Private Medical Insurance Underwriting

Continuing Personal Medical Exclusions

Continued Personal Medical Exclusions (CPME) underwriting is available to individuals who already have a Health Insurance plan in place and are looking for alternative cover. If you find a better deal elsewhere, either in terms of cheaper premiums or better benefits, you’re able to switch insurers.

When do I need CPME health insurance underwriting?

Your insurer won’t reassess your medical history from scratch, instead, you’ll be able to retain the same level of cover you had on your previous policy.

If you have had any medical conditions treated under the old plan, CPME underwriting is highly recommended as the new insurer won’t add any new exclusions based on those conditions.

If you have pre-existing conditions, it’s especially important you get expert advice to ensure you are making the right decision when it comes to changing insurers.

How does Continued Personal Medical Exclusions underwriting work?

For CPME health insurance underwriting, you have to provide the following details:

  • The most recent copy of your current policy certificate
  • Information about any claims that you made on your current policy
  • Basic information about your medical history

However, it’s important to note that, although your coverage remains the same, your new policy’s terms and conditions may differ from your old policy.

Full medical underwriting or moratorium health insurance?

Mainly, there are two types of underwriting available for private health insurance:

  • Moratorium
  • Full Medical Underwriting

The type you choose varies based on your risk tolerance.

What is Moratorium Underwriting Health Insurance?

Moratorium Underwriting (MORI) is the most common form of Health Insurance underwriting. Here, your insurer will usually decline to cover any condition you’ve had advice, medication or treatment for in the past 5 years.

Moratorium underwriting sets a waiting period for pre-existing medical conditions to limit risk to the insurer. This way insurers can do their utmost to keep premiums affordable for plan members. A moratorium will therefore exclude all pre-existing medical conditions for a set period, often two years, but may then cover the conditions after that.

Advantages of moratorium underwriting

  • There’ll be no automatic exclusions if you haven’t suffered from any major health conditions in the past 5 years.
  • In case of pre-existing conditions, you may be able to get coverage for them after a 2 year period on the policy.
  • As you don’t usually have to fill in a health declaration, Moratorium underwriting can speed up the implementation of your policy.

Disadvantages of moratorium underwriting

  • Any medical condition that has occurred in the last five years, will be excluded.
  • You may not be sure exactly what you’re covered for based on your past medical history until you try to claim.

What is Full Medical Underwriting Health Insurance?

For this, you have to provide us with a complete medical history regarding your past health and any pre-existing conditions. We would then review your condition and let you know if the insurer is able to offer cover for those medical conditions.

If you opt for full medical underwriting then you’ll need to fill out a health questionnaire to buy Medical Insurance.

You will want to fill in a health declaration form, which will ask a set of questions about your health and previous medical conditions.

The purpose is to identify pre existing conditions that may not be covered by the insurance plan due to exclusions or limitations in the policy. Most people think they are healthy enough to pass this evaluation flawlessly. However, it pays for them to know what might come up during the examination before taking steps forward with their application.

Advantages of full medical underwriting

  • The transparency of information – you will get a clear picture what would and won’t be covered in the policy.
  • You may be able to get coverage for conditions that have occurred during the past 5 years.

Disadvantages of full medical underwriting

  • When it comes to full medical underwriting, it takes extra time to fill in the health questionnaire.
  • If further down the line you want to examine having a medical exclusion removed from your policy with evidence from your GP, you may need to pay for these reports. However, there’s no guarantee that the insurer will accept your attempt to get the exclusion removed even after you’ve paid for the reports.
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