WeCovr.

Login

How to Appeal a Rejected Private Health Insurance Claim

How to Appeal a Rejected Private Health Insurance Claim

Receiving a letter stating your private medical insurance claim has been rejected can be distressing, especially when you're focused on your health. At WeCovr, an FCA-authorised broker that has arranged over 900,000 policies, we understand the complexities of the private medical insurance market in the UK. This guide will empower you to challenge a refusal with confidence.

A practical guide to challenging PMI claim refusals

Navigating the world of private medical insurance (PMI) can feel complex. You pay your premiums diligently, trusting that your provider will be there for you when you need them. So, when a claim is denied, it's easy to feel frustrated and confused.

The good news is that a rejection isn't always the final word. You have the right to appeal, and a significant number of complaints are resolved in the customer's favour. This comprehensive guide will walk you through the entire process, from understanding why your claim was denied to escalating it to the Financial Ombudsman Service if necessary.

Why Might a Private Health Insurance Claim Be Rejected?

Understanding the reason for the refusal is the first and most critical step in building a successful appeal. Insurers don't reject claims without a reason, and it almost always relates back to the terms and conditions of your policy.

Here are the most common reasons for a PMI claim rejection in the UK.

The 'Big Two': Pre-existing and Chronic Conditions

This is the most fundamental principle of standard UK private medical insurance and the source of most misunderstandings.

  • Pre-existing Conditions: PMI is designed to cover new, eligible medical conditions that arise after your policy begins. It does not cover conditions (or related symptoms) for which you have experienced symptoms, sought advice, or received treatment in the years leading up to your policy start date (typically the last 5 years).
  • Chronic Conditions: PMI is for the diagnosis and treatment of acute conditions—illnesses or injuries that are expected to respond to treatment and lead to your recovery. It does not cover the ongoing management of chronic conditions, which are long-term illnesses with no known cure, such as diabetes, asthma, hypertension, or arthritis. The NHS remains the primary provider for chronic care management.

Crucial Point: If your claim is for a condition deemed either pre-existing or chronic, it will almost certainly be rejected as it falls outside the scope of what standard PMI covers.

Common Policy Exclusions

Every policy has a list of specific treatments and circumstances that are not covered. These are always detailed in your policy documents. Common exclusions include:

  • Visits to A&E (Accident & Emergency)
  • Normal pregnancy and childbirth
  • Cosmetic surgery (unless for reconstruction after an accident or eligible surgery)
  • Treatment for addiction (alcohol, drugs)
  • Experimental or unproven treatments
  • Self-inflicted injuries
  • Certain mental health treatments (though many modern policies offer enhanced mental health cover)
  • Mobility aids, such as wheelchairs or stairlifts

Procedural Missteps

Sometimes, a claim is rejected not because the treatment isn't covered, but because you didn't follow the insurer's required procedure.

  1. No GP Referral: Most PMI policies require you to see your NHS or private GP first. Your GP assesses your condition and provides a referral to a specialist consultant. Bypassing this step can invalidate your claim.
  2. Lack of Pre-authorisation: You must contact your insurer before any consultations, tests, or treatment. They need to confirm that the procedure is covered and provide you with a pre-authorisation number. Proceeding without this approval is a common reason for rejection.

Underwriting and Disclosure Issues

  • Non-Disclosure: When you apply for a policy, you have a duty to answer all questions about your medical history fully and honestly. If your insurer later discovers that you failed to disclose a relevant condition (even if you forgot), they may void your policy or reject a claim related to that condition.
  • Moratorium Period Issues: Many people choose 'moratorium underwriting'. With this, you don't declare your full medical history upfront. Instead, the insurer applies a waiting period (usually two years). They will not cover any condition you had in the five years before the policy started, unless you remain completely free of symptoms, treatment, and advice for that condition for a continuous two-year period after your policy begins. A claim can be rejected if it falls within this moratorium.

Benefit Limits and Financial Caps

Your policy will have limits on how much it will pay out. These can be:

  • An overall annual financial limit (e.g., £1 million or 'unlimited').
  • Limits on specific treatments (e.g., a maximum of 8 physiotherapy sessions per year).
  • Limits on outpatient consultations or diagnostics (e.g., up to £1,000 per policy year).

If your treatment costs exceed these limits, the claim for the excess amount will be rejected.

