TL;DR
Choosing the right private medical insurance in the UK can feel like navigating a maze. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we know that the choice often comes down to two leading names: the mainstream giant, Aviva, and the specialist friendly society, The Exeter. This definitive guide dissects their offerings, focusing on the three pillars that determine your policy's real-world value: underwriting, excess options, and the all-important renewal experience.
Key takeaways
- Scale & Reach: With a vast network of hospitals and a massive customer base, Aviva offers comprehensive and well-established products.
- Brand Trust: Their long history and brand recognition provide a sense of security for many policyholders.
- Traditional Structure: Their flagship "Healthier Solutions" policy follows a conventional, easy-to-understand structure with a standard No Claims Discount (NCD) system.
- Target Audience: Aviva appeals to a broad market, from individuals and families to large corporations, who value a comprehensive network and a reputable brand.
- Member-Focused: As a friendly society, their decisions are driven by member interests, not shareholder returns.
Choosing the right private medical insurance in the UK can feel like navigating a maze. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we know that the choice often comes down to two leading names: the mainstream giant, Aviva, and the specialist friendly society, The Exeter.
This definitive guide dissects their offerings, focusing on the three pillars that determine your policy's real-world value: underwriting, excess options, and the all-important renewal experience.
A breakdown of underwriting, excess options, and renewal experience
When you compare private health cover, it's easy to get lost in lists of benefits. However, the true performance of your policy hinges on these three technical, yet crucial, elements. They dictate what’s covered, how much you pay, and whether your premiums remain affordable long-term. Let's explore how Aviva and The Exeter stack up.
Meet the Contenders: Aviva vs The Exeter
Understanding the philosophy behind each insurer is the first step to finding the right fit. They represent two very different approaches to the UK private medical insurance market.
Aviva: The Household Name
Aviva is one of the UK's largest and most recognised insurance providers. Think of them as the reliable superstore of insurance.
- Scale & Reach: With a vast network of hospitals and a massive customer base, Aviva offers comprehensive and well-established products.
- Brand Trust: Their long history and brand recognition provide a sense of security for many policyholders.
- Traditional Structure: Their flagship "Healthier Solutions" policy follows a conventional, easy-to-understand structure with a standard No Claims Discount (NCD) system.
- Target Audience: Aviva appeals to a broad market, from individuals and families to large corporations, who value a comprehensive network and a reputable brand.
The Exeter: The Specialist Friendly Society
The Exeter operates as a mutual organisation, or "friendly society." This means it's owned by its members (the policyholders), not shareholders. Any profits are reinvested into the business to benefit members, for example through better products or stable pricing.
- Member-Focused: As a friendly society, their decisions are driven by member interests, not shareholder returns.
- Specialist Expertise: They have carved a niche by offering more flexible underwriting and catering to clients who might be considered non-standard, including older applicants or those with some past health issues.
- Unique Features: The Exeter is known for its innovative approach, particularly its "rolling moratorium" underwriting and long-term No Claims Discount protection.
- Target Audience: The Exeter is often the go-to choice for individuals seeking more flexible terms, those who have been declined cover elsewhere, or clients prioritising long-term premium stability over a large corporate brand.
| Feature | Aviva | The Exeter |
|---|---|---|
| Business Type | Public Limited Company (PLC) | Friendly Society (Mutual) |
| Market Position | Mainstream, Large-Scale | Specialist, Niche-Focused |
| Key Strength | Vast hospital network, brand recognition | Flexible underwriting, member focus |
| Pricing Model | Standard No Claims Discount (NCD) | Protected NCD & long-term freeze |
Underwriting Compared: The Most Critical Choice You'll Make
Underwriting is the process insurers use to assess your medical history and decide what they will and will not cover. Crucially, standard UK private medical insurance is designed for new, acute conditions that arise after you take out a policy. It does not cover pre-existing conditions or long-term, chronic illnesses like diabetes or asthma.
How an insurer treats your past medical history is defined by the type of underwriting you choose. This is arguably the most important decision you'll make.
