What is Private Health Insurance?
Private Medical Insurance is
designed to allow you to receive treatment privately, avoiding
delays through the NHS in securing treatment for eligible medical
Private Medical Insurance (PMI) provides cover for acute,
treatable medical conditions.
Are there any conditions that are normally excluded on a medical
Yes. In general, most medical insurance plans do not cover the
- Normal pregnancy, drug abuse, infertility, GP fees, any medical
prescriptions, normal dentistry, alcohol abuse, self inflicted
injuries, AIDS, chronic long term illness such as diabetes or
asthma, cosmetic surgery or regular renal dialysis.
- Medical conditions suffered prior to joining a new plan are
known as pre-existing conditions. All plans for individuals and
their families exclude pre-existing conditions either permanently,
or for a given period of time.
How does the health insurance company decide what to exclude?
When you complete the application form for membership, you are
generally offered two alternative styles of what is called
"Underwriting"; in other words the means by which the company
reviews and accepts your application.
What is moratorium underwriting?
With moratorium underwriting, the health insurance company will
take on each individual covered by the plan, but will exclude any
medical condition where medical advice, medication, or treatment
has been sought in a given period, usually five years before
joining the plan.
Once the individual has been free of all medication, treatments,
consultations and symptoms for that condition, or any related
condition, for a given period after joining the plan, usually 2
years, they will automatically be covered for that condition.
There are some pre-existing conditions, such as heart problems,
cancer and psychiatric conditions that will never be covered by the
plan, as the member will have regular checkups and/or
What is full underwriting?
With Full Underwriting, a medical declaration is given by each
person to be covered by the medical insurance plan. This
information is then put before an underwriter, who will assess the
risk factors for each person. Normally, any previous serious
medical conditions, and possibly non-serious conditions, will be
permanently excluded from cover. In extreme cases, cover may be
Usually you are offered the choice of these two methods although
some medical insurance providers only offer Full Underwriting.
Regardless of underwriting styles, it is important that all
questions are answered in full as failure to disclose information
could invalidate the policy.
Do all the health insurance companies offer the same sort of benefits?
No, benefits do vary significantly from one health insurance
company to the next. Comparing policies is a little easier now
because all companies have to offer a benefits table laid out in
the same format.
In general terms there are two types of scheme:
- BUDGET PLANS, these cover inpatient and day case costs, but
won't cover outpatient consultations and tests. Some of them cover
limited outpatient costs if they relate in some way to inpatient
- COMPREHENSIVE PLANS, these cover outpatient costs as well as
inpatient costs, but check the benefit table carefully, sometimes
there are limits to the amount you can claim in any one year.
Benefit tables for the medical insurance plan or
plans recommended will be enclosed with your documents. If you have
any questions about them please call Chase Templeton Ltd. To obtain
insurance quote click here
Which health insurance policy is recommended for me?
The policy or policies suggested will depend on a number of
- Do you want a comprehensive private healthcare plan or are you
willing to pay for any outpatient costs yourself to reduce the
- What is your age, medical insurance plans are good value for
younger age groups but get very expensive as you get older.
- Where do you live? Some medical insurance plans are good value
in the provinces but more expensive the nearer you live to
- Do you have any specific requirements such as cover for
- Are there any specific hospitals you want the health insurance
company to include?
- Are you happy to have a voluntary excess on the plan to reduce
monthly premiums, or even pay a proportion of the claim yourself to
reduce premiums still further?
Taking into account the above, a health insurance
quote and Key Features documents of specific health insurance
plans should be included within your information pack; together
with comparison quotations of alternatives in ascending order of
premium. Your pack should also enclose a listing of the benefits of
all the comparable policies.
Do health insurance premiums increase in the future?
The answer in almost all cases is "Yes". A limited number of
health insurance plans are available with premiums that are fixed
for five or ten years, but these can be extremely expensive. All
the other health insurance providers review their premiums
regularly in light of claims experience, increasing them at your
annual renewal with a percentage known as medical inflation.
In addition with the exception of just three insurance companies
(Exeter Friendly Society, Norwich Union Medios and Permanent Health
Company) your medical insurance premiums increase as you get older.
Some health insurance companies offer a premium for each individual
age, others have a premium for what is called an age band, e.g.
between 30 and 34 or 35 to 39.
Medical costs are increasing in all western economies, each year
more and more people claim on their medical insurance and the
sophistication of treatments and diagnostic tests is increasing the
cost of claims.
What do I do if I have a complaint?
We aim to provide you with the highest standards of service. However, there may be occasions when our service falls short of your expectations. For more information on how to make a complaint please visit our complaints section.
To ensure your maximum protection our complaints process has been designed to meet the requirements of the Financial Services Authority and the Financial Ombudsman Service.
Can I change my mind when I read the policy documents?
Yes, the health insurance companies will not draw any money from
you for 14 days, if you decide not to proceed let us know within
that period. As long as you have not made a claim you can cancel
the policy without incurring any costs.
If you change your mind within 14 days but paid the first
premium by cheque, the sum paid will be refunded.
How do I pay my Medical Insurance premiums?
The most popular means of payment is a monthly direct debit,
although some people pay annually in advance by direct debit or
Some medical insurance companies do ask for the first month's
premium by cheque, if so you will be asked to enclose a cheque with
your application form. The cheque must always be made payable to
the medical insurance company, not Chase Templeton Ltd or the
introducer. Never make payments in cash.
Who looks after me in the future?
Chase Templeton Ltd will look after all the commercial aspects
of your Private Medical Insurance plan. We will usually be the ones
that send out renewal notifications. If you wish to add or remove
anyone on the plan let us know, if in the future you wish to change
an excess level, again let us know.
It is extremely important that you let us know if any
circumstances that affect your health insurance policy change in
For confidentiality if you need to make a claim this will be
done directly with the health insurance company. There will be a
card in the welcome pack with a Freephone or local rate number for
all claims enquiries.
So how do I go about making a claim?
All claims start when your GP considers that a medical condition
requires further investigation or treatment. If you are told by
your GP that you need to be referred, telephone the claims line
immediately, they will ask basic details and will usually send you
a claims form. Your GP will fill in one section, you the other.
Return it as quickly as possible to the health insurance company
who will then authorise treatment.
If you need any advice about the process call Chase Templeton
Ltd. It is only the health insurance company that can authorise a
claim but sometimes Chase Templeton can help.
If necessary, the approval process can be speeded up by using
fax, but if the treatment is of an urgent nature the approval
process can take place after the event. However for peace of mind
always try to get the claim pre-authorised.
Do you give my name and address to other companies?
We will hold some, or all of the information you give in
connection with your private medical insurance and it will be dealt
with by us and our agents to administer your plan(s). Personal
files are kept in a locked alarmed environment. If at any time you
wished to see a copy of your file, please let us know.
Chase Templeton Ltd is registered under data protection
legislation and any personal data will not be given to marketing
companies without your consent. Some information may be passed to
third parties by law, eg, your professional adviser, compliance
checks, health insurance providers, the FSA, Chase Templeton Ltd,
police, etc. We reserve the right to withhold copies of these
records if information pertaining to other parties would be