Summary of Common Rejection Reasons

Reason for RejectionExplanationHow to Avoid It
Pre-existing ConditionThe condition existed before your policy began.Be aware that PMI is for new conditions. Choose a policy with underwriting that suits your history.
Chronic ConditionThe condition requires long-term management, not a cure.Understand that PMI covers acute conditions. Rely on the NHS for chronic care.
Policy ExclusionThe treatment is specifically listed as not covered.Read your policy documents carefully before starting your cover.
No Pre-authorisationYou did not get approval from the insurer before treatment.Always call your insurer before any appointment or procedure.
Non-DisclosureYou didn't declare a past medical issue during application.Be completely honest and thorough when applying for your policy.
Benefit Limit ReachedYou've exceeded the financial or session limits of your policy.Track your usage and be aware of your policy's financial caps.

Your Immediate First Steps After a Claim Rejection

Finding that rejection letter can be a shock. Take a deep breath and follow these steps methodically. Acting with a clear head is far more effective than reacting with frustration.

Step 1: Read the Rejection Letter Carefully

The letter from your insurer is your starting point. Do not just skim it. Read it several times to understand the exact reason they have given for the refusal. It should quote the specific clause or term in your policy that they believe justifies their decision. Is it a general exclusion? Do they believe the condition is pre-existing? Is it a procedural error? The reason they provide will be the foundation of your appeal.

Step 2: Review Your Policy Documents

Locate your policy documents. You are looking for the following:

  • The full Policy Terms and Conditions (the 'policy wording').
  • Your Schedule of Cover or Table of Benefits.
  • The original application form, if you have it.

Compare the reason given in the rejection letter with the wording in your policy. Does the insurer's interpretation seem fair and accurate? Sometimes, the wording can be ambiguous, which can form the basis of a strong appeal.

Step 3: Gather All Your Evidence

Create a dedicated file for your appeal. Organisation is your best weapon. Gather every piece of relevant paperwork, including:

  • The claim rejection letter.
  • Your policy documents.
  • All correspondence with the insurer (emails, notes from phone calls with dates, times, and who you spoke to).
  • Your GP referral letter.
  • Any letters or reports from your consultant or specialist.
  • Your original claim form and all associated invoices.

Building Your Case: A Step-by-Step Appeal Guide

Once you have your evidence organised, you can begin the formal appeal process. The first stage is always to go back to the insurer themselves.

Phase 1: The Internal Appeal with Your Insurer

Every insurer has a formal complaints and appeals procedure, which they are required to have by the Financial Conduct Authority (FCA).

1. Write a Formal Appeal Letter or Email

Your appeal should be in writing so there is a clear paper trail. Structure your letter for maximum impact:

  • Header: Include your full name, address, policy number, and the original claim reference number.
  • Opening: State clearly and simply, "I am writing to formally appeal the decision to reject my claim [Claim Reference Number], as detailed in your letter dated [Date of Letter]."
  • Address the Reason for Rejection: This is the core of your letter. Go directly to the reason they gave for the refusal and explain, point-by-point, why you disagree.
    • Example: "Your letter states the claim was rejected because my knee condition was deemed pre-existing. However, as you can see from the attached letter from my GP, Dr. Smith, the knee pain I experienced four years ago was a minor sprain to my left knee and is medically unrelated to the current torn meniscus in my right knee."
  • Present Your Evidence: Refer to the evidence you have gathered. Don't just say you have it; explain what it shows. "The enclosed report from my consultant, Mrs. Evans, confirms that my condition is acute and that a full recovery is expected following the proposed surgery."
  • Be Clear About the Outcome You Want: State what you expect. "I request that you reconsider your decision and provide pre-authorisation for the recommended treatment without further delay."
  • Maintain a Professional Tone: Be firm and factual, not angry or emotional. A polite, well-reasoned argument is far more persuasive.
  • Set a Deadline: Conclude by stating that you expect a formal response in line with FCA guidelines and that if you do not receive a satisfactory resolution, you will be taking your complaint to the Financial Ombudsman Service.

2. Send Your Appeal to the Right Department

Send your letter or email to the insurer's official Complaints Department. The contact details should be in the rejection letter or on their website. Send it via recorded delivery if posting, or request a read receipt for an email.

3. Await the 'Final Response'

The insurer has up to eight weeks to investigate your complaint and provide you with a 'final response'. They may contact you during this time for more information.