Underwriting Options at a Glance
| Underwriting Type | Aviva | The Exeter |
|---|---|---|
| Moratorium (Mori) | Standard 2-Year Moratorium | Standard & Rolling Moratorium |
| Full Medical Underwriting (FMU) | Yes | Yes |
| Switch / CPME | Yes (Continued Personal Medical Exclusions) | Yes (Continued Personal Medical Exclusions) |
Deep Dive: Moratorium Underwriting
Moratorium is the most common type of underwriting as it requires no medical forms upfront. The insurer applies a blanket exclusion for any condition you've had symptoms, treatment, or advice for in the 5 years before your policy starts.
Aviva's Standard Moratorium
This is the industry-standard approach.
- Any condition you've experienced in the 5 years pre-policy is excluded.
- If you go for a continuous 2-year period after your policy starts without any symptoms, treatment, or advice for that condition, it may become eligible for cover.
- The 2-year clock is fixed from the policy start date for each condition.
Example: You had knee pain 3 years before starting an Aviva policy. For the first 2 years of the policy, you have no knee trouble at all. After that 2-year anniversary, your knee would likely become eligible for cover for new issues.
The Exeter's Rolling Moratorium
This is The Exeter's key differentiator.
- Like a standard moratorium, it excludes conditions from the past 5 years.
- However, the 2-year symptom-free period is "rolling." This means any time you have symptoms or seek treatment for an excluded condition, the 2-year clock resets for that specific condition.
Example: You had knee pain 3 years before starting a policy with The Exeter. One year into the policy, you see your GP for a minor ache in the same knee. The 2-year countdown to get that knee covered resets from that GP visit. You would need another 2 full years from that point with no knee issues for it to become eligible.
Broker Insight: A rolling moratorium can be a double-edged sword. For someone with a truly historic, one-off issue, it makes little difference. But for someone with a recurring but minor issue (e.g., occasional back pain), a rolling moratorium could mean that condition is effectively excluded forever. An expert adviser at WeCovr can analyse your medical history to determine if this flexibility is a benefit or a risk for you.
Deep Dive: Full Medical Underwriting (FMU)
With FMU, you complete a detailed health questionnaire upfront. The insurer then reviews your medical history and gives you a definitive list of what is and isn't covered from day one.
- Clarity: You know exactly where you stand. There are no grey areas.
- Potential for Cover: Sometimes, an insurer might agree to cover a past condition, perhaps with a premium loading.
- Process: It takes longer to set up, but provides complete certainty.
Both Aviva and The Exeter offer excellent FMU options. It is often the best choice for individuals who want absolute clarity on their cover before they commit.
Excess Options: How to Manage Your Premiums
An excess is the amount you agree to pay towards a claim before the insurer pays the rest. A higher excess leads to a lower monthly premium. The key difference between providers lies in whether the excess is payable per claim or per policy year.
Aviva vs The Exeter Excess Options
| Provider | Excess Levels (£) | How It's Applied |
|---|---|---|
| Aviva | £100, £200, £250, £500, £1,000, £3,000, £5,000 | Per policy year. You only pay it once, no matter how many claims you make. |
| The Exeter | £0, £100, £250, £500, £1,000, £2,500, £5,000 | Per policy year. You can also choose a per-claim excess on some plans. |
Aviva's "Per Year" Excess
Aviva's structure is simple and predictable. You choose an excess amount, and once you have paid that amount towards eligible claims in a policy year, you pay nothing further for the rest of that year.
Scenario: You have a £500 excess.
- Illustrative estimate: Claim 1 (Diagnostics): Costs £800. You pay £500, Aviva pays £300.
- Illustrative estimate: Claim 2 (Surgery): Costs £6,000. You pay £0, Aviva pays £6,000.
- Your excess for the year is fully paid.
The Exeter's "Per Year" Flexibility
The Exeter also primarily uses a per-year excess, giving you great predictability. The inclusion of a £0 excess option is a key benefit for those who want to avoid any out-of-pocket costs at the point of claim, though this comes with a significantly higher premium.
Adviser Tip: Choosing an excess is about balancing monthly cost with your ability to pay at the point of claim. A common mistake is choosing a very high excess to lower premiums, only to find you can't afford it when you need treatment. Most clients find a sweet spot between £250 and £500.
Renewal Experience: Premiums, Claims, and Long-Term Value
How an insurer calculates your renewal premium is vital for long-term affordability. A cheap policy today is no good if it becomes unaffordable after your first claim. This is where Aviva and The Exeter differ dramatically.
