Medical History Disregarded (MHD) Underwriting Explained
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr specialises in making private medical insurance (PMI) clear and accessible. In the UK, understanding your policy's underwriting is crucial, and in this guide, we break down one of the most comprehensive options: Medical History Disregarded.
WeCovr explains MHD and when it applies to corporate PMI switching
Medical History Disregarded, or MHD, is a premium type of underwriting for private medical insurance. In simple terms, it means the insurer agrees to ignore the past medical history of the members joining the scheme. This allows them to receive cover for pre-existing conditions that would normally be excluded.
However, MHD is not available to everyone. It is almost exclusively offered to corporate or group health insurance schemes, typically those with 20 or more members. It is the gold standard of underwriting for businesses looking to provide an exceptional health benefit to their employees.
This guide will walk you through exactly what MHD is, how it compares to other underwriting types, and, crucially, how it works when a company decides to switch its PMI provider.
What is Underwriting in Private Medical insurance?
Before we dive deep into MHD, let's clarify what 'underwriting' means. Think of it as the insurer's risk assessment process. When you apply for a health insurance policy, the provider needs to understand the level of risk you present. This involves looking at factors like your age, lifestyle, and medical history.
The outcome of this underwriting process determines:
- Whether the insurer can offer you cover.
- How much your premium will be.
- What, if any, exclusions will be applied to your policy.
In the UK private medical insurance market, there are three primary methods of underwriting. The one you choose has a massive impact on what you can claim for.
The Core Principle: Acute vs. Chronic Conditions
It is absolutely vital to understand a fundamental principle of all standard UK private medical insurance, regardless of the underwriting type. PMI is designed to cover acute conditions that arise after your policy begins.
- An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include a joint injury, appendicitis, cataracts, or a hernia.
- A chronic condition is a long-term illness that cannot be cured but can be managed through medication and monitoring. Examples include diabetes, asthma, hypertension (high blood pressure), and eczema.
Standard private health cover does not pay for the ongoing management of chronic conditions. While MHD can provide cover for pre-existing acute conditions, it will still not cover the routine treatment of chronic illnesses. This is a key distinction we will explore further.
The Main Types of PMI Underwriting in the UK
To appreciate the unique benefits of MHD, it's helpful to compare it with the other common types of underwriting available for both individuals and groups.
1. Full Medical Underwriting (FMU)
With FMU, you provide a complete picture of your medical history by filling out a detailed questionnaire when you apply. You must declare all previous conditions, treatments, and consultations. The insurer's underwriting team then reviews this information and decides what can be covered.
- Pros: You have complete clarity from day one. Your policy documents will list any specific exclusions, so there are no grey areas about what is and isn't covered.
- Cons: The application process is lengthy and intrusive. You may end up with a number of permanent exclusions on your policy for conditions you've had in the past, even if they were minor.
Example: You had keyhole surgery on your right knee five years ago. With FMU, you would declare this, and the insurer would likely place a permanent exclusion on your policy for any future issues related to your right knee.
2. Moratorium (Mori) Underwriting
This is the most common type of underwriting for individual and small group policies because it's quick and simple. You don't need to complete a medical questionnaire. Instead, the insurer applies a general rule.
Under a moratorium, the insurer will not cover any medical condition (or related condition) for which you have had symptoms, treatment, or sought advice in the five years before your policy started.
However, if you then complete two continuous years on the policy without experiencing any symptoms, treatment, or advice for that specific condition, it may become eligible for cover. This is often called a "rolling" moratorium.
- Pros: The application is fast and non-intrusive. It offers a potential pathway for pre-existing conditions to be covered in the future.
- Cons: There is a degree of uncertainty. You may not know for sure if a condition is covered until you need to make a claim. This can lead to disappointment and frustration.
Example: You suffered from back pain three years before taking out a moratorium policy. For the first two years of your cover, any treatment for your back will be excluded. If you then remain completely free of back-related symptoms or advice for two full years, your back pain may become eligible for cover in the third year and beyond.
3. Medical History Disregarded (MHD) Underwriting
MHD is the most generous form of underwriting. As the name suggests, the insurer agrees to disregard your previous medical history. This means you can get cover for pre-existing acute conditions right from the start of the policy.
- Pros: Unrivalled peace of mind and comprehensive cover. Employees can claim for new episodes of past medical problems. It's confidential, as no medical declarations are needed.
- Cons: It is the most expensive option and is almost always reserved for larger corporate groups.
Example: An employee joining a company scheme with MHD underwriting had knee surgery five years ago. If their knee problem flares up again, the MHD policy would cover the cost of consultations and treatment, whereas both FMU and Moratorium policies would have excluded it.
A Deep Dive into Medical History Disregarded (MHD) Underwriting
MHD underwriting is a powerful tool for businesses aiming to offer a top-tier benefits package. It removes one of the biggest barriers to using private healthcare: pre-existing condition exclusions.
