
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.
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.
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 is one of the UK's largest and most recognised insurance providers. Think of them as the reliable superstore of insurance.
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.
| 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 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 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) |
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.
This is the industry-standard approach.
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.
This is The Exeter's key differentiator.
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.
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.
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.
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.
| 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 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.
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.
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 uses a traditional NCD ladder, similar to car insurance.
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 has a unique approach designed for long-term stability.
This model is a cornerstone of The Exeter's proposition. It aims to remove "claim fear" and provide more predictable renewal costs.
| 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.
Aviva is an excellent choice for individuals and families who:
The Exeter stands out for those who:
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.
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.
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.






