Peter is a 42-year-old bachelor living in Glasgow. He was recently made redundant from his job as an oil rig worker and is about to start up his own consultancy in the oil industry. Having left the company he was with, he is now not going to have any private medical insurance. He is in good health apart from experiencing flashbacks from an incident on the oil rig where his colleague was injured a few years ago. Peter is receiving therapy for this and it is under control. He has never smoked. He is not restricted in terms of budget, having been left a large sum of money from his family, who were all healthy. What do you recommend?
Stephen Walker, Medical Insurance ServicesHaving joined the ranks of the self-employed, Peter should be looking at a comprehensive policy that will get a problem diagnosed and treated as quickly as possible in order to minimise the time away from work and any subsequent loss of earnings.
Should he apply for a policy on a fully-underwritten basis, he will have an exclusion on treatment relating to his flashbacks, and this would not be covered either on an industry-standard moratorium until a two-year 'clear' period has elapsed after the commencement date of the policy. However, the PruHealth standing moratorium provides cover for pre-existing non-chronic conditions after a policy has been in place for two years, irrespective of any treatment received during that period. And Pru, unlike some insurers, do provide psychiatric cover on its Comprehensive and Essential (mid-range) policies. The Comprehensive policy (national hospital scale) will include 45-days inpatient cover and full outpatient cover for psychiatric treatment at a monthly premium of £60.17 (including the full-starter discount for a healthy non-smoker), while the Essential policy only includes limited outpatient cover in this respect at a premium of £48.36. Future premiums can be kept to an affordable level by leading a healthy lifestyle and utilising Pru's Vitality programme. If psychiatric cover is not an issue, a good value comprehensive alternative would be BCWA's Personal Health policy, options one, two, three and four at a monthly premium of £43.61 (including a 35% low-claims starter discount).Dave Priestley, PruHealthBeing self-employed means Peter should be looking for a policy that encourages him to look after his health and wellbeing so that he can run his new consultancy effectively and ensure its success.
And, although he is not restricted in terms of budget, this does not mean Peter should not be looking for a good deal.
PruHealth's Vitality programme could result in reduced premiums in future years if he continues to live a healthy lifestyle and collects Vitality points for doing so. If he reaches Silver status, he is eligible for a 50% discount. Gold status would give him a 75% discount and, ultimately, he could receive a 100% discount if he reached Platinum status.
The therapy Peter is receiving would not affect his premium, but would most likely not be covered by the policy as it is an existing condition that Peter continues to be treated for.
Peter can collect points to move up the status levels in a number of ways; of which being a non-smoker is one.
By stating once a year on his Vitality statement that he is a non-smoker, he can collect 150 points. He can also collect points for participating in healthy activities such as going to the gym - which he could soon do for free if he goes twice a week or more to one of PruHealth's gym partners - or downloading healthy meal planners from the website and having a health screening.Nicole Hockley, Norwich Union HealthcareOur Health Solutions should be a good option for Peter as it offers flexible private health insurance cover and is affordable. It offers core benefits that can be upgraded to meet the client's demands.
Through the policy, Peter would be able to access Norwich Union Healthcare's 'Personal Health Manager' - which means that, as well as being able to access online facilities such as the Symptom Assessment tool, he will have access to a 24-hour helpline and qualified GP, which will be particularly useful when he is not able to visit his doctor. There is also a Stress Counselling Helpline available 24 hours a day.
In this case, the fact that he is having therapy may mean that it will be excluded from cover on the policy. The medical underwriters will sometimes review this after a couple of years at the request of the customer. While Peter suggests he is in good health, any other pre-existing conditions may well also be excluded. Current premiums would be around £62.36 a month or, including the optional optical and dental cover, would be £88.79 a month.
If the customer has a pre-existing condition, such as Peter's potential psychiatric condition, then the claims assessor uses the mori rule, which looks back five years before the start date of the policy at his medical history. Ordinarily, for any of these conditions for a claim to be eligible, the patient must go two years advice, treatment, symptom and medication-free from the start date and Norwich Union Healthcare would consider covering the condition if it is eligible on the policy type. If the customer is having treatment then they have to go two years, advice, treatment, symptom and medication-free from the last date of any advice or treatment during the policy term.