How Exactly Does MHD Work?
When a company sets up a group scheme on an MHD basis, the insurer makes a commercial decision. They calculate that by insuring a large group of people, the risk is spread. The claims from a few members with pre-existing conditions will be balanced out by the many healthy members who won't claim.
This allows the insurer to offer cover for conditions that would be excluded for an individual. The key benefit is that it provides cover for pre-existing acute conditions.
Let's revisit our acute vs. chronic distinction with an MHD example:
- Covered: An employee had treatment for gallstones three years before joining the company. If they have a recurrence, an MHD policy would cover it.
- Not Covered: An employee has had Type 1 Diabetes since childhood. The MHD policy will not cover the cost of their insulin, blood sugar monitoring, or routine diabetic check-ups. This is the management of a chronic condition, which remains the responsibility of the NHS. However, if that same employee developed an unrelated acute condition, like a hernia, the MHD policy would cover the treatment for it.
Who is Eligible for MHD?
Eligibility is primarily determined by group size. While rules vary between insurers, the general thresholds are:
| Group Size (Number of Employees) | Likely Underwriting Options |
|---|---|
| 1-9 | Full Medical Underwriting or Moratorium |
| 10-19 | Moratorium. Some insurers may offer MHD, often with broker negotiation. |
| 20+ | Medical History Disregarded is widely available. |
Insurers offer MHD to larger groups because the "law of large numbers" reduces their risk. A specialist broker like WeCovr can be invaluable here, as we have strong relationships with insurers and can often negotiate MHD terms for groups that fall slightly below the standard threshold.
The Business Benefits of MHD
For an organisation, choosing a group PMI scheme with MHD underwriting is a strategic decision with multiple advantages:
- Maximum Value for Employees: It provides staff with genuine peace of mind, knowing that past medical issues won't prevent them from accessing private care. This is a highly tangible and valued benefit.
- Aids Recruitment and Retention: In a competitive job market, a comprehensive health insurance plan can be a deciding factor for top talent. MHD is a clear differentiator.
- Complete Confidentiality: Employees are not required to disclose any sensitive personal health information to their employer or the insurer. This fosters trust and encourages take-up of the scheme.
- Administrative Simplicity: For HR and benefits managers, MHD is the simplest to administer. There are no medical forms to handle when new employees join the scheme.
- Reduced Sickness Absence: By providing fast access to treatment for both new and pre-existing acute conditions, MHD helps employees get diagnosed and treated faster, reducing their time off work.
When Does MHD Apply to Corporate PMI Switching?
This is a critical area where expert advice is essential. Many companies already have a group PMI scheme in place and may be looking to switch providers to get a better deal, improved service, or enhanced benefits. The existing underwriting of their scheme plays a huge role in this process.
The "Switch" Process: Protecting Your Cover
When a group wants to move from one insurer to another, the goal is to do so without any loss of cover for the members. Insurers have specific "switch" processes to facilitate this, and the terms depend on the group's existing underwriting.
1. Switching an Existing MHD Scheme
If your company already has a group scheme with MHD underwriting, you are in a strong position. When you switch to a new insurer, you will typically be offered terms on a Continued Medical History Disregarded (CMHD) basis.
This means the new insurer agrees to continue the MHD terms, ensuring no new medical exclusions are applied and all members retain the cover they had with the previous provider. The process is seamless. A broker's role here is to survey the market to ensure you are getting the best possible premium for your CMHD terms.
2. Upgrading to MHD When Switching
What if your company has a group scheme on a Moratorium or Full Medical Underwriting basis? This is where the opportunity lies.
If your group has grown over time and now meets the size criteria for MHD (e.g., 20+ employees), switching providers can be the perfect time to upgrade your underwriting.
An expert PMI broker like WeCovr can manage this process for you. We will approach the market's best PMI providers, presenting your company's claims history and membership data to negotiate a move to a new MHD scheme. This can dramatically enhance the value of your employee benefits package, often for a modest increase in premium.
Table: Corporate PMI Switching Scenarios
| Current Scheme Underwriting | Group Size | Company's Goal | How WeCovr Can Help |
|---|---|---|---|
| MHD | 35 employees | Find a more cost-effective provider. | We survey the market to find a new insurer offering CMHD terms at a more competitive price, ensuring a seamless switch with no loss of cover. |
| Moratorium | 25 employees | Improve the benefit for staff retention. | We negotiate with leading insurers to upgrade the scheme to MHD, removing the uncertainty of moratorium and providing cover for pre-existing acute conditions. |
| Full Medical Underwriting | 18 employees | Simplify administration and improve cover. | We explore the market to see which insurers will offer an upgrade to MHD for a group of this size, or move the group to a simpler Moratorium scheme. |
| No Previous Cover | 22 employees | Launch a new, high-value employee benefit. | We approach the market to set up a brand new scheme on MHD terms from day one, ensuring the best possible start for your benefits programme. |
Comparing Underwriting Types: A Summary Table
This table provides a clear, at-a-glance comparison of the three main underwriting types in the UK private medical insurance market.
