Health Insurance Underwriting
All health insurance policies are underwritten in some way. When applying for health insurance, an insurer will assess a person’s medical history and current health status so they can apply the appropriate underwriting terms to the policy.
As with any insurance policy, in general, health insurance cannot cover you for conditions you currently have or have had in the past. However, some pre-existing conditions can be covered if the condition you have had treatment for is now resolved. This will depend on the status of the condition at the time of applying and the number of years since you have had symptoms, advice, diagnostic tests, or treatment.
There are several underwriting options you can choose from dependent on your current situation. Some require you to disclose your medical history and others do not.
The main two underwriting options for someone taking out health insurance for the first time are moratorium (MORI) and full medical underwriting (FMU).
If you are switching insurers, you also have the option to choose continued personal medical exclusions underwriting (CPME). A continued moratorium (CMORI) is also available for those switching policies when the existing underwriting is on a moratorium basis.
Medical history disregarded underwriting (MHD) is available when joining a business health insurance policy or switching from one business policy to another. It is also accepted by an insurer when you switch from a business policy to an individual policy.
Moratorium underwriting (MORI) is the most common form of underwriting if you are taking out health insurance for the first time. You will not need to disclose your medical history when you take out the policy, the insurer will request this at the point of claim when deciding if the condition will be covered.
For the first two years of the policy, you will not be covered for anything you have had symptoms, advice, diagnostics, or treatment for in the five years preceding the policy start date.
If you go two consecutive years without symptoms, advice, diagnostics, or treatment for a previous condition it will then be covered by the policy.
Under a moratorium underwriting the insurer will request medical history from your GP and or consultant at the point of claim to establish if you have had symptoms, advice, diagnostics, or treatment within the five years preceding the start date of the policy.
Moratorium underwriting is good for covering conditions you have had in the past but are unlikely to require further immediate cover for. However, if you will always require advice, medication, or treatment for a condition then a moratorium underwriting will be unlikely to ever cover it.
- No exclusions are applied to the policy itself.
- You may be able to get cover for pre-existing conditions after two years subject to the moratorium criteria.
- As there is no need to disclose your medical history, moratorium underwriting can speed up the implementation of your policy.
- Moratorium underwriting results in lower premiums than other forms of underwriting.
- Any medical condition that has occurred in the previous five years will not be covered for the first two years and is subject to going two years clear of symptoms, advice, diagnostics, and treatment for that condition.
- You may not be exactly sure what you are covered for based on your past medical history until you need to claim.
Full medical underwriting
Full medical underwriting (FMU) is where you are asked to provide full details of your medical history to the insurance company. This will usually be a full medical questionnaire about any pre-existing conditions and medications you are prescribed. There may be a requirement to provide further information from your GP or consultant. Most pre-existing conditions declared during this process will be excluded from the policy but may be subject to a review in future, should symptoms resolve or treatment end.
- You will know exactly what is and is not covered on the policy.
- The claims process can be quicker as the insurer will have already assessed your medical history.
- Full medical underwriting results in lower premiums than other forms of underwriting.
- Exclusions may be written into the policy from the outset. These can be removed in the future subject to certain criteria, but you will need to obtain evidence, at your own expense, that the condition is cured.
- It takes extra time to fill in the health questionnaire.
Switching your health insurance policy
All health insurance policies come up for renewal after twelve months. At this point you may decide to renew with your existing provider or switch your policy to a new insurer. This does not mean you have to wait until your renewal date to switch your cover, you can switch at any time.
Morehealth have a wealth of experience in switching health insurance policies. Underwriting can be complex; we use our in-depth knowledge to guide you through alternative options and the underwriting process.
We compare your existing policy with all the UK’s leading health insurers to find you the best deal in terms of price and benefits. You do not have to of taken your original policy out with us, we offer a no obligation review and we do not charge for our services. If we find you a suitable alternative you may be able to switch your policy to a new provider, saving you money and ensuring continuous cover for your previous medical conditions.
Each insurer has its own switch eligibility criteria which generally include no consultations, either private or NHS, in the preceding twelve months, no ongoing symptoms, treatment and diagnostics and nothing planned and pending.
However, many insurers have a list of conditions that do not need to be disclosed and would not be subject to further underwriting. Because of this it is not possible to assume all insurers will treat your previous medical history in the same way.
Therefore, using Morehealth to manage the process for you is invaluable, it saves you time and hassle. We understand the complexities of underwriting and will guide you through the process, whilst making you fully aware of what will and will not be covered before you switch insurers.
There are two main options for switching your health insurance policy and transferring your existing underwriting; continued personal medical exclusions (CPME) and continued moratorium underwriting (CMORI).
Continuing personal medical exclusions
Continued personal medical exclusions underwriting (CPME) is available to individuals who already have a health Insurance policy and are switching their cover to another insurer. The insurer will not reassess your full medical history, but each insurer has their own criteria for accepting a switch under CPME terms. In general, you will need to disclose your medical history for the twelve months preceding the start of a new policy. In addition, you may be asked questions on specific conditions such as cancer, cardiovascular problems, and joint issues.
If you meet the eligibility criteria, you can transfer your underwriting from your current provider with no new exclusions applied. However, if your current policy already includes an exclusion, this will be carried over to the new policy.
- You will know exactly what is and is not covered on the policy.
- You may be able continue cover for a pre-existing condition.
- Any exclusions on your previous policy will transfer to the new policy.
- CPME underwriting can be slightly more expensive than other forms of underwriting.
A continued moratorium underwriting (CMORI) is only available when switching to a new insurer when your existing policy is underwritten on a moratorium basis. It means you can keep the effective date of the original policy rather than starting a new moratorium.
If you have been symptom, advice, and treatment free for two years you would not have to start the two-year wait for cover for previous conditions again. Previous conditions would be those you have experienced in the five years preceding your original moratorium start date.
For example, if you take out a continued moratorium one year after the original moratorium, you will only have to be symptom, advice, and treatment free for one further year rather than two years.
Medical history disregarded
Medical history disregarded underwriting (MHD) is typically used for business health insurance policies. It can also be transferred with a policy when leaving a business scheme and taking out an individual health insurance policy.
If you already have business health insurance with an insurer and all members are insured on a medical history disregarded basis, you can choose this option when transferring to a new policy.
This underwriting option is also available for companies who do not have a policy in place already and are looking to insure several employees. Each insurer has their own criteria for minimum employee numbers for this option, but it is usually around 20 insured employees. MHD underwriting covers pre-existing conditions and there are no medical history questionnaires to complete.
The other underwriting options can also be applied to a business health policy. The best option for your business depends on how much information you want your employees to have to disclose and whether you already have a business policy in place.
If you are leaving a company and want to continue your health insurance it is advisable to talk through your options with one of our advisors as the underwriting can be transferred, however sometimes it may not be necessary which would result in cost savings.
- All pre-existing conditions will be covered.
- As there is no need to disclose your medical history, medical history disregarded underwriting can speed up the implementation of your policy.
- The claims process is quicker.
- It is a more costly form of underwriting.
Hopefully, this guide has helped to explain health insurance underwriting and its complexities. We would advise speaking with our experts as each insurer has different criteria when assessing an application. We are always available at the end of the telephone to assist you with any questions you have or to review the market for you.