The needs and choices of you the client are our prime consideration when offering healthcare advice.
We strive to understand those needs, so that together we can make the right choices for you, when selecting a policy.
The options we consider, are based on your choices and together we look at all of the following:
- Choice of Benefits
- Choice of Cancer care
- Choice of Premium
- Choice of Hospitals
- Choice of Doctors
- Choice of Providers
This is the one area which it is important to have our expertise within. We have formed strong relationships with underwriters and have built a strong knowledge of how they apply and endorse policies.
Full Medical Underwriting (FMU)
This is the means by which medical insurance applications are written and accepted by the insurer. The client completes a application form, which includes questions about their medical history. The insurer will review the application and exclude from cover any serious pre-existing conditions or conditions that may arise from existing conditions or symptoms.
Continued Personal Medical Exclusion (CPME)
CPME underwriting describes the process by which insurers accept a transfer in from another company. This process is almost exclusively in the company paid market and allows client companies to transfer one insurer to another on renewal without losing cover for conditions that arose after the start of the original scheme CPME is also known by the following terms:
- No Worse Terms Transfer
- Protected Underwriting Terms
Moratorium underwriting is the style of acceptance of a medical insurance application in which the client signs a declaration to accept that medical conditions or symptoms suffered in a period of time prior to the inception date (usually five years) are excluded from cover. If the member is free of symptoms, medication and medical advice for a period after inception (usually two years) the exclusion is lifted.
Medical History Disregarded (MHD)
Policies written on an MHD basis obligate the insurer to all eligible medical expenses that arise after the
How a particular provider operates their claims process can vary, the following steps are a guideline to some of the options when making a claim.
Visit with your GP, they will determine as to whether you need to be referred to a specialist or consultant for further treatment, diagnostic etc, if so…
Contact your provider who will confirm authorisation, you can do this by the following methods, dependent on your provider:
- By telephone
- Paper claim
Authorisation confirmed, now contact your consultant or specialist to arrange an appointment.
Paying for your treatment, most providers will settle your costs directly with your healthcare provider. If you have an excess on your policy, you will need to check with your provider as to whether you should pay the excess to them or the healthcare provider.
Ensure that you keep a record of all your communications through out your claim process.
If you need follow up treatment, it may mean that you need to obtain further authorisation. It is advisable to contact your provider throughout the stages of your treatment, to ensure that you are fully covered.