Complete Your Medical Declaration Form

Your employer has insurance cover with Legal & General that’s designed to pay an amount when there’s a claim which meets the terms of the cover. The insurance cover your employer set up aims to provide protection for you as their employee, to provide financial help if a claim is made. You need to complete this form for one of the following reasons:  

• the insurance cover for you, is more than the minimum amount we provide without the need to ask for personal health information,  
• the insurance cover for you, needs to start at a date that is different to when we normally begin cover for employees at your employer,
• you are applying for insurance cover where you’ll be paying for it from your salary, this is referred to as Voluntary Cover, or
• your employer wishes to improve the insurance cover. 

Your answers will help us decide whether we can provide the insurance cover.  

We normally provide confirmation of the insurance cover under your employer’s policy once we receive the completed form. Occasionally, the details you’ve provided need further assessment where we may also need to contact your General Practitioner (GP) or another medical practitioner for further details. We’ll then confirm to your employer if: 

• we can provide the insurance cover being applied for,  
• if due to your personal circumstances we may only pay a claim in certain instances, or 
• we’re unable to provide the insurance cover being requested. In these instances, we’ll let you know the reasons why. 

Sometimes the responses to these questions aren't enough for us to complete our assessment. If this is the case, we’ll contact you to request further information. We do sometimes need to ask your General Practitioner (GP) for information about your medical history, but we’ll let you know if this is the case. You have the right to view any report that your GP creates. Further details can be found within the within the Consent section of our form. 

The medical report that your GP sends to us could include details of consultations with any doctor or healthcare professional. We only ask for information about your current or past health that’s relevant to the request for cover. The medical report your doctor fills in asks about the following: 

Your current health

• any care, medication or treatment you are currently receiving 
• the results of referrals or tests you are waiting for 
• any time off work in the last three years 

Your past health 

• Details of any relevant illness, trauma, or referrals for specialist advice or treatment, hospital admissions, consultations with your GP or any other medical adviser, therapist or counsellor, in particular, whether you have a history of: 
  • malignancy (cancer), cardiovascular (heart) disease, diabetes, and degenerative (gradually worsening) diseases 
  • musculoskeletal disease or injury, for example arthritis, rheumatism, back problems or any other disorder of the joints or muscles 
  • anxiety, depression, neurosis (such as phobias, obsessions and so on), psychosis (a mental disorder where you lose contact with reality), stress or fatigue 
  • suicidal thoughts or attempts at suicide; or 
  • conditions related to drug or alcohol misuse, or smoking, or chewing tobacco 

• Details of any biopsies, blood tests, electrocardiograms (heart tests), height, weight if measured in the last two years, urinalyses (test on urine), x-rays or other investigations 
• Any blood pressure readings in the last three years 
• Any history of disease among your parents or brothers or sisters that you have told your GP about. 

Occasionally we need you to have a medical assessment. This can sometimes be because the insurance cover for you is more than the amount we normally provide to employees of your employer or because we need to have a better understanding of a medical condition you have.

These requests are arranged at our expense and at a time and place convenient to you. If you have had medical screenings through your employer, please let us know, as this can sometimes be used in place of our own.

We can sometimes use the applications that you have made to other Insurers which means we can save you time and inconvenience. Usually, these other applications need to be less than two years old. We will ask you for full details including a policy number so that we can trace the information you provided. We’ll also ask you to complete a short consent that allows the other insurer to share the information when we request it. 

Once the assessment is complete we’ll confirm to your employer that insurance cover for you can start . If this isn’t possible, your employer will be advised of the circumstances where we will not be able to make a payment when there’s a claim. If you don’t receive a request for further information or confirmation of the insurance cover within 10 working days, please contact your HR Team. 

If you’re not sure why you’ve been requested to complete this process please contact your HR Team. If you are experiencing problems with accessing the link to the form, please call 0345 026 0094, option 1.