Real-Life Scenario: David's insurer rejected his claim for an MRI scan on his back, stating he had not disclosed a 'back problem' on his application. David reviewed his records and realised he had mentioned visiting a chiropractor for minor stiffness five years prior. In his appeal, he argued that minor stiffness did not constitute a 'back problem' or a formal medical condition requiring disclosure. He included a note from his GP confirming he had no history of chronic back issues. The insurer reviewed his case and agreed their initial assessment had been too strict, and they approved the claim.

What If Your Internal Appeal is Rejected? Escalating Your Complaint

If you receive a final response from your insurer that still upholds their decision, or if they fail to respond within eight weeks, you have the right to take your case to the Financial Ombudsman Service (FOS).

The Financial Ombudsman Service (FOS)

The FOS is a free, independent, and impartial service for settling disputes between consumers and financial services businesses, including insurance companies. They are your most powerful ally if you believe you have been treated unfairly.

When can you go to the FOS? You must complain to the FOS within six months of the date on your insurer's final response letter.

How does the FOS process work?

  1. Submit Your Complaint: You can do this online via their website or by post. You will need to provide all the same information you gave to your insurer, including your appeal letter and their final response.
  2. Case Handling: The FOS will first check if they can handle your complaint and will ask the insurer for their side of the story. An FOS case handler will then review all the evidence from both sides. They will assess whether the insurer has acted fairly and reasonably and correctly applied the terms of the policy.
  3. The Decision: The handler will give their initial assessment. If you and the insurer agree, the case is closed. If you disagree, you can ask for a formal, final decision from an ombudsman.
  4. A Binding Outcome: An ombudsman's decision is legally binding on the insurance company. If they find in your favour, they can order the insurer to pay the claim and may also award compensation for any distress or inconvenience caused.

According to the FOS's own data, they often find in the consumer's favour. In their 2022/23 annual review, they reported upholding 34% of general insurance complaints they received, showing that challenging an insurer's decision is often worthwhile.

The Role of an Expert Broker Like WeCovr

This entire process can be daunting. This is where having a good PMI broker on your side from the beginning is invaluable.

If you purchased your policy through an expert broker like WeCovr, they can provide crucial support during an appeal. As your representative, they can:

  • Advocate on Your Behalf: They can speak to their contacts at the insurance company to argue your case.
  • Interpret Policy Wording: Their expertise means they can spot ambiguities or unfair interpretations of the policy terms.
  • Help Structure Your Appeal: They can guide you on what evidence to include and how to phrase your arguments for the best chance of success.

While a broker's primary duty is to the clients who bought policies through them, their advice highlights the significant benefit of using an expert service to find the best PMI provider from the outset.

Key Terminology Explained: Understanding Your PMI Policy

Insurance documents are filled with jargon. Understanding these key terms is essential.

  • Acute Condition: A disease, illness, or injury that appears suddenly, is likely to respond quickly to treatment, and leads to a full or near-full recovery. Example: A broken bone, appendicitis, or a cataract.
  • Chronic Condition: A condition that is long-lasting, has no known cure, and needs ongoing monitoring and management. Example: Diabetes, high blood pressure, asthma, Crohn's disease.
  • Moratorium Underwriting: The most common type of underwriting. You don't declare your medical history, but a 2-year waiting period is applied to any condition you've had in the 5 years before joining.
  • Full Medical Underwriting (FMU): You complete a detailed health questionnaire. The insurer reviews it and may apply specific exclusions to your policy from day one, but anything not excluded is covered immediately.
  • Pre-authorisation: The process of getting formal approval from your insurer before you undergo any consultation, scan, or treatment. It is a mandatory step.
  • Benefit Limit: The maximum amount your policy will pay, either for a specific treatment type or for all your claims within a policy year.

Proactive Tips to Avoid Claim Rejections in the First Place

The best way to deal with a rejected claim is to prevent it from happening.

  1. Be Meticulously Honest: When applying for cover, disclose everything, even if it seems minor. It is better to have a condition excluded from the start than to have a claim rejected later.
  2. Read and Understand Your Policy: Before you sign up, read the key facts and policy wording. Pay close attention to the exclusions list.
  3. Use an Expert PMI Broker: This is arguably the most effective preventative measure. A broker like WeCovr will take the time to understand your needs and health history. They will then compare policies from across the market to find one with suitable terms, explaining the differences in underwriting and cover. This expert guidance dramatically reduces the risk of choosing an inappropriate policy.
  4. Always Follow the Procedure:
    • Get a GP referral.
    • Get pre-authorisation before every single step.
    • Use a consultant or hospital from your insurer's approved list.
  5. Keep Good Records: Store your policy documents, along with a log of every interaction you have with your insurer, in a safe place.

