Understanding Health Insurance Underwriting

When you ask for a quotation for private medical insurance, you will be offered different types of underwriting. You may find it confusing but we hope to help you understand what you are being offered.

Please use the information below to discover:

  • What health insurance underwriting is?
  • Why health insurance underwriting is used?
  • The difference between health insurance underwriting options?

What is health insurance underwriting and why do health insurers use it?

Health Insurance underwriting is a process used by all health insurers. It is a way to evaluate a number of risks including any pre-existing medical conditions you may have.If you have a pre-existing condition, the insurer will either accept the risk or exclude it from cover. By discussing your medical history with your broker, you can buy a plan with the best underwriting type for your policy.

What different types of Health Insurance Underwriting that are available?

There are five different types of Health Insurance Underwriting:

Moratorium (MORI)

– Full Medical Underwriting (FMU)

– Continued Personal Medical Exclusions (CPME)

– Continued Moratorium (CMORI)

– Medical History Disregarded (MHD) – only available for large group schemes

We have decided to focus on the two main methods of underwriting offered by all insurers, subject to age and these are:

– Moratorium Underwriting; &

– Full Medical Underwriting

The following underwriting definitions are taken from the Association of British Insures (ABI) guide “Are You Buying Private Medical Insurance?” which was published in 2012. These definitions will show you the differences between both underwriting options and the processes you will be required to undertake. It is important to note that underwriting definitions can vary between insurers. You should always check the specific insurers underwriting definition in their terms and conditions before purchasing a policy.

For more information from the ABI relating to health insurance, or to download the Health Insurance Guide (January 2017):


Moratorium Underwriting

Under this underwriting method you are not asked to give details of your medical history. Instead, the insurer does not cover treatment for any medical condition that you have received treatment for, taken medication for, asked advice on or had symptoms of. In other words, you will not be covered for any condition that existed in the past few years. Five years is the usual time period.

These conditions may automatically become eligible for cover. But this will only happen when you do not have symptoms of, or receive treatment, medication, tests and advice (from your GP, a healthcare professional or a specialist) for that condition, or a related condition, usually for a continuous period of two years after your policy has started.

You do not need to tell the insurer about your medical history when you take out the policy. If you claim, however, your insurer might ask for medical notes that are needed to decide if your claim can be covered.

Full Medical Underwriting

Under this underwriting method you are asked to give details of your medical history. The insurer may write to your doctor for more information, but they do not do so in every case. You must give all the information you are asked for. If you don’t, your insurer may refuse to pay any claim that you make in the future, or may cancel your policy.

If you are not sure whether to mention something, it is best to do so. When you have a medical condition that is likely to come back, the insurer will issue a policy, but that condition (and any related to it) might not be covered. This condition may never be covered, or not covered for a set period of time.

Which method of underwriting is right for me?

Depending on your medical history, you may find one method of underwriting may be more suitable for you. However, we understand that you may have certain questions you wish to ask before making this decision. This is why we are here to help guide you through the underwriting process.

Whether you are new to private medical insurance or have a policy in place, we can help you understand the options available to you. SMP Healthcare are an independent and specialist health insurance broker based in the heart of Chelmsford. Our team have years of experience in the health insurance sector which we will be happy to share with you.

For more information, please contact us on 01245 929 129 or email us at enquires@smphealthcare.com.