My client had cancer five years ago and has now been given the all clear. However, his employer has refused to allow him to join the company's PMI scheme. Is this fair and what are the other PMI options available?
A company-paid plan is a policy paid for by the employer for the benefit of the employees. The company may hold a policy with an insurer who requires specified membership ' including all employees within an acceptable specified membership category, for example, 'all directors' or 'all full-time staff'. Every employee who falls within the category would be included in the scheme. This could be the case with your client. However, a company under a non-specific company scheme can legitimately pick and choose which staff members are included, and it is up to them who they include.
If the company will not provide cover, your client does have the option of taking out his own private medical insurance (PMI) ' this could be a traditional PMI policy or a self-pay policy. With both of these options, you can only take out cover against unforeseen events, which is why PMI cannot cover pre-existing conditions.
However, in the case of your client with his cancer history, a moratorium clause is a means by which he can get PMI which would not require them to complete a health questionnaire. Instead, the health insurer would apply a blanket exclusion for any pre-existing conditions your client has, or has had in the past five years before he joins. The 'moratorium' refers to the fact that this exclusion is not necessarily permanent.
If your client did not require any further treatment for the cancer or any other pre-existing conditions over a period of two consecutive years, he might well be covered if subsequent treatment for that condition was required in the future.
