‘Moratorium’ Vs ‘Full medical’ Underwriting

‘Moratorium’ Vs ‘Full medical’ Underwriting

When you have made an application for private medical insurance (PMI), insurers use one of two methods to underwrite your application. These are:

  • Moratorium underwriting
  • Full medical underwriting

What do these two terms mean? And how do they affect your application? Keep reading to find out.

What is ‘moratorium’ underwriting?

Many health insurance providers use ‘moratorium’ underwriting. Here, you are not required to provide details of your medical history on your health insurance application. Instead, the insurer does not cover you for:

  • Any medical condition you have received treatment for in the previous few years
  • Any medical condition you have taken medication for in the previous few years
  • Any medical condition you have experienced symptoms of or sought advice about in the previous few years

Different insurers use different time periods but the standard time period is five years.

This means that you will be covered for any treatment for a new condition that you have not experienced in the previous few years. As with full medical underwriting (see below), any new conditions that occur after the start of the policy will be fully covered. However, anything you have suffered from in the past few years will be considered a ‘pre-existing’ condition and won’t be covered under your private medical insurance.

With many insurers, your cover could later include these conditions. If you go treatment, symptom and advice free for a time period - typically two continuous years after the start of your policy - your insurer will often reinstate cover for that condition.

Remember that you should never avoid being treated for a particular condition simply to gain cover for that condition. Always seek medical advice when you need it.

The main advantage of a private medical insurance policy that uses ‘moratorium’ underwriting is that they are quick and simple to set-up. However, you should consider carefully what conditions you have previously sought treatment for in the past few years and whether you would like to try and ensure these conditions are covered.

When you take out your policy, make sure that you are clear on the terms of the moratorium and how far back your insurer considers pre-existing conditions.

What is ‘full medical’ underwriting?

When a PMI provider uses ‘full medical’ underwriting they will ask you to provide full details of your medical history on your application form. You should provide all the information that is requested. If you’re not sure whether you should mention something it is better to do so otherwise the insurer may refuse to pay a claim in the future.

Under full medical underwriting, the insurer will agree your policy based on your medical history. They may also write to your doctor for more information if they need it. In certain cases, you may also be required to attend a medical examination before your health insurance policy is issued.

If you have a medical condition that is likely to return, the insurer may issue your policy but exclude this condition (and any conditions relating to it). The condition may be excluded from your cover permanently or for a specified period of time.

When you receive your PMI policy you will know specifically which conditions are excluded from your cover. You can then request that your insurer reconsiders your cover in future years if these conditions have not reoccurred.

The main advantage of ‘full medical underwriting’ is that it provides certainty as to what you are covered for. Your policy will identify any specific exclusions from your cover so there is no doubt as to what you are covered for – assuming you have declared all information on the application.

Comparing health insurance policies

Different insurers use different underwriting methods. At Briggs & Butler, we can help you find the right health insurance at the right price. When you complete our simple online form, one of our FSA registered PMI experts will contact you to discuss you and your family’s needs. They can then compare health insurance policies to find the right cover – and the right underwriting – for you. Complete the form now and we’ll connect you with a PMI expert.

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