Moratorium underwriting is popular with insurers, but widely misunderstood by policyholders. It’s the most complicated kind of underwriting, as the conditions and symptoms you can claim for change over time.
Treatment for pre-existing conditions that policyholders have suffered with in the past 5 years before taking out the policy, are automatically excluded. You can claim for them once a two year clear period has elapsed from the start of the policy without you obtaining any advice, treatment or taking any medication.
How does it work?
Yes, I know what you’re thinking, that’s quite a mouthful, and unless you’ve received formal insurance training it can be hard to understand. To try and help I’ll break down the definition so it makes more sense, and give you some examples of how it would be applied in practice by your insurer.
Key Points
Only pre-existing conditions can ever be excluded from cover. Nothing that develops after the policy starts will ever be excluded, regardless of how long it lasts.
- Advice refers to when you speak to your GP, this will be documented on your medical records so your insurer will be able to identify if you’ve received any by requesting a claim form be filled in by your GP.
Treatment is medical care you receive for an illness or injury.
Medication doesn’t just refer to prescriptions, it can mean any kind of over the counter medication, such as paracetamol. Although these won’t be documented on your medical record, your insurer will ask you questions to try and establish if you’ve self-medicated, and if you have then they could use this information to deny you cover.
For example, imagine you started a policy in 2010 with a pre existing condition for lower back pain. You were managing the condition yourself with the help of over the counter paracetamol until 2013, when you pulled your lower back and wanted to claim on the policy. Your insurer won’t cover you as you’ve been taking medication, but if you hadn’t been taking the medication you would have had over a 2 year clear period, and so would be eligible to make a claim.
The two year clear period has to be continuous.
For example, imagine your policy started in 2010 and you had pre-existing high blood pressure. If you went from the start of your policy for a year without any symptoms, but and then you went to your GP and were prescribed blood pressure medication, the clock would effectively reset until you finished taking the medication. At this point the countdown for a 2 year clear period would begin again.
Is moratorium underwriting right for you?
Advantages
Easy to apply for – You can complete an application on-line with most major insurers. You won’t have to waste time filling in any long and complicated forms about your medical history, so applying is easy and hassle free.
Cheapest type of policy – If you’re on a budget a moratorium policy could be ideal as it offers the lowest premiums.
Accessible – Moratorium underwriting is widely available from all major private medical insurance companies. You can purchase this policy as an individual, or through a company scheme.
Ideal if little medical history – If you’ve got no history of serious medical problems then a moratorium can be ideal. You’ll have both the luxury of saving money on your premiums, and the peace of mind that you’ll be covered for any new conditions or symptoms you may experience.
Disadvantages
Complicated – Moratorium policies aren’t the easiest to understand so it can take some working out whether you’ll be able to claim or not.
Claim forms – If you’ve recently taken out a moratorium policy then when you make a claim the chances are you’ll need to fill in a claim form. You’ll need to take this to the GP and send it back to your insurer to process. Delays with claims can be stressful. Although your insurer will advice you can proceed at your own financial risk while the form is being assessed, due to the cost involved many people prefer to wait.
Dissatisfaction – No other aspect of medical insurance brings about quite as many complaints as moratorium underwriting. This usually stems from people who haven’t understood the policy correctly, and falsely believe they’ll be covered for pre-existing conditions. However, due to the complexity of this kind of underwriting even the most savvy policyholders can be caught off guard sometimes, and there’s nothing more maddening that believing wholeheartedly you’ll be covered only to find out you’re not.
Moratorium insurance may save you money, but it’s not the right option for everyone. Think carefully about your circumstances, and whether you’d prefer to know upfront if a condition is to be excluded from your policy or not.
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