What Is Full Medical Underwriting Pros and Cons Explained
Choosing private medical insurance in the UK involves several key decisions. At WeCovr, an FCA-authorised broker that has helped arrange over 800,000 policies of all types, we believe the most crucial choice is your underwriting method. It dictates what your policy will and won't cover, setting the foundation for your healthcare journey.
Guide to FMU vs moratorium underwriting and which suits different applicants
When you apply for private health cover, the insurer needs to understand the level of risk they are taking on. This assessment process is called underwriting. In the UK, there are two main paths you can take: Full Medical Underwriting (FMU) or Moratorium (Mori) underwriting.
Think of it like this: FMU is like having a detailed, upfront conversation about your health, while Moratorium is more of a "wait and see" approach. Each has significant pros and cons, and the right one for you depends entirely on your personal circumstances, your medical history, and your tolerance for uncertainty. This guide will break down everything you need to know to make an informed choice.
What is Underwriting in Private Medical Insurance?
Before we dive into the specifics of FMU and Moratorium, it's vital to understand the fundamental purpose of underwriting and the core principles of UK private medical insurance (PMI).
Underwriting is the process an insurer uses to evaluate your application. They look at your age, lifestyle, and medical history to decide if they can offer you cover and on what terms. This includes setting your premium and, most importantly, deciding on any exclusions.
A Critical Point: Standard private medical insurance in the UK 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. Examples include joint replacements, cataract surgery, or treatment for a hernia.
- A pre-existing condition is any ailment, illness, or injury for which you have experienced symptoms, received medication, or sought advice from a medical professional before taking out the policy.
- A chronic condition is a long-term illness that cannot be cured but can be managed. Examples include diabetes, asthma, arthritis, and high blood pressure.
PMI does not cover the routine management of chronic conditions, which remains the responsibility of our cherished NHS. It also generally excludes pre-existing conditions, and the way these are excluded is the main difference between FMU and Moratorium underwriting.
Full Medical Underwriting (FMU) Explained in Detail
Full Medical Underwriting is the more traditional and thorough of the two methods. It involves a deep dive into your medical history right at the start of your application.
How Does FMU Work?
- The Health Questionnaire: You will be required to complete a comprehensive application form. This will ask detailed questions about your medical history and that of your family. You must be completely honest and disclose everything, from major surgeries to minor consultations.
- Disclosure is Key: You'll need to provide information on past illnesses, treatments, medications, diagnostic tests, and any symptoms you've experienced, even if they didn't lead to a formal diagnosis.
- Potential GP Report: With your explicit consent, the insurer may request access to your medical records from your GP to verify the information you've provided.
- The Decision: Based on this full picture, the insurer's underwriters will decide precisely what they will and will not cover. Any conditions or related ailments they decide to exclude will be written explicitly into your policy documents from day one. These exclusions are typically permanent.
The Pros of Full Medical Underwriting
- ✅ Absolute Clarity from Day One: The biggest advantage of FMU is certainty. You know exactly what is covered and what is excluded before you even pay your first premium. There are no grey areas or potential for nasty surprises when you need to make a claim.
- ✅ Potentially Faster Claims: Because all the medical vetting is done upfront, the claims process is often much smoother and quicker. The insurer already has your history and knows the claim isn't for a pre-existing condition they have excluded.
- ✅ Opportunity to Discuss Exclusions: In some cases, you may be able to discuss an exclusion with the insurer. For very old or minor conditions, they might agree to cover them from the start, which is not an option with a moratorium.
- ✅ Can Be Cheaper: Because the insurer has a precise understanding of the risk they are taking on, FMU policies can sometimes have lower premiums than their moratorium counterparts. The risk of the unknown is removed for the insurer.
The Cons of Full Medical Underwriting
- ❌ Lengthy and Intrusive Application: The process can be time-consuming. You need to recall your medical history accurately, which can be difficult. Some people also find the level of detail required to be invasive.
- ❌ Permanent Exclusions: Unlike a moratorium, the exclusions applied under FMU are usually for the life of the policy. There's no pathway for an old condition to become eligible for cover later on.
- ❌ The Risk of Forgetting: The requirement for full disclosure puts the onus on you. If you genuinely forget to declare a past consultation or symptom (accidental non-disclosure), an insurer could refuse a future claim or even void your policy.
- ❌ Can Exclude More: Because the underwriters are looking at your entire history, they may apply exclusions for conditions you had forgotten about or considered trivial.
Moratorium (Mori) Underwriting Explained in Detail
Moratorium underwriting is the most popular choice in the UK, favoured for its speed and simplicity. It operates on a "wait and see" basis rather than a detailed upfront investigation.
How Does Moratorium Work?
- Simple Application: You won't have to fill out a long medical questionnaire. The application process is typically much faster.
