A guide for an informed Private Medical Insurance (Part 2 of 4)

How to buy a Private Medical Insurance

You can buy a PMI directly from the insurer, through an agent or an independent adviser, through the internet, over the phone, meeting in person or by post.

The application method may differ by insurer. Serch terms of ‘health insurance’ and ‘medical insurance’ should provide you results. An independent insurance adviser will provide you policies with a variety of insurers while a tide agent or an insurer, is only capable to provide you that insurer’s policies only. So, if you choose to buy a policy directly from an insurer or from an agent without an advisor, you hold the responsibility to select a policy that suits you.

You will need to fill an application including information about your health. Application you filled in or any statement you make to your insurer, is extremely important, which forms the basis of your contract with the insurer. Answer the questions as accurately and fully, to the best of your knowledge to avoid rejecting payments or maybe cancellation of your policy. After your application is accepted, you will be informed when the cover will commence.

You will have at least 14 days after you receive policy documents – known as a cooling off period -, to choose whether this policy is suitable for you.

You must cancel your policy within the declared period if you think you should cancel the policy, and usually you’ll receive a full refund of any payments you made, if you haven’t made a claim.

What are the details needed about my health?

All Private Medical Insurance companies will provide ‘Full Medical Underwriting’ (medical history declaration) option.

Here, you will be asked to furnish details of your medical history. In some cases, the insurer may contact your doctor for more info. And, you are required to provide all the info you are asked for to the best of your knowledge. Your insurer may conclude your policy, or decline your forth coming claims, if you don’t provide the required information. 

Some PMI companies have another option – Moratorium Underwriting. Here, you don’t need to provide information of your medical history. But you won’t be covered for any conditions that you had in the past five years.

These conditions may become eligible after a continuous period of two years of your policy has started. But this will only take place when you don’t receive treatment, medication, investigation, advice (from your general practitioner a specialist) or have symptoms of that condition. Your insurer will explain you how their moratorium underwriting works.

Choosing the appropriate cover

First, you should find out if you have a Private Medical Insurance cover already. Some employers include insurance cover for you and your family members as an additional benefit.  

If you are not covered, and you are willing to have one yourself, you need to consider what are the most important benefits you’ll need. The more benefits you add, it is highly likely your premium will raise. You should consider:

1. How much are you willing to spend as premium?

2. Are you equipped to pay for some part of the treatment?

3. As an out patient, do you want to include consulting a specialist and having diagnostic tests?

4. Would you be satisfied to have necessary treatment in a hospital accessible from a narrow range selected by your insurer or do you want your choice of hospitals?

5. What you don’t wish to be covered?

Policies range from low cost, limited covered ones to policies that offer higher benefits and wide ranged cover for higher premiums.  

The following illustration gives you an example of how you might receive private treatment.

How do you start to claim...