TL;DR
Choosing private medical insurance in the UK involves a key decision that shapes your entire policy: the underwriting path. As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr knows this choice is crucial. This guide demystifies the two main options: Moratorium and Full Medical Underwriting.
Key takeaways
- Full Medical Underwriting is like having a detailed survey done on a house before you buy it. You know every single issue upfront.
- Moratorium Underwriting is like buying a house with a standard clause that excludes any existing faults, but some might be fixed and covered later if they don't cause problems for a set period.
- Health Questionnaire: You will be required to fill out a detailed application form. This will ask specific questions about your health, lifestyle, and medical history, as well as that of your family. You must answer every question truthfully and completely.
- Information Gathering: You'll need to disclose any consultations, tests, treatments, or advice you have received for any condition in the past. Be prepared to recall dates and details.
- GP Report (Optional): In some cases, the insurer may ask for your consent to contact your GP for more information or to see your medical records. This helps them verify the information you've provided.
Choosing private medical insurance in the UK involves a key decision that shapes your entire policy: the underwriting path. As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr knows this choice is crucial. This guide demystifies the two main options: Moratorium and Full Medical Underwriting.
Contrast, scenarios, and real-life examples of choosing an underwriting path
Deciding between Moratorium and Full Medical Underwriting (FMU) is one of the most important steps when you take out a private health cover policy. It determines how the insurer assesses your medical history, what they will cover, and even how quickly your claims are processed.
Think of it like this:
- Full Medical Underwriting is like having a detailed survey done on a house before you buy it. You know every single issue upfront.
- Moratorium Underwriting is like buying a house with a standard clause that excludes any existing faults, but some might be fixed and covered later if they don't cause problems for a set period.
Throughout this guide, we'll explore real-life scenarios, provide clear comparisons, and give you the expert insights you need to choose the path that best protects your health and finances.
What is Underwriting in Private Medical Insurance?
Before we dive into the specifics, let's clarify what "underwriting" actually means. In simple terms, underwriting is the process an insurance company uses to evaluate risk. When you apply for private medical insurance (PMI), the insurer needs to understand your health status to work out the terms of your policy and the price of your premium.
The primary goal for the insurer is to assess the likelihood of you making a claim. This process is fundamental to how insurance works.
The Golden Rule of UK Private Medical Insurance
It is absolutely vital to understand a core principle of the UK PMI market:
Standard private medical insurance 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 (e.g., a joint replacement, cataract surgery, or hernia repair).
PMI does not typically cover pre-existing conditions (health issues you already had before taking out the policy) or chronic conditions. A chronic condition is a long-term health issue that needs ongoing management rather than a cure (e.g., diabetes, asthma, arthritis, or high blood pressure). Management for these conditions rightly remains the responsibility of our cherished NHS.
Understanding this distinction is key to having the right expectations for your private health cover.
Full Medical Underwriting (FMU) Explained
Full Medical Underwriting is a process where you provide the insurer with a comprehensive overview of your medical history at the point of application. It's the more traditional and detailed of the two main underwriting methods.
How Does FMU Work?
- Health Questionnaire: You will be required to fill out a detailed application form. This will ask specific questions about your health, lifestyle, and medical history, as well as that of your family. You must answer every question truthfully and completely.
- Information Gathering: You'll need to disclose any consultations, tests, treatments, or advice you have received for any condition in the past. Be prepared to recall dates and details.
- GP Report (Optional): In some cases, the insurer may ask for your consent to contact your GP for more information or to see your medical records. This helps them verify the information you've provided.
- Personalised Exclusions: Based on this information, the insurer will give you a definitive list of what is and what isn't covered from day one. These exclusions are tailored specifically to you and are usually permanent for the life of the policy.
Pros and Cons of Full Medical Underwriting
| Pros of FMU | Cons of FMU |
|---|---|
| ✅ Total Clarity: You know exactly where you stand from the start. No nasty surprises when you need to make a claim. | ❌ Time-Consuming: The application process can be long and requires significant effort to complete accurately. |
| ✅ Potentially Lower Premiums: If you are in good health with a clean medical history, FMU can often result in a cheaper policy because the insurer views you as a lower risk. | ❌ Intrusive: You have to disclose sensitive and personal medical information. |
| ✅ Faster Claims: Because all the investigative work is done upfront, the claims process is generally much quicker and smoother. | ❌ Permanent Exclusions: Any condition the insurer decides to exclude will almost certainly be excluded for good. |
Real-Life Example: When is FMU a Good Choice?