Enhancing Your Wellbeing with Modern PMI

Today's private health cover is about more than just treating illness; it's also about promoting wellness. Many top-tier policies now include valuable benefits designed to keep you healthy:

  • Digital GP Services: 24/7 access to a GP via phone or video call.
  • Mental Health Support: Access to counselling and therapy, often without needing a GP referral.
  • Wellness Programmes: Discounts on gym memberships, fitness trackers, and health screenings.

At WeCovr, we believe in supporting your entire health journey. That's why customers who purchase a PMI or Life Insurance policy through us receive complimentary access to CalorieHero, our cutting-edge AI calorie and nutrition tracking app. We also offer our valued clients discounts on other types of cover, helping you protect your family and finances more affordably. Our high customer satisfaction ratings reflect our commitment to providing ongoing value.

Comparing Your Appeal Options

FeatureInternal Appeal with InsurerFinancial Ombudsman Service (FOS)
Who you deal withThe insurer's internal complaints teamAn independent, impartial adjudicator
Cost to youFreeFree
Is it the first step?Yes, this is always the mandatory first step.No, you can only go to the FOS after receiving a 'final response'.
Typical TimelineUp to 8 weeks for a final response.Can take several months due to high caseloads.
Decision PowerThe insurer can choose to overturn its own decision.The FOS's decision is legally binding on the insurer.

Can I appeal a rejection for a 'pre-existing condition' if I didn't know I had it?

Yes, you can appeal, but success depends on your policy's underwriting. If you have 'moratorium' cover, the insurer can investigate your medical history for the 5 years prior to your policy start date. If they find evidence of symptoms or advice for that condition, they can reject the claim. Your appeal would need to show the symptoms were for a different, unrelated issue. With 'Full Medical Underwriting', if you didn't declare it because you genuinely didn't know, you have a stronger case, but the insurer may argue it was a symptom you should have sought advice for.

How long do I have to make an appeal against a rejected claim?

You should first complain to your insurer as soon as possible. They have up to 8 weeks to provide a 'final response'. Once you have this letter, you have six months from the date on the letter to take your complaint to the Financial Ombudsman Service (FOS). Do not miss this six-month deadline, as the FOS is unlikely to review your case after this period has passed.

What are my chances of winning a health insurance appeal?

Your chances depend entirely on the quality of your evidence and the reason for the rejection. If the rejection is due to a clear policy exclusion, your chances are low. However, if the issue is a subjective interpretation of your medical history (e.g., whether something was 'pre-existing') or if the policy wording is ambiguous, you have a reasonable chance. The Financial Ombudsman Service upholds over a third of general insurance complaints, demonstrating that challenging an insurer is often successful.

Will making a complaint or an appeal affect my future health insurance?

No. You are legally protected from being penalised for making a legitimate complaint. Your insurer cannot cancel your policy, increase your premiums at renewal, or refuse to offer you cover in the future simply because you made a complaint or took them to the Financial Ombudsman Service. The entire process is regulated to ensure it is fair for consumers.

Navigating a claim rejection is challenging, but you are not powerless. By understanding your policy, gathering your evidence, and following a structured process, you can build a compelling appeal.

The best foundation for a smooth claims experience is choosing the right policy from the start. For clear, independent advice on finding the right private medical insurance in the UK for your needs and budget, speak to our friendly experts.

Get your FREE, no-obligation PMI quote from WeCovr today and gain peace of mind.

Related guides

Can You Appeal a Rejected Claim Real Life Case Studies
Can You Appeal a Rejected Claim Real Life Case Studies
Read more →
How to Appeal a Denied PMI Claim in 2026
How to Appeal a Denied PMI Claim in 2026
Read more →
How to Appeal a Denied PMI Claim in 2026
How to Appeal a Denied PMI Claim in 2026
Read more →
How to Appeal a Denied Private Medical Insurance Claim
How to Appeal a Denied Private Medical Insurance Claim
Read more →
Private Medical Insurance Claim Denied Appeal and Complaint Guide
Private Medical Insurance Claim Denied Appeal and Complaint Guide
Read more →
UK Denied Health Claim Appeal
UK Denied Health Claim Appeal
Read more →
Get A Free Quote

Why private medical insurance and how does it work?

