
Choosing private medical insurance in the UK can feel complex, but at WeCovr, an FCA-authorised broker that has helped arrange over 800,000 policies, we believe in making it simple. This guide demystifies one of the most crucial choices you'll make: the type of underwriting for your policy.
When you apply for private health cover, the insurer needs to understand your health history to calculate the risk and decide what they can cover. This process is called underwriting.
The two main ways they do this in the UK are Moratorium Underwriting and Full Medical Underwriting (FMU). Your choice between them affects what’s covered, how quickly you get your policy, and what happens when you need to make a claim. Understanding this difference is the key to finding the best private medical insurance policy for you and your family.
Think of underwriting as the insurer's health check on you before they offer you a policy. Its main purpose is to identify any pre-existing medical conditions you've had in the past.
Why is this so important? Because standard private medical insurance in the UK is designed to cover new, acute conditions that arise after you join. It does not cover long-term, ongoing (chronic) conditions or medical issues you already had before taking out the policy.
Underwriting allows the insurer to set the terms of your contract, making it clear from the outset what will and won't be covered. This prevents surprises later and helps keep premiums fair and affordable for everyone in the insurance pool.
Moratorium underwriting is the most common type offered in the UK. It’s popular because it’s quick, simple, and doesn’t require you to fill out a long medical questionnaire.
Instead of asking about your entire medical history upfront, a moratorium policy applies a simple rule: it automatically excludes treatment for any medical condition you've had symptoms, treatment, or advice for in a set period before your policy starts (usually the last five years).
The "moratorium" is a waiting period. Here’s the typical rule, broken down:
Let's look at a simple table to illustrate.
| Timeline | Event | Is Treatment for Old Knee Pain Covered? |
|---|---|---|
| 2023 | You saw a GP for knee pain. | N/A (Before policy starts) |
| Jan 2025 | You take out a PMI policy with moratorium underwriting. | No. Your knee pain is a pre-existing condition from the last 5 years. |
| Jan 2027 | You have remained symptom-free and had no advice for your knee for 2 full years. | Yes. The condition may now be eligible for cover as you've passed the 2-year moratorium. |
| June 2026 | Alternative Scenario: You see a physio for a knee twinge. | No. The 2-year clock resets. You'd need to go another 2 years from June 2026 without issues for it to become eligible. |
Meet David. David is 45 and generally healthy. He wants private health cover quickly to bypass potential NHS queues for any future problems. He had some shoulder pain after a sports injury three years ago, which was resolved with a few physiotherapy sessions.
David chooses a policy with moratorium underwriting.
| Advantages (Pros) 👍 | Disadvantages (Cons) 👎 |
|---|---|
| Speed & Simplicity: No lengthy medical forms to complete. You can often get cover in place very quickly. | Lack of Certainty: You don't know for sure what's excluded until you make a claim. |
| Privacy: You don't need to disclose your full medical history at the start. | Claims Can Be Slower: When you claim, the insurer will investigate your medical history to see if the condition is pre-existing. This can add delays. |
| Potential for Future Cover: Pre-existing conditions can become eligible for cover over time if you remain symptom-free. | The 'Reset' Rule: The 2-year symptom-free period can be difficult to achieve for recurring issues, meaning they may never be covered. |
| Most Common Option: It's the standard offering from most major UK PMI providers. | "Grey Areas": It can be hard to define if a new symptom relates to an old condition, leading to potential disputes. |
Full Medical Underwriting (FMU) is the opposite of a moratorium. It’s a more detailed process where you provide your complete medical history to the insurer upfront by filling out a comprehensive health questionnaire.
The insurer’s medical underwriters then review your application and decide precisely what they will and will not cover. Any specific conditions they decide to exclude are written explicitly into your policy documents. These are called exclusions.
Meet Chloe. Chloe is 52 and had a minor back issue five years ago that required an MRI scan. She also has a history of occasional migraines. She wants absolute clarity on what her private health insurance will cover from day one.
Chloe chooses a policy with Full Medical Underwriting.
| Advantages (Pros) 👍 | Disadvantages (Cons) 👎 |
|---|---|
| Total Certainty: You know exactly what is and isn't covered from the very beginning. No surprises at the point of claim. | Slower Application: The process takes longer due to the detailed questionnaire and potential need for medical reports. |
| Faster Claims: Because underwriting is done upfront, claims are often processed more quickly as there's no need to investigate your past history. | Requires Full Disclosure: You must be prepared to share your entire medical history. Forgetting something can invalidate your policy. |
| Potential for Lower Premiums: If you're in good health with a clean medical history, an FMU policy can sometimes be cheaper than a moratorium equivalent. | Permanent Exclusions: Exclusions applied at the start are usually permanent and won't become eligible for cover later on. |
| Negotiable Terms: In some cases, you or your broker may be able to discuss the terms of an exclusion with the insurer. | More Intrusive: Some people find the process of sharing detailed personal health information uncomfortable. |
Choosing between these two underwriting methods is a personal decision based on your priorities. Here’s a direct comparison to help you decide.
| Feature | Moratorium Underwriting | Full Medical Underwriting (FMU) |
|---|---|---|
| Application Speed | Fast. Often minutes or hours. | Slow. Can take days or weeks. |
| Convenience | High. No long forms. | Low. Requires detailed health questionnaire. |
| Upfront Certainty | Low. You only find out what's excluded when you claim. | High. All exclusions are clearly stated in your policy documents. |
| Claim Speed | Slower. Insurer investigates your history at the time of claim. | Faster. Underwriting is already complete. |
| Privacy | High. No need to disclose medical history at the start. | Low. You must provide a full medical history. |
| Cover for Pre-existing Conditions | Possible after a 2-year symptom-free period. | Unlikely. Conditions are typically excluded permanently. |
| Best For... | People who want cover quickly, have a clean or simple medical history, and value privacy. | People who want absolute clarity, have a complex medical history, or want to ensure faster claims. |
This is the single most important concept to grasp about private medical insurance in the UK.
Standard UK PMI is designed to cover acute conditions that begin after your policy starts. It is not designed to cover pre-existing conditions or chronic conditions.
Insurers exclude chronic conditions because managing them is long-term and costly. Covering them would make premiums unaffordable for the majority of people. PMI acts as a complement to the NHS, which provides excellent care for chronic conditions, allowing you to get fast access to treatment for new, curable health problems.
Regardless of whether you choose moratorium or FMU underwriting, long-term chronic conditions will not be covered.
Your personal circumstances and preferences will guide your choice. As expert PMI brokers, the team at WeCovr can provide personalised advice, but here are some general guidelines.
You might favour Moratorium Underwriting if:
You might favour Full Medical Underwriting if:
With NHS waiting lists in England remaining a significant concern for millions, according to official NHS data, taking control of your health with PMI is a sensible step. But navigating the market alone can be daunting.
That’s where an independent broker like WeCovr comes in.
As a WeCovr client, you also get complimentary access to our AI-powered nutrition app, CalorieHero, to help you stay on top of your health goals. Plus, clients who take out a private medical or life insurance policy with us are eligible for discounts on other types of cover, like home or car insurance.
While private medical insurance is an excellent tool for when things go wrong, the best strategy is always proactive health management. Insurers increasingly recognise this, often including wellness benefits and rewards in their policies.
By combining a healthy lifestyle with the security of a well-chosen PMI policy, you put yourself in the strongest possible position to manage your health.
Ready to take the next step?
Choosing the right underwriting method is the foundation of a good private medical insurance policy. Let our friendly, expert team at WeCovr help you build a plan that gives you peace of mind and fast access to the best care.
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