a postponement or a decline.
- Bank Negara Malaysia's rules say an insurer must not refuse you solely because another insurer refused you; it has to assess the risk under its own underwriting policies.
- For a new medical card, the insurer must give its decision in writing within 14 calendar days of receiving your complete information (BNM medical and health insurance policy document).
- Great Eastern's health declaration asks whether you used any tobacco or nicotine product in the last 12 months, and its Malaysian rate tables price smokers and non-smokers separately.
- At Great Eastern, a request to reduce or remove a health extra or an exclusion can only be considered after the policy has been in force for more than one year, and it is underwritten again.
- These conditions are common: NHMS 2023 found high cholesterol in 33.3% of Malaysian adults, overweight or obesity in 54.4%, and 19.0% currently smoking tobacco.
Can I still buy insurance with high cholesterol, fatty liver, hepatitis B, asthma or a thyroid problem?
Yes, you can apply. A health condition does not stop you from applying for a medical card, life insurance or critical illness cover in Malaysia. What it changes is the answer that comes back. Every application goes through underwriting: an underwriter reads your answers, plus any reports or check-up the insurer asks for, and decides whether to accept you and on what terms. The consumer education site InsuranceInfo lists the factors as age, sex, habits, personal and medical history and occupation, and says the decision rests on the application form and the medical examination report, if one is required.
You are far from alone. The Ministry of Health's National Health and Morbidity Survey (NHMS) 2023 shows how common these conditions and habits are among Malaysian adults:
| Condition or habit | Adults in Malaysia (NHMS 2023) |
|---|---|
| High cholesterol | 33.3% (only 15.2% know they have it) |
| High blood pressure | 29.2% (17.3% know they have it) |
| Overweight or obese | 54.4% (32.6% overweight, 21.8% obese) |
| Known asthma | 6.2% |
| Currently smoke tobacco | 19.0% |
| Currently use e-cigarettes (vape) | 5.0% |
| Depressive symptoms | 4.6% |
Because so many people share these conditions, insurers have set ways of assessing them. Bank Negara requires every medical insurer to keep written underwriting policies that cover which kinds of risk it is prepared to accept and which it is restricted from accepting, and when it needs more information or medical investigation reports before it decides (Policy Document on Medical and Health Insurance/Takaful Business, paragraph 8.1). So the useful question is not only "will they take me?" but "what will they need to see, and on what terms?" The rest of this guide answers that, condition by condition. If your condition is diabetes or high blood pressure, read my guide for diabetes and high blood pressure first.
What is underwriting, and what do standard, loading, exclusion, postponement and decline mean?
Underwriting is the insurer's assessment of your application. Great Eastern's own health declaration form (PSF02) shows the range of outcomes when it asks whether any earlier application of yours was "declined, postponed, rated, restricted or in any way modified or subjected to additional terms". In plain words, there are five results:
| Decision | What it means | What it means for claims |
|---|---|---|
| Standard | Accepted on the normal terms and premium for your age, gender and plan | Claims are assessed under the normal policy terms |
| Loading (extra premium; Great Eastern calls it a "health extra") | Accepted, but you pay more than the standard premium because of a health or lifestyle risk | The extra is in the premium; claims follow the policy terms |
| Exclusion | Accepted, but a named condition, often with its complications, is written out of the cover | Claims for that condition are not paid; other illnesses and accidents are assessed normally |
| Postponement | No decision yet: the insurer asks you to apply again later, for example after a test result, a recovery or a period of stable treatment | No cover from that application until you reapply and are accepted |
| Decline | The application is not accepted | No cover from that application |
Even a standard policy has its own general exclusions. Great Eastern's GREAT 110 Legacy brochure, for example, lists pre-existing conditions among the cases where no benefit is payable, and its Smart Health Protector PDS says the premium and policy terms "may vary depending on the underwriting requirements of the Company".
Rules that protect you during underwriting
- For a new medical card, the insurer must tell you its decision in writing within 14 calendar days of receiving your complete information, so that you can look for other cover if it declines or offers terms you cannot accept (paragraph 8.7 of Bank Negara's medical insurance policy document).
- Insurers and their agents must use plain language, help you meet your duty of disclosure, and help you send in the reports they ask for (paragraph 8.6).
- Bank Negara's Policy Document on Fair Treatment of Financial Consumers lists, as good practice, explaining to an applicant the reasons when an application is rejected.
