Health Insurance Underwriting Explained
Understanding how your medical history is assessed is one of the most important decisions you'll make when choosing health insurance. Our independent advisers will guide you through every option.
DISCUSS YOUR OPTIONSWhat is Health Insurance Underwriting?
Underwriting is the process insurers use to assess your medical history when you apply for private health insurance. It determines what will and won't be covered under your policy, particularly around pre-existing conditions.
The type of underwriting you choose can significantly affect your cover, your certainty at claim stage, and your premiums. It is crucial to get this right from the outset to avoid unexpected exclusions or denied claims later on.
Types of Health Insurance Underwriting
There are four main underwriting methods used in UK private health insurance. Understanding the differences is essential to choosing the right policy.
Full Medical Underwriting (FMU)
Recommended for individuals and families who want clarity rather than waiting until the point of a claim. Typically a good choice for the older demographic or those with a colourful or complicated medical history.
Moratorium Underwriting
A simpler application with fewer questions. Pre-existing conditions are assessed at claim stage rather than when you apply.
Medical History Disregarded (MHD)
Your medical history is not fully assessed, but you will still need to answer a short set of heart and cancer risk filter questions. Each insurer's questions may vary, but the concept is the same. Pre-existing conditions are generally covered from day one. Typically available for group schemes only.
Continued Personal Medical Exclusions (CPME)
Also known as switch underwriting. Your existing underwriting terms and medical history transfer to your new insurer when you switch providers. However, each insurer has specific switch criteria. Any recent hospital admissions, consultations, or planned or pending treatment or investigations are typically referred to the underwriting team and may be excluded. All other medical history is carried over on the same terms.
Full Medical Underwriting (FMU)
The most thorough assessment, giving you complete clarity from day one.
How It Works
- You complete a detailed health questionnaire covering your full medical history
- The insurer may request your GP medical records for a complete picture
- Based on this information, specific exclusions are applied to your policy
- All exclusions are confirmed in writing before your policy starts
- No surprises when you need to make a claim
Key Advantages
- Complete certainty. You know exactly what is covered from the outset
- Faster, smoother claims process with no retrospective medical checks
- Potentially lower premiums for those in good health
- No two-year waiting period for pre-existing conditions to become eligible
- Ideal for individuals and families who value transparency
Moratorium Underwriting
A quicker application process, but with less certainty when claiming.
How It Works
- You answer a few basic lifestyle and eligibility questions. No detailed medical history required
- Any condition you've had symptoms of, treatment for, or advice about in the five years before your policy starts is automatically excluded
- If you remain symptom, treatment, advice and medication free for a continuous two-year period after your policy begins, the exclusion may be lifted
- Your medical history is assessed at claim stage rather than at application
Important Considerations
- You won't know for certain what is covered until you make a claim
- The insurer will review your GP records when you claim. This can delay the process
- Pre-existing conditions are excluded for a minimum of two years
- Some conditions may never become eligible if symptoms recur
- Can cause frustration if a claim is declined unexpectedly
Types of Moratorium
Not all moratorium underwriting is the same. Different insurers offer different types, and choosing the right one can make a significant difference to your cover.
Specified Moratorium
- Excludes only the specific pre-existing condition itself and its underlying cause
- Other, unrelated conditions remain fully covered from the outset
- Often the better choice for people with conditions such as blood pressure or arthritis
- Provides a narrower, more targeted set of exclusions
Related Moratorium
- Excludes the pre-existing condition itself and any conditions related to it
- Can result in a broader range of exclusions than you might expect
- For example, someone with blood pressure could find that cardiovascular conditions are also excluded, which can be daunting
- Important to understand the full scope of what may be excluded before choosing this option
Medical History Disregarded (MHD)
The most inclusive form of underwriting, covering pre-existing conditions from day one.
MHD is the gold standard of underwriting. Your medical history is completely disregarded, meaning all pre-existing conditions are covered from the first day of your policy. However, MHD is typically only available for group business health insurance schemes, usually requiring a minimum of 15-25 employees depending on the insurer.
- All pre-existing conditions covered from day one
- No medical questionnaires or GP reports required
- Simplest application process for employers and employees
- Typically available for groups of 15-25+ employees
- Ideal for businesses wanting to provide comprehensive cover for their team
Continued Personal Medical Exclusions (CPME)
Switching providers without losing the cover you've built up.
How It Works
- When switching insurers, your new provider applies the same exclusions from your previous policy
- Conditions that developed after your original policy started remain covered
- You avoid new underwriting and new exclusions for conditions already covered
- A similar principle applies for moratorium policies. Your qualifying time carries over
Key Benefits
- Continuity of cover with no gaps or new exclusions
- Conditions covered under your old policy remain covered
- Often the safest way to switch to a better deal
- Avoids the risk of a fresh moratorium or new FMU exclusions
- Our advisers handle the entire switching process for you
Which Underwriting Method is Right for You?
New to Health Insurance
If you're taking out private health insurance for the first time, Full Medical Underwriting is typically recommended. You'll know exactly what is covered before your policy begins.
Generally Healthy
If you have a clean bill of health with no recent medical history, Moratorium underwriting offers a quick and simple application process.
Pre-existing Conditions
If you have pre-existing conditions, speak to our advisers. We'll explain how each underwriting method would treat your specific circumstances.
Business Owners
If you're arranging cover for your employees, your group size will determine whether MHD underwriting is available, often the most beneficial option. Learn more about business health insurance.
Switching Providers
If you already have health insurance and want to switch, CPME underwriting protects the cover you've built up over time. Learn more about switching.
Families
Family policies can be underwritten on either an FMU or moratorium basis. We'll recommend the best approach based on your family's medical history. Learn more about family cover.
Why Choose Elective Health?
Underwriting is one of the most important, and most misunderstood, aspects of health insurance. The wrong choice can mean unexpected exclusions, denied claims, or paying more than you need to. Our independent advisers take the time to explain every option and recommend the right approach for your circumstances.
- Independent, whole-of-market comparison
- Expert underwriting guidance tailored to your medical history
- Free advice. No cost, no obligation
- Ongoing support through renewals and policy changes
- Deal directly with Kingsley and Louis. No call centres
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Frequently Asked Questions
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