Medical Insurance Underwriting can be a mind field and making the right choice is vital for both the individual and business. Below are the Health Insurance Underwriting options available to our clients. Although the below will help you make an informed decision, we would always recommend having a conversation in relation to Private Insurance Underwriting, as this is a vital part of ensuring you understand what you are and are not covered for.
Individuals and Families
Medical Insurance policies are accepted by the Insurer in 2 ways either;
• Full medical declaration (FMU)
• or what is known as Moratorium
Full Medical Underwriting (FMU)
In the case of full medical underwriting, all the medical information is review by the Medical Insurance underwriters before the policy is accepted. If you disclose any serious medical conditions or illnesses on the application form these conditions may be excluded - sometimes on a permanent basis. In very extreme cases cover will be refused. Clearly full medical underwriting is costly for the Health Insurance Companies as each client has to be individual assessed and this causes delays in cover being offered.
Moratorium
In an attempt to reduce costs, insurers have designed a moratorium underwriting. The insurer will automatically issue medical insurance cover, but within the terms and conditions of the Medical Insurance policy, they will exclude any medical conditions for which you have had or sought advice in usually the last five years. If, over the first two years of your policy you do not seek or need treatment for those conditions then at the end of the period you will receive cover for them. As a result, Medical Insurance policies on a moratorium underwriting basis will exclude cover for many serious conditions such as cancer and heart conditions if they are pre-existing as you will have regular follow-up checkups or treatment.
Companies
Medical Insurance policies are accepted by the Insurer in 4 ways for Company schemes,
• Fully Medical Underwritten (FMU)
• Moratorium
• Continued Personal Medical Exclusion (CPME)
• Medical History Disregarded (MHD).
To be considered for CPME or MHD will depend on the number employees within the scheme and certain Health Insurance question's relating to existing conditions being disclosed before the application.
Switch or (Continued Personal Medical Exclusion)
CPME underwriting describes the process by which Health Insurance Companies accept a transfer in from another company. This process is almost exclusively in the company paid market and allows client companies to transfer one Insurance Company to another on renewal without losing cover for conditions that arose after the start of the original scheme. CPME is also known by the following terms:
• Switch
• No Worse Terms Transfer
• Protected Underwriting Terms
Medical History Disregarded (MHD)
Medical Insurance Policies written on an MHD basis commit the Health Insurance Company to all eligible medical expenses that occur after the inception date of a policy. This type of underwriting is usually limited to groups of more than 50 members.