
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr is dedicated to demystifying the world of private medical insurance in the UK. This article explores the significant new regulations poised to reshape the industry, ensuring you have the clearest possible picture of your rights and options.
The UK's private medical insurance (PMI) landscape is on the cusp of a major transformation. The introduction of the landmark Data (Use and Access) Act 2025 is set to redefine the relationship between you and your insurer. This new legislation places unprecedented control over personal health data back into the hands of the consumer.
For years, the process of applying for health cover involved complex forms and uncertainty about how your personal information was being used to calculate your premium. This new Act, effective from mid-2025, aims to make that process fairer, more transparent, and more secure for everyone. It directly impacts how insurers underwrite policies, protect your data, and uphold your rights.
In this comprehensive guide, we'll break down exactly what the Data (Use and Access) Act 2025 means for you, your policy, and the future of private health cover in the UK.
Think of the Data (Use and Access) Act 2025—often shortened to the 'Data Act'—as a specialised and powerful extension of existing data protection rules like GDPR, but built specifically for the health and insurance sectors. Its primary goal is to empower individuals by giving them clear rights and control over how their sensitive health information is collected, used, and shared.
The government's aim, supported by regulatory bodies like the Financial Conduct Authority (FCA), is to build consumer trust and encourage fairer competition within the market. According to recent FCA reports, consumer confidence is paramount for a healthy insurance market, and this Act is the most significant step in a decade to bolster that confidence.
The Act is built on four key pillars:
Underwriting is the process an insurer uses to assess your health and risk factors to decide whether to offer you cover and at what price. The Data Act 2025 brings profound changes to this fundamental process.
First, it’s vital to remember a core principle of private medical insurance in the UK: PMI is designed to cover acute conditions that arise after your policy begins. It does not cover pre-existing conditions (illnesses you already have or have had) or chronic conditions (long-term illnesses like diabetes or asthma that require ongoing management).
The new regulations primarily affect how insurers can assess your risk for future acute conditions.
Previously, underwriting could feel like a black box. The new Act forces transparency. Insurers must now be explicit about the data points they use. For example, they can no longer use non-health-related data, such as your social media activity or retail spending habits, to infer health risks.
Here’s a comparison of the old versus the new rules:
| Data Aspect | Old Rules (Pre-2025) | New Rules under the Data Act 2025 |
|---|---|---|
| Consent | Often bundled into a single "I agree" checkbox. | Granular consent required for each data category (e.g., GP report, wearable data). |
| Data Sources | Could be broad, sometimes including data from third-party brokers without clear disclosure. | Strictly limited to relevant health and lifestyle data, which must be explicitly declared. |
| Genetic Data | A grey area, with a voluntary moratorium. | An explicit ban on using predictive genetic test results for underwriting PMI. |
| Wearable Data | Used inconsistently, often without clear rules on interpretation. | Can only be used with explicit consent and for offering discounts/rewards, not for penalising members. |
| Transparency | Insurers did not have to disclose the exact weighting of factors in premium calculation. | Insurers must provide a clear summary of how your premium was calculated if you request it. |
What this means for your premium: Initially, some experts predict a slight turbulence in pricing as insurers adapt their models. However, the long-term outlook is positive. By focusing on relevant, consented data, premiums are expected to become fairer and more accurately reflect an individual's health profile. It also paves the way for more dynamic pricing, where you can earn discounts for actively managing your health.
The Data Act 2025 is, at its heart, a consumer rights bill. It equips you with powerful new tools to manage your health insurance and your personal data.
If you're ever confused about why your premium is a certain amount or why a decision was made on your application, you now have the right to ask for and receive a clear explanation. Insurers can no longer hide behind complex algorithms or "commercial sensitivity."
This is perhaps the most impactful change for consumers. Historically, switching PMI providers was cumbersome. You had to re-submit your entire medical history, and the new insurer would start their underwriting process from scratch.
Example in action: Let's say David has been with Insurer A for five years. He's seen his premium rise and wants to see if he can get a better deal.
If you find an error in the data your insurer holds about you, you have a strengthened right to have it corrected promptly. You also have a "right to be forgotten," meaning you can request that an insurer delete your personal data once it's no longer needed for the original purpose for which it was collected (though insurers are required to hold some data for regulatory reasons for a set period).
The new regulations aren't designed to stifle innovation; they're designed to guide it. The Act provides a clear ethical framework for how insurers can use technology like Artificial Intelligence (AI) and data from wearable devices (e.g., Apple Watch, Fitbit, Garmin).
The key principle is empowerment, not punishment.
This move towards proactive wellness is a positive shift for the industry. To support our clients in this new era, WeCovr provides every health and life insurance customer with complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero. It’s a tool that empowers you to manage your own health data for your own benefit.
| Technology Use Case | Permitted under Data Act 2025? | Conditions |
|---|---|---|
| Premium discounts for daily step counts | Yes | Must have explicit, opt-in consent. Data cannot be used to penalise. |
| Using AI to scan GP reports for underwriting | Yes | The process must be transparent, and the customer has a right to an explanation. |
| Denying a claim based on GPS location data | No | Considered intrusive and not directly relevant to the medical condition being claimed for. |
| Using predictive genetic data to set premiums | No | Explicitly forbidden to prevent genetic discrimination. |
While the Data Act focuses on data, it supports a much larger trend in private medical insurance: the shift from reactive treatment to proactive wellbeing. With the NHS facing record waiting lists (the elective care waiting list in England stood at over 7.5 million in late 2024, according to NHS England data), more people are looking to PMI not just for peace of mind, but as a tool to stay healthy.
Here are some practical tips to align with this new wellness-focused approach:
By taking proactive steps to manage your health, you not only improve your quality of life but also position yourself to take full advantage of the wellness rewards and discounts that the best PMI providers now offer.
Navigating the nuances of the new regulatory landscape can be complex. The market is changing, and while these changes are overwhelmingly positive for consumers, they also mean that policies are becoming more varied and sophisticated.
This is where an independent, expert PMI broker becomes more valuable than ever. A broker's job is to understand the entire market and how these new rules affect the offerings from different insurers like Bupa, AXA Health, Aviva, and Vitality.
Working with an FCA-authorised broker like WeCovr provides several key advantages:
The Data Act 2025 is ushering in an era of transparency and empowerment. It's the perfect time to review your private medical insurance needs and ensure you have the right cover for you and your family.
The world of UK health insurance is evolving for the better. Take control of your health and your cover today.
Get a free, no-obligation quote from WeCovr and let our experts help you find the perfect private medical insurance policy for the new era.






