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
We don't need medical evidence.
What happens if we ask for medical evidence?
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.
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:
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.
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.
We may record and monitor calls. Call charges will vary.
Access our useful online flexible benefits guide to help you administer a policy.