A brief introduction to health insurance underwriting

Private health insurance policies offer different types of coverage depending on the type of underwriting you choose. There are two main types on individual policies; moratorium underwriting and full medical underwriting. If you work for a large company and have group medical insurance as one of your employee benefits, you may also have medical history disregarded underwriting, which lets you access private treatment for any condition.

We'll focus on the other two types of underwriting. Here's how they work.

Moratorium underwriting

Every health insurance policy excludes pre-existing medical conditions. These are defined as any medical condition for which you needed advice or treatment in the five years before you took out the policy. However, there's a two-year moratorium, so if the condition doesn't return during the first two years of your policy, it can be added to your cover in the future.

For example, if you needed physiotherapy for knee pain before you had the policy, any treatment relating to that knee would be excluded for the first two years. This means that you wouldn't be able to have more physiotherapy or a knee replacement privately within that time.

When you opt for moratorium underwriting, you won't need to provide any details of your medical history when taking out the policy. However, that can mean that your claim will take longer, as your insurance company will look at your medical history when you contact them to seek treatment.

Full medical underwriting

When you opt for full medical underwriting, pre-existing medical conditions will still be excluded for the first two years in the same way as they would with moratorium underwriting. The main difference is that you'll be asked to complete a health questionnaire giving details of your medical history before you take out the policy.

This means the premiums tend to be lower as your insurer can accurately assess the risk you'll claim before they give you a quote. You'll also benefit from knowing what's covered from the start, so you're less likely to have a claim rejected. The whole claims process is usually quicker too.

Read this guide for a detailed explanation of the the differences between full medical underwriting and moratorium underwriting.

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Why CPME health insurance underwriting could be for you

Continued personal medical exclusions (CPME) underwriting lets you move to a new insurer without losing the terms you had with your previous insurer. It's only available if you had full medical underwriting rather than moratorium underwriting on your previous health insurance policy.

The main advantage of CPME underwriting is if you've had treatment for a medical condition on your existing policy and know that you're likely to need more in the future. This could apply to a musculoskeletal condition that flares up regularly. You may also want to switch insurance providers when you're in the middle of a course of cancer treatment, where any delay could negatively affect the outcome.

Chronic medical conditions will always be excluded from your private medical insurance, including a policy with CPME underwriting.

What our customers say

When is continuing personal medical exclusions underwriting needed?

CPME underwriting is only needed if you want to change your policy from one insurance company to another. Different insurers offer different terms, so when your policy comes up for its annual renewal, you might get a comparison quote from your health insurance provider or broker and find that you can get better benefits or more comprehensive coverage from another insurer.

Switching is easy if you don't have any pre-existing conditions or haven't had treatment with your current insurer. However, if you've had treatment or new symptoms but don't want to have further exclusions added to your new health insurance policy, continuing personal medical exclusions underwriting can help.

With CPME health insurance underwriting, your insurer won't reassess your medical history. They'll transfer any existing exclusions to your new health insurance plan. This means you'll be able to keep the same level of cover you had before.

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What's the underwriting process for Continuing Personal Medical Exclusions Underwriting (CPME)?

If you want to change your private medical insurance using CPME, you might wonder whether it's a complicated process. You'll need to provide your new insurer with enough information to assess whether they can offer you a new policy on the same terms as your existing one.

When you're contacting an insurer for a quote, you'll need to provide them with the following information:

  • A copy of your most recent insurance certificate.
  • Some basic details on your medical history.
  • Details of any claims made on your current policy.

If they're able to offer you a policy, your new insurer will use your policy certificate to transfer your personal medical exclusions to your new policy. They won't go through the full medical underwriting process again, but they may decide that they can't offer you insurance with the same exclusions as the previous policy.

It's also important to check the small print before you sign up for a new policy. Insurance providers have different terms and conditions, and some have additional standard exclusions.

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Are there any alternatives to CPME health insurance underwriting?

If you have moratorium underwriting on your policy, you won't be able to transfer to a new insurer using CPME underwriting. However, you can opt for continued moratorium underwriting (CMORI), also known as switch underwriting.

CMORI allows you to switch insurers and keep the moratorium you accumulated under your previous policy. Ordinarily, your new insurer will restart your moratorium period from scratch, so you won't be able to get coverage for any pre-existing conditions for another two years.

This will leave you at a disadvantage if you've been symptom-free for two years. Your existing insurer would likely have been prepared to cover your pre-existing conditions, but your new insurer won't. If you haven't needed any treatment or advice for a year, you'd have two years to wait for coverage with a new insurance provider, but only one if you stayed with your existing provider.

Switch underwriting allows you to avoid this as you can transfer your existing moratorium in the same way you'd transfer your no-claims bonus if you switch to a new car insurance provider.

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A note of caution when you switch providers

We've mentioned this before, but it bears repeating. It's important to remember that each insurer has its own terms, benefits and exclusions. A new insurer can offer you cheaper premiums or improved coverage in one area, but the trade-off may be that you lose coverage or perks in other areas. Please check all the details before switching insurers to ensure you aren't losing something important to you.

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Getting professional advice

Switching insurers can be complex, and seeking professional advice can help you to switch to a private health insurance policy that's right for you. Contact us for a comparison quote, and we'll provide guidance and support to help you make an informed decision.

Matt Fletcher
Senior Broker

Matt Fletcher

Matt, one of our senior brokers, joined us from Axa several years ago. His knowledge and expertise span health, life and income protection insurance alongside critical illness cover.

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