Underwriting explained

Full Medical Underwriting (FMU) 

FMU requires each employee to complete an application form, detailing any past and present medical conditions for themselves and any dependent spouses / children. Typically, this will include any history of major conditions, GP / specialist consultations, hospital-stays and other treatment received within the past five years. The insurers’ underwriters will assess the information provided and may decide to exclude any / all conditions on a permanent or temporary basis. If exclusions have been applied, these will be noted on the members’ insurance certificate.

Moratorium 

Under the terms of a moratorium, any conditions suffered during a set period prior to enrolment (typically five years) would normally be excluded for a period of at least two years. Unlike full medical underwriting (FMU) which would normally exclude a condition at inception for the life of the policy, it is possible for a condition to become eligible for cover so long as the member has remained free of medication, advice, symptoms, diagnostic tests or treatment for that condition for a period of typically two consecutive years. Different insurers may use different time periods for the moratorium or apply different terms in respect of medical conditions that may be related to conditions suffered in the period prior to enrolment, please check your chosen insurer’s terms and conditions.

Continued Personal Medical Exclusions (CPME) 

If your company is currently covered by private medical insurance, you will be able to ‘switch’ the scheme to a new provider without the need for your employees to be re-underwritten with this option. CPME means that so long as a medical declaration can be satisfied, the new insurer will not impose any new medical exclusion on members that have already been underwritten by the previous insurer. All existing personal medical exclusions will continue, no new personal medical exclusions will be imposed, unless advised by the new insurer. If your company scheme is currently underwritten on a moratorium basis, the new insurer will continue each member’s moratorium period from their original start date, as detailed on their insurance certificate.

CPME may also be referred to as continued medical exclusions (CME) or no further underwriting (NFU) depending on the insurer.

Medical History Disregarded (MHD) 

This represents the widest form of underwriting open to the insured and is therefore the greatest risk to the insurer. As it suggests, any / all medical conditions that are pre-existing to the membership will be covered by the policy, provided the required treatment is covered within your selected benefit options and does not form part of the general exclusions of the policy.