TL;DR
WeCovr explains the two main underwriting types and which suits your medical history best Choosing a private medical insurance policy in the UK can feel complex, but it doesn't have to be. As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr is here to demystify the process. A key decision you'll face is the type of underwriting: Moratorium or Full Medical Underwriting.
Key takeaways
- Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include a broken bone, appendicitis, cataracts, or a hernia. PMI is designed for these.
- Chronic Condition: A disease, illness, or injury that has one or more of the following characteristics: it needs ongoing or long-term monitoring, has no known cure, is likely to recur, or requires palliative care. Examples include diabetes, asthma, high blood pressure, and arthritis. These are managed by the NHS and are not covered by standard PMI.
- Initial Exclusion: Any condition you've had in the 5 years before the policy starts is automatically excluded.
- The Two-Year Rule: If you then go for a continuous two-year period after your policy begins without experiencing any symptoms, needing treatment, or seeking advice for that specific condition, it may become eligible for cover.
- The "Reset" Clause: If you do need treatment or advice for that condition during the two-year moratorium period, the clock resets. You would need to complete another two-year trouble-free period from that point before the condition could be considered for cover.
WeCovr explains the two main underwriting types and which suits your medical history best
Choosing a private medical insurance policy in the UK can feel complex, but it doesn't have to be. As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr is here to demystify the process. A key decision you'll face is the type of underwriting: Moratorium or Full Medical Underwriting.
This choice determines how an insurer assesses your medical history and what they will cover. Understanding the difference is crucial to finding a policy that offers you security and peace of mind. In this guide, we'll break down everything you need to know to make the right choice for you and your family.
What is Underwriting in Private Health Insurance?
Before we dive into the two main types, let's clarify what "underwriting" means.
In simple terms, underwriting is the process an insurance company uses to understand the level of risk you present. For health insurance, this means looking at your medical history to decide the terms of your policy. The primary goal is to identify any pre-existing medical conditions.
This brings us to the most critical point about private medical insurance (PMI) in the UK:
Standard PMI policies are designed to cover new, unforeseen, and acute medical conditions that arise after your policy begins. They are generally not designed to cover pre-existing conditions or chronic conditions.
It's vital to understand the difference between 'acute' and 'chronic' conditions:
- Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include a broken bone, appendicitis, cataracts, or a hernia. PMI is designed for these.
- Chronic Condition: A disease, illness, or injury that has one or more of the following characteristics: it needs ongoing or long-term monitoring, has no known cure, is likely to recur, or requires palliative care. Examples include diabetes, asthma, high blood pressure, and arthritis. These are managed by the NHS and are not covered by standard PMI.
The type of underwriting you choose—Moratorium or Full Medical Underwriting—is simply the method the insurer uses to identify and handle these pre-existing conditions.
Understanding Moratorium Underwriting: The 'Wait and See' Approach
Moratorium underwriting is the most common type offered in the UK. It's often favoured for its speed and simplicity.
With a moratorium policy, you don't have to complete a lengthy medical questionnaire when you apply. Instead, the insurer applies a blanket temporary exclusion for any medical conditions for which you have experienced symptoms, received medication, or sought advice or treatment in the five years leading up to your policy start date.
How does it work?
The key feature is the "moratorium period," which is typically two years from the date your policy starts.
- Initial Exclusion: Any condition you've had in the 5 years before the policy starts is automatically excluded.
- The Two-Year Rule: If you then go for a continuous two-year period after your policy begins without experiencing any symptoms, needing treatment, or seeking advice for that specific condition, it may become eligible for cover.
- The "Reset" Clause: If you do need treatment or advice for that condition during the two-year moratorium period, the clock resets. You would need to complete another two-year trouble-free period from that point before the condition could be considered for cover.
A Real-Life Example:
Let's say David had physiotherapy for shoulder pain 18 months before he took out a moratorium policy. For the first two years of his policy, any claims related to his shoulder would be excluded.
- Scenario A: David goes for two full years without any shoulder pain, medication, or consultations. After this point, if he develops a new problem with his shoulder, it would likely be covered.
- Scenario B: One year into his policy, David's shoulder pain returns, and he sees his GP. This visit "resets the clock." His shoulder will remain an exclusion, and he would need to go another two continuous years from this GP visit without any shoulder issues for it to be considered for cover again.