What is Private Medical Insurance?

Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.

How does it work?

Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:

• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment

Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.

Questions to ask yourself regarding private medical insurance

Just ask yourself:
👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?

Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.

Benefits offered by private medical insurance

Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:

Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.

Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.

Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.

Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.

Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.

Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.

Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.

Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.

Important Fact!

There is no need to wait until the renewal of your current policy.
We can look at a more suitable option mid-term!

Why is it important to get private medical insurance early?

👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.

👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.

Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.

It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.

You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.

By tapping the button below, you can book a free call with them in less than 30 seconds right now:

Our Group Is Proud To Have Issued 900,000+ Policies!

We've established collaboration agreements with leading insurance groups to create tailored coverage
Working with leading UK insurers
Allianz Logo
Ageas Logo
Covea Logo
AIG Logo
Zurich Logo
BUPA Logo
Aviva Logo
Axa Logo
Vitality Logo
Exeter Logo
WPA Logo
National Friendly Logo
General & Medical Logo
Legal & General Logo
ARAG Logo
Scottish Widows Logo
Metlife Logo
HSBC Logo
Guardian Logo
Royal London Logo
Cigna Logo
NIG Logo
CanadaLife Logo
TMHCC Logo

How It Works

1. Complete a brief form
Complete a brief form
2. Our experts analyse your information and find you best quotes
Experts discuss your quotes
3. Enjoy your protection!
Enjoy your protection

Any questions?

Life Insurance and Private Medical Insurance cover you for two different purposes, so you will need to assess your needs but may wish to consider holding the two policies. Private Medical Insurance covers you if you get sick or need treatment and want or need to go privately. Life Insurance covers you in the case of death, giving a payout to family/those left behind.

Health insurance covers conditions that develop after your policy starts. Pre-existing conditions are typically not covered, and insurers may exclude related issues. Some policies may cover symptoms of pre-existing conditions under specific circumstances. Always review your policy's exclusions. Coverage for pre-existing medical conditions may be available if you currently hold a medical insurance policy or are transitioning from a company scheme. However, if you have never had medical insurance before or if your policy is not active at the moment, pre-existing conditions will not be covered. This limitation exists because health insurance is primarily intended to protect against unexpected health issues. To simplify, it's akin to getting into a car accident and then trying to obtain insurance coverage afterward to repair the vehicle — insurance companies typically do not cover such claims. Nevertheless, there is an option to gain coverage for pre-existing conditions after a two-year waiting period, subject to specific rules and conditions.

If you prefer to get straight into treatment in the private sector without the long waiting times with the NHS, or you just prefer the private sector anyway, without having to pay it all yourself, then you would need to have Private Medical Insurance to cover it. Sometimes treatments and drugs that are not covered by the NHS can be covered by Private Medical Insurance.

It's free to use WeCovr to find health insurance - we never charge you for quotes. Health or private medical insurance is an investment that can pay for itself the first time you might need medical treatment.

It depends on your personal choice and preferences. If you are prepared to limit yourself to NHS-covered treatments only and can or want to endure long waiting times to get into treatment, then yes, NHS might work for you. Your cover there is free. If you don't want to be exposed to long waiting times or if your treatment is not covered by the NHS, then you would benefit from Private Medical Insurance.

Private Medical Insurance is an important financial product that insurance companies take a lot of care and diligence so speaking to real human beings ensures that they understand your requirements fully so that you can get the right cover.

All of our partners are carefully vetted and authorised by the FCA, which means they are held to the highest standards that the FCA expects from them and treat all customers fairly!

Our revenue comes from commissions paid by the insurance providers when a policy is taken out through us. Essentially, when you choose to secure a policy from one of the providers we work with, they compensate us for facilitating the transaction. It's important to note that this commission does not impact the premium you pay. We remain committed to providing transparent and unbiased quotes to help you find the best insurance options tailored to your needs.

The cost of private health insurance depends on several factors, including your age, location, smoking status, and the type of policy you choose. Your health insurance policy is tailored to your needs, and the cost can vary based on the level of cover you require, such as the amount of excess and specific treatment allowances.

