Acute condition – A medical condition that is sudden in onset and generally short in duration. It will respond well to treatment and normally leads to a full recovery to the patients previous state of health.
Authorisation code – The code you are given when your treatment has been authorised by your insurer. You’ll need this when you go for your treatment, as the hospital use it for invoicing purposes.
Chronic Condition – Medical condition of long term duration. While treatment can alleviate symptoms it cannot provide a cure.
Claim – A request for payment on the terms of your insurance policy.
Claim form – A form your insurer may require you to fill in so a proper assessment of the claim can be carried out. The form will ask questions regarding your medical history and will need to be signed and stamped by a GP. Some GP’s can charge up to £25 for this service and this cost is non reimbursable by your insurer.
Company policies – Policies which are taken out on behalf of staff by an employer.
Day patient – A stay in hospital for a procedure or monitoring whereby you are given your own hospital bed, and require a period of supervised recovery, but do not stay in hospital overnight.
Excess – An amount payable in the event of a claim.
Exclusion – A medical condition which you cannot receive cover from under the policy.
FMU – Fully medically underwritten. A common type of underwriting in which you disclose your medical history on the application form.
FSA – Financial Services Authority. Regulator of all financial service providers in the UK.
Inception date – The date at which the policy becomes active. From this point onwards you are covered by the policy terms and can make a claim.
Individual policies – Policies taken out directly from an insurance company, usually for an individual or small family unit.
In patient – Refers to a hospital stay where you are kept in overnight.
Insurance broker – A third party agent who sells insurance policies.
MHD – Medical history disregarded. This is the best form of underwriting available as no conditions will be excluded based on your medical history. It’s the most expensive kind of insurance and with some insurers it is only available under company insurance schemes.
Mori – Insurance industry slang for moratorium. This is a kind of policy underwriting whereby your insurer will exclude conditions which you have had in a fixed period of time (usually 5 years) prior to the start of the policy. You will be able to claim for this condition in the future once you have undergone a period of time (usually 2 years) without any treatment, advice or medication. This is one of the most confusing and complicated kinds of underwriting, although it is also the cheapest. See the moratorium section for further information and some examples which will help you.
NCD – No claims discount. A pricing scheme whereby you are rewarded with money off your premium for each year you don’t claim. The maximum no claims discount is usually around 75%.
Non-disclosure – Failure to disclose a material fact, such as a medical condition, when taking out a fully medically underwritten insurance policy. If it later comes to light that your insurer was not informed, your policy will have to go through the underwriting process once again and this condition could be excluded from your cover.
Outpatient – A patient who comes into hospital for a consultation or treatment and goes home again straight after. No period of supervised recovery is needed.
Outpatient Limit – A maximum amount of benefit that is available for outpatient treatment. Once you exceed this limit no further outpatient treatment will be covered by your policy until the start of the next policy year.
PMI – Private medical insurance.
Policy – Your contract of insurance.
Premium – The price you will pay for your insurance policy. Can usually be paid annually or monthly.
Pre existing medical conditions – Medical conditions you had prior to taking out a medical insurance policy. These can be excluded from cover on certain kinds of underwriting. See underwriting section for further details.
Procedure code – Codes uses to identify specific medical treatments. Every medical treatment has a corresponding code and your insurer will need to know this. For example, AC100 is the code for a local anaesthetic.
Private ambulance – Vehicle used to transport a patient to a private hospital, only covered under your policy in limited circumstances such as hospital transfers.
Specialist – The medical professional who is in charge of your care, normally a doctor or consultant.
Underwriting – The process whereby your premiums will be calculated based on a risk assessment. In medical insurance there are 3 main types – fully medically underwritten, medical history disregarded and moratorium underwriting.
WOP – Without prejudice payment. Where your insurer gives you a discretionary payment for something that doesn’t normally fall within the scope of your policy. This usually occurs when you’ve been told incorrect or misleading information.
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