For UK financial adviser use only. This information has not been approved for use with customers. If you are a customer please go to www.aviva.co.uk/health-insurance.

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Reminder of Optimum & GuideWell T&C Changes

Published: 28 Feb 2017

At Aviva we are constantly reviewing our products to ensure they continue to meet your clients needs. These changes are a demonstration of our commitment to clients in a forever evolving market.

Back in October 2016, we communicated some important changes to the Terms and Conditions of our Optimum & GuideWell policies.

Changes to our policies applied to your clients' renewal dates, as well as any new policies written after 1 January 2017, so we thought we’d use this opportunity to remind you.

 

Changes to Terms & Conditions

Your clients would have seen the following changes to their terms and conditions. These key changes have been implemented to bring us in line with the rest of the market and provide a sustainable price in the future:

  • Networks - we have introduced a number of networks for diagnosis of, or treatment for specified medical conditions. A network is a specified group of facilities and/or specialists or other practitioners that are the only providers we recognise to provide the treatment required for a particular condition.
  • Hospital charges - we no longer automatically recognise all NHS hospitals under Optimum and GuideWell policies. This means that if we don't have a network in place for your clients treatment and they want to use an NHS hospital, they will need to check with us to ensure it is recognised. 
  • Consultation Fees - if your client has an eligible consultation with a specialist or other practitioner who is ‘fee approved’ then we will pay in full. However, if they have an eligible consultation with a specialist/practitioner who isn't fee approved we will only pay up to the limits we pay our fee approved providers.

View our Optimum and GuideWell Update Flyer  to read the full details of all the changes that applied from 1 January 2017 - this can also be shared with your clients.

 

BacktoBetter

Our BacktoBetter service should still be the first port of call for clients with musculoskeletal conditions with no need to contact their GP. However those who have already seen their GP or a specialist, and who suffer from specific musculoskeletal complaints, no longer need to go through the Telephone Clinical Assessment (TCA) and case management process. 

This applies if:

  • the member's GP has recommended osteopathy or chiropractic treatment, or
  • the member's condition does not relate to their back or neck, and
  • the member's GP has recommended radiology, pathology, or referral to a specialist.

We're here to help

Our Optimum and GuideWell customers can see their updated terms with the policy update flyer.

If you or your clients have any questions or want more information around these changes please speak to you usual Aviva contact or call 0800 0014 272.

*calls to and from Aviva may be monitored and/or recorded.


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