Private health insurance covers you for conditions that arise after your policy begins. You pay a monthly fee and can make claims for private healthcare covered by your policy. One of the main benefits of private healthcare is quicker access to treatment compared to the NHS, along with access to new drugs or specialist treatments.

Most health insurance covers private hospital stays and may include outpatient treatments like scans, tests, or appointments. Policies vary in coverage, and exclusions often include emergency treatment, maternity care, cosmetic surgery, and ongoing conditions present before the policy started.

Unfortunately, you cannot pay extra to have a pre-existing condition covered as part of your health insurance policy. However, you have access to support from a nurse or digital GP. If you have questions about what is covered under your policy, please contact us for clarification.

Your health insurance policy begins once you've selected your policy and set up your payment. After setup, you'll receive your cover documents detailing what is and isn't covered. It's important to review these details carefully as policies differ.

An excess is the amount you contribute towards treatment when you make a claim. Choosing a higher excess can reduce your policy's monthly cost but requires a larger contribution when claiming. WeCovr's experts will offer you flexible excess options depending on your preferences.

To reduce health insurance costs, consider choosing a higher excess, which lowers the monthly premium. However, ensure the plan still meets your needs. Other factors affecting cost include lifestyle choices like smoking and potential savings for couples or family plans.

There is no age limit for taking out health insurance, but age influences the policy's cost. The benefits of health insurance are consistent regardless of age. If you're considering health insurance, you can get a quote from WeCovr's experts regardless of your age.

Let WeCovr's experts do the legwork for you and compare health insurance plans at no cost to you to find the best fit for your needs. Consider individual, couple, or family plans and review coverage details thoroughly before choosing. WeCovr provides transparent information on coverage options for easy comparison.

Yes, you can add your partner (if you live at the same address) or dependents to your policy at any time. The cost of couple's or family health insurance depends on factors like location, age, health, and chosen excess. Contact WeCovr or your insurer for assistance in adding someone to your policy.

While WeCovr's private health insurance plans are tailored for the UK, we offer global health insurance options for those living or working abroad. For holiday coverage, travel insurance is recommended.

Comprehensive cover provides extensive benefits, including full outpatient services such as consultations, diagnostic tests, physiotherapy, and mental health therapies. Our team at WeCovr can assist in understanding the various coverage levels available.

Private health insurance typically does not cover dental treatment. However, WeCovr's experts can guide you to dental insurance policies offered by our partner insurers. Reach out to us to explore these options.

Yes, private health insurance covers cancer treatment from diagnosis through treatment. At WeCovr, we can help you navigate the cancer cover options that suit your needs.

At WeCovr, you have flexibility in adjusting your cover. Speak to our experts within 21 days of receiving your paperwork or at policy renewal to make changes.

Accessing a private GP appointment is fast and convenient with WeCovr's services, available through your digital platform provided under your chosen insurance plan.

Yes, family members on the same policy can potentially have different levels of cover tailored to their individual needs.

WeCovr works with insurers offering a range of cover levels to accommodate different budgets and needs. Our experts can discuss these options with you.

Discovering healthcare facilities and specialists is easy with WeCovr's resources. Contact us for personalised assistance by tapping one of the buttons above or below and filling in a few details for personalised assistance.

Fee-assured consultants provides transparency and no hidden costs for clients.

WeCovr prioritises mental health support with comprehensive coverage and access to specialist advice and services.

Children up to a certain age can be included in your policy, and we offer discounts for family coverage.

Like most health insurance plans, premiums may increase annually due to factors such as age and medical cost inflation.

The cost of health insurance varies based on several factors. Connect with our experts by tapping a button below and get your own personalised quote.

Private health insurance offers quicker access to consultations, treatments, and personalised care compared to the NHS.

Yes, WeCovr's experts can guide you which health insurance plans include coverage for physiotherapy treatments.

Immediate access to certain services like our digital GP app is available upon enrolment.

You can obtain a range of suitable quotes easily by tapping one of the buttons above or below and filling in a few details for personalised assistance.

Health insurance covers new conditions that arise after the policy starts. Pre-existing conditions and certain exclusions may apply.

WeCovr's experts help you arrange health insurance that simplifies access to private healthcare services, including consultations and treatments.

Outpatient cover includes consultations, physiotherapy, and mental health therapies outside hospital admissions.

