Pre Existing Condition

If you have a medical problem or have suffered from one in the past, you need to alert your insurer before taking out the policy. Any medical problems you have come under pre-existing medical conditions.

The options are:

• The insurer will take you on but the premiums will be increased to take the extra risk of you needing expensive treatment into account;
• The insurer will take you on, but will write a special exclusion for that condition into your policy which means you can't claim for it:
• It will set up a plan on a moratorium basis. A moratorium is a waiting period during which your pre-existing conditions will not be covered.

What is moratorium underwriting?

Moratorium underwriting offers the chance of having pre-existing conditions covered after a period of time.

The insurer won't need you to fill out a medical questionnaire, but it will put a blanket ban on cover for any medical conditions for which you've required advice, treatment or medication in the (typically) five years before the start of the plan.

If no medical treatment or consultations have been required for the illness, or any related ones, for two years (though this can be as long as five years), cover will be extended to these pre-existing conditions.

The moratorium works on a rolling ban, so the two years starts again after treatment is sought for a condition, or any directly related to it. So of course, this does mean some pre-existing conditions will never be covered, as treatment will be needed on a recurring basis.

However, don't be tempted to delay getting treatment for a condition to try and reach the two year deadline.

What is full underwriting?

If you choose the full underwriting route, you will be required to complete a full medical questionnaire covering every illness, condition and doctor’s diagnosis. It's a good idea to get a copy of your medical history from your GP to help you fill in the form.

This questionnaire then forms the basis of the insurer’s underwriting decision. Typically, pre-existing conditions will be excluded with little or no chance of them being covered, even after a number of treatment-free years.

The only way to get these conditions covered is to move insurer and hope they will look more sympathetically at your medical history.

Do I have a choice?

If your private health insurer offers both underwriting routes, you will usually be given a choice, and the most suitable method of underwriting will depend on your personal medical history.

However, some insurers only offer one route or the other, so you'll need to decide which will be best for you before applying for cover.

What should I keep in mind?

Always remember, when it comes to your application form, to be completely truthful and answer all questions in full. Failure to disclose any information could lead to claims being rejected, and invalidate your policy.