HomeInsuranceHealth conditionsWhat disqualifies you
What disqualifies you from burial insurance
Strictly speaking, nothing does. Guaranteed issue policies accept everyone inside their age band and ask no health questions at all, so cover of some kind exists at every health status. What a health condition actually decides is which of three tiers you land in, and that is a far more useful question than whether you qualify.
Nothing here is medical advice and nothing here should change how anyone manages a health condition. Underwriting rules differ from one insurance company to the next and change without notice. The outcome of any application is decided by the carrier on the individual case, not by a website.
Disqualified is the wrong word
Three products sit under the heading of burial insurance, and the health questions decide which one is on offer.
| Tier | Health questions | When it pays |
|---|---|---|
| Level benefit | A full page of them, answered favourably | Full amount from day one, any cause |
| Graded | The same questions, with some conditions declared | A reduced amount in the first year or two, full afterwards |
| Guaranteed issue | None at all | Premiums returned with interest for two years on natural death, full amount afterwards |
All three pay the full amount from day one for accidental death. The waiting period only ever applies to death from natural causes. There is more on how to tell which one you are being sold.
The knockout page, question by question
| Knockout question | Notes |
|---|---|
| Living in a nursing home or assisted living facility | Asked whatever the reason, and asked as a present state |
| Receiving hospice care or home health care | Usually separate questions, both near the top of the form |
| Needing help with activities of daily living | Washing, dressing, eating, moving about, using the lavatory. This one decides an enormous number of cases |
| Bedridden, or using a wheelchair for a chronic illness | A wheelchair used after an injury is a different answer, so describe it exactly |
| A terminal illness, or a life expectancy given in months | Asked with no time limit on every form |
| Dementia, Alzheimer’s disease or memory loss | Usually with no time limit, and worded broadly enough to catch related diagnoses |
| Currently receiving dialysis | Also asked as dialysis advised but not yet started |
| Using oxygen to assist breathing | Sometimes asked as current use, sometimes as ever. A CPAP machine is not this question |
| An organ transplant, or being on a transplant waiting list | Usually with no time limit |
| Cancer currently in treatment, spread or recurrent | Basal cell and squamous cell skin cancers are normally carved out |
| Congestive heart failure | A knockout on most forms, a graded trigger on a minority |
| AIDS, AIDS related complex or HIV | Still on many forms, narrowed or removed on some |
| Amyotrophic lateral sclerosis, Huntington’s disease, cystic fibrosis, muscular dystrophy | Progressive conditions listed by name on many applications |
| Currently in hospital, or a hospital admission recommended | Asked as a present state |
| A test, biopsy, procedure or treatment advised and not yet completed | The most frequently tripped question on the whole form, and the easiest one to avoid |
General market patterns rather than a promise about any company. Wording, windows and the exact list differ between companies and change over time.
The conditions that usually mean graded
Below the knockout page sits a second layer. These do not end the application, they move it down a tier, and most of them are dated windows that clear with time.
- Cancer treatment that finished inside the last one to two years.
- A heart attack, stent, bypass, valve operation or implanted defibrillator inside the look back, or more than one cardiac event.
- A stroke or mini stroke inside the look back, or more than one.
- COPD with recent hospital admissions, repeated steroid courses, or a period on oxygen that has since stopped.
- Diabetes with complications, particularly an amputation, a diabetic coma, or kidney involvement.
- Chronic hepatitis, cirrhosis or other chronic liver disease.
- Seizure disorders that are not well controlled.
- Treatment for drug or alcohol misuse inside the last few years, which almost every application asks about directly.
- A serious mental health condition where there has been a recent hospital admission, although treated and stable depression or anxiety is usually not an issue at all.
The non medical questions people forget
- Height and weight. Every company publishes a build chart with a maximum and a minimum for each height, and falling outside it can decline an application on its own. The limits differ noticeably between companies.
- Age. Every product has an issue age band. Level benefit policies commonly run to the mid eighties, guaranteed issue bands are usually narrower.
- Tobacco and nicotine. Not a decline, but it sets the rate class, and most forms ask about the last twelve months.
- Criminal justice status. Many applications ask about being incarcerated, on probation or on parole.
- Driving. A recent conviction for driving under the influence is asked about on a large number of forms, usually inside a one or two year window.
The long list of things that are not a problem
This is the section most people actually need, because the worry is usually larger than the reality. None of the following is, on its own, a barrier to a level benefit policy that pays in full from day one.
- High blood pressure and high cholesterol, treated and stable.
