Medical history disregarded underwriting explained
Medical history disregarded, usually shortened to MHD, is the most generous type of underwriting in UK private medical insurance. The insurer covers eligible claims regardless of an employee's past health, including pre-existing conditions. It is only available on company schemes, and it is one of the strongest reasons to offer business health insurance.
What does medical history disregarded mean?
Every private health insurance plan has to decide how to treat conditions you already have. That decision is called underwriting. With medical history disregarded underwriting, the insurer agrees to ignore each member's medical history when they join the scheme. There are no medical questions, no GP reports and no exclusions for health conditions you had before the policy started.
In practice, medical history disregarded means an employee with a bad back, a history of knee problems or a previous cancer can be covered for eligible treatment from day one, subject to the terms of the policy. The underwriting effectively ignores the past, so you know exactly what's covered for every member of the company scheme.
How does MHD underwriting work?
With MHD underwriting, the insurer prices the scheme on the group as a whole rather than on each person's health status. When employees join, they simply give their name and date of birth. The insurer does not ask for a full medical history upfront and does not apply a moratorium.
When a member needs to make a claim, they see their GP, get an open referral and call the insurer. The claims process is the same as any private medical insurance policy, except the insurer will not decline the claim because the medical condition started before the member joined. Standard policy exclusions still apply, which is covered below.
Because the insurer is taking on more risk, the cost of your premiums is usually higher than for the same cover on moratorium underwriting. Claims experience also has a bigger effect on renewal prices.
Does medical history disregarded cover all pre-existing conditions?
It covers pre-existing medical conditions in the sense that past illness does not create an exclusion. It does not change what private medical insurance is designed to cover. That means:
- Acute conditions, meaning illnesses or injuries that respond quickly to treatment, are covered even if they are a pre-existing condition.
- Chronic conditions such as diabetes, asthma or high blood pressure are generally not covered for ongoing management on any type of underwriting, including MHD. Some insurers cover an acute flare-up of a chronic condition.
- Standard exclusions such as normal pregnancy, cosmetic surgery, emergency care and treatment available via the NHS for accident and emergency still apply.
MHD removes medical exclusions based on your health history, but not the general policy exclusions that apply to everyone.
What are the types of medical underwriting?
UK health insurance providers use four main types of underwriting. The type of underwriting you choose affects price, cover and how simple it is to make a claim.
Moratorium underwriting
No medical questions are asked when you join. Instead, any condition you had symptoms, treatment or advice for in the five years before joining is excluded. That exclusion can be lifted if you then go two continuous years without symptoms, treatment or advice for that related condition. Quick to set up, but claims can be slower because the insurer checks your medical history at the point of claim.
Full medical underwriting
Each person completes a health questionnaire when they apply. The insurer lists any specific medical exclusions on the policy. You know exactly what's covered from the start, but pre-existing health conditions will normally be excluded, often permanently.
Continued personal medical exclusions
Known as CPME, used when you switch to a new insurer. The new health insurer carries over the same terms and exclusions you had before, so you do not lose cover you had built up. The same approach on a moratorium basis is called a continued moratorium.
Medical history disregarded
No questions and no exclusions for past health. The broadest cover and the easiest claims, but only for group health insurance and at a higher premium.
Is medical history disregarded available for individual policies?
No. MHD is a group-only underwriting option. Insurers offer it because the risk is spread across a workforce. It is not available on individual health insurance policies.
Historically, many insurers would only offer MHD terms to schemes with 20 employees or more. Today, several insurers such as AXA, Bupa, Aviva, Vitality and WPA will offer MHD to smaller businesses, sometimes from as few as two or five members, although terms vary and some apply limits. Larger schemes usually get the best MHD terms.
Could your business get MHD terms?
Check with our PMI teamWhat are the benefits and drawbacks of MHD?
Benefits
- Employees with pre-existing medical conditions get covered, which is where employee benefits make the biggest difference.
- No health questionnaires, so joining is fast and private.
- Simpler claims, with no moratorium checks at the point of claim.
- A strong recruitment and retention tool, especially for older or experienced staff.
Drawbacks
- Higher premiums than moratorium or full medical underwriting.
- Renewal prices react more to claims, particularly on smaller schemes.
- If an employee leaves and buys their own policy, they will normally lose MHD terms.
- Insurers may apply a waiting period or refuse MHD to very small schemes.
Can you switch to medical history disregarded underwriting?
Yes. A business can move an existing scheme from moratorium or full medical underwriting to MHD, either at renewal with the same insurer or when it switches to a new insurer. Whether you become eligible depends on the size of the scheme, claims history and the insurer. We check the MHD market for you as part of every switching health insurance review.
Moratorium scheme
Past five years of conditions excluded until two clear years pass. Claims checked against medical records.
MHD scheme
Past health ignored from day one. Claims assessed on the treatment needed, not on history.
How far back is a pre-existing condition?
On moratorium underwriting, a pre-existing condition is usually anything you had symptoms, medication, tests or advice for in the five years before joining. On full medical underwriting, the health questionnaire usually asks about the past five years too. On MHD, the look-back period does not matter, because the insurer takes no medical history into account.
Do insurance companies always check medical records?
Not always. Life insurance companies and full medical underwriting health insurers rely mainly on your answers to medical questions, and may ask your GP for a report, with your consent, if something needs clarifying. Moratorium insurers check your records when you need to make a claim. Travel insurers usually ask about the last two to five years. Under MHD, the health insurer does not check records for past conditions at all, although it will still need medical evidence of the condition being claimed for.
If you do not declare a condition when asked, the insurer can reduce or refuse a claim, or cancel the policy. Always answer medical questions fully.
Am I better off with no insurance?
The NHS provides excellent emergency and long-term care, and nobody needs private medical insurance. What it buys is speed and choice: faster diagnosis, a choice of consultant and hospital, and treatment at a time that suits you. For a business, company health insurance on MHD terms gets people back to work sooner, which is often worth more than the premium.
Medical history disregarded: quick answers
Is MHD more expensive?
Usually, yes. Expect a higher premium than moratorium underwriting for the same cover.
Does MHD cover mental health?
If the plan includes mental health cover, MHD means a past mental health condition will not be excluded.
Can my family be covered on MHD?
Many insurers extend MHD to family members added to a company scheme.
Does MHD apply to new joiners?
On most company schemes, yes. Employees who join the business after the scheme starts are usually added on the same MHD terms, provided they join within the eligibility window the insurer sets. Staff who opt in late, after that window has closed, may be underwritten on a moratorium basis instead, so it pays to enrol new starters promptly.
What happens to MHD terms if the scheme gets smaller?
Insurers set a minimum number of members for MHD terms. If headcount falls below that level, the insurer may review the underwriting at renewal. We check this with you before each renewal so there are no surprises.
Is MHD the same as no underwriting at all?
For past health, in effect yes: there are no medical questions and no exclusions based on your history. The policy terms, benefit limits and general exclusions still apply, so it is not unlimited cover, and chronic conditions are still treated the same way as on any other plan.
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