One point people often mix up: the 25% cap they read about in the news is about something else. It limits the loading an insurer may add to a medical card at renewal because of your past claims (paragraph 8.20). A health extra set when you first apply, because of a condition you declared, is part of the underwriting decision on your application.
Which question on the form covers my condition, and what records should I prepare?
Take Great Eastern's health declaration form (PSF02, used when you change an existing policy, for example to add a rider) as an example of how detailed the questions are. Each condition below is named, directly or through its body system, in one of its questions. The last column is what I suggest you have ready, because an underwriter can only work with what is on paper.
| Condition | Where the form asks | Records worth preparing |
|---|---|---|
| High cholesterol | Question 5(d), which names "raised cholesterol" with heart and blood vessel conditions | Latest cholesterol (lipid) test, the medicine and dose, when treatment started |
| Fatty liver | Question 5(g), any disease or disorder of the liver | Ultrasound report, liver function test, your doctor's advice |
| Hepatitis B | Question 5(g), which names Hepatitis B or C | Latest liver function and hepatitis test results, specialist follow-up letters, any treatment |
| Asthma | Question 5(c), which names asthma with other lung conditions | How often you have attacks, the inhalers you use, any hospital admission or emergency visit |
| Thyroid condition | Question 5(e), which names thyroid disease and goiter | Diagnosis, treatment received, latest thyroid blood test |
| Heart disease | Question 5(d), from chest pain and palpitations to heart attack, valve disorders and heart surgery | Cardiologist reports, ECG or echo results, details of any procedure |
| Cancer, now recovered | Question 5(i): cancer, tumour, cyst, lump and any malignant or pre-malignant condition | Pathology (biopsy) report, treatment dates, the date treatment ended, latest follow-up report |
| Depression or anxiety | Question 5(b), which names depression and anxiety | Diagnosis date, medicine, whether you are still on treatment |
| Past surgery | Question 5(m), any surgical operation not of a routine nature, and Question 3 on current treatment | Discharge summary, pathology report if any, the date you fully recovered |
| Health screening results | Question 8: any blood test, scan or screening in the past 5 years, including ones you were advised to have | The full screening report, including results marked "borderline" |
The same form also asks about your parents' and siblings' history of heart disease, stroke, hypertension, diabetes, kidney disease, mental disorders, cancer and hereditary conditions, about alcohol, and about dangerous sports. A condition described with dates and test results gives the underwriter something clear to assess, while a condition described from memory usually leads to more questions. That is why I ask families to bring their reports to our first meeting, not after the insurer writes back.
Will a high BMI, smoking or vaping make my insurance more expensive?
BMI
Every health form asks your height and weight, and from these the underwriter can work out your body mass index (BMI): your weight in kilograms divided by your height in metres, squared. With 54.4% of Malaysian adults overweight or obese (NHMS 2023), this is one of the most common things an underwriter sees. How a BMI figure is treated is up to each insurer's own underwriting rules, so write your real height and weight today, not the figures from years ago.
| Worked example (made-up figures) | Height | Weight | BMI |
|---|---|---|---|
| Person A | 1.70 m | 68 kg | 68 ÷ (1.70 × 1.70) = 23.5 |
| Person B | 1.70 m | 88 kg | 88 ÷ (1.70 × 1.70) = 30.4 |
| Person C | 1.58 m | 75 kg | 75 ÷ (1.58 × 1.58) = 30.0 |
These figures only show the arithmetic. They say nothing about how any insurer would decide, which also depends on your other answers and reports.
Smoking and vaping
It can, yes. Great Eastern's health declaration asks whether you have smoked or used any tobacco or nicotine product in the last 12 months, and how many a day. Its Malaysian rate tables price smokers separately: the GREAT 110 Legacy brochure, for example, has separate non-smoker and smoker columns, and for adult entry ages the smoker rate is higher for the same age.
Vaping is where people get caught out. The question covers any tobacco or nicotine product, not only cigarettes. If your vape liquid contains nicotine, treat it as a nicotine product and tell the insurer; if you are not sure what is in it, ask before you sign rather than tick "No". NHMS 2023 counted 5.0% of Malaysian adults as current e-cigarette users. If you have quit, check the time window on the form you sign: on this Great Eastern form it is the last 12 months.
How do I declare a health condition properly?
