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FAQ's Medical Insurance Which underwriting method is best for me?
FAQ's Medical Insurance Which underwriting method is best for me? | Which underwriting method is best for me? |
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| Frequently Asked Questions - Medical Insurance | ||
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There are several options available, it is impossible to say which is 'best' depending on your needs and state of health... A. Full Medical Declaration If you choose this option, your answers to the questionnaire will help the insurance company to understand your medical history. You will need to consider the questions very carefully for each person covered, and answer them fully. The insurer will then look at the details you have given and decide the basis on which they can accept you for cover. Sometimes, the insurers may need to ask your doctor for any further information they need to help them do this. If you have a medical condition that is likely to need treatment in the future it will usually be excluded from cover, together with any conditions related to it. If the insurer puts any specific exclusions on your membership, they will show them on the documents they send to you when they have processed your application. The insurance company will apply the same process for any spouse or dependent children you include in your application and will cover any unexpected eligible medical conditions arising after the start of your membership immediately (subject to the terms and conditions in the Membership Document).
B. Moratorium With this option, you do not need to complete a medical questionnaire. Instead, the insurer will automatically exclude any conditions that you (and spouse/ dependent children included in your application) have: • had symptoms of, and/or • asked advice on, and/or • received treatment for, and/or • received medication for during the five years before your membership starts. However, if you do not have any symptoms, advice, treatment or medication for those conditions or any conditions related to them, for two continuous years of membership, then the insurer may cover these conditions in future. This two year period is known as the moratorium. Although you do not have to complete a medical questionnaire when you join, both you and your General Practitioner (or the patient's General Practitioner if you are not the patient) will need to complete a claim form if you want to make a claim. The information given on this form will help the insurance company to decide whether or not the condition is covered under the terms of the moratorium. They may also need to contact the General Practitioner for further information to help them make this decision. It is important to understand that you will probably never be covered for long-term medical conditions that are likely to need periodic or regular treatment, medication or regular advice. This is because each time you need such treatment the moratorium period starts again, so it is unlikely that there would ever be two clear years during which you do not have any symptoms, treatment, advice and medication. The insurer will also cover any unexpected eligible medical conditions arising after the start of your membership immediately (subject to the terms and conditions in the Membership Document). C. Continued Personal Medical Exclusions (CPME) / Switch With this method of underwriting a company scheme are enabled to switch from another insurer without any new underwriting taking place. Members transfer on the same medical underwriting terms they had with the previous insurer, but the benefits and general policy exclusions applied are those of the insurer. Up to date certificates from the previous insurer are needed in support of the transfer. D. Medical History Disregarded (MHD) MHD underwriting is limited to large group schemes with many members (normally over 100). The insurer will accept a scheme, and disregard all previous medical conditions. However, the scheme is always claims related, and if the scheme loses money, future premiums will increase, and sometimes they will be greater than the standard rates offered for the plan based on other underwriting terms. |
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