Rhys (52) has just taken early retirement due to stress and serious heart problems which resulted in surgery. He and his family were previously covered under his company's PMI plan, and now he wants to provide this cover for his wife (Heather, 48) and two children (Justine, 21 & Carl, 15) who are all healthy. He also wants some cover for himself, but is realistic that he may face exclusions to keep the policy affordable. What are his options?
Richard Kerton, PMI Partners
The first thing to consider is when his previous policy lapsed. If within the last two months then there are policies that will offer a ‘switch CPME’ underwriting. This option would benefit his family by not adding any further exclusions to a policy.
Another consideration is the stress, heart problems and surgery; when were the last symptoms, advice or claims made?
It may be necessary to look at two policies, one for Rhys & one for his wife and children.
Due to the claims, Rhys may not be eligible for most ‘switch’ options so would be faced with a Moratorium or FMU that will impose exclusions. It may be that the best way forward is to have a group leaver scheme for Rhys, which is not always the cheapest option, but will enable a continuation of his medical conditions. If he can then go a year with no claims or visits to a consultant, he could switch to a cheaper individual policy.
For his wife and children, they could switch to an individual policy as they have had no claims recently offering them a better solution to retaining the medical insurance cover they currently have.
In summary, Rhys should sort a quote from his company’s insurance provider to obtain a group leaver policy and his wife and children should consider a switch to an individual scheme. This option will bypass the use of a Moratorium or FMU underwriting which will impose exclusions.
Neal Archbold, Aviva UK Health
While Rhys would need to be re-underwritten if he was transferring from another provider, if his company cover was provided by Aviva, he’ll have the choice of either being re-underwritten or transferring onto a Healthier Solutions policy with his current terms, within 30 days of leaving the group scheme.
Assuming Heather and his children were claims free, they could transfer onto an individual policy on the same underwriting terms. What’s more, their previous good health means they could be eligible for a significant no claim discount on their premium.
Aviva’s Healthier Solutions plan enables Rhys to pick and choose benefits to meet his family’s needs and budget. As affordability is key, he may want to consider one or more of the cost savings options available on this plan. Choosing the six-week option and a £500 excess for example will give him a discount of 40% off his premium.
Given Rhys’ history, he’ll be pleased to know that this policy includes MyHealthCounts, an invaluable health management tool offering personalised advice on the steps he can take to improve his health and wellbeing. He may also want to take advantage of a discounted pharmacy health check and leisure club membership discount available with his Aviva policy.
In addition to the no claim discount available as part of the policy, if Rhys and his family demonstrate good health, they’ll be rewarded with up to 15% MyHealthCounts discount off their health insurance renewal irrespective of whether they claim on their policy.
Kim Gilbert, Chartis Insurance
Rhys could join Healthchoice on a moratorium basis, which means depending on whether his heart condition needed further treatment/medication it may be covered in the future, however, if he does continue to have ongoing treatment it would be excluded.
Having seen the benefits of PMI; possibly having had his heart surgery in an NHS hospital; Healthchoice would offer Rhys and his family some extra benefits. For example, if they chose to have any future surgery on the NHS, the policy would pay the entire amount they would have paid a BMI private hospital directly to Rhys, which could be up to £21,750. Rhys could also take advantage of this by using the money for treatment at any hospital worldwide.
Cover for his whole family would be £146.38pm. Rhys could also choose to upgrade and add either £25,000 or £50,000 as a cash payout if either he or Heather were diagnosed with either a serious illness or cancer; this would alter the family premium to £173.36pm.
Rhys needn’t worry about paying any excess if he needs to make a claim. There are no excesses on the policy; similarly he needn’t be concerned about any claims causing future renewal premium increases as Healthchoice does not have a no claims discount.
In fact, each year’s premium will be calculated purely on age with no reference to past claims. This simplicity makes it easy to understand and budget for.
