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Medical underwriting for businesses can be confusing. We explain the four types of medical underwriting, how they work, and the best fit for your business.
Lee Doran
Underwriting Manager
Understanding underwriting for businesses can be complex, but choosing the right approach is essential for securing the best coverage for your employees. We break down the four types of underwriting, how each one works, and which option may be the best choice for your business.
When you receive a group health insurance offer, it will include a clear explanation of the underwriting method applied, ensuring transparency in how coverage is determined for your employees.
Underwriting is the process of evaluating an application for health insurance coverage by examining the applicant’s medical history. Premium rates, coverage limits and exclusions are determined by the risk factors of the applicant/s.
After applicants complete a health questionnaire, we will then advise them in writing about any endorsements which may be applied to the group members cover. Pre-existing medical conditions would not be covered unless they have been declared to our underwriters within the application form and the underwriters have agreed to proceed without adding any exclusions or terms to the cover.
If you choose this option, group members who do have pre-existing medical conditions will know right from the start exactly which medical conditions will be excluded from cover.
Your William Russell policy will be shaped around the requirements of your business and will clearly state any exclusions that apply.
Pre-existing medical conditions which have required treatment, medication or advice, or for which the applicant has suffered symptoms (whether or not they have received a diagnosis) during the 24-month period preceding the commencement of the plan will not be covered.
With Mori applications, the group member doesn’t need to answer any medical questions. At the point of claim, additional information may be requested in order for the claims team to assess whether the condition is pre-existing or not.
After a continuous 24-month period we may consider claims for pre-existing conditions provided the group member has been symptom, treatment, medication and advice free during that period. Long-term and serious medical conditions which are likely to continue to need regular or periodic treatment, testing, medication and/or medical advice, are unlikely to be covered by a moratorium policy.
This type of underwriting means your policy may include cover for conditions that group members have suffered from in the past—after two years with no symptoms, medical advice or treatment.
If you already have a corporate health plan in place which is on a fully underwritten, or moratorium basis, we can quote to provide cover in respect of your existing employees and their dependents on the same underwriting terms agreed by your previous insurer.
This means that we will honour the medical acceptance terms issued by your current insurer, and any personal medical exclusions applied by your existing insurer will be continued on your policy with us.
All existing employees will keep the start date of their existing policy for the purpose of any moratorium periods or waiting periods, meaning they would not need to re-qualify for benefits that are already available to them.
Please note that this continuation applies only to the underwriting terms at which each person has been accepted into your current insurer’s plan and will be subject to acceptance.
The actual benefits, terms and conditions of our policy will replace those of your existing insurer. Future new employees and new dependants will be added to your policy on a Moratorium or Fully Underwritten basis.
In order to set up cover on continuous terms, we will require copies of the current Group Certificate of Insurance, copies of each employee’s certificate and a copy of the existing benefit table for the group.
Your William Russell plan will be one that closely resembles your existing plan from your current provider, giving you the same, or very similar, cover and terms—without requiring your employees to re-qualify for any benefits they already have or applying new terms to them just because the insurance provider has changed.
Underwriting terms can make a big difference to your cover. If you require cover for pre-existing medical conditions and have 10 or more employees on the scheme, we can also consider offering cover with Medical History Disregarded (MHD). Subject to disclosures and acceptance by the underwriters, MHD can provide cover for all pre-existing conditions—including chronic conditions.
MHD underwriting is a good option for larger groups of employees to simplify the on-boarding process and paperwork. It is a good option to ensure all members are covered regardless of their medical background. The claims process experience is also generally quicker with MHD.
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We show the benefits on this webpage in US dollars, but we can also denominate your policy in pounds sterling or Euros. You won’t find complete information for our plans on this webpage, nor the full T&Cs, limitations, and exclusions that would apply if you purchase group health insurance. You can find complete information in the plan agreement, which we suggest you read together with this webpage. We work hard to ensure the information we provide on this webpage is accurate and up-to-date, but inaccuracies are possible. We rectify errors as soon as we become aware of them. The T&Cs that apply to your policy are those found in your plan agreement.
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