If you’re thinking about buying Optimum, you may have questions you’d like to ask. Your adviser may have the answers or, if there’s something more specific you’d like to ask – perhaps in connection with your industry or business needs – we’re always happy to help. Some of the questions we’re asked most often are answered here…
In our industry, both terms refer to the same type of cover. Optimum is a policy that helps employees get private treatment – we call it private health insurance, but you may hear other providers refer to policies as private medical insurance.
Flexibility is key, we understand that. From our experience working with large companies, we’re confident that Optimum can offer an appropriate level of benefits and services for your business. However, if there's something specific you'd like to include such as a particular combination of benefits for certain employees, then we're happy to discuss how we can adapt Optimum to create a benefits package specifically for your business.
We’ll offer them an individual UK policy. Details will be given to your Group Administrator when you start an Optimum policy.
The terms and conditions may change annually at renewal. This may include the removal of some benefits and services, or the improvements or benefits and services. Optimum is an annual contract, so we’ll tell you about any changes prior to renewal.
We’ll take your scheme’s membership profile, claims experience and any changes to the benefits chosen into account when we calculate your premiums. With new treatments and technologies also appearing, we’ll also take into account general changes in the cost of claims to reflect medical inflation.
It’s a one year contract.
Aviva is covered by the Financial Services Compensation Scheme (FSCS). You may be entitled to compensation from the FSCS if we can’t meet our obligations, depending on the type of product and the circumstances of the claim. Of course, we’ll make sure you have all the necessary details when we give you the paperwork accompanying your Optimum policy. More information about compensation scheme arrangements is available from:
Financial Services Compensation Scheme
15, St Botolph Street
London EC3A 7QU
You and your employees will be speaking to a team of experts at Aviva, here in the UK, via our Customer Services Helpline. They’ll answer any questions you have and offer guidance to your staff. If you choose Recorded Membership, then employees can make use of our Telephone Assessment service and speed up the claims process. When a claim is confirmed as being eligible, we’ll deal with the paperwork and, if necessary, send any claim forms directly to the member.
For musculo-skeletal (MSK) claims, Aviva partners with carefully selected expert rehabilitation companies (Nuffield Health and HMCL) to ensure these claims are managed to the highest clinical quality. These strategic rehabilitation partners are quality assured and their performance is regularly monitored against a strict contractual arrangement. In addition, our approach to managing MSK claims is supported exclusively by the Chartered Society of Physiotherapy (CSP), the UK’s independent professional body for physiotherapists.
We’ll send you a Group Administrator’s Report once a month, showing claims made during the previous period. This will help you keep track of the claims spend on your policy. Before renewal, we’ll also give you a detailed Management Report showing the annual spend, frequency of claims and membership information. This annual report will have an analysis and commentary on the scheme’s performance, which we’ll take into account for your renewal terms.
When it comes to underwriting, different insurers offer different options. We offer the following types:
With Optimum, you have access to a service called BacktoBetter. BacktoBetter is a unique end-to-end clinical case management service that co-ordinates appropriate clinical pathways for members with musculoskeletal (MSK) claims. We’ve designed it to help your employees recover as quickly as possible, helping them and helping your business as they return to work. As soon as your employees suffer back, neck or any other muscle or joint pain, they can call us straight away and we’ll deal with the claim – there's no need to see a GP.
Specialists may change the hospitals they work from. It would be almost impossible to keep a list of specialists up to date. Rather than give you incorrect information, we would rather let you know that we’ll do our best to help you find a specialist or hospital covered under your policy, if your employees need to make a claim.
If your employee has an open referral from their GP (a recommendation for a medical investigation or treatment that doesn't name a specialist or hospital) we can use our specialist finder tool to find an appropriate consultant and treatment unit in their chosen area. We have over 16,000 specialists on our specialist finder tool who operate out of hospitals across the UK.
Want to talk about Optimum? Talk to dedicated account teams:
National Accounts - North
0845 300 1530
National Accounts - South
0845 300 4451
Calls to and from Aviva may be monitored and/or recorded