Health Insurance
Undestanding Underwriting
Understanding Underwriting Options for Health Insurance in the UK
When applying for health insurance, selecting the right type of underwriting for your personal circumstances is essential. Each option is tailored to specific needs, so it’s important to discuss these with a broker or health insurance specialist to ensure you choose the most suitable plan.
Below, we outline the main underwriting options available:
1. Moratorium Underwriting
With moratorium underwriting, there is no need to complete a medical questionnaire. Instead, the policy includes automatic, temporary exclusions. These exclusions typically apply to pre-existing conditions — defined as any condition for which you have sought medical advice, experienced symptoms, or received treatment (including over-the-counter medication) in the five years before your policy begins.
If you have a condition that remains symptom-free and untreated for two continuous years after the policy start date, it may then become eligible for cover, subject to the policy terms and conditions.
Key Points:
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No medical questionnaire is required.
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Acceptance is automatic and instant.
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Pre-existing conditions are excluded initially.
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Automatic exclusions are in place.
2. Full Medical Underwriting
Under full medical underwriting, you will complete a detailed health questionnaire as part of the application process. The insurer will assess the information provided and confirm the terms of cover, including any exclusions for pre-existing conditions. In some cases, they may request additional information from your GP or specialist.
It is crucial to provide complete and accurate details about your medical history, including all past or current conditions, no matter how minor. Failure to do so could affect your policy’s validity or any future claims.
Key Points:
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A medical questionnaire is required.
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Terms of cover and exclusions are determined upfront.
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Pre-existing conditions are assessed on a case-by-case basis.
3. Continued Personal Medical Exclusions (CPME) – Switch Plans
A CPME policy allows you to transfer from an existing health insurance policy to a new one while maintaining your current terms, including exclusions for pre-existing conditions, as shown on your existing medical certificate. Claims history from the past five years may be reviewed, and a copy of your current certificate will be required during the application process.
Key Points:
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Continuous cover for pre-existing conditions, based on the current policy's terms.
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Exclusions remain as detailed on your existing medical certificate.
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Subject to the insurer’s terms, conditions, and underwriting criteria.
4. Continued Moratorium – Switch Plans
A continued moratorium plan enables you to transfer from an existing moratorium policy while maintaining the same terms. The exclusions outlined in your current medical certificate will remain, and no new underwriting is required. Claims made within the last five years should be disclosed, and your existing certificate will need to be provided.
Key Points:
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No new medical underwriting required.
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Pre-existing conditions remain excluded, as per the existing certificate.
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Terms and conditions are subject to insurer approval.
5. General and Medical Switch Plans
Some providers, such as General & Medical, offer unique switch criteria. These plans may include waiting periods but can provide advantages depending on your specific requirements. Unlike many insurers, General & Medical may allow continued cover for pre-existing conditions in certain circumstances. The exact terms will depend on your policy and individual needs.
Key Points:
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Switch options may include coverage for pre-existing conditions.
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Specific terms and conditions apply.
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Can be tailored to individual requirements.
The following procedures will be excluded from your transfer of cover to us for a minimum period of 24 months where you have had, in the 60 months prior to the start of your cover with us, any symptoms or condition (present or in remission) requiring any of these procedures or treatments, a) cardio procedures (including by-pass surgery), b) cancer care, investigations, or treatment, c) psychiatric or mental health care or treatment, d) joint replacement or revision surgery.
All other treatment, investigations, or tests, required, for conditions for which symptoms were present prior to the start of your cover with us, will be excluded from your transfer of cover to us for a minimum period of 10 months. In addition, benefit, care or treatment which relate to pregnancy, or complications of pregnancy (including private delivery), are excluded from your transfer of cover for a minimum period of 10 months.
Important Considerations
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Always consult with a broker or health insurance specialist to understand which underwriting option is best for your situation.
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Providing accurate and complete information is essential to ensure the validity of your policy and avoid complications during claims.
This guide is for informational purposes only and is subject to the specific terms, conditions, and approval criteria of each insurer.
Please also see details on No Claims Discount