Plain-English guide

How your medical history meets each underwriting basis

Moratorium underwriting and full medical underwriting treat a medical history differently, and the condition that brought you here is usually excluded under both. The guides here explain how each basis works, using the range of rules insurers publish.

Before you choose a policy

Five questions to answer before you buy

Each one shapes what your policy will pay for, and most first-time buyers only find out the answers after a claim is turned down.

Moratorium or full medical underwriting

Each basis treats your medical history differently, and the condition that brought you here is usually excluded at the outset under both.

What counts as pre-existing

A claim is judged against your medical records at the time it's made.

Standard cover and add-ons

In-patient and day-patient treatment is typically standard; out-patient care, therapies and extended cancer cover are usually optional extras.

Why renewal premiums rise

Age bands, medical inflation, claims experience and Insurance Premium Tax all feed into the figure on your renewal letter.

Self-pay or take out cover

A single treatment paid for once can cost less than a policy carrying you through years of unpredictable need.

The claims process

From the appointment that triggers it to the decision an insurer makes

A claim does not start when you ring an insurer. It starts earlier, at whatever appointment first raised the problem you now want treated, because that date becomes the reference point for everything that follows.

  1. A claim starts with a visit

    A claim begins with a visit to a GP or specialist about a problem. That first appointment becomes the fact an insurer checks everything else against, whatever treatment follows from it.

  2. You tell the insurer what the treatment is for

    You contact the insurer before, or shortly after, treatment and name the condition, the specialist and the hospital involved. Most insurers will not settle payment until this has been checked against your file.

  3. The insurer checks when the condition first showed up

    The claim is assessed against your medical records. What the insurer is establishing is the date of first symptoms, advice or treatment, because that date decides whether the condition counts as pre-existing, meaning you had symptoms of it, sought advice for it, or were treated for it before cover began.

    Moratorium underwriting

    The insurer checks whether you had symptoms, advice or treatment for the condition within the period your policy sets as the look-back period. If you did, the condition stays excluded until you complete a trouble-free period, a stretch with no symptoms, treatment or advice for it.

    Full medical underwriting

    The insurer checks what you declared on the application against your GP records. A condition you disclosed and the insurer accepted is covered unless it was excluded in writing at the time; an undisclosed condition can be refused however long ago it arose.

  4. The wording that decides it often arrives after you buy

    The definitions and exclusions an insurer applies at claim stage are usually set out in the membership certificate, a document issued once your cover starts. It is worth reading that document on its own terms, because it is what a claim is measured against. You can find a given insurer's current contact details and published material in the UK health insurers directory on this site.

  5. The outcome

    Once the check is complete, the insurer either pays the claim, declines it as pre-existing, or asks for further GP or specialist notes before deciding either way.

    Only the insurer, working from your own medical records, can say how a particular claim will be assessed. This sets out the sequence it follows.

    Paid

    The condition falls outside the look-back period, or it was declared at application and accepted without a specific exclusion.

    Declined

    The records show symptoms, advice or treatment for the condition before cover started, or within the period the policy sets as its look-back period.

    More information requested

    The insurer needs further records before it can place the condition on either side of the line.

Who underwrites private medical insurance in the UK

Before you weigh up moratorium underwriting against full medical underwriting, it helps to know which insurers are behind the policies you're reading about. The directory lists operating UK health insurers, with notes on what being an ABI member means for a buyer, so you can look up an insurer's own published terms.

National Friendly National Deposit Friendly Society

National Friendly is the trading name of National Deposit Friendly Society, a UK mutual society founded in 1868 offering private medical insurance and other financial services.

  • Cover types inpatient, outpatient, cancer, mental health (outpatient sessions only, no inpatient mental health cover) source
  • Established year 1868 source

Freedom Health Insurance

Freedom Health Insurance is a UK independent insurer founded in 2003, offering private medical insurance for individuals and small to medium businesses.

  • Cover types inpatient and day-patient treatment, outpatient cover, therapies/complementary treatment, psychiatric/mental health as an inpatient, cancer treatment, dental and optical cover source
  • Established year 2003 source

The Exeter

The Exeter is a UK mutual society founded in 1927 offering private medical insurance, income protection and life insurance primarily to individuals.

  • Cover types inpatient and day-patient treatment, outpatient cover, therapies/complementary treatment, psychiatric/mental health as an inpatient, cancer treatment source
  • Established year 1927 source

WPA

WPA (Western Provident Association) is a UK not-for-profit private medical insurer founded in 1901, offering health insurance as its sole product.

  • Cover types inpatient and day-patient treatment, outpatient cover, therapies/complementary treatment within outpatient limit, psychiatric/mental health as an inpatient, cancer treatment, dental and optical cover, travel cover source
  • Established year 1901 source

Vitality Health Discovery Holdings

Vitality Health is a UK-based private medical insurer owned by Discovery Holdings that rewards members for healthy living through a programme of discounts and incentives.

  • Cover types inpatient and day-patient treatment, outpatient consultations and tests, therapies/complementary treatment, psychiatric/mental health as an inpatient, cancer treatment, dental cover, travel cover source
  • Established year 2004 source

Aviva Health Aviva

Aviva Health is the health insurance division of Aviva, one of the UK's largest insurance companies, offering tiered private medical insurance plans for individuals, families and businesses.

  • Cover types inpatient and day-patient treatment, outpatient cover, therapies/complementary treatment within outpatient limit, psychiatric/mental health as an inpatient, cancer treatment, dental and optical cover source
  • Established year 1990 source

AXA Health AXA Group

AXA Health is a UK-based private medical insurer and part of the global AXA Group, known for flexible, modular policy options and digital health services.

  • Cover types inpatient and day-patient treatment, outpatient cover, therapies/complementary treatment, psychiatric/mental health as an inpatient, cancer treatment, dental and optical cover, travel cover source
  • Established year 1938 source

Bupa

Bupa (British United Provident Association) is a UK-based not-for-profit private medical insurer offering policies for individuals, families and employers, with no shareholders and all profits reinvested into the business.

  • Cover types inpatient and day-patient treatment, outpatient consultations and tests, therapies/complementary treatment, psychiatric/mental health as an inpatient, cancer treatment, dental and optical cover, travel cover source
  • Established year 1947 source

What this site does, and where it stops

When you're trying to work out whether private medical insurance is right for you, the first thing you need is a clear picture of how it actually works. That's the gap this site fills: explanations of underwriting, exclusions and renewal pricing, and guides that help you read your own medical history against the rules insurers publish.

What you'll find here

The guides set out how insurers decide what they will and won't pay for, how a pre-existing condition is defined, what's typically included as standard cover and what's usually sold as an add-on, and why premiums tend to rise at renewal. The underwriting guide explains how moratorium underwriting and full medical underwriting would each treat a medical history, based on the range of rules insurers currently publish. No two insurers' terms are identical, so it is a starting point for reading your own policy documents, not a coverage decision. There's also a directory of UK health insurers, kept for reference.

What this site doesn't do

None of this is advice about which policy to choose, and nothing here recommends that you buy, keep, switch or cancel a policy. The site doesn't sell or arrange insurance, doesn't take applications, and doesn't carry out a regulated activity under the Financial Services and Markets Act 2000. If you want advice on your own circumstances, that's a conversation for a regulated adviser or the insurer itself.

There are no forms on this site, and nothing here asks for your name, your contact details or your medical history. No link on this site exists because an insurer pays for it to be there.

You can read more about how the site is put together on the about page, and the full list of insurers is on the insurer directory.