Health Insurance Underwriting

Moratorium underwriting is a way of taking out health insurance without completing a full medical questionnaire. Instead, anything you’ve had symptoms, treatment or advice for in the 5 years before your policy starts is not covered for the first 2 years. It’s the most common option for people buying cover for the first time.

The word “moratorium” simply means a temporary pause. Your medical history isn’t reviewed when you apply, so the insurer doesn’t write specific exclusions into your policy at the start. Instead, the general rule applies to any condition from the previous 5 years, and the insurer checks whether it applies when you make a claim.

New conditions that start after your policy begins are covered from the outset, within the terms and limits of your policy.

As an illustrative example, if you had physiotherapy for a knee problem 3 years before taking out moratorium health insurance, that knee problem would not be covered for at least the first 2 years. A new, unrelated condition, such as a hernia diagnosed in your first year, would usually be eligible for cover.

A pre-existing condition may become eligible for cover once you’ve gone 2 continuous years after your policy starts without symptoms, treatment or advice for it. If you do need any of these during that time, the 2-year period usually starts again from that point. Each insurer applies its own policy wording.

This is why a moratorium is sometimes described as “rolling”. The clock isn’t fixed to your policy start date. It runs from the last time you had symptoms, treatment or advice for that particular condition.

As an illustrative example, if you see your GP about recurring back pain 18 months into your policy, the 2-year clear period for that back condition would normally restart from that appointment.

Insurers usually treat medication, check-ups, tests and consultations as treatment or advice, and many also include related conditions and undiagnosed symptoms. Definitions vary, so we’ll explain how a particular insurer words its moratorium terms before you choose a policy.

Conditions that have fully resolved and needed no further care are the ones most likely to become covered in time.

Usually not. Private medical insurance is designed for acute conditions that respond to treatment. Generally, chronic conditions are not covered. Some policies may cover the initial diagnosis and treatment of a flare-up, but the ongoing management of a chronic condition is not covered, whichever type of underwriting you choose.

There’s an extra factor with moratorium underwriting. A condition that needs regular medication, monitoring or check-ups will rarely reach 2 continuous years without treatment or advice. That means a pre-existing chronic condition, such as diabetes or high blood pressure managed with medication, is very unlikely to ever pass the moratorium.

This doesn’t mean a moratorium is unsuitable for someone with a long-term condition. It may still provide valuable cover for new, unrelated acute conditions. It simply means that the existing condition will stay outside the cover.

If you have an ongoing condition, it’s worth understanding the difference between acute and chronic before you buy. Our guide to chronic conditions and health insurance explains how insurers usually treat them.

You contact your insurer before treatment starts, usually after a GP referral, and they’ll ask about your symptoms and when they began. Because your history wasn’t reviewed upfront, the insurer may ask your GP or specialist for medical records, with your consent, to check whether the condition falls within the moratorium.

This check is the main practical difference from full medical underwriting. It can mean a claim takes a little longer to authorise, particularly in the first few years of a policy, while the insurer reviews your records.

To make claims run smoothly:

• Contact Your Insurer Before Booking Any Private Treatment
• Be Clear And Accurate About When Symptoms First Started
• Keep Track Of Past Appointments, Referrals And Prescriptions

If the insurer decides a condition is pre-existing, they’ll decline cover for that condition, not for your policy as a whole. Other claims are assessed separately on their own merits.

Many people find it helpful to understand the terms insurers use in claims letters. Our health insurance glossary of common terms explains them in plain English.

It depends on your medical history and how much certainty you want. A moratorium suits people with little recent medical history, or past conditions that have fully resolved. Full medical underwriting may suit you if you’d prefer to know exactly what’s excluded from day 1, or if you have a more complex history.

With full medical underwriting, you complete a health questionnaire and the insurer confirms any exclusions at the start. Some conditions you’d expect to be excluded under a moratorium may be accepted after review, while others may be excluded permanently, subject to any future review the insurer allows.

You must answer the questions honestly and carefully. Under the Consumer Insurance (Disclosure and Representations) Act 2012, consumers must take reasonable care not to misrepresent information to an insurer, and a careless answer could affect a future claim.

The price difference between the 2 options varies by insurer and by your circumstances, so it’s worth comparing both before deciding. If you’re arranging a new private health insurance policy, we’ll talk you through how each option is likely to treat your history. We can’t make medical judgements, but we can explain how insurers typically apply their terms.

Yes. If your current policy uses moratorium underwriting, you may be able to switch on continued moratorium terms. This lets you keep the effective start date of your original policy, so time already built up towards the 2-year clear period isn’t lost. Acceptance depends on each insurer’s switching criteria.

As an illustrative example, if you switch insurers 1 year after your original moratorium began, you would normally need only 1 further clear year for a past condition, rather than starting a new 2-year wait. The 5-year look-back also stays linked to your original start date.

Insurers set their own rules, but they typically look for no consultations in the last 12 months, no ongoing symptoms or treatment and nothing planned. Recent claims can also affect the terms and price a new insurer offers.

Starting a brand new moratorium with a different insurer is also an option, but it would reset the clock on any conditions from the previous 5 years. We check which route protects your position before you cancel your existing cover. You can find out more about how we review or switch an existing policy.

Yes, but it applies to each person individually. On a family or joint policy, each member’s own medical history from the 5 years before joining is assessed separately. One person’s pre-existing condition doesn’t affect what’s covered for anyone else on the same policy.

The clear period also runs separately for each person and each condition. A partner who has had no recent medical care may have very few conditions affected, while another family member could have several conditions sitting within the moratorium at the same time.

Business schemes work a little differently. Smaller company schemes often use moratorium or full medical underwriting, but larger schemes, usually around 20 insured employees or more depending on the insurer, may qualify for medical history disregarded underwriting. This covers pre-existing conditions without any health questionnaires.

If you’re leaving an employer’s scheme, medical history disregarded terms can sometimes be accepted when moving to an individual policy, so it’s worth checking your options before your company cover ends. We explain these options further on our business health insurance page.

We’ll talk through your medical history, your priorities and whether you’re buying for the first time or switching, then explain how each underwriting option is likely to work for you. Our advice is free, and as an FCA-regulated broker we’ll set out the limitations as clearly as the benefits.

Choosing underwriting is one of the most important decisions when buying private medical insurance, because it affects what you can claim for long after your policy starts. It’s often harder to put right later, especially once a condition has developed.

Morehealth Limited is authorised and regulated by the Financial Conduct Authority (FCA), firm reference number 815733. We compare underwriting terms across the leading UK insurers, since each applies its own criteria, and we’ll explain where those differences could matter for you.

When you’re ready, you can request a health insurance quote, call us or message us on WhatsApp.