Will My Company Health Insurance Scheme Provide Cover for Existing Medical Conditions?

We are looking to take out Health Insurance for our employees but are unsure on if an insurer will provide cover for anyone with pre-existing medical conditions?

Question asked by Seema Shah
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Answered by Tom Conner

The answer to this question is dependent upon a number of factors some specific to your company’s Health Insurance scheme and some specific to the medical condition.

Group health insurance policies can be underwritten in one of three ways:

  • Full medical underwriting
  • Moratorium underwriting
  • Medical history disregarded.

Regardless of the policy underwriting, the general everyday treatment of chronic conditions tends not to be covered. Private medical insurance is designed to provide you with access to private healthcare for the treatment of acute conditions.

Fully Medically Underwritten

With a fully medically underwritten scheme you would disclose your past medical history when joining the scheme and the insurer will make a judgement based on the information disclosed as to whether any exclusions are to be added to your plan.

Moratorium

A plan underwritten on a moratorium basis usually states that any medical conditions suffered in the past 5 years will not be covered for the first two years of the policy.

Should you not suffer any symptoms of that condition during the first two years of the plan it may be re-included within the policy at the insurer’s discretion.

Medical History Disregarded

If your company scheme is large enough (typically at least between 20-25 members), the policy can be underwritten on a medical history disregarded basis.

On this basis, there is no need to declare your medical history and your employees’ acute pre-existing medical conditions will covered upon joining the scheme.

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This information does not constitute financial or other professional advice. You should consult your professional adviser or contact us directly on 02084327333 should you require financial advice. It is important to ensure any insurance policy you take out is suitable for your needs.
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