Pros and Cons of Moratorium Underwriting
| Pros of Moratorium | Cons of Moratorium |
|---|---|
| Quick & Simple Application: You can get cover in place very quickly without filling out long medical forms. | Lack of Upfront Certainty: You only discover if a condition is covered when you make a claim. |
| Less Intrusive: You don't need to recall and disclose your entire medical history from the outset. | Slower Claims Process: The insurer will need to investigate your medical history at the point of a claim, which can cause delays. |
| Potential for Cover: Pre-existing conditions have a pathway to becoming covered over time, which isn't usually possible with FMU. | The "Rolling" Nature: The two-year clock can reset, making it hard to predict when, or if, a condition will ever be covered. |
| Often Good Value: Because the admin is lower upfront, moratorium policies can sometimes be slightly more affordable. | Potential for Disputes: The ambiguity can sometimes lead to disagreements about whether a new symptom is related to a past condition. |
Who is Moratorium Underwriting Best For?
Moratorium underwriting is an excellent choice for:
- Individuals who are generally healthy and have not had significant medical issues in the last five years.
- Younger people who want to get cover quickly and easily.
- Anyone who values a fast application process over having absolute certainty from day one.
Full Medical Underwriting (FMU): The 'Cards on the Table' Approach
Full Medical Underwriting (FMU) is the more traditional method. As the name suggests, it involves a full declaration of your medical history at the time of application.
With FMU, you will be asked to complete a detailed health questionnaire. You must disclose information about past consultations, treatments, and conditions for yourself and any other family members on the policy.
The insurer's underwriting team will then review your answers and decide on the terms of your policy.
How does it work?
- Medical Declaration: You provide complete and accurate answers to a series of health-related questions.
- Insurer Assessment: The underwriting team assesses your declarations to identify any pre-existing conditions.
- Clear Exclusions: Based on your history, the insurer will apply specific, named exclusions to your policy. For example, "any treatment related to the ligaments of the right knee" or "investigations and treatment for gallstones."
- Policy Documents: These exclusions are written clearly in your policy documents. You know from the very beginning exactly what is and isn't covered.
Unlike a moratorium, these exclusions are typically permanent. However, some insurers may be willing to review an exclusion after a certain number of years if you can provide medical evidence that the condition is fully resolved.
A Real-Life Example:
Let's say Sophia applies for a policy with FMU. On her form, she declares that she had surgery for an ovarian cyst three years ago. The insurer reviews this and adds a permanent exclusion to her policy for "any investigation or treatment related to ovarian cysts." A year later, she develops knee pain and needs an MRI scan. Because this is unrelated to her exclusion, her claim is processed quickly and without any queries about her past gynaecological history. She had total clarity from day one.
Pros and Cons of Full Medical Underwriting
| Pros of FMU | Cons of FMU |
|---|---|
| Total Certainty: You know exactly what is and isn't covered from the moment your policy starts. No surprises at the point of a claim. | Longer Application Process: Completing the medical questionnaire can be time-consuming and requires you to recall past medical details accurately. |
| Faster Claims: As the underwriting is done upfront, claims are generally much quicker and more straightforward to process. | Can Feel Intrusive: Some people are uncomfortable disclosing their entire medical history. |
| Clear & Transparent: All exclusions are explicitly named in your policy documents, leaving no room for ambiguity. | Permanent Exclusions: Declared conditions are usually excluded for the life of the policy, with no pathway to being covered later. |
| Potential for Review: In some cases, you may be able to ask the insurer to review an exclusion after several years of being symptom-free. | Forgetting is a Risk: If you accidentally forget to declare a condition, an insurer could decline a future claim and even void your policy. |
Who is Full Medical Underwriting Best For?
Full Medical Underwriting is often the better choice for:
- Individuals with a known medical history who want to know for certain what will be excluded.
- People who prioritise clarity and peace of mind over a quick application.
- Anyone who wants to avoid potential delays or disputes when they need to make a claim.
Moratorium vs. FMU: A Head-to-Head Comparison
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 & simple. No upfront medical questionnaire. | Longer & more detailed. Requires a full declaration of your medical history. |
| Cover for Pre-existing Conditions | Conditions from the last 5 years are excluded. They may become covered after a continuous 2-year trouble-free period on the policy. | Conditions you declare are assessed and typically excluded from the start. These exclusions are usually permanent. |
| Certainty of Cover | Low. You only find out if a condition is covered when you submit a claim. This can lead to uncertainty when you need care. | High. Your policy documents clearly list all exclusions from day one. You have complete transparency. |
| Claims Process | Can be slower. The insurer needs to investigate your medical history at the time of the claim to check if it's a new or pre-existing condition. | Generally faster and smoother. The underwriting work is already done, so unrelated claims are processed with minimal fuss. |
| Best For | Healthy individuals wanting a fast start; those with very minor past issues who are happy with the "wait and see" approach. | People with a known or complex medical history who want absolute clarity on their cover before they commit. |
| Cost | Can sometimes be slightly cheaper due to lower initial administration. | The price is based on the risk assessed from your application. It can be more or less expensive depending on your health. |
How to Choose: Which Underwriting Suits Your Medical History?