Yes, you can use your health insurance cover immediately. You have access to a nurse through your helpline and can consult with a GP using the digital GP app. If you need to make a claim right away, we may require a medical report from your GP. Health insurance is designed to cover new conditions that arise after the policy has started.

No, health insurance does not cover A&E (Accident and Emergency) visits. Private hospitals do not typically have the facilities for handling A&E cases. In case of an emergency, please dial 999 or use the NHS emergency services. However, if you require follow-up treatment after an emergency situation, your private medical insurance may be able to assist.

Yes, many insurers offer rewards in leisure, wellbeing, and health. Speak to WeCovr's experts or visit your insurer's website for more details on member rewards.

You may continue your cover or get another own personal policy. If you continue your cover, existing or ongoing medical conditions might be covered depending on the level of cover you choose. Contact our friendly experts to discuss your options and find the right option for you.

You can tap one of the buttons above or below and fill in a quick form to arrange a call with us to discuss your options.

Your cover may be similar but not identical. We will help you find the right level of cover that suits your needs, and ongoing medical conditions may be covered. Contact our friendly advisers to explore all available options.

No, the price won't be the same as before since employers often contribute to the cost of employee cover. Additionally, different cover levels and medical histories may affect the price. Contact WeCovr's experts for detailed information.

You have a few weeks or months from leaving your job to decide to continue with your insurer or change to another one. Your policy may start the day after you left your work policy, and our experts can guide you through other available options.

After leaving your job, contact WeCovr's experts with your leave date to discuss available options.

Yes, ongoing treatment may be covered on your new personal policy, although it could affect the price. Contact our experts for personalised advice on your options.

Details on paying excess fees will be provided when you contact your insurer for treatment authorisation.

No, there is no excess fee for utilising these services.

Excess adjustments can be made at specific intervals during your policy term.

No claims discounts can impact renewal costs based on claims history.

Pre-existing conditions typically aren't covered but can be discussed with our healthcare specialists.

This involves health-related questions before policy enrolment to determine coverage.

Moratorium underwriting simplifies enrolment but may require health disclosures during claims.

Claims may require additional information if under moratorium underwriting.

Pre-existing conditions refer to medical issues existing before policy inception. A pre-existing condition is anything you've previously had medical treatment for, such as diabetes, heart disease, or asthma. Most insurance providers consider any condition you've had symptoms or treatment for in the past five years as pre-existing. Our experts at WeCovr can help you understand how pre-existing conditions affect your policy options.

While some insurance providers automatically renew your private healthcare cover, it's beneficial to compare policies when yours is about to end. This ensures you're still getting the best deal for the coverage you need. Our experts at WeCovr can assist you in finding the right policy for you.

Typically, you must be over 18 to take out your own policy, but minors can usually be included in a family policy. There may also be an upper age limit for private health insurance, and premiums typically increase with age. Our experts at WeCovr can provide guidance on age-related policy aspects.

Paying for health insurance annually often results in savings compared to monthly payments. However, this depends on your insurance provider. For help determining the most cost-effective option, consider consulting our experts at WeCovr.

If your employer offers private health insurance as part of your benefits package, you likely don't need additional cover. However, there may be limits on the cover you receive, and it may not extend to your entire family. Remember, any insurance you get through work only covers you while you're employed there.

If you don't have pre-existing conditions, a medical exam is usually not required. You'll just need to complete a medical history form and select your level of cover. However, if you're older, have a pre-existing condition, or lead an unhealthy lifestyle, a medical exam may be necessary. Our experts at WeCovr can clarify the requirements of different policies.

Many private health insurance providers now offer GP services, either digitally or face-to-face. This means you can often get a private GP appointment quickly, sometimes even on the same day. Our experts at WeCovr can help you find policies that offer GP services.

With private health insurance, you can often secure a GP appointment much quicker than with traditional methods, sometimes even on the same day. Our experts at WeCovr can help you find policies that offer quick GP appointment services.

Inpatient care refers to any treatment requiring a stay in a hospital or clinic for at least one night. Outpatient care refers to treatments or tests that don't require hospital admission, such as minor diagnostic tests or physiotherapy sessions. Our experts at WeCovr can help you understand the different types of care and find a policy that suits your needs.

Private health insurance covers your medical treatment if you fall ill, while critical illness cover provides additional financial help if you develop one of the critical illnesses listed in the policy, such as covering loss of income if you're unable to work. For assistance in understanding the differences and finding the right coverage, consult our experts at WeCovr.

