General Exclusions applicable to Health Insurance


When people invest in a private medical insurance policy in the UK whether as an individual, family or business, they have the peace of mind that if they need medical treatment and the NHS cannot treat them quickly, they have their private medical insurance policy to fall back on. When you take a policy though, are you made aware of the general exclusions that may apply to your cover?

All insurance providers may have a different stance as to what is included in their general exclusions but as a guideline, the following conditions may not be covered:

  • Pre-existing conditions (unless you have a company policy with Medical History Disregarded policy)
  • Chronic Conditions
  • AIDS and HIV
  • Addictions and substance abuse
  • Appliances (such as wheelchairs and hearing aids)
  • Cosmetic Treatment
  • Routine Dental Treatment (unless you have a dental cover add-on)
  • Experimental Treatment
  • GP fees and charges
  • Loss of hearing
  • Infertility
  • Injuries sustained whilst playing a sport professionally
  • Sleep disorders
  • Self-inflicted injury
  • Routine Pregnancy and childbirth
  • Birth Control
  • Dialysis

As with all insurance policies, there are terms and conditions that will apply to the general exclusions section of your policy and before purchasing a policy, it would be advantageous to ensure you know what would be excluded from cover should you need to make a claim.

There are policy add-ons such as dental insurance cover that would enable you to claim for dental treatment and some providers offer different “add-on” benefits that may provide cover for benefits such as GP fees and charges.

If you are looking for a private medical insurance and would like to know exactly what you would have cover for, SMP Healthcare Ltd can explain everything to you in detail enabling you to make an informed decision before buying your policy. You can contact us by phone 01245 929129 or by email,