5 Types of Medical Underwriting Explained

Medical underwriting is the process that insurers use to assess the risks of a potential policyholder, evaluating your medical history, current health status and various lifestyle factors that can affect the terms of your policy. The results of this process will impact the coverage options available to you, the premiums you’ll pay and whether any pre-existing conditions will be excluded from your plan. It’s a standard practice private medical insurers use to ensure the coverage they offer aligns with the risks of the new policyholder. 

A pre-existing medical condition refers to any health condition or illness that you had before applying for a private medical insurance policy, including a range of chronic conditions like asthma or diabetes, as well as previous surgeries or even minor health issues. Insurance companies will typically ask for full details of any previous or ongoing conditions or illnesses during the underwriting process to determine whether they will be covered under the new policy. 

Some insurers may exclude you from certain policies or apply higher premiums to your coverage based on your pre-existing conditions, so it’s important to understand the process and be prepared to explore your options. Certain types of medical underwriting, such as moratorium underwriting, may offer more flexible policies for those with pre-existing conditions, allowing them to qualify for full coverage after a specific period of time.

Medical underwriting is a three-step process that takes you from initial application to your policy offering: 

1. Application: The first step of medical underwriting is applying for private health insurance. This is typically done by filling out a form with all the necessary details and receiving a quote, either online or over the phone.   
2. Assessment: Next is the assessment phase, where insurers will typically use advanced computer software to analyse your details at great depth and determine your risk level.
3. Policy Offering: Using the analysis, insurers will then decide on the terms of your policy. Some applications will be accepted on standard terms if they exclude pre-existing conditions, otherwise the terms will be specific to you. 
   

5 types of medical underwriting

Full medical underwriting is the most comprehensive form of underwriting, involving a thorough review of your medical history from details about past illnesses and surgeries to ongoing treatments and any lifestyle factors that can affect your risk, such smoking or diet. During your application, you must disclose your entire medical history so the insurer can accurately assess your risk and provide coverage that’s specific to you. 

While full medical underwriting may take longer than other applications, it typically provides a more tailored policy and if you pass the assessment, you could avoid having any restrictions on your coverage at all.

Continued personal medical exclusion underwriting is a specific variation of medical underwriting where pre-existing conditions are excluded from coverage, even if they have been in remission or under control for some time. 

However, if you are currently insured on a ‘full medical underwriting’ the replacement underwriting would try and provide a full continuation of your medical history on the same terms and to cover pre-existing conditions. You would also be asked fewer questions upon switching.

For the first two years of your membership, any pre-existing medical conditions which you’ve had symptoms, medication, treatment and advice for in the last five years prior to joining us will not be covered. However, after a two-year period from the commencement of your policy where you have been free of symptoms, medication, treatment and advice in connection with that condition, you’ll be covered for it going forward. 

Continued moratorium, otherwise known as switch moratorium, is a type of medical underwriting only offered if you are switching from a policy that was originally underwritten on moratorium terms. This allows you to continue with your previous underwriting, while also providing the chance to carry across your cover for the same conditions. 

When considering this option, it’s important to know whether your new provider will apply their own moratorium terms or honour the terms of your previous policy before you switch. For example, if you have asthma and this is covered by your current insurer, always check whether your new policy will maintain the same coverage.

With medical history disregarded underwriting, the insurer doesn’t consider your medical history when analysing your risk and offering coverage. While this type of medical underwriting provides quick policies without exclusions based on pre-existing conditions, it is only available on company policies over a certain size. However, if you have been covered by this type of policy through a company and then leave, you may be able to continue on an individual basis, but the premiums are typically much higher to account for the increased risk to the insurer. 

To ensure you’re getting the best rates and coverage, our compare and switch process is here to help, with a free policy review and expert advice designed to save you money.

Medical underwriting plays a significant role in determining your quote. By assessing your medical history, current health status and lifestyle, insurers calculate your level of risk and adjust your policy’s premiums accordingly. For example, if you have no significant health issues, you might receive a more competitive quote with comprehensive coverage. However, if you have a history of pre-existing conditions, you may be offered higher premiums or in some cases, exclusions for those conditions. 

It's important to note that various insurers will handle the underwriting of your policy differently, which can impact the coverage and costs available to you. This is where comparing policies is essential. At The Private Healthcare Company, we simplify this process by working with leading insurers like Bupa, AXA, Aviva and Vitality to find a plan tailored to your needs. 

Ready to explore your options with a team of experts? Take the first step by requesting your free quote today.