- The 5-Year Rule: The policy automatically excludes cover for any medical conditions for which you have had symptoms, treatment, medication, or sought advice in the 5 years leading up to the policy start date.
- The 2-Year Rolling Period: Here's the key part. If you join the policy and then go for a continuous 2-year period without needing any treatment, medication, or advice for that pre-existing condition (or any related condition), the exclusion is lifted. The condition may then become eligible for cover.
- The "Rolling" Nature: It's called a "rolling" moratorium because if you experience symptoms or seek advice for that condition during the 2-year waiting period, the clock resets, and a new 2-year symptom-free period must begin.
Real-Life Example: Imagine you had knee pain 3 years before starting a moratorium policy. For the first 2 years of your policy, any treatment related to your knee will be excluded.
- Scenario A: You go for 2 full years with no knee pain, no consultations, and no medication for it. After this 2-year anniversary, your knee becomes eligible for cover.
- Scenario B: After 18 months, you get a twinge in the same knee and visit a physiotherapist. This resets the clock. You would now need to go another 2 full years from that physio visit before the knee could be covered.
The Pros of Moratorium Underwriting
- ✅ Quick and Simple: The application process is fast and straightforward. You can often get cover in place the same day.
- ✅ Less Intrusive: You don't need to dredge up your entire medical past, which many people prefer.
- ✅ Path to Cover for Past Conditions: This is a major benefit. Moratorium offers the possibility for pre-existing conditions to become eligible for cover after the 2-year clear period, something FMU does not allow.
- ✅ No Risk of Accidental Non-Disclosure: As you aren't filling out a detailed health history, you can't be penalised for forgetting something.
The Cons of Moratorium Underwriting
- ❌ Lack of Certainty: The primary drawback is ambiguity. You don't know for sure if a condition will be covered until you make a claim. This can cause significant stress and anxiety just when you need support the most.
- ❌ Slower Claims Process: When you make a claim, the insurer's claims team will need to investigate your medical history to determine if the condition is new or pre-existing from the 5 years before your policy began. This can delay approval for treatment.
- ❌ The "Rolling" Moratorium Trap: The clock-resetting mechanism can be frustrating. A minor, related symptom can restart your 2-year wait, meaning conditions can remain excluded for many years.
- ❌ Can Be More Expensive: The uncertainty for the insurer can sometimes be factored into the premium, making it slightly more expensive than a comparable FMU policy where the risks are clearly defined.
Comparison Table: FMU vs. Moratorium Underwriting
To make the choice clearer, here is a direct comparison of the two underwriting methods.
| Feature | Full Medical Underwriting (FMU) | Moratorium (Mori) Underwriting |
|---|---|---|
| Application Process | Long and detailed medical questionnaire. Can be slow. | Quick and simple. No upfront medical questions. |
| Upfront Clarity | High. You know exactly what is excluded from day one. | Low. Uncertainty until a claim is made. |
| Claims Speed | Generally faster, as vetting is done upfront. | Can be slower due to medical history investigation at claim time. |
| Cover for Past Issues | No. Exclusions are typically permanent. | Yes. Possible to gain cover after a 2-year clear period. |
| Risk of Non-Disclosure | High. Forgetting to declare a condition can void the policy. | Low. No risk of forgetting as no history is declared. |
| Intrusiveness | High. Requires full disclosure of personal medical history. | Low. No need to share detailed medical history upfront. |
| Typical Applicant | Someone who values certainty above all and has a clear medical history. | Someone who wants quick cover or hopes an old issue may get covered in future. |
Who is Full Medical Underwriting (FMU) Best For?
FMU is not for everyone, but it is the perfect choice for certain individuals.
- The Meticulous Planner: If you are the kind of person who reads the fine print and hates surprises, FMU is for you. The peace of mind that comes from knowing your exact cover from day one is invaluable.
- Those with a Very Clear Medical History: If you are young, fit, and have had very few interactions with doctors, the FMU process will be straightforward and may result in a "clean" policy with no exclusions and a lower premium.
- Anyone with an Old, Resolved Medical Issue: If you had a condition over 5 years ago that is now fully resolved (e.g., a broken bone from a sports injury), declaring it on an FMU form allows the insurer to formally accept it. Under a moratorium, any related ache or pain in the future could be queried.
- People Switching Insurers with Existing Exclusions: If you are already on an FMU-style policy and want to switch providers, using a broker like WeCovr to arrange a "Continued Personal Medical Exclusions" (CPME) switch is essential. This is a form of FMU that carries your existing underwriting terms over to the new insurer, ensuring continuity of cover.
Who is Moratorium Underwriting Best For?
The popularity of moratorium underwriting is a testament to its convenience and flexibility.
- The Busy Professional: If you want cover sorted quickly without the hassle of paperwork and digging through medical records, a moratorium is the fastest route to getting a policy in place.