| Feature | Full Medical Underwriting (FMU) | Moratorium (Mori) | Medical History Disregarded (MHD) |
|---|---|---|---|
| Best For | Individuals who want absolute clarity on exclusions from the start. | Individuals and small groups wanting a quick application process. | Corporate groups (usually 20+) wanting the most comprehensive cover. |
| Application Process | Long medical questionnaire required. | No medical questionnaire needed. | No medical questionnaire needed for members. |
| Cover for Pre-existing Conditions | No, conditions are typically permanently excluded. | Potentially, after a 2-year clear period of no symptoms or advice. | Yes, for pre-existing acute conditions. Chronic conditions are not covered. |
| Certainty of Cover | High. Exclusions are clearly stated in writing. | Low. You may not know if a condition is covered until you claim. | Very High. Only standard policy and chronic condition exclusions apply. |
| Typical Use Case | Individual policies. | Individual and small group policies. | Medium to large corporate schemes. |
| Relative Cost | Variable, can be lower if you have a clean bill of health. | Generally the mid-range price point. | The most expensive, premium option. |
The UK Health Landscape in 2025: Why Businesses Choose PMI
Investing in corporate health insurance is no longer just a "nice-to-have" perk; it's a strategic business tool. The current pressures on the UK's public health system underscore its importance.
According to the latest NHS England data, the referral to treatment (RTT) waiting list remains a significant challenge, with millions of people waiting for consultant-led elective care. As of early 2024, the list stood at approximately 7.54 million treatments. For businesses, this translates into extended employee sickness absence, lost productivity, and a negative impact on team morale.
Furthermore, data from the Office for National Statistics (ONS) on "Sickness absence in the UK labour market" shows that millions of working days are lost to ill health each year. In 2022, an estimated 185.6 million working days were lost because of sickness or injury.
Private medical insurance with MHD underwriting directly addresses this. By giving employees fast access to diagnosis and treatment for a wide range of conditions, it helps them get back to health and back to work sooner, benefiting both the individual and the business.
Beyond the Policy: Proactive Health and Wellness
At WeCovr, we believe that health insurance should be about more than just claims. Modern PMI policies are increasingly focused on proactive wellness, offering a suite of tools to help members stay healthy. These can include:
- 24/7 remote GP services
- Mental health support lines and therapy sessions
- Discounts on gym memberships and fitness trackers
- Nutrition consultations
WeCovr enhances this by providing our clients with extra value. When you arrange a PMI policy through us, you also receive:
- Complimentary access to CalorieHero: Our proprietary AI-powered calorie and nutrition tracking app to help you and your employees manage dietary goals.
- Exclusive discounts: Clients who take out PMI or Life Insurance with us are eligible for discounts on other types of cover we offer.
Combining a comprehensive insurance policy with proactive wellness tools creates a holistic approach to employee wellbeing. Encouraging simple, healthy habits can have a profound long-term impact:
- A Balanced Diet: Following principles like the NHS Eatwell Guide helps ensure you get a good balance of nutrients to support physical and mental health.
- Regular Physical Activity: The NHS recommends at least 150 minutes of moderate-intensity activity a week. This can reduce the risk of major illnesses, such as heart disease, stroke, and type 2 diabetes, by up to 50%.
- Prioritising Sleep: Most adults need 7-9 hours of quality sleep per night. Good sleep is crucial for cognitive function, mood regulation, and physical recovery.
- Managing Stress: Techniques like mindfulness, regular breaks, and exercise are powerful tools for managing the pressures of modern life and work.
Final Thoughts from WeCovr
Choosing the right underwriting is the most important decision you will make when setting up a private medical insurance policy. While Moratorium and Full Medical Underwriting have their place, Medical History Disregarded (MHD) offers an unparalleled level of cover and peace of mind for corporate groups.
It removes the barriers and anxieties associated with pre-existing conditions, ensuring your employees can make full use of their health benefit when they need it most. For a business, it is a clear and powerful statement that you value your team's health and wellbeing.
Navigating the complexities of group schemes, switch terms, and underwriting negotiations can be daunting. An FCA-authorised broker like WeCovr exists to make this process simple, transparent, and effective, all at no cost to you. We leverage our market expertise and insurer relationships to secure the best possible terms for your organisation.
Does MHD cover all pre-existing conditions?
Can I get Medical History Disregarded underwriting for an individual policy?
What is the minimum group size to qualify for MHD?
Will my company's premium be higher with MHD underwriting?
Ready to explore the best private medical insurance options for your business? The team of experts at WeCovr is here to help. Get your free, no-obligation quote today and let us compare the market to find the perfect cover for your team.
Related guides
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?
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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!
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.
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