The right choice is personal. It depends on your health, your attitude to risk, and what you value most in an insurance policy. Let's look at some common scenarios.
-
Scenario 1: Aisha, 28, Fit and Healthy Aisha has rarely visited her GP and has no ongoing health concerns. For her, a Moratorium policy is likely ideal. It's fast to set up, and since she has no pre-existing conditions to worry about, the lack of upfront certainty is not a major drawback.
-
Scenario 2: Ben, 42, Past Knee Injury Ben had physiotherapy for a recurring knee ligament sprain two years ago. He wants to ensure that if he needs surgery in the future, he'll be covered.
- With Moratorium, his knee would be excluded. If he has any more symptoms or consultations for it in the first two years of the policy, the exclusion period will reset. He faces uncertainty.
- With FMU, he would declare the knee issue. The insurer will almost certainly apply a permanent exclusion for his knee ligaments. While he won't get cover for his knee, he will have certainty and know that any other new, unrelated condition (like a hernia or back pain) will be covered without question. For Ben, FMU provides the clarity he's looking for.
-
Scenario 3: Carol, 55, Prefers Certainty Carol is in good health but had a benign lump removed from her back four years ago. She doesn't want any hassle or delays if she ever needs to claim.
- With Moratorium, her back would be excluded for the first two years. Any claim could be delayed while the insurer requests her medical records to see if the new problem is related to the old one.
- With FMU, she would declare the lump. The insurer would likely apply a specific exclusion for that area of her back. She can then proceed with confidence, knowing that any other health issue will be handled smoothly. For Carol, FMU offers valuable peace of mind.
Navigating these choices can be daunting. As an expert private medical insurance broker, WeCovr can walk you through the pros and cons based on your specific circumstances. Our advisory service comes at no cost to you and ensures you find the best policy from leading UK providers.
The Role of PMI in the UK's Health Landscape
With NHS waiting lists remaining a significant concern, more people than ever are turning to private health cover for prompt access to treatment. According to the latest NHS England data, the referral to treatment (RTT) waiting list involves several million treatment pathways. In late 2024, this figure stood at around 7.56 million. Private medical insurance offers a valuable way to bypass these queues for eligible acute conditions.
It's important to remember that PMI complements the NHS rather than replacing it. The NHS remains world-class for:
- Accident & Emergency services
- GP services
- Management of chronic conditions (like diabetes and asthma)
- Maternity care
PMI gives you choice and control over your elective (planned) healthcare, allowing you to be seen and treated quickly at a time and hospital that suits you.
How WeCovr Enhances Your Health and Wellbeing
At WeCovr, we believe in a proactive approach to health. We don't just help you find the right insurance; we provide tools to help you stay healthy.
- Complimentary Access to CalorieHero: All WeCovr customers who purchase PMI or life insurance receive free access to our AI-powered calorie and nutrition tracking app, CalorieHero. Managing your diet and weight is a cornerstone of good health, and this tool makes it easy and intuitive.
- Discounts on Other Cover: We value our customers' loyalty. When you take out a private medical insurance policy with us, you become eligible for discounts on other products, such as life insurance, helping you protect your family's future for less.
Our commitment to our customers is reflected in our high satisfaction ratings. We are proud to be an FCA-authorised broker dedicated to providing clear, impartial advice.
Can I switch from Moratorium to Full Medical Underwriting?
What happens if I forget to declare a condition on a Full Medical Underwriting application?
Does private health insurance cover chronic conditions like diabetes or asthma?
Which underwriting type is cheaper, Moratorium or FMU?
Take the Next Step with Confidence
The choice between Moratorium and Full Medical Underwriting is one of the most important you'll make when buying private health insurance. Moratorium offers speed and simplicity with a "wait and see" approach to pre-existing conditions. FMU provides complete transparency and certainty from day one.
The right path depends on your medical history, your personal priorities, and your appetite for risk.
Ready to find the right private health cover for you? The expert advisors at WeCovr are here to provide clear, personalised advice. We'll help you compare leading UK insurers and find a policy that fits your needs and budget perfectly.
Get your free, no-obligation quote today and take control of your health.
Sources
- NHS England: Waiting times and referral-to-treatment statistics.
- Office for National Statistics (ONS): Health, mortality, and workforce data.
- NICE: Clinical guidance and technology appraisals.
- Care Quality Commission (CQC): Provider quality and inspection reports.
- UK Health Security Agency (UKHSA): Public health surveillance reports.
- Association of British Insurers (ABI): Health and protection market publications.
