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About Group Private Medical Insurance

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About PMI

Private medical insurance (PMI) is designed to treat curable medical conditions. Having private medical insurance allows you to have more choice - choice to decide when, where and who will provide your medical treatment. In most instances this will also mean no waiting lists, a private room and reduced risk of further infection.

Will premiums increase?

Medical insurance premiums are subject to medical inflation and also age related price increases. This simply means that the older you get the more expensive your insurance premiums will become, however there are a number of cost containment measures that can be explored; for example taking out an excess which is payable either at every claim or once per annum if necessary. An excess could reduce premiums by between 5-15%.

How are premiums paid?

Insurance premiums can be paid monthly or annually and most payment methods are accepted, however discounts can be achieved by opting to pay annually.

Underwriting methods

There a number of different underwriting methods that can be selected when applying for private medical insurance:

  • Moratorium
  • Fully Medically Underwritten
  • Switch

Moratorium

Any symptoms, conditions or medical treatment received in the last 5 years will automatically be excluded until there have been 2 clear years (from start date) of symptom, condition or treatment. This underwriting method simply involves signing the insurer-specific declaration but means you can be on cover immediately.

Fully Medically Underwritten

All symptoms, conditions and treatment received in the last 5 years need to documented on the application form. This is then assessed by an underwriter who will decide whether this will be covered going forward. If any medical conditions are excluded, they could be removed after 2 clear years providing there has been no additional symptom or treatment.

Switch

This involves transferring the underwriting on a current PMI policy over to a new insurer but on no worse terms. This means that the client will not be disadvantaged by doing so. In order to be able to "switch" to another insurer there will be a medical declaration which may ask questions about cancer, heart or psychiatric conditions. This is specific to each insurer and will differ.

What will be excluded?

Any medical condition or symptom suffered in the previous years will automatically be excluded plus:

  • AIDS / HIV
  • Self Harm
  • Alcoholism
  • Cosmetic Surgery
  • Chronic Conditions±

Please see policy specific wording for full list.

± Conditions that currently can not be cured only alleviated

No claims discounts (NCD)

A no claims discount simply limits the percentage amount that a premium can be increased if there is a claim made on the policy. If no claims are made then the premium will not reduce but will only encounter a smaller increase than if a claim were made.

Making a claim

All treatment needs to be pre-authorised by the insurer to ensure settlement in full. In all instances we would advise making contact with the insurer at the point of a referral from GP.

Find out how much peace of mind will cost you. Get an online quote for private group medical insurance.

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