Meet Sarah, 32. Sarah is a fit and healthy marketing manager. She hasn't seen a doctor for anything other than a routine check-up in over a decade. She wants the peace of mind of knowing exactly what her policy covers and is keen to get the lowest possible premium.
Sarah chooses Full Medical Underwriting. She spends an hour filling out the health declaration, confirming she has no pre-existing conditions. The insurer approves her application quickly with no exclusions. Her claims process will be straightforward, and she benefits from a premium that is around 10% lower than an equivalent moratorium policy.
Moratorium Underwriting Explained
Moratorium underwriting is the most common type offered in the UK today. It's a much faster and less intrusive way to get private health cover, as you don't need to complete a medical questionnaire.
How Does a Moratorium Work?
Instead of asking you about your health history, a moratorium policy automatically excludes any medical conditions for which you have experienced symptoms, received treatment, or sought advice in the five years prior to your policy start date.
This exclusion isn't necessarily permanent. The "moratorium" is a waiting period. Here’s how it typically works for most insurers:
- The Look-Back Period: The insurer looks back 5 years from your policy start date.
- The Moratorium Period: You must then go for a continuous two-year period after your policy has started without having any symptoms, treatment, medication, or advice for that specific pre-existing condition.
- Coverage Begins: If you successfully complete this two-year clear period, that condition may become eligible for cover under the terms of your policy.
It's crucial to check the insurer's specific wording. Some policies use a "rolling moratorium," where seeking advice for a related condition can reset the two-year clock. A good PMI broker can help you understand these subtle but important differences.
Pros and Cons of Moratorium Underwriting
| Pros of Moratorium | Cons of Moratorium |
|---|---|
| ✅ Quick and Simple: You can often get cover in place the same day without filling out lengthy forms. | ❌ Lack of Certainty: You won't know for sure if a condition is covered until you make a claim. |
| ✅ Less Intrusive: You don't have to disclose your entire medical history upfront, preserving your privacy. | ❌ Slower Claims Process: The insurer will investigate your medical history at the point of claim, which can cause delays and added stress. |
| ✅ Potential Future Cover: It offers a pathway for some pre-existing conditions to become covered after the two-year moratorium. | ❌ Potentially Higher Premiums: The insurer is taking on an unknown risk, so premiums can sometimes be slightly higher than an equivalent FMU policy for a healthy person. |
Real-Life Example: When is Moratorium a Good Choice?
Meet David, 48. David is a self-employed builder. He tweaked his shoulder playing tennis about three years ago, had one physio session, and it hasn't bothered him since. He can't remember the exact dates and doesn't want the hassle of digging through his records.
David chooses a Moratorium policy. His shoulder issue is automatically excluded from day one. However, if his shoulder remains completely trouble-free for the first two years of his policy, he can then make a claim for it if a new problem arises. This gives him a quick start to his policy and a chance for future cover.
Direct Comparison: Moratorium vs Full Medical Underwriting
To help you decide, here is a head-to-head comparison of the two underwriting options.
| Feature | Moratorium Underwriting | Full Medical Underwriting (FMU) |
|---|---|---|
| Application Process | Very fast. No medical questionnaire. | Slow and detailed. Requires a full health declaration. |
| Upfront Certainty | Low. You only find out what's excluded when you claim. | High. You receive a clear list of exclusions from day one. |
| Premiums | Can be slightly higher to account for unknown risk. | Can be lower if you have a clean bill of health. |
| Claims Process | Slower. The insurer investigates your medical history at the time of claim. | Faster. Underwriting is already complete, so eligibility is clear. |
| Pre-existing Conditions | Automatically excluded for a set period. May become eligible for cover after a 2-year clear period. | Declared upfront and typically excluded permanently. |
| Privacy | High. No need to disclose medical history at the start. | Low. Requires full disclosure of sensitive health information. |
| Best For... | People who want a quick start, value privacy, or have minor, historic conditions they hope to cover later. | People in good health who want certainty and the lowest possible premium, or those with complex histories who need clarity on exclusions. |
Which Underwriting Path is Right for You? Key Scenarios
The best choice for you depends entirely on your personal circumstances, your health history, and what you value most in a policy.
Scenario 1: The Young and Healthy Professional
- Profile: 28 years old, no significant medical history, non-smoker.
