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Glossary
This list is intended as a guide for those considering the purchase of medical insurance and is not exhaustive, nor does it bind any Insurer.
See our Guide to buying and using Private Medical Insurance for further information to help you make an informed decision.
Are curable and normally of short duration. Medical Insurance is designed to help with these conditions. This includes acute episodes of chronic conditions developed after taking out the policy, for example a hip replacement for an arthritis sufferer.
The date on which your annual policy is renewed, normally the same date in each consecutive year. Any amendments to benefits and premium are made at this time. Your medical insurance is valid for one policy year so is subject to renewal yearly.
Some policies impose monetary or time limits on some or all of the benefits offered. Even the term "in full" usually means that the benefit is paid in full for "normal or reasonable" costs. You should check with your Insurer to ensure that fees charges by Consultants and Anaesthetists are met in full. If they are not you have the options of paying the difference between the fee charged and the Insurer's payment yourself or finding another Consultant.
Are those diseases, illnesses or injuries that have one or more of these characteristics:
- It lasts indefinitely
- It has no known cure
- It may recur
- You may need rehabilitation or professional advice on coping with it
- It needs long term monitoring or tests. (Please also see Acute Conditions)
The amount requested by an insured person from their Insurer for a single condition. Premiums must be paid up to date in order to make an eligible claim. (See also claim form)
It is essential that any eligible claim is approved by the Insurer before treatment or consultation. An Insurer may stipulate the completion of a claim form be completed by the policyholder and their GP or Specialist before treatment starts. The claimant is responsible for any costs incurred for the completion of the form Increasingly, claims may be authorised by telephone. Failure to submit a claim before treatment may lead to the claim not being paid.
Is a method of transferring to another Insurer's policy with no additional underwriting. Your replacement policy will carry the same personal exclusions as your previous cover. This is generally available for employer paid polices but some Insurers will also allow individuals to transfer on these terms. "Switch" and "no worse terms" have a similar meaning.
Where a patient is admitted to an hospital but does not stay overnight.
This normally involves x-rays or blood tests as an aid to diagnosis of a condition. High tech scans are paid for under a separate heading.
This is an amount that the policyholder agrees to pay before the policy benefits become available. It may be payable once per person per policy year, per claim, once for all those on the policy. The amount paid may be deducted from the benefits paid byof the policy. If a claim crosses a renewal date it may be payable again.
The applicant completes a medical history questionnaire and the Insurer advises if there are any pre-existing conditions, and others that may arise from them, that it will exclude from cover.
Always complete the application form fully. Do not assume that a condition you consider as trivial may not be thought so by an Insurer. If in doubt give details on the application. The greatest cause of claims being declined is non-disclosure.
Admission to a Hospital that involves staying at least one night.
Medical knowledge is constantly improving with more and more conditions becoming treatable. This inevitably means that more claims are made with a consequent effect on premiums. It id generally reckoned that medical inflation is currently 8-10% per year in the developed World.
A form of underwriting where the applicant does not answer any health questions but signs a declaration. This normally states that the applicant accepts that any eligible condition suffered in the five years prior to taking out the policy will not be covered until each of those to be covered have, after taking the policy, at some point have gone two policy years with no treatment, consultation, advice or symptoms of that condition. If there are more than person covered it applies individually. Exact wording differs between Insurers.
Consultations and/or Diagnostic tests that do not include admission to a Hospital.
Conditions or symptoms that the applicant had before the start date of a policy, even if there have been no consultations or treatment.
A condition that arises from another, separate, condition. Insurers vary in their interpretation of such conditions.