Aviva's Renewal Model: No Claims Discount (NCD)
Aviva uses a traditional NCD ladder, similar to car insurance.
- You start on a certain level (e.g., Level 5).
- For every year you don't claim, you move up a level, receiving a larger discount (up to a maximum, often around 70-75%).
- If you make a claim, you typically drop down several levels (e.g., 3 levels), and your premium increases significantly at renewal.
Pros: Rewards you for not claiming. Cons: Can lead to large, unexpected premium hikes after a claim, creating "claim fear" where people hesitate to use the policy they're paying for.
The Exeter's Renewal Model: Protected NCD and 10-Year Freeze
The Exeter has a unique approach designed for long-term stability.
- Protected NCD: If you make a claim, your NCD level doesn't change. Your premium will still rise due to age and medical inflation, but you won't be penalised with a drop down the NCD ladder for using your policy.
- 10-Year NCD Freeze: Once you have been a member for 10 continuous years, your NCD level is frozen at the top level for life, as long as you remain a member.
This model is a cornerstone of The Exeter's proposition. It aims to remove "claim fear" and provide more predictable renewal costs.
Renewal Pricing Model Comparison
| Aspect | Aviva (Healthier Solutions) | The Exeter (Health+) |
|---|---|---|
| Model | Standard No Claims Discount (NCD) | Protected No Claims Discount |
| Impact of a Claim | NCD level drops, premium increases significantly | NCD level is protected, claim has no direct impact on NCD |
| Long-Term Benefit | Maximum discount for claim-free years | NCD is protected and eventually frozen after 10 years |
| Predictability | Lower. A claim can cause a large price shock. | Higher. Renewal increases are primarily driven by age and inflation. |
Real-World Scenario: A 45-year-old client has a policy and makes a £7,000 claim for a hip replacement.
- With Aviva: At renewal, their premium will increase due to their age, medical inflation, AND a drop of 3-4 levels on the NCD scale. The total increase could easily be 40-60%.
- With The Exeter: At renewal, their premium will increase due to age and medical inflation only. Their NCD level remains the same. The increase might be 10-15%.
Who is Aviva Best For?
Aviva is an excellent choice for individuals and families who:
- Value a major, trusted brand with a proven track record.
- Want access to one of the most extensive hospital lists in the UK.
- Have a clean bill of health and are comfortable with a standard moratorium and NCD structure.
- Are looking for a comprehensive, all-around policy from a mainstream provider.
Who is The Exeter Best For?
The Exeter stands out for those who:
- Prioritise long-term premium stability and want to avoid large price hikes after a claim.
- May have a more complex medical history that could benefit from specialist underwriting review.
- Are older applicants, as The Exeter has a strong track record of covering a wider age range.
- Appreciate the member-first ethos of a friendly society.
Making the Right Choice with WeCovr
As you can see, there is no single "best" provider. The right choice depends entirely on your personal medical history, your budget, and your priorities.
- Aviva offers breadth, scale, and the security of a household name.
- The Exeter offers specialism, flexibility, and a focus on long-term value.
This is where independent, expert advice becomes invaluable. An experienced broker like WeCovr doesn't just give you prices. We take the time to understand your unique circumstances to recommend the provider, the underwriting, and the excess that truly fits your needs. Our service is completely free, and we often have access to the same or better prices than going direct.
Furthermore, as a WeCovr customer, you get complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, and can benefit from discounts on other policies like life or income protection insurance.
Let us help you compare the market and secure the right private medical insurance UK for you and your family.
Frequently Asked Questions (FAQ)
Does Aviva or The Exeter cover pre-existing conditions?
What is the main difference between Aviva's and The Exeter's moratorium?
Is it cheaper to go directly to Aviva or The Exeter than using a broker?
Ready to find out whether Aviva or The Exeter is the right fit for you? Speak to one of our friendly, expert advisers today for a free, no-obligation quote and market comparison. We'll handle the hard work, so you can get the peace of mind you deserve.
Sources
- Department for Transport (DfT): Road safety and transport statistics.
- DVLA / DVSA: UK vehicle and driving regulatory guidance.
- Association of British Insurers (ABI): Motor insurance market and claims publications.
- Financial Conduct Authority (FCA): Insurance conduct and consumer information guidance.