- Type 2 diabetes controlled on tablets or on insulin, with no complications.
- Taking a long list of medications. Companies care what they treat, not how many.
- Arthritis, osteoporosis, a hip replacement or a knee replacement.
- An underactive or overactive thyroid.
- Acid reflux, diverticulitis, an ulcer, or a gall bladder removal.
- Sleep apnea managed with a CPAP machine.
- Depression or anxiety that is treated and settled.
- A cancer treated years ago that has not returned.
- Basal cell or squamous cell skin cancer, usually written out of the question entirely.
- A single stent or a bypass well outside the look back.
- Being in your eighties. Many companies write level benefit policies to the mid eighties.
- Having been declined before. It is asked about, it is not a knockout, and the reason for it often no longer applies.
The look back periods that matter
| Window | Typically covers |
|---|---|
| Last 12 months | Hospital admissions, cardiac events, strokes, changes of medication, treatment for substance misuse, a driving conviction, anything advised and not done |
| Last 24 months | The same events on most forms, plus cancer treatment end dates, amputations, and repeat events of any kind |
| Last 36 months | Used by a minority of companies, usually for repeat events or for two serious conditions together |
| Ever, with no time limit | The knockout page. Daily living help, nursing home confinement, hospice, dementia, dialysis, transplant and terminal illness |
What guaranteed issue gives you
Guaranteed issue asks no health questions, cannot be declined for health inside its age band, caps the cover amount, usually somewhere around $25,000 and often lower, and applies a two year period during which death from natural causes returns the premiums paid plus interest. Accidental death is paid in full from day one, and after two years the full benefit is paid for any cause. The premium is fixed for life and the policy cannot be cancelled because health changes.
If you have already been declined
Two things are worth knowing. A decline is recorded, and later applications ask whether you have ever been declined, so applying scattershot to five companies in a week is a genuinely costly strategy. It is better to have one person who holds several appointments read the answers first and send the file to the company whose wording fits.
How much cover to buy
Whichever tier you land in, size the policy to the actual bill. A burial once the cemetery has billed commonly totals about $15,395. Funeral home charges alone for a service with viewing and a metal casket run about $8,300. A cremation with a service is nearer $6,280, and a direct cremation nearer $2,202. The calculator gives your own state figure, and the full cost guide shows where each line comes from.
The questions are the only way to find out
Companies disagree about almost everything on this page, which is the single most useful fact in this market. The same answers can produce a level benefit offer at one company and a decline at another on the same afternoon.
(786) 818-0383Talk to one of our licensed agentsCommon questions
Can anyone actually be turned down for burial insurance?
For a level benefit or graded policy, yes. For cover of some kind, no. Guaranteed issue policies ask no health questions and cannot be declined for health inside their age band, so the practical question is never whether you can be covered but which of the three tiers is available to you.
What is a knockout question?
A question near the top of a simplified issue application where a single yes ends that application for that product. The list is broadly consistent across the market and covers nursing home confinement, needing help with daily living, hospice care, terminal illness, dementia, dialysis, oxygen use, organ transplant and current or spreading cancer, among others.
Which single question turns down the most people?
The one asking whether any test, procedure, surgery or treatment has been advised and not yet completed, or whether any result is outstanding. It appears on almost every form, it catches people who are otherwise perfectly insurable, and it is the one item on the whole list that is usually within the applicant control. Complete it first, then apply.
Does height and weight really matter?
Yes. Every company publishes a build chart with a maximum and a minimum weight for each height, and falling outside it can decline an application on its own. The limits differ noticeably between companies, which means a build that fails at one is often comfortably inside the chart at another.
Should you apply to several companies at once?
No. A decline is recorded and later applications ask whether you have ever been declined, so scattershot applying makes the next attempt harder. It is better to have the answers read first by someone holding several appointments, then send the file to the company whose wording actually fits the facts.
If a condition improves, can you replace a graded or guaranteed issue policy?
Yes, and it is worth reviewing. Most of the triggers are dated windows, so a policy taken during a difficult period can often be replaced with a level benefit policy once the window clears. The rule that matters is never to cancel existing cover until the replacement has been issued and is in force.
Sources cited
- National Association of Insurance Commissioners, life insurance
- National Association of Insurance Commissioners, consumer information and state departments
- National Institute on Aging, Alzheimer’s and dementia
- National Institute of Diabetes and Digestive and Kidney Diseases, kidney failure
- Centers for Disease Control and Prevention, FastStats on deaths and mortality
- National Funeral Directors Association, statistics and price survey