Blood Tests for a Life Insurance Medical (Australia)
What gets tested, why each result matters to underwriters, how results affect premiums, and how to understand your own copy of the results.
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The Quick Answer
When you apply for life insurance, TPD (total and permanent disability) cover, or income protection above a certain sum insured, the insurer may require a paramedical examination. This typically involves a nurse visiting you or you attending a clinic for a blood draw, urine sample, blood pressure, and weight and height measurements.
The blood panel is a standardised set of tests designed to assess your mortality and morbidity risk. An abnormal result does not automatically mean refusal — it more often means a premium loading (paying more), a condition exclusion, or a request for further information from your GP or a specialist.
When Does an Insurer Require a Blood Test?
Paramedical requirements (including blood tests) are triggered by a combination of your age and the sum insured. Each insurer has its own requirements table, but as a general guide:
Under 40, cover below $1.5M
Usually no blood test required. Tele-interview or online application only.
Under 40, cover $1.5M-$3M
Blood and urine test typically required. Basic panel (lipids, glucose, liver, kidney, FBC, HIV, cotinine).
Age 40-50, cover above $1M
Blood and urine test, ECG may be added.
Age 50+, cover above $500K-$1M
Full panel including PSA (men), ECG, and possibly stress test for higher sums.
Any age with a pre-existing condition
Additional specific tests related to the condition (e.g. HbA1c for diabetics, LFTs for known liver disease).
What Gets Tested and Why
Each test in the panel has a specific underwriting purpose. Modifiable markers are those where lifestyle changes before the medical can make a genuine difference to the result.
HIV antibody test
Why insurer tests it: HIV significantly increases mortality risk and long-term treatment costs. Most insurers test all applicants above a certain sum insured.
Likely impact: Positive result typically leads to decline or very high loading. Modern antiretroviral treatment has narrowed this gap - policies are evolving.
Hepatitis B surface antigen (HBsAg)
Why insurer tests it: Active hepatitis B infection is associated with cirrhosis and liver cancer risk over decades. Chronic carriers face elevated premiums.
Likely impact: Chronic active infection - loading or exclusion. Resolved past infection (HBsAg negative, HBcAb positive) - usually standard terms.
Hepatitis C antibody
Why insurer tests it: Untreated chronic hepatitis C leads to cirrhosis and hepatocellular carcinoma. Successfully treated hepatitis C is viewed more favourably.
Likely impact: Active viraemia - loading or exclusion. Sustained virological response after treatment - usually improved underwriting outcome.
Fasting glucose
Why insurer tests it: Diabetes and pre-diabetes increase risk of cardiovascular disease, kidney failure, and other complications that affect mortality.
Likely impact: Raised fasting glucose (5.5-6.9 mmol/L) - possible loading or further investigation. Diabetes (above 7.0) - loading, exclusion, or decline depending on control.
HbA1c (glycated haemoglobin)
Why insurer tests it: Reflects average blood glucose over 2-3 months. More reliable than a single fasting glucose for assessing diabetes risk.
Likely impact: Pre-diabetes range (39-47 mmol/mol) - likely loading. Diabetic range (48+) - significant loading. Well-controlled diabetes (below 58) treated more favourably.
Fasting lipid panel (total cholesterol, LDL, HDL, triglycerides)
Why insurer tests it: Cardiovascular disease is the leading cause of death in Australia. Lipid levels are strong predictors of future cardiac events.
Likely impact: High LDL or total cholesterol - loading, particularly if combined with other risk factors. Low HDL (below 1.0 mmol/L) also unfavourable.
GGT (gamma-glutamyl transferase)
Why insurer tests it: GGT is the most sensitive marker of regular alcohol use. Elevated GGT in the absence of other liver disease strongly suggests excess alcohol.
Likely impact: Mildly elevated GGT - possible loading or further questions about alcohol intake. Significantly elevated - loading, liver function exclusion, or deferral pending investigation.
ALT and AST (liver enzymes)
Why insurer tests it: Reflect liver cell damage from fatty liver, viral hepatitis, alcohol, or medications. Persistent elevation needs explanation.
Likely impact: Mild elevation with normal GGT - often standard terms with GP report. Significant elevation - deferral pending investigation.
Creatinine and eGFR
Why insurer tests it: Chronic kidney disease is associated with increased cardiovascular mortality and progression to dialysis.
Likely impact: Mild eGFR reduction (60-89 mL/min/1.73m2) - usually standard terms. Moderate reduction (30-59) - loading. Severe or dialysis - likely decline.
Full blood count (FBC)
Why insurer tests it: Anaemia, abnormal white cells, or platelet abnormalities may indicate haematological conditions, bone marrow disease, or chronic illness.
Likely impact: Mild isolated anaemia - often standard. Pancytopenia or significant abnormalities - deferral for investigation.
Cotinine (nicotine/smoker status)
Why insurer tests it: Smoking approximately doubles mortality risk across most age groups. Cotinine directly confirms nicotine use regardless of the type (cigarettes, vapes, patches).
Likely impact: Positive cotinine while declared non-smoker - material non-disclosure, can void claims. Declared smoker with positive cotinine - smoker premium rates apply.
PSA (prostate-specific antigen)
Why insurer tests it: Added for men typically above 45-50 depending on sum insured. Elevated PSA may indicate prostate cancer, which is the most common cancer in Australian men.
Likely impact: Mildly elevated PSA - deferral for urological investigation. Significantly elevated or rising PSA - deferral or decline pending specialist report.
How Results Affect Premiums and Terms
Insurers use underwriting guidelines to translate blood test results into one of the following outcomes. The boundaries between them are not always clear, and underwriting decisions are made holistically — a single elevated GGT alongside otherwise excellent results is treated very differently to elevated GGT plus raised glucose plus elevated BMI.
Standard terms
Results within acceptable ranges. Cover issued at the advertised premium with no exclusions.
Premium loading
Increased risk identified. Cover is issued but at a higher premium, typically 25-200% above standard depending on the severity.
Condition exclusion
Cover is issued at standard or loaded premiums, but claims related to a specific condition are excluded (e.g. liver disease excluded after elevated GGT).
Deferral
Decision postponed pending further information, a specialist report, or a review after a certain period (e.g. 6 months of improved glucose control).
Decline
Cover cannot be offered at any premium. This is less common than media coverage suggests and is typically reserved for very high-risk results.
Getting a Copy of Your Results
Under the Privacy Act 1988 and general insurer obligations, you have the right to access your own medical information including the results of any examination conducted as part of an insurance application.
To request your results, contact the insurer in writing (email is fine) and ask for a copy of all medical examination results associated with your application. You can also ask the paramedical examiner or nurse who conducted the test at the time. Some insurers provide results proactively; others require a written request.
Preparing for Your Insurance Medical
For the modifiable markers (those with a green label above), meaningful improvements are possible before the medical if you have enough lead time. The table below shows realistic timeframes.
Reduce alcohol for at least 4-6 weeks
GGT (the primary alcohol marker) normalises within 4-6 weeks of stopping or significantly reducing alcohol. It is one of the most modifiable markers in the panel.
Improve fasting glucose with diet and exercise
Cutting refined carbohydrates and increasing daily walking can meaningfully reduce fasting glucose over 6-12 weeks. HbA1c takes 3 months to fully reflect changes.
Address cholesterol with diet changes
Reducing saturated fat and increasing soluble fibre (oats, legumes) can lower LDL by 10-15% over 6-8 weeks, enough to shift some borderline results.
Stop smoking well in advance
Cotinine is detectable for 1-3 days after any nicotine use. To be classified as a non-smoker by an insurer, you typically need to have stopped for 12 months or more.
Understanding Your Numbers Before and After
Knowing your baseline before applying — and understanding what the insurer will see — helps you plan. If you have had routine blood tests in the past year from your GP or a pathology lab, those results cover most of the same markers the insurer will test.
Upload your existing pathology results to SmarterBlood to see where each modifiable marker currently sits, track improvements over time, and arrive at the insurance medical with a clear picture of your own health numbers.
After the medical, request your copy of the results and upload those too. If you are deferred or loaded and want to reapply in 12 months, having a baseline makes it straightforward to demonstrate improvement — in writing, with a graph — when you reapply.
Life Insurance Medical Blood Tests - FAQ
What blood tests are typically done for an Australian life insurance medical?
A standard Australian life insurance medical blood panel typically includes: HIV antibody test, hepatitis B surface antigen and hepatitis C antibody, fasting glucose and HbA1c (diabetes screen), full lipid panel (total cholesterol, LDL, HDL, triglycerides), liver function tests including GGT (alcohol marker), kidney function (creatinine and eGFR), full blood count, and cotinine (nicotine/smoker test). PSA may be added for men over 45-50. The exact panel depends on your insurer, the sum insured, and your age.
Can an abnormal blood test result cause my life insurance to be refused?
An abnormal result does not automatically mean refusal. Insurers use results to assess risk and decide on terms - they may offer standard cover, apply a premium loading (extra cost), exclude a specific condition, or in rare cases decline cover. A high GGT suggesting alcohol use or elevated glucose suggesting pre-diabetes is more likely to result in a loading or requirement for further medical information than an outright refusal. Each insurer has different underwriting guidelines.
What is cotinine testing and why do insurers test for it?
Cotinine is the primary metabolite of nicotine and remains detectable in blood for 1-3 days after smoking (or using other nicotine products including patches and vapes). Insurers test for cotinine because smokers have significantly higher mortality rates, so premiums for smokers are typically 50-100% higher than for non-smokers. Declaring as a non-smoker while cotinine-positive is considered material non-disclosure and can void a claim.
Am I entitled to a copy of my insurance medical blood test results?
Yes. Under Australian privacy law and the Insurance Contracts Act, you have the right to request a copy of your medical examination results, including blood test results, from the insurer or the medical examiner. Ask the nurse or paramedical examiner who conducted the test, or write to the insurer directly requesting your results under the Privacy Act 1988.
How can I improve my results before an insurance medical?
Several modifiable markers respond well to lifestyle changes. Fasting glucose and HbA1c improve with reduced refined carbohydrates, regular exercise, and weight loss. Cholesterol (particularly LDL) improves with dietary changes and exercise over 6-12 weeks. GGT (alcohol marker) returns to normal within 4-6 weeks of stopping or significantly reducing alcohol. If your insurance medical is 3-6 months away, addressing these factors could make a meaningful difference to your results.
Does fasting matter for an insurance medical blood test?
Yes. Most insurance medical blood tests require an overnight fast (8-12 hours) because fasting glucose and fasting lipids are significantly affected by recent food intake. The medical examiner will confirm fasting requirements when booking your appointment. Drinking water is fine and encouraged. Fasting for the test also requires avoiding alcohol for at least 24 hours beforehand.
Can I use SmarterBlood to understand my insurance medical results?
Yes. Once you receive your copy of the results (which you are entitled to request), you can upload the PDF or photo to SmarterBlood. The AI will explain every marker in plain English, show you how each value compares to Australian reference ranges, and add the results to your personal health timeline. This helps you understand what the insurer saw and, if you want to apply again later, track whether modifiable markers have improved.
Related Reading
Understand Every Marker in Your Insurance Results
Upload your copy of the insurance medical results or your recent pathology PDFs. SmarterBlood explains every test in plain English and tracks your progress over time.
This page is for general educational purposes only. It is not financial, insurance, or medical advice. Insurance underwriting decisions depend on your full individual circumstances. For advice on your specific application, consult a licensed financial adviser. For medical questions, consult your GP.