Partner Insight: Is PMI cover really unaffordable if you have a complex medical history?

There is an open conversation to be had with an insurer

Gareth Jones
clock • 3 min read
Partner Insight: Is PMI cover really unaffordable if you have a complex medical history?

This myth is now outdated for many people because medical science has progressed and the insurance sector has evolved, according to WPA

The idea that you can't get affordable PMI cover if you have a complex medical history has long been seen as a hurdle for many suffering from conditions such as diabetes or high blood pressure.

This myth for many is now truly outdated for two key reasons: medical science has progressed and the insurance sector has evolved. 

Arguably, if a customer has an ongoing condition that is flaring up currently, they are requiring insurance for a ‘known' event, and that is not the purpose of PMI. However, if it is a condition that has been under control for a long period of time, controlled with medication, there is an open conversation to be had with an insurer, according to Edward Watling, senior employee benefits consultant at Mattioli Woods. 

Dialogue is important in this situation, says Mark Southern, sales and marketing director at WPA: "We need to have conversations that draw out the needs of the customer and not make assumptions about a condition, the treatment, and whether it would be covered or not. The customer also needs to be prepared to share the details and clarify symptomatic conditions."

This outlook is applied to hundreds of chronic conditions by insurers. Take cancer: although cancer often becomes chronic, most PMI policies no longer exclude it when it does. Millions of sufferers from other common chronic conditions - such as asthma, diabetes, epilepsy or bad backs - may also be able to obtain cover for everything apart from the condition in question (or even for the condition subject to certain restrictions). 

Southern adds: "Today many people live with a range of chronic conditions managed very well by the NHS, meaning the condition can simply be removed from a policy and the customer still allowed to be covered for a plethora of other illnesses and treatments, and benefit from additional tailored services."

Bounce it off an advisor

The key to finding a policy if a customer has such a condition is to use a skilled advisor who can search for the best provider and tease out the demands and needs of the customer, without making assumptions about the condition, the treatment, or their impact on a generic policy.

Southern continues: "Experience of having dealt with a huge number of different scenarios, and understanding what is possible, is essential to securing a client a suitable policy."

The merits of moratorium

Individuals with pre-existing conditions can even gain cover without having to disclose their full medical history by opting for a policy that uses ‘moratorium' underwriting. 

This will typically exclude pre-existing conditions from the previous five years for a set period - most commonly two years. If no symptoms or treatments occur within these two years, then the pre-existing conditions will start being covered. 

But Watling warns that moratorium wordings and the claims ethos of various insurers differ, so businesses and individuals must pick an insurer that is right for them.

This myth-busting article is one of a series of 10 addressing common myths around PMI. Access the full list

This article was funded by WPA

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