Health insurance policies are designed for cover in the UK. For cover abroad, consider travel insurance for short trips or international health insurance for longer stays or if you have a holiday home overseas. Our experts at WeCovr can guide you in finding the appropriate coverage for your travel needs.

If your employer provides health insurance, it's considered a 'benefit in kind' and is not tax deductible. Your employer should calculate the tax you owe for your health insurance premiums and deduct it from your pay. There are some exceptions for small companies. For more information on tax implications, consider reaching out to our experts at WeCovr.

When you purchase a policy, you choose how much excess you pay, which is your contribution to the cost of treatment if you make a claim. The higher your excess, the lower your premium is likely to be. Our experts at WeCovr can help you understand how excess works and choose the right level for you.

These are two methods of underwriting a health insurance policy, relating to how insurance providers consider your pre-existing medical conditions when you take out cover. For help understanding the differences and choosing the right option for you, consult our experts at WeCovr.

Some private health insurance providers offer a no-claims discount, similar to car insurance. Every year you don't make a claim gives you an extra year of no-claims discount, potentially reducing your premium when you renew. Our experts at WeCovr can help you find policies that offer no-claims discounts.

To find the best health insurance for you, compare various policies to find one that offers the features you need at a price you can afford. Consider your personal circumstances and what you want from your policy. Our experts at WeCovr can assist you in evaluating your options and selecting the right coverage for you.

If you need treatment, a GP referral is not always necessary. However, this depends on how you plan to pay for your treatment. Most hospitals will allow you to book appointments with a consultant without a GP referral if you are paying out-of-pocket. If you have private medical insurance, you'll need to check the terms of your policy to see whether your insurer requires you to consult with a GP first (most insurers do). Some policies offer a direct booking system without a referral for certain conditions, such as counseling for mental health issues.

Yes, you can obtain financing for a loan to cover the cost of surgery. Many private healthcare companies have partnerships with finance companies to allow you to spread the cost of private treatment over time. You could also explore getting an ordinary loan from your bank if this option proves to be more cost-effective for you.

WeCovr has conducted extensive research into the cost of private health insurance in the UK. Click the link to find out more detailed information.

Yes, you can continue to receive treatment through the NHS even if you have private health insurance and have received private treatment in the past. This could be for rehabilitation after private surgery or for treatment that is not covered by your health insurance policy. For example, some cosmetic surgeries may be available through the NHS but are generally not covered by private medical insurance.

This is a difficult question to answer definitively. There are certain services that cannot be obtained privately, such as emergency treatment at an Accident and Emergency (A&E) department. Many NHS consultants also practice privately, so you could potentially see the same consultant regardless of whether you choose private or public healthcare. However, private healthcare typically offers shorter waiting times, guaranteed private rooms, and more relaxed visiting hours. Additionally, you may have access to treatments and drugs that are not routinely available through the NHS.

Yes, you can self-refer to a private specialist without the need for a GP referral. However, the British Medical Association believes that in most cases, it is best practice to start with your GP, as they are familiar with your medical history.

Yes, if you have a health concern and pay for private tests and scans but cannot afford to have private surgery, you should be able to have your test results transferred to an NHS provider for treatment.

Learn more

...

Who Are WeCovr?

WeCovr is an insurance specialist for people valuing their peace of mind and a great service.

👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.

Just a quick and simple form and an easy conversation with one of our experts and your valuable insurance policy is in place for that needed peace of mind!

Important Information

Since 2011, WeCovr has helped thousands of individuals, families, and businesses protect what matters most. We make it easy to get quotes for life insurance, critical illness cover, private medical insurance, and a wide range of other insurance types. We also provide embedded insurance solutions tailored for business partners and platforms.

Political And Credit Risks Ltd is a registered company in England and Wales. Company Number: 07691072. Data Protection Register Number: ZA207579. Registered Office: 22-45 Old Castle Street, London, E1 7NY. WeCovr is a trading style of Political And Credit Risks Ltd. Political And Credit Risks Ltd is Authorised and Regulated by the Financial Conduct Authority and is on the Financial Services Register under number 735613.

About WeCovr

WeCovr is your trusted partner for comprehensive insurance solutions. We help families and individuals find the right protection for their needs.

Insurance Products

Resources

Legal

© 2026 WeCovr. Made with in London