Health insurance

FAQs

Q. 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 conditions.

Private Medical Insurance (PMI) provides cover for acute, treatable medical conditions.

Are there any conditions that are normally excluded on a medical insurance plan?
Yes. In general, most medical insurance plans do not cover the following:

• 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.

Q. 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.

Q. 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 medication.

Q. 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 refused.

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.

Q. 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 procedures.
• 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 a health insurance quote click here

Q. Which health insurance policy is recommended for me?

The policy or policies suggested will depend on a number of factors:

• Do you want a comprehensive private healthcare plan or are you willing to pay for any outpatient costs yourself to reduce the monthly premiums?
• 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 London.
• Do you have any specific requirements such as cover for complementary therapies?
• 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.

Q. 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.

Q. 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.

Q. 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.

Q. 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 cheque.

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.

Q. 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 the future.

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.

Q. 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.

Q. 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 disclosed.