Under Schedule 9 of the Financial Services Act 2013, the insurer may ask you specific questions, and you must take reasonable care not to misrepresent anything when you answer. You must also take reasonable care to tell the insurer any other matter you know is relevant to its decision, and the duty lasts until the contract is entered into. This is how I go through it with families:
- Gather the reports before you fill in anything. Screening results, specialist letters, discharge summaries, and the names and doses of the medicines you take.
- Read the time window in each question. Some ask whether you have ever had a condition, the screening question covers the past 5 years, and the smoking question covers the last 12 months. Answer the question as it is written.
- Give details, not labels. Instead of "minor" or "under control", write the diagnosis, when it started, the treatment and the latest result, and attach the report.
- Include what is still pending. The screening question also covers tests you were advised to have or intend to have, so a scan booked for next week belongs on the form.
- Tell the insurer in writing if anything changes before the cover starts. Great Eastern's form says any change in your health between the date of the application and the date the company is on risk must be communicated in writing.
- Check the copy when the policy arrives. The LIAM consumer guide on medical insurance suggests checking that your original application is attached, that it accurately reflects your medical information, and that there are no unexpected exclusions. On Great Eastern's Smart Health Protector rider, you can cancel within 15 calendar days of delivery, and the units deducted for its charges are put back, less any medical examination expenses.
The mistake I see most often is treating a "borderline" screening result, or a clinic visit that ended without a diagnosis, as nothing. The LIAM guide says that consulting a doctor for any pain or discomfort is regarded as a symptom. What can happen when something is left out is explained in my guide on non-disclosure and claims.
Declined, loaded or excluded: what can I do next, and can it be removed later?
First, read the letter slowly. Note exactly which condition is excluded and how the exclusion is worded, or how much the extra premium is and on which benefits. Then:
- Ask why. Ask which finding led to the decision, and which report, if any, could change it.
- Do not cancel cover you already have. Great Eastern's form warns that switching to a different plan can bring new waiting periods, exclusions of additional pre-existing conditions and changes in cover. An older policy that started before your diagnosis may already cover the condition.
- A decline from one insurer is not a decline from all. Bank Negara's fair treatment rules say an insurer must not refuse you solely because another insurer refused you, unless sound underwriting principles support it, and its medical insurance rules require each insurer to assess the risk under its own underwriting policies. You must still answer the question about past declines or postponements truthfully.
- If you were postponed, reapply once the reason has passed, with the new report.
- Know what MediAsas is and is not. The base medical plan planned for national launch in January 2027 is a fully underwritten product: you still declare your conditions, and exclusions and underwriting terms can still apply (MediAsas pilot FAQ). My MediAsas guide explains how it works.
Can a loading or an exclusion be reduced or removed later?
It can be reviewed. Great Eastern's customer service form has a section headed "Appeal to reduce/waive health extra and/or exclusion". Its notes say such a request can only be considered after the policy has been in force for more than one year, that it is subject to underwriting and "continued evidence of assurability", and that the company may ask for further requirements. So keep your follow-up reports: a stable record after the first year is what you would send.
| Worked example (assumptions only, not a real case): a 38-year-old with asthma accepted on a medical card with an exclusion for asthma and its complications | How it is treated |
|---|---|
| Admitted for dengue fever after the waiting period | Assessed under the normal policy terms |
| Admitted for a severe asthma attack | Excluded under the assumed wording |
| Broken arm from a fall | Assessed under the normal policy terms |
| Asthma stable, appeal lodged after the first policy year | Underwritten again; the insurer may keep, reduce or remove the exclusion |
How I can help, before you apply or after a decision letter
I am Lulu Loke, a Great Eastern Life Planning Advisor in Kuala Lumpur and Selangor. This is my own guide, not a Great Eastern website. Health questions are where I slow down most with families in Seri Kembangan, Serdang, Puchong, Cheras and across the Klang Valley, in Mandarin, English or Cantonese. I can:
- go through the health questions with you before anything is signed, and list the reports worth attaching for your condition;
- look at the policies you already have, from any insurer, before you cancel or replace anything;
- read an underwriting letter with you, whether it is a loading, an exclusion, a postponement or a decline, and explain what it means for future claims;
- prepare the reports for a review after the first policy year if your condition has improved.
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 complete and accurate. Start with a free policy review, or WhatsApp me at 016-914 0086 with your age, the condition and when it was diagnosed. No hard selling.
This is general information, not legal or medical advice. Acceptance and cover depend on the product, your declaration and the insurer's underwriting.