Use this glossary of common – and not so common – insurance terms to help you understand words and phrases you may not have come across before.
A disease, illness or injury which has at least one of the following characteristics:
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:
An excess on a policy is the amount of eligible medical costs which the client has to pay before the insurance company starts to pay benefit. Excesses are usually defined as payable per person per membership year, although in some cases the excess is payable per claim or per course of treatment.
This is the means by which medical insurance applications are written and accepted by the insurer. The client completes a lengthy application form, which includes questions about the 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.
Medical inflation is the term used for the increase in medical insurance premiums each year. Medical inflation has exceeded headline inflation for many years. Claims costs borne by the insurers have risen sharply in recent years due to both the incidence of claims and the rising cost of high tech treatment and drugs. Most commentators would say that medical inflation is currently about 8% p.a....
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
A person who smokes tobacco, cigarettes, pipes or cigars. Two medical insurers on the panel ask this question but have differing requirements as follows: