Unfortunately, Private Medical Insurance is there to protect for the unexpected, not for conditions which are already known to us or likely to occur.
With this being the case, insurers offer a range of ways for customers to take out a policy.
Moratorium underwriting: The simplest set-up option
Also known as ‘underwritten at point of claim’, this method is the simplest and least labour-intensive way to begin a new Private Medical Insurance policy.
Moratorium underwriting eradicates the need for you to complete medical forms or health declarations. Instead, it is agreed at the start of the policy that any conditions you have suffered with five years prior to the scheme start date, will not be covered.
However, if you complete a full two years covered by the policy with no treatment, advice, medication, or symptoms of the pre-existing condition; it will automatically become covered once again. Any new conditions that arise from the first day of cover onwards will be covered immediately.
The downside of Moratorium underwriting is that it can delay the claims process. This is because the insurer will want to verify the condition being claimed for wasn’t pre-existing – so expect some due diligence!
Full Medical Underwriting (FMU): The fast claim option
Also known as ‘underwritten at inception’, with Full Medical Underwriting, customers are required to complete a medical questionnaire prior to the policy start date.
This would ask for details of medical history such as:
- GP and specialist appointments
- Hospital stays
- Ongoing medication
- Any other conditions which you may have suffered with previously
Once submitted, the questionnaire is passed to the insurer’s medical underwriting team, who may choose to liaise with your GP and/or request further information. Following assessment, the insurer may choose to apply specific medical exclusions (conditions which will not be covered).
The benefit of this form of underwriting is that customers will know from the outset what they are and aren’t covered for, and therefore the claims process will be a lot quicker and more streamlined. The downside is that the process can sometimes take weeks to complete.
Continued Personal Medical Exclusions (CPME/CME): The transferable option
Also known as “switch”, CPME is for customers who already have UK Private Health Insurance in place, but would like to transfer to a new insurer and retain their previous underwriting and medical underwriting start date.
This will either be because of enhanced benefits elsewhere, a service issue with the holding insurer, or for a premium saving.
For customers transferring in this way, a “medical switch declaration” would need to be satisfied which contains several questions. The questions asked in this declaration can vary considerably between insurers, with some more lenient and less obtrusive than others. Generally speaking, insurers want to check that a customer transferring to them with continued underwriting has not recently suffered with a serious medical condition, and that there is nothing significant planned or pending in the near future.
Medical History Disregarded (MHD): The non-intrusive option
This form of underwriting means that irrespective of a customer’s medical history, their policy will cover them.
MHD is only likely to be in place if a customer has transferred from a company scheme to an individual scheme. If they were on a MHD scheme when they were an employee, then it’s possible to continue on that basis on an individual UK Private Health Insurance scheme.
It is not available to select for a new UK PMI schemes, but can be sourced under International Private Medical Insurance.