What is underwriting?

Find out what underwriting is and what options are available on joining.

When you apply for health insurance with WPA, as part of the application process you may need to answer questions about you and anyone else you wish to be covered. WPA will consider any answers and determine the risk being presented to us. The application will guide you through the information we require, as this differs depending on the underwriting term selected and whether you are joining a family policy or company scheme. We will then decide whether we are able to offer insurance terms and upon what basis. This process is known as underwriting.

Pre-existing conditions

We define a pre-existing condition as any disease, illness or injury for which:

  • You have received medication, advice or treatment; or
  • You have experienced symptoms, whether the condition has been diagnosed or not, before the start of your cover.

When we refer to condition(s), the term also includes any related condition(s) and any undiagnosed symptom(s). A related condition is where a current UK body of reasonable medical opinion considers another symptom, disease, illness or injury to be related to or associated with a condition.

Underwriting options if you are new to health insurance

There are usually two different types of underwriting available if you are taking out health insurance for the first time:

Moratorium Underwriting;

Full Medical Underwriting;

The type of underwriting you choose will depend on how much information you want to provide on joining.

Please see below for more details on each option.

Moratorium (Mori) Underwriting

Would you prefer to provide basic information until you need to make a claim? With Moratorium Underwriting you do not have to provide full medical history details on your application; however, we may request more detailed information from your GP (or the GP of any family member(s)) when making a claim.

Pre-existing conditions

Benefit will not be provided for at least two years, for any pre-existing condition(s) that occurred in the five years before your membership starts.

If you do not have any symptoms, treatment, medication or advice for pre-existing conditions for two continuous years after your membership starts, then benefit for these pre-existing conditions may be provided under the terms of your chosen product.

Five years before joining

Any condition in the five years
before joining is excluded.

Join WPA

Your WPA membership commences.

Free of previous condition(s)

No symptoms, treatment,
medication or advice.

+ Two years after joining

Benefit will start after a clear two year
period.

Benefit is not provided for pre-existing long term medical conditions (and related conditions) which are likely to require regular or periodic treatment, medication or advice. This is because the moratorium period starts each time you receive such treatment, so it’s unlikely you’ll ever have two consecutive years free of symptoms and/or treatment.

Example pre-existing long term conditions include:
  • Diabetes;
  • Fibromyalgia;
  • Multiple sclerosis;
  • Uncontrolled hypertension.

Please note, the above list is not exhaustive.

Full Medical Underwriting (FMU)

Would you prefer to have certainty and clarity when you join of any conditions which may not be covered? With FMU you will be asked a number of questions to help us to understand your medical, lifestyle and family history. We rely on you providing us with full and accurate details.

It is essential that you give us all the information we ask for, even if you have symptoms that have not been diagnosed. If you are unsure whether you should mention a condition or symptom, (including those undiagnosed) please contact us.

We will review your application and decide the basis on which we can offer you insurance.

Although FMU underwriting involves more of your time when completing the application, it means that when you receive your documentation you will have certainty and clarity of what condition(s) and symptom(s) will or will not be covered.

Pre-existing conditions

Our underwriters review the information you provide and, for example, determine whether you have a greater than average risk of requiring treatment for any condition. Such conditions have underwriting terms applied to them, which we refer to as your personal exclusions. These personal exclusions are recorded on your Certificate of Insurance.

Underwriting options if you are already insured.

There are usually two ways to switch cover depending on your underwriting with your current insurer:

Continued Moratorium; or

Continued Personal Medical Exclusions (CPME)

There must be no break in cover between your existing insurance and the start date of your WPA membership. If you transfer from another health insurer, only your underwriting terms transfer. WPA terms & conditions will apply and these may be different to your previous cover.

Please see below for more details on each option.

Continued Moratorium

If you were previously underwritten on a moratorium basis you may be able to join WPA on a Continued Moratorium basis and keep the underwriting dates of your existing moratorium. This option is not available for existing insurance that is on a ‘Fixed Moratorium’. Please contact us if you are unsure if you meet our criteria.

With Continued Moratorium you do not have to provide full medical history details on application; however, we may request more detailed information from your GP or the GP of any family member(s) for each new condition claimed for.

Pre-existing conditions

Your previous moratorium period will apply to your new membership with us. This means that you will not be able to claim for any conditions that existed before your initial moratorium underwriting date with your previous insurer, unless you have satisfied their ‘symptom, treatment, medication and advice free’ moratorium period as shown on your previous insurer’s Certificate of Insurance (or equivalent).

It may be necessary to ask some further medical questions and subsequently apply additional personal exclusions. We will let you know in advance if any new personal exclusions apply.

Benefit is not provided for pre-existing long term medical conditions (and related conditions) which are likely to require regular or periodic treatment, medication or advice. This is because the moratorium symptom-free period starts each time you receive such treatment, so it’s unlikely you’ll ever have the required years free of symptoms and/or treatment.

Example pre-existing long term conditions include:
  • Diabetes;
  • Fibromyalgia;
  • Multiple sclerosis;
  • Uncontrolled hypertension.

Please note, the above list is not exhaustive.

Continued Personal Medical Exclusions (CPME)

If you have previously undergone Full Medical Underwriting you may be able to join WPA on a CPME basis and keep your original underwriting date.

You are not required to have been fully medically underwritten with your last insurer, as long as there has been no break in insurance cover from the time you initially underwent Full Medical Underwriting.

Pre-existing conditions

We will transfer any existing personal exclusions from your current insurer and occasionally it may be necessary to ask some further medical questions and subsequently apply additional personal exclusions. We will let you know in advance if any new personal exclusions apply.

Are there any other options?

Medical History Disregarded (MHD)

If you are new to health insurance or switching from another health insurer, some of our larger company health insurance schemes may offer Medical History Disregarded (MHD) underwriting.

Depending on the size of the scheme and a number of other factors, you could join a WPA large company scheme without declaring any medical history. This means that no medical underwriting is completed for the scheme members and pre-existing conditions would be covered within the terms & conditions and benefit limits.

We can also offer MHD with heart and cancer qualifying questions as an alternative underwriting option.

WPA underwriting explained

The following videos have been created to help you understand Moratorium (Mori) and Full Medical Underwriting (FMU) when joining WPA without any previous health insurance and Continued Moratorium and Continued Personal Medical Exclusions (CPME) options when switching from your current provider to WPA. The examples given in these videos are based on individual/family underwriting and may differ slightly for company schemes.

WPA Underwriting: Moratorium and Full Medical Underwriting explained

WPA Underwriting: Continued Moratorium and Continued Personal Medical Exclusions (CPME) explained

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