What is medical underwriting?
Find out what medical underwriting means along with how it affects you and your cover.
Key points:
- Medical underwriting looks at your previous medical history.
- There are two types – full medical and moratorium. These sound technical, but the differences are simple to understand.
- Underwriting helps insurers like Aviva work out how much you’ll pay for your cover, as well as what you’re covered for.
Most health insurance providers use a process called underwriting to work out which conditions they can cover you for. It also plays a part in the cost of your premiums. At Aviva, you can usually choose from two options - moratorium or full medical underwriting.
Transcript
Hi I'm Keith, part of the Clinical team here at Aviva and welcome to Health 101.
You know that bit when you're taking out health insurance and it asks you to pick an underwriting option, and you think… what does that even mean?
Well, yeah, let's talk about that.
Put simply, health insurance is designed to support you with new, acute conditions – that means short-term issues that come up unexpectedly, like an injury, a new diagnosis, or something that needs investigation.
Medical underwriting is just how we understand your health history before your cover begins.
And I know that might sound a bit formal, but really, it’s about avoiding those moments later on where you think, “Wait… am I actually covered for this?”
When we think about your health history, we’ll focus on pre-existing conditions, something you’ve dealt with before your policy starts.
That could be anything from seeing your GP about ongoing migraines, to having treatment for anxiety, or even getting advice about that dodgy knee that never quite healed properly.
Now, underwriting comes with options.
The first option you have is full medical underwriting.
This is where you tell us about your health upfront - usually through a questionnaire, and sometimes with a bit of input from your GP.
And I get it, that might feel a bit like, “Do I really need to go into all that?”
But the benefit is peace of mind. Because once it’s done, you’ll know exactly what’s covered and what isn’t, right from day one.
So, if you ever need to make a claim, there’s no back-and-forth or uncertainty. It’s already clear.
The second option is moratorium underwriting.
This one is a bit simpler at the start, you don’t need to go through your medical history when you apply. Instead, we check it if and when you make a claim.
Now, there’s one key thing to understand here.
If you’ve had a condition in the five years before your cover starts, it can become eligible for cover, but only after you’ve gone two continuous years without symptoms, treatment, advice, or medication for it.
So, for example, if you had back pain a few years ago but haven’t needed any help with it for a while, it may become covered over time.
So, which suits you better? With full medical underwriting, we've already got your health history, so if you need to make a claim, the process is straightforward. No paperwork to chase, no surprises. You know exactly what's covered from day one.
With moratorium, it's quicker to get started, but you will need to provide medical information if you make a claim.
There's no right or wrong. It just depends on whether you'd rather have everything clear upfront, or get covered quickly and deal with the detail later.
Because when it comes to your health, feeling supported and clear on what’s covered makes all the difference.
For more information, visit the Aviva website.
Types of medical underwriting
It's important to understand the different underwriting options and which one might be right for you. On one hand, you can choose to give us your medical history upfront. Alternatively, you can wait until you have to make a claim before going through the underwriting process.
Full medical underwriting
When you choose full medical underwriting, we’ll give you a form to fill in before you set up your policy. You’ll answer questions about your medical history, and based on your answers we might speak to your doctor to get more information. Once we have all the information we need, we’ll confirm the symptoms and conditions we can and can’t cover.
Moratorium underwriting
If you select moratorium underwriting, you don’t need to tell us about any pre-existing conditions up front. Instead, when you make a claim, we’ll look at your medical history to see if you’re covered. We might be able to cover a pre-existing condition after a continuous two-year period without medication, diagnostic tests, treatment or advice.
What is considered as a pre-existing condition?
If you're looking into health insurance, chances are you'll hear the word 'condition' a lot. It can mean exactly that - a health condition, diagnosed or not - an illness, injury or a symptom.
Usually health insurers don't cover pre-existing conditions because health insurance is meant for new and unexpected medical conditions.
A pre-existing condition can be any disease, illness or injury for which you have either:
- received medication, advice, or treatment
- experienced symptoms
whether the condition has been diagnosed or not, before your health insurance policy begins.
Please be aware, with this in mind, long-term conditions and congenital conditions have a greater chance of being a pre-existing condition.
How does medical underwriting work?
The process depends on the type of underwriting you have on your policy. For moratorium underwriting, we'll assess your medical history when you make a claim. For full medical underwriting, the process usually involves three stages:
Application
You give us details like your age, job, lifestyle as well as your medical history and family medical history.
Assessment
We assess your application by looking at your medical history and the likelihood of future claims based on the information you’ve given us.
Decision
We tell you what we can cover you for and how much you’ll pay. In some cases, we might have to decline your application.
How does medical underwriting affect your health insurance?
Underwriting works out what conditions will or won’t be covered for under your policy.
With full medical underwriting, you’re covered if you develop a new medical condition during the time you’re covered. It doesn’t generally cover pre-existing conditions which might need ongoing treatment, monitoring, or medication, or could lead to future claims.
When you choose full medical underwriting, we’ll review any medical conditions you’ve had and assess whether they’re likely to need further treatment or lead to future claims. We may not cover a condition if it's an ongoing concern.
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