In this guide, we’ll explain how full medical underwriting works, how claims are handled and how it compares with other underwriting options.
What is full medical underwriting?
When you take out private health insurance, you will be asked how you would like your medical history to be assessed. Full medical underwriting is the option where everything is looked at upfront.
You complete a health questionnaire when you apply, giving details of your medical history. This includes any conditions, symptoms, treatment, medication or advice you have had in the past, even if you were not formally diagnosed. Insurers sometimes apply a time frame, for example the last five years.
The insurer then uses this information to decide what they can offer you and what will be covered. Any exclusions are set out clearly in your policy documents before your cover begins. Typically, any pre-existing conditions are excluded from the policy and you won’t be able to claim for them, unless your insurer agrees to make an exception.
How full medical underwriting works in practice
With full medical underwriting, your insurer reviews your health information before your policy begins. In some cases, they may also ask for your permission to access your medical records via your GP. That’s typically when they need more detailed information to properly understand your medical history.
You may be asked about:
Any past or current medical conditions.
Symptoms you have experienced, even if nothing has been diagnosed.
Medication you have taken or are taking.
Treatment or surgery you have had.
Tests, scans or investigations you have undergone.
You might also be asked about:
When symptoms started and how often they occur.
The type and dates of any treatment you have received.
Any ongoing investigations or tests.
Family medical history, particularly for hereditary conditions.
Once the insurer has everything they need, they will confirm your policy terms, including any conditions or treatments that won’t be covered by your policy. If you agree to go ahead, your cover will begin on the agreed start date.
If you have an illness or injury after your policy starts, you will usually be covered for it (subject to the policy’s overall terms) as long as it’s not linked to something already excluded.
A simple example
Imagine you have a history of back pain and are managing it with medication and physiotherapy. When you apply for health insurance with full medical underwriting, you would include details of your condition and treatment.
The insurer would be likely to exclude back problems from your coverage, although they may be able to include it in some cases, perhaps with certain terms. Their decision would be clearly set out in your quotation and policy documents from the outset.
Although having your condition excluded from cover would be disappointing, at least you would know exactly where you stand from day one. That’s in contrast to moratorium underwriting, where you’d only find out whether you’re covered when you make a claim.
Pros and cons of full medical underwriting
You may choose full medical underwriting if you want to be certain about what is and isn’t covered from day one. Like most options, it has both positives and potential negatives to consider.
Advantages of full medical underwriting
You know exactly what is covered before your policy starts.
Less uncertainty when it comes to making a claim.
Claims can often be processed more quickly.
Some recent or minor conditions may still be covered, depending on the insurer.
Disadvantages of full medical underwriting
The application takes longer because you complete a full health questionnaire that the insurer will assess.
There is a risk that if you forget to declare something relevant, your policy may be invalid or your claim rejected.
Some conditions may be permanently excluded, depending on your history.
Exclusions are usually permanent once your policy starts.
Full medical vs moratorium underwriting
Full medical underwriting is one way insurers assess your health history. The other main option is moratorium underwriting.
With full medical underwriting, everything is assessed before your policy begins. With moratorium underwriting, your medical history is usually looked at when you make a claim.
Here is a simple comparison of the two approaches:
Feature | Full medical underwriting | Moratorium underwriting |
|---|---|---|
Full medical disclosure when applying | Yes. You complete a full health questionnaire when you apply. | No. Your medical history is only reviewed when you make a claim. |
How quickly you can get cover | Can take longer as your medical history is assessed before cover starts. | Usually faster as there is no medical questionnaire at the application stage. |
Clarity of cover | Clear from the start as exclusions are listed in your policy documents. | Less certainty upfront as exclusions are only confirmed when you claim. |
Pre-existing conditions | Based on what you declare, with exclusions confirmed before cover begins. | Conditions from the last few (typically five, sometimes three) years are excluded and assessed at claim stage. |
Speed at which claims are assessed | Medical history is already assessed, so claims are usually quicker to process. | Medical history is reviewed when you claim to check if the condition is pre-existing, which can add time to the claim. |
Removal of exclusions | Exclusions are usually set at the start and remain in place. | Some conditions may become eligible for cover after a continuous symptom-free period – often two years. |
Which approach is right for you? That will depend on your medical history and whether you prefer simplicity at the start or certainty from day one.
What happens when you make a claim?
With full medical underwriting, the claims process is usually straightforward because your medical history has already been reviewed.
You contact your insurer with your policy details and referral if needed.
They check your policy to confirm what is covered and whether your current condition is included or excluded.
If it is covered, they approve treatment.
You go ahead with your treatment in line with your policy.
Because it’s already clear what is and isn’t covered, there is usually less back and forth at this stage, compared to moratorium underwriting.
Key things to be aware of
A few simple points are worth keeping in mind:
You need to give a full and honest medical history when applying.
You will know what is covered before your policy starts.
Some conditions may be excluded depending on your history.
Claims are often quicker because underwriting is done upfront.
The application stage takes a little longer than other options.
Who might full medical underwriting suit?
This option may suit you if you like clarity from the start in terms of what your policy does and doesn’t cover. By having your medical history reviewed upfront, you should avoid a nasty surprise with a claim being denied later on.
Also, it may be possible to get cover for a minor pre-existing condition, if the insurer’s underwriters are willing to accept it. With moratorium underwriting, it is very unlikely that a claim for a pre-existing condition would be met, unless you have passed the (typically) two-year symptom-free period after taking out the policy.
Get free guidance and compare plans
Choosing between full medical underwriting and moratorium underwriting is an important part of setting up private health insurance. The right option depends on your health history, how much certainty you want and how you prefer things to be assessed. Because it can feel a bit technical, many people choose to get a bit of help before deciding.
At Money Service, our specialist health insurance advisers are here to explain how different underwriting approaches work, and which might best suit you. As part of the service, which is entirely free of charge, your dedicated adviser can also look at policies from a carefully selected panel of leading UK insurers and highlight the differences, so you do not have to do all the comparing yourself.
We can help with things like:
Explaining how full medical underwriting works for you in real terms.
Helping you understand how your medical history may affect cover.
Comparing policies from leading UK insurers to find suitable options.
Highlighting differences in cover, exclusions and claims process.
Helping you see which option may fit your needs best.
We’re here to help. Speak to one of our friendly health insurance advisers for free, impartial support. They will compare plans from leading insurers, explain your underwriting options and help you find the right cover. Call us now on 0800 144 4777 or request a callback to get started.