
Navigating the world of private medical insurance (PMI) in the UK can feel complex, but understanding one key choice—how your policy is underwritten—is the most crucial step. As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr is here to demystify the two main options: Moratorium and Full Medical Underwriting. This choice will define what your policy covers, how you make a claim, and the peace of mind you get from your health cover.
At its heart, private health insurance is designed to cover the costs of treatment for new, acute medical conditions that arise after your policy begins. It’s your safety net for prompt diagnosis and private treatment, helping you bypass long NHS waiting lists. But before an insurer can offer you this cover, they need to understand your health background. This assessment process is called underwriting.
This guide will walk you through everything you need to know about Moratorium and Full Medical Underwriting, helping you make an informed decision for you and your family.
Think of underwriting as the foundation upon which your health insurance policy is built. It's the method an insurer uses to assess the level of risk they are taking on by insuring you. They look at your medical history to determine the likelihood of you needing to make a claim.
The primary goal of underwriting is to identify any pre-existing medical conditions. These are ailments, injuries, or symptoms you have experienced before the start date of your policy.
Why is this so important?
Standard private medical insurance in the UK is not designed to cover pre-existing conditions. It’s for unforeseen, acute (short-term and curable) health issues. By excluding conditions you already have, insurers can keep premiums affordable for everyone and operate a sustainable business model.
The type of underwriting you choose dictates how these pre-existing conditions are identified and handled. Let's explore the two main paths you can take.
Moratorium underwriting is the most common type for individual private medical insurance policies in the UK, mainly because it’s quick and simple to set up.
How does it work?
With a moratorium policy, you don’t need to complete a detailed medical questionnaire upfront. Instead, the insurer applies a blanket exclusion for any medical condition for which you have experienced symptoms, sought advice, or received treatment in a set period before your policy started (typically the last five years).
This exclusion isn't necessarily permanent. The condition may become eligible for cover later, subject to two key rules, often called the "2-year rule":
If you meet both these criteria, the condition will no longer be considered pre-existing and could be covered in the future.
Real-Life Example: Sarah's Knee Pain
Sarah, a 32-year-old graphic designer, wants to take out a PMI policy. Three years ago, she saw her GP for some knee pain after a long run, who advised her to rest it. She hasn't had any trouble since.
She chooses a moratorium policy.
- Initially: Her knee is not covered, as she sought advice for it within the last five years.
- The "Wait and See" Period: Sarah holds the policy. For the next two years, she has no further knee pain, doesn't see a doctor about it, and requires no treatment.
- After Two Years: Because she has passed the two-year trouble-free period, her knee condition is now potentially eligible for cover under her policy, should a new, acute issue arise with it.
| Advantages of Moratorium | Disadvantages of Moratorium |
|---|---|
| Fast & Simple Setup: No long medical forms to fill in, so you can get cover in place very quickly. | Lack of Initial Certainty: You don't know for sure what's excluded until you make a claim. |
| Less Intrusive: You don't have to recall and disclose every detail of your medical past. | Slower Claims Process: When you claim, the insurer will need to investigate your medical history to check if the issue is pre-existing. This can add delays and stress. |
| Potential to Cover Past Conditions: Old conditions can become eligible for cover over time, which isn't usually possible with the alternative. | Risk of Claim Rejection: A claim might be rejected if the insurer finds it relates to a recent pre-existing condition, which can be upsetting. |
Moratorium underwriting is often a good fit for:
Full Medical Underwriting (FMU) is the opposite of a moratorium. It's a more detailed and transparent process that provides complete clarity from the very beginning.
How does it work?
With FMU, you are required to complete a comprehensive medical history questionnaire as part of your application. You must disclose all your past medical conditions, treatments, and any symptoms you've experienced.
The insurer’s underwriting team will then review your application. They may:
Based on this full disclosure, the insurer will offer you a policy with a list of specific, named exclusions. These are conditions that will not be covered by the policy. Unlike a moratorium, these exclusions are typically permanent.
Real-Life Example: David's Health History
David, a 58-year-old accountant, has a more complex medical history. He had a heart palpitation scare six years ago (which turned out to be benign) and suffers from occasional gout in his big toe.
