Medical underwriting.

Onederwriting

Our premier medical underwriting approach

For all our Group Life Assurance and Dependants’ Pensions and Group Income Protection policies, we’ll apply a once only medical underwriting approach which means that we’ll underwrite once and if accepted, then in most cases, never again. Where no further medical evidence is needed we can normally make a decision within five working days (ten working days for Group Income Protection policies).

ONEderwriting is available for schemes with over 50 members.

Our approach means

  • Fewer high earners need to be underwritten.
  • When we do need to underwrite, we make it easy by offering tele-interviews or an online member’s declaration form.
  • Should a medical be needed, we can arrange for this to be carried out at home or in the office.
  • If you switch your scheme to us we may be able to cover individual employees over the free limit without the need to fill in our health form.
  • Early and late entrants who you wish to be covered outside the normal eligibility conditions can sometimes be covered without any additional terms. Where this is not possible they will need to complete a discretionary entrant's form before we’ll consider cover.
  • Onederwriting applies to increases in cover resulting from salary increases and flexing up following a lifestyle event. However, for group income protection Onederwriting doesn't apply when flexing up to the state pension age.
Onederwriting
Who needs to be medically underwritten?

We’ll normally underwrite any members:·

  • Whose benefit exceeds the scheme’s free limit at the start of the policy, renewal or following a significant benefit increase.
  • Who are joining outside of the policy’s normal eligibility conditions.
  • Who are joining on a discretionary entrant basis.
We won’t need to underwrite
  • For future increases up to £5 million benefit for Group Life Assurance and Dependants' Pensions or £350,000 for Group Income Protection.
  • Where the insured basis is changed at a future date for all members.
  • Where the insured basis is changed at a future date for all members in a category of five lives or more, provided the policy does not cover equity partners or limited liability partnership members or include a flexible benefit category.
  • Even where the member’s benefit is subject to a premium loading or exclusion (provided no premium loading has ever been declined).
When we’ll need to underwrite
  • If a future increase takes all the cover for the member over £5 million for Group Life Assurance and Dependants' Pensions policies.
  • If a member with flexible benefits flexes up other than at a lifestyle event.
  • If a member with flexible benefits flexes up by more than one step at a lifestyle event.
  • If the insured basis is changed in the future for:
    • members of a category of less than five lives.
    • a policy covering equity partners or limited liability partnership members.
Medical underwriting
What does this mean?Medical underwriting is the process where we ask the member to give us medical evidence about their health and pastimes. This helps us make a decision on the level of cover we can offer.
When we'll need medical evidence
  • When the member’s benefit is more than the free limit.
  • Employees who are joining outside of the policy’s normal eligibility conditions.
  • Employees who are joining on a discretionary entrant basis.
  • If their benefit entitlement increases at a later date after providing medical evidence, we may need to ask for more depending on the amount of the increase and any special terms that already apply.
  • We may set terms and conditions that specify when medical evidence maybe needed outside the normal requirements.
What happens if we ask for medical evidence?Health questions

If we ask for medical evidence, we’ll need the following so that when a claim is made, the benefit level is not affected:

Tele-interview. Members can take advantage of our tele-interview service, where a qualified nurse will call at a time convenient to the member to help fill in the member’s declaration form over the phone. The nurse will fill in the member’s declaration form and send it to the member to sign before returning to us.

Medical underwriting

Often company medical reports will give us the information we need. We can accept medical reports from examinations taken within the last two years, as long as they meet our requirements.

We’ll consider the following when deciding if a medical examination is needed:

  • The level of cover requested.
  • The age of the member.
  • The information supplied in the member’s declaration form.

Nurse screening. If we need further medical examinations, we can offer nurse screening to take place at a convenient time at the member’s home or their office.

You need to know

Medical underwriting may lead to special terms being applied, which normally consists of an additional premium being added to the underwritten amount. Specific conditions or activities may also be excluded which means a claim cannot be made against them.

In most cases, only benefits above the free limit are due for medical underwriting or subject to loadings or exclusions.

We’ll let you know if an application for cover has been postponed or declined. If the member would like further information or wish to make an appeal against our decision, we recommend they write to our chief medical officers (CMO) at the contact details provided.


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