When purchasing private health insurance an important thing to consider is the type of medical underwriting underpinning your policy.
In the world of health insurance, 'underwriting' refers to the way your health information is used by insurers when you apply for private health insurance. It essentially helps insurers to identify and exclude any pre-existing medical conditions you may have.
A medical condition that a person has prior to taking out any form of health cover
What is a pre-existing medical condition?
Before we dive into the different types of medical underwriting, it's important to understand the meaning of pre-existing medical conditions.
Put simply, a pre-existing medical condition is any health condition a person has prior to enrolling in health cover, such as health insurance.
You'll typically find that most healthcare providers in the UK won't cover you for any pre-existing conditions. Instead, they will cover any new and unexpected health conditions. Why is this the case? Well, pre-existing conditions are predictable, and in many cases require ongoing treatment. This can be extremely costly, so insurers are far less willing to pay out for this!
This is where medical underwriting comes in. Insurers will use the information you provide to assess whether you have any pre-existing medical conditions and use this to evaluate your application for health cover.
Let's take a closer look at the main types of medical underwriting...
Types of Medical Underwriting
There are two main methods of medical underwriting that insurers will use, for example, in your application for private health insurance:
- Moratorium underwriting
- Full medical underwriting
With this type of medical underwriting you won't need to disclose information about your medical history to your insurer when you apply for private health insurance. However, you will need to provide this should you wish to make a claim, and your insurer may also need information form your GP, too.
This is simply to understand whether your claim relates to a new condition or a pre-existing one. For this reason claims made under this type of medical underwriting may take longer to process, due to the information required by your insurer.
Under moratorium underwriting you may be covered for a pre-existing condition, but this depends on when you last experienced symptoms or received treatment. You'll typically find most insurers will not cover any pre-existing conditions you have experienced within the five years prior to taking out cover. The benefit of this type of underwriting, however, is that many insurers will cover pre-existing conditions provided you have not received any treatment, diagnosis, medication or advice for a set period of time after you have taken out your policy, in most cases this is two continuous years.
This means that you will then be be covered for this condition after this period has ended.
Another benefit of moratorium underwriting is that, because you don't need to fill out a health questionnaire at the point of application, applying is relatively straight forward, quick and easy! In fact, most insurers will automatically use moratorium underwriting as the default for this reason.
You won't be covered for any treatment, tests or medication costs for this condition once your policy starts.
You will need to wait until you have completed the set period of time agreed by your insurer, usually two continuous years, without needing any treatment, diagnostic tests, medication or advice for this back condition. Only after you have been treatment, test and medication-free for this continuous period of time after you joined will your insurer then cover this condition.
Full medical underwriting
Unlike moratorium underwriting, if you choose full medical underwriting you will need to complete a full health questionnaire and let your insurer know of any pre-existing medical conditions you have. Your insurer may also request information from your GP, too. If you choose to add a partner or family to your health insurance policy you'll also need to disclose their medical history.
It is crucial that the answer you give are accurate and truthful — if you don't, issues may arise further down the road if you need to make a claim, and in some cases can even result in your insurer canceling your policy altogether.
Your insurer will then review this information and detail what conditions they will and will not cover. It's important to note that, in most cases, insurers will not cover pre-existing conditions.
The benefits of opting for full medical underwriting is that there is greater understanding and clarity from the get-go about what is and isn't covered in your policy. Also, as your insurer already has a record of your medical history, the claims process is typically a lot quicker. The downside to this type of underwriting, however, is that it can be time-consuming completing the health questionnaire upfront at the point of application, so you may find the process takes a little bit more time than with moratorium underwriting.
Which is better: Moratorium or Full medical underwriting?
There is no right or wrong answer to this question, and it really does depend on your own personal circumstances. Moratorium may be a better option for some whilst full medical underwriting may be more appropriate for others. Here are some helpful questions to ask yourself:
Summary: Moratorium vs Full medical underwriting
|Full medical underwriting
|No need to fill out a health questionnaire or disclose any pre-existing conditions
|You'll need to fill out a full health questionnaire and let your insurer know about any pre-existing conditions. Your insurer may also require additional information from your GP
|Any pre-existing conditions you had prior to taking out cover won't usually be covered. It'll only be covered once you've been symptom, treatment, diagnosis and medication free for a set period of time after taking out your policy (usually two continuous years)
|Pre-existing conditions aren't typically covered. Your insurer will review your health questionnaire and outline what is and isn't covered by your policy from the get-go
|May take a little longer, as your insurer will need to look at your medical history and may ask your GP for more information for every new claim you make
|May be quicker, as your insurer already has a detailed record of your medical history and will have already outlined what conditions are and are not covered by your policy
|Typically more affordable
|Typically more expensive, however can be more flexible