He opts for Full Medical Underwriting because he wants to know exactly where he stands.
- Application: David declares both his historic heart investigation and his gout on the application form.
- Insurer's Decision: The insurer reviews his history. They decide the heart issue was a one-off event over five years ago and agree to cover it. However, because gout is a recurring (chronic) condition, they place a permanent exclusion on it.
- The Outcome: David receives his policy documents which clearly state: "Gout and related conditions are excluded from cover." He now has complete certainty. If he needs to claim for anything else, like a hip replacement or cataract surgery, he knows the process will be straightforward as the underwriting is already done.
| Advantages of FMU | Disadvantages of FMU |
|---|---|
| Total Clarity: You know precisely what is and isn't covered from day one. No nasty surprises at the point of a claim. | Slower Application: The process takes longer due to the detailed questionnaire and potential need for GP reports. |
| Faster Claims Process: As the underwriting work is done upfront, claims are generally processed much more quickly and smoothly. | More Intrusive: You must provide detailed personal medical information, which some people find uncomfortable. |
| No Ambiguity: You have a clear, written contract that specifies all exclusions, giving you complete peace of mind. | Exclusions are Usually Permanent: Unlike a moratorium, a named exclusion on an FMU policy is unlikely to be removed later. |
Full Medical Underwriting is often the preferred choice for:
To help you decide, here is a direct comparison of the key features of each underwriting type.
| Feature | Moratorium Underwriting | Full Medical Underwriting (FMU) |
|---|---|---|
| Application Process | Quick and simple. No initial medical questionnaire. | Detailed medical questionnaire required. Can be slow. |
| Clarity of Cover | Ambiguous at the start. You only discover what's excluded when you make a claim. | Crystal clear from day one. You receive a list of named exclusions with your policy. |
| Claims Process | Can be slow. The insurer investigates your medical history at the time of the claim. | Fast and straightforward. Underwriting is already complete. |
| Pre-existing Conditions | Conditions from the last 5 years are automatically excluded. They may become eligible for cover after a 2-year trouble-free period. | You declare all conditions. The insurer decides what to exclude, and these exclusions are usually permanent. |
| Speed of Setup | Very fast. Cover can often be arranged the same day. | Slower. Can take several days or even weeks to get the policy finalised. |
| Best Suited For | People wanting quick cover with a clean medical history. | People wanting absolute certainty, especially those with a known medical history. |
It is vital to understand this fundamental principle of UK private medical insurance, regardless of which underwriting you choose.
Both Moratorium and FMU underwriting are designed to exclude pre-existing and chronic conditions from cover. The only difference is how they do it. An FMU policy will name the chronic condition as a specific exclusion. A moratorium policy will exclude it by default if you've had symptoms or treatment for it in the last five years.
The demand for private medical insurance continues to grow as people seek to avoid long waits for NHS treatment.
These figures highlight the growing role of private health cover in the UK's healthcare landscape, making it more important than ever to choose the right policy and underwriting for your needs.
Choosing between Moratorium and Full Medical Underwriting is a significant decision. You don't have to make it alone. A specialist, independent PMI broker like WeCovr provides impartial, expert guidance at no cost to you.
Our role is to:
With high customer satisfaction ratings, our team is dedicated to finding you a policy that offers genuine peace of mind.
While insurance is a crucial safety net, the best policy is always to stay as healthy as possible. Many modern PMI providers actively encourage this by including a range of wellness benefits with their policies, such as:
As a WeCovr client, you get more than just an insurance policy. We provide complimentary access to CalorieHero, our proprietary AI-powered calorie and nutrition tracking app, to help you stay on top of your health goals. Furthermore, customers who purchase a PMI or Life Insurance policy through us are often eligible for discounts on other types of cover we arrange.
A few simple lifestyle habits can make a huge difference:
Choosing between moratorium and full medical underwriting is the cornerstone of building a private medical insurance policy that works for you. One offers speed and simplicity; the other provides absolute clarity and peace of mind. Neither is inherently better—the right choice depends entirely on your personal health history and preferences.
Ready to find the right private health cover for your needs? Speak to the friendly experts at WeCovr today. We'll compare the UK market for you and find a policy that fits your life and budget—all at no cost to you.
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