- Priority: Lowest possible cost and absolute certainty about cover.
- Best Choice: Full Medical Underwriting (FMU). By proving their low-risk status, they can lock in a lower premium and enjoy the peace of mind that comes with zero ambiguity.
Scenario 2: The Person with a Minor, Past Injury
- Profile: 50 years old, sprained an ankle 4 years ago but has had no issues since.
- Priority: Simplicity and the potential for the old injury to be covered in the future.
- Best Choice: Moratorium. The application is hassle-free. The ankle is excluded initially, but after two years of the policy being active with no ankle-related issues, it could become eligible for cover.
Scenario 3: The Person with a More Complex Medical History
- Profile: 55 years old, had investigations for chest pains 18 months ago (which turned out to be muscular) and has a history of acid reflux.
- Priority: Clarity. They need to know what will happen if they have cardiac or digestive symptoms in the future.
- Best Choice: Full Medical Underwriting (FMU). A moratorium policy would create huge uncertainty. A claim for anything remotely related to these issues would trigger a lengthy investigation and likely be declined. With FMU, the insurer will state clearly that "any condition related to the heart or oesophagus" is excluded. While disappointing, this clarity is crucial for financial planning and managing expectations.
Scenario 4: Switching Insurance Providers
- Profile: 60 years old, has been with an insurer for 10 years on an FMU policy and now wants to find a better deal.
- Priority: Maintaining cover for conditions that have developed while insured.
- Best Choice: Continued Personal Medical Exclusions (CPME) underwriting. This is a third option available only when switching. It allows you to carry over your existing underwriting terms, ensuring no new exclusions are added for conditions that have arisen while you were covered by your previous policy. An expert PMI broker like WeCovr is invaluable for navigating a CPME switch, as it can be complex.
The Role of a PMI Broker in Navigating Underwriting
Choosing the right underwriting path and the best PMI provider can feel overwhelming. The definitions and rules can vary between insurers, and the long-term consequences of your choice are significant.
This is where an independent and FCA-authorised broker like WeCovr becomes your most valuable asset.
An expert broker provides:
- Personalised Advice: We take the time to understand your unique health history and priorities to recommend the best underwriting path for you.
- Market Comparison: We compare policies and prices from the UK's leading insurers, ensuring you get the best value.
- Application Support: We help you complete your application accurately, whether it's a detailed FMU form or navigating a switch.
- No Extra Cost: Our expert service is free to you. We are paid a commission by the insurer you choose, so you get impartial advice without any hidden fees.
With high customer satisfaction ratings, WeCovr is committed to making the process of securing private medical insurance UK clear, simple, and effective.
Beyond Underwriting: Building a Healthy Lifestyle
While insurance is there for when things go wrong, the best strategy is always to proactively manage your health. A healthy lifestyle not only improves your quality of life but can also help keep your insurance premiums more manageable over the long term.
- Balanced Diet: Aim for at least five portions of fruit and vegetables a day, limit processed foods, and stay well-hydrated. As a WeCovr client, you get complimentary access to CalorieHero, our AI-powered app to help you track your nutrition effortlessly.
- Regular Activity: The NHS recommends at least 150 minutes of moderate-intensity exercise (like brisk walking or cycling) or 75 minutes of vigorous-intensity exercise (like running or tennis) per week.
- Quality Sleep: Most adults need 7-9 hours of sleep per night for optimal physical and mental health. A consistent sleep schedule is key.
- Mental Wellbeing: Make time for activities that reduce stress, such as mindfulness, yoga, or spending time in nature. Many PMI policies now include access to mental health support services.
Furthermore, when you purchase a PMI or Life Insurance policy through WeCovr, you can also benefit from discounts on other types of essential cover, helping you protect your family's entire financial future.
Do I have to declare a minor illness from years ago on a Full Medical Underwriting form?
If a pre-existing condition becomes covered under my moratorium policy, will my premium increase?
What is the difference between a pre-existing condition and a chronic condition?
Find the Right Path for You
The choice between moratorium and full medical underwriting is personal. It’s a balance of speed versus certainty, and privacy versus potential cost savings. With NHS waiting lists for elective treatment in England remaining a concern for millions, securing the right private cover has never been more important.
Ready to explore your private medical insurance options? The expert team at WeCovr can provide a free, no-obligation comparison of the UK's leading insurers.
[Get Your Personalised Quote Today and Find the Perfect Cover for You]
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.