- Those with a Vague Medical History: If you can't recall the exact dates of consultations or aren't sure what a doctor noted down years ago, a moratorium removes the pressure and the risk of accidental non-disclosure.
- People Hoping to Cover a Past Condition: This is the key appeal for many. If you had a health issue 3 or 4 years ago and are optimistic you won't need care for it in the near future, the moratorium offers a clear pathway to getting it covered down the line.
- Most First-Time PMI Buyers: For the majority of people buying private medical insurance UK for the first time, a moratorium is the standard, default option due to its simplicity.
The Critical Role of a PMI Broker Like WeCovr
Choosing between FMU and a moratorium is a significant decision with long-term consequences. The definitions, rules, and insurer appetites can be complex. This is where an independent, expert PMI broker becomes your most valuable asset.
An expert broker like WeCovr provides impartial advice tailored to your unique situation at no extra cost to you. Our specialists understand the subtle differences between how top PMI providers like Bupa, AXA Health, and Vitality approach underwriting.
- We can advise if your specific medical history is better suited to an FMU application, potentially securing you better terms or a lower premium.
- We can navigate the market to find an insurer who may be more lenient towards a particular past condition.
- We handle the paperwork for complex switches, such as CPME, ensuring you don't lose valuable cover when changing providers.
- We enjoy high customer satisfaction ratings because we put our clients' needs first, explaining the pros and cons clearly so you can make a confident choice.
Trying to navigate this alone can lead to choosing the wrong underwriting type, resulting in disappointment at the point of claim.
Beyond Underwriting: Proactive Steps for a Healthier Life
While your insurance policy is a safety net, the best way to manage your health is to live a proactive, healthy lifestyle. This not only improves your quality of life but also reduces the likelihood of needing to claim. Many of the best PMI providers now include wellness benefits and rewards to encourage this.
Here are some tips supported by NHS guidelines:
- Balanced Nutrition: Aim for a balanced diet rich in fruit, vegetables, lean protein, and whole grains. Good nutrition is the foundation of health. As a WeCovr client, you get complimentary access to our AI-powered nutrition app, CalorieHero, to help you track your diet and make healthier choices.
- Regular Physical Activity: The NHS recommends at least 150 minutes of moderate-intensity activity (like brisk walking or cycling) or 75 minutes of vigorous-intensity activity (like running) a week. Regular exercise is proven to reduce the risk of major illnesses, such as heart disease, stroke, and type 2 diabetes.
- Prioritise Sleep: Aim for 7-9 hours of quality sleep per night. Sleep is crucial for physical recovery, mental health, and a strong immune system. Create a relaxing bedtime routine and a dark, quiet, and cool sleeping environment.
- Manage Stress: Chronic stress can negatively impact your health. Incorporate stress-management techniques into your day, such as mindfulness, meditation, yoga, or simply spending time in nature. Many PMI policies now offer access to mental health support lines and apps.
Purchasing PMI or Life Insurance through WeCovr can also unlock discounts on other types of cover, helping you protect your family's financial future in a more affordable way.
What happens if I forget to declare a condition on an FMU application?
Generally, if you accidentally forget to declare a past medical condition (known as non-disclosure), an insurer has the right to reject a future claim related to that condition. In more serious cases, especially if they believe the non-disclosure was deliberate, they could cancel your policy from the start, leaving you without cover. This is why absolute honesty and thoroughness are vital with FMU.
Can I get private health insurance for a chronic condition like diabetes or asthma?
No, standard UK private medical insurance is designed to cover acute conditions that can be resolved with treatment. It does not cover the day-to-day management, check-ups, or medication for long-term chronic conditions like diabetes, asthma, or high blood pressure. This care remains with the NHS. However, PMI may cover acute complications that arise from a chronic condition, depending on your policy terms.
Is full medical underwriting always cheaper than a moratorium?
Not always, but it often can be, especially for individuals with a clean bill of health. Because FMU gives the insurer a complete and certain view of the risk they are underwriting, they can often price it more competitively than a moratorium policy, where there is an element of the unknown. The best way to find out is to get quotes for both options, which a broker can easily do for you.
Your Next Step to a Secure Health Future
Choosing your underwriting method is the single most important decision you'll make when buying private health insurance. Full Medical Underwriting offers clarity and potentially lower costs at the expense of a detailed application and permanent exclusions. Moratorium offers speed, simplicity, and a chance to cover past conditions, but with an initial period of uncertainty.
The right choice is personal. It depends on your health, your history, and your priorities. Don't make the decision alone.
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
There is no need to wait until the renewal of your current policy.
We can look at a more suitable option mid-term!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
By tapping the button below, you can book a free call with them in less than 30 seconds right now:
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WeCovr is an insurance specialist for people valuing their peace of mind and a great service.👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.
Just a quick and simple form and an easy conversation with one of our experts and your valuable insurance policy is in place for that needed peace of mind!