Medical underwriting.

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 need medical evidence

Members

Children

  • When the member's benefit is more than the free limit.
  • Employees who are joining outside of the scheme's normal eligibility conditions.
  • 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 may be needed outside the normal requirements.

We don't need medical evidence.

What happens if we ask for medical evidence?

Health questions

If we ask for medical evidence, we'll need one of the following before deciding on whether cover can be provided or if any other terms will be applied:

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 then fill in the member's declaration form and send it to the member to sign before returning to us.

Medical examinations

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 a further medical examination to take place, we can offer nurse screenings at a convenient time and location, such as the member's home or place of work.

You need to know

Medical underwriting may lead to special terms being applied, which can consist 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 for them.

In most cases, only the benefits above the free limit are due for medical underwriting. Benefits below the free limit are normally automatically accepted subject to our switch terms, however, pre-existing and related condition clauses will still apply.

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.


0845 072 0751

We may record and monitor calls. Call charges will vary.

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Winner for Group Critical Illness Cover at the Cover Excellence Award 2007, 2008, 2010 and 2011.

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