Pre-Existing Medical Condition Travel Compare quotes to find the best insurance policy for you
In the UK, a pre-existing medical condition in insurance refers to any illness, injury, or disease that you had symptoms of before your policy started, even if you hadn’t received a formal diagnosis. Many policies don’t cover treatment for pre-existing conditions, although some insurers offer options to include them for an additional premium.
Key Points:
Definition:
A pre-existing condition is a health problem that you experienced before your insurance policy began.
Symptoms Matter:
Having symptoms of a condition, even without a diagnosis, can make it a pre-existing condition.
Timeframe:
Most insurers consider conditions you’ve had symptoms of within the 5 years prior to taking out the policy as pre-existing.
Policy Exclusions:
Many policies have blanket exclusions for claims related to pre-existing conditions.
Additional Cover:
Some insurers offer add-on policies or the option to include pre-existing conditions for an extra premium.
Acute v Chronic
Acute conditions are short-term and usually have a clear end date, while chronic conditions are ongoing.
Examples:
Common pre-existing conditions include asthma, diabetes, high blood pressure, arthritis, and mental health issues.
Disclosure:
You need to disclose pre-existing conditions when applying for insurance, and failing to do so could result in policy cancellation or denial of claims
Pre-existing conditions and UK insurance coverage
Understanding how pre-existing medical conditions affect insurance in the UK is crucial for securing appropriate coverage across various policy types, particularly private health insurance, life insurance, and travel insurance. A pre-existing condition generally refers to any illness, injury, or medical issue (including mental health conditions) for which an individual has received advice, treatment, medication, or diagnosis before taking out an insurance policy or during a specified look-back period.
Defining pre-existing conditions
Medical History: Insurance providers consider a range of past and present health concerns as potential pre-existing conditions, including chronic illnesses like diabetes, asthma, or heart conditions, mental health issues such as anxiety or depression, and even seemingly minor past ailments like a broken bone or ongoing back pain.
Timeframes: Insurers typically look back a certain number of years (often 5 years for health insurance) when evaluating medical history. The relevant timeframe for pre-existing conditions insurance can vary depending on the specific policy and insurer.
Symptoms and Treatment: Even if a condition is not officially diagnosed, having experienced symptoms, undergone tests, or received medical advice or treatment can render it a pre-existing condition in the eyes of an insurer.
Underwriting methods and their impact
When applying for health insurance with pre-existing conditions, UK insurers use different underwriting processes to assess risk and determine coverage:
Moratorium Underwriting:
This approach typically excludes pre-existing conditions for a set period (usually 2 years) from the start of the policy.
If no further symptoms, treatment, or advice are received for the condition during this moratorium period, the insurer may then consider covering it.
It is often seen as a simpler initial application process as a full medical history questionnaire may not be required upfront.
Full Medical Underwriting (FMU):
This involves a detailed review of the applicant’s complete medical history, including any past medical conditions and existing health concerns.
Applicants typically complete a comprehensive medical questionnaire, and the insurer may request access to medical records or a report from a GP.
Insurers make upfront decisions about coverage and exclusions before the policy begins.
This method can provide greater clarity regarding health insurance coverage from the start, but it might result in higher premiums or permanent exclusions for certain conditions.
Disclosure obligations and consequences
Honest and Full Disclosure: It is paramount to be completely honest and transparent about all pre-existing medical conditions when applying for any insurance policy.
Consequences of Non-Disclosure: Failing to declare relevant medical information can lead to significant repercussions, including:
Claims being denied or rejected, leaving the policyholder to bear the financial burden of medical treatment or other costs.
Policy invalidation or cancellation, potentially leading to the loss of premiums paid.
Difficulty obtaining future insurance coverage.
Deemed Knowledge: Insurers assume individuals are aware of their own medical history, so even forgotten ailments documented in medical records can be considered pre-existing if they become relevant to a claim.
Accuracy is Key: When completing application forms or undergoing medical screening, provide precise and thorough information to avoid complications later.
Types of insurance affected by pre-existing conditions
Private Medical Insurance (PMI):
Coverage: Typically covers acute conditions that arise after the policy starts.
Pre-existing Exclusions: Chronic pre-existing conditions requiring ongoing management are usually excluded, as are any related conditions. However, some insurers may offer cover for acute exacerbations of certain chronic conditions, according to myTribe Insurance Experts.
Benefit: Offers access to private healthcare facilities and faster access to specialists compared to the National Health Service (NHS).
Travel Insurance with Medical Conditions:
Importance of Declaration: Crucial for ensuring coverage for medical emergencies abroad.
Medical Screening: Often involves a series of questions or a medical screening process to assess risk.
Specialist Coverage: For more complex or serious pre-existing conditions, specialist travel insurance providers may be necessary.
EHIC/GHIC: These cards offer reciprocal healthcare arrangements with certain European countries but do not replace comprehensive travel insurance, especially when dealing with pre-existing conditions.
Life Insurance with Pre-Existing Conditions:
Impact on Premiums: Pre-existing conditions can increase the cost of life insurance due to higher perceived risk.
Individual Assessment: Each application is assessed on a case-by-case basis.
Shopping Around: It is advisable to compare quotes from multiple providers as their views on specific conditions can vary.
Managing insurance with pre-existing conditions
Seek Advice: If unsure about declaring a condition, it’s always best to consult with the insurer or an independent insurance broker.
Understand Policy Documents: Thoroughly read and comprehend the policy terms, conditions, and exclusions related to pre-existing health conditions before purchasing coverage.
Consider Underwriting Options: Weigh the pros and cons of moratorium versus full medical underwriting based on individual circumstances and comfort levels.
Complaint Resolution: If a dispute arises over a claim related to a pre-existing condition, follow the insurer’s internal complaints procedure. If unsatisfied with the outcome, escalate the complaint to the Financial Ombudsman Service (FOS). The FOS is an independent body that can investigate and resolve disputes between consumers and financial service providers.
Key takeaways
Transparency is paramount when dealing with pre-existing medical conditions and insurance.
Carefully consider the implications of different underwriting methods for health insurance.
Ensure travel insurance provides adequate cover for any existing health concerns.
Shop around and compare quotes for life insurance with pre-existing conditions to find the most suitable policy.
Understand the complaint process and utilise resources like the FOS if necessary.
By understanding these nuances, individuals with pre-existing conditions can navigate the complexities of the UK insurance market and secure the appropriate level of protection for their needs.
To provide the best experiences, we use technologies like cookies to store and/or access device information. Consenting to these technologies will allow us to process data such as browsing behavior or unique IDs on this site. Not consenting or withdrawing consent, may adversely affect certain features and functions.
Functional
Always active
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
Preferences
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
Statistics
The technical storage or access that is used exclusively for statistical purposes.The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
Marketing
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.
