Private health insurance

General FAQs

If you’re thinking about buying Solutions, you may have questions you’d like to ask. We’re always happy to talk over the phone, so take a look at these FAQ’s and then call us or ask us to call you back.

Is there a maximum amount that we could claim on our policy?

No. The number of times an employee can claim per policy year is unlimited. There’s no limit to the number of claims you can make for eligible treatment at hospitals on your chosen hospital list. But some benefits do have specific limits.

Which kinds of underwriting do you use?

When it comes to underwriting, different insurers offer different options. We offer the following types:

• Full Medical Underwriting. We ask your employees questions about their past health. Their pre-existing medical conditions and related conditions will be excluded unless we agree to accept them.
• Moratorium. This replaces filling out a health questionnaire. An automatic exclusion applies to any disease, illness or injury (whether or not diagnosed) or any related condition if:
  • A member had symptoms of, medication or treatment for, or advice about such a disease, illness or injury within five years before joining Solutions and
  • There has not been a clear two-year period after joining during which the member has been free of medication for, diagnostics test for, treatment for, and advice about such a disease, illness or injury or related condition.
• Continued Medical Exclusions. This option can be chosen if your company is transferring from an existing fully medically underwritten medical insurance plan. We’ll apply the same personal medical exclusions that were applied to the previous plan. No new personal medical exclusions will be added.
• Continued Moratorium. Your company can apply to transfer from an existing medical insurance plan which is underwritten on a moratorium basis. We apply our moratorium wording with effect from each member’s original start date.
• Medical History Disregarded. This means that we do not apply any medical exclusions to your employees, but only for schemes covering 20 or more employees.

Is there a difference between ‘Private Health Insurance’ and ‘Private Medical Insurance’?

We say ‘private health insurance’ most often, but your current provider may call it ‘private medical insurance’. Both terms describe the same thing: a policy that helps employees get private treatment could be called private health insurance or private medical insurance.

What information do I need to supply when I call for a quote?

It’s up to you, which type and level of cover you’d like for your staff. We’ll need details about your employees, their dates of birth, and – if you are switching cover from another provider – you’ll need to supply your renewal date, the type of underwriting on your current policy and details of any past claims.

Our employees have a lot of back problems, can you help?

With Solutions, you can choose to include Back-Up as part of the service we provide. Back-Up is an award-winning service aimed at reducing absenteeism due to back or neck pain. We’ve designed it to help your employees recover as quickly as possible, helping them and helping your business as they return to work.

Why don’t you list your specialists and hospitals on the internet?

We do keep copies of our Solutions hospital lists online, but 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, if your employees need to make a claim we’ll do our best to help you find a specialist or hospital covered by your policy.

Does Solutions include cover for international travel?

Solutions includes a limited emergency overseas cover if your employees are temporarily abroad for a period of up to 90 days. If you or any of your employees are going to be spending extended periods of time abroad (more than six months at a time), we can offer you a more extensive level of cover under International Solutions.

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