Underwriting on your contract will probably be one of the greatest concerns and issues you may have. There are several options available, each being noticeably different in their approach. You must confirm with your adviser in the first instance whether there are any present or prior conditions which are of concern to you; we will then approach the scheme with a view to obtaining cover where possible for these conditions.

Historically, many insurers have used age bands to price their contracts; typically, these are 5 years bands such as 30-34, 35-39, 40-44,45-49 etc, however the down side to this can be when several employees move up an age band in one go which can have a noticeable effect on the following years premium.
Due to this issue, many insurers have tried to remove banding, so every year the policy cost will increase very slightly due to age, but less noticeable than the 5 year leap. This is an important consideration if your membership is more mature and thereby more likely to be affected.

This option is increasingly used by insurers to reflect the performance of the group so far as claims being made. It rewards you for those years you do not have need to use your policy – thereby reducing the premium to be paid. However, the opposite can be achieved when claims are made and the same discount is eroded. Once certain types of claims have been made (heart, cancer & psychiatric), you may find it difficult to move to a more competitively priced plan, for this reason you should give some serious thought to whether an NCD is a good idea or not.

The core principle of Medical Insurance is the ability to choose where and when you receive treatment, both of which should be convenient to you. However, as insurers continue to negotiate with hospitals and clinics, your choice of facility may change.
Additionally, some insurers use restrictive networks to enable them to keep pricing competitive. Check that your chosen facility is accessible in all respects, out-patient, in-patient and the necessary scans to compliment this treatment.
Does the insurer you have chosen have good relations with hospitals nationwide or will be forced to use a facility you would not have chosen.

Increasingly, insurance companies are looking at the general claims performance of your scheme at renewal to gauge the premium they should be charging. You do not necessarily have to be on a ‘claims related’ contract to be affected in this manner.
If your scheme is used heavily one year, you may be faced with a difficult decision at the policy renewal point when the premium has escalated and due to the nature of the claim, your choices of change are limited.
Ask your adviser whether the contract you are considering will present any nasty surprises in the future should you have need to claim.

An excess is whereby the member (or company) aggress to pay the first part, or a percentage of an eligible claim. This will result in your basic premium being discounted to reflect the share in risk by both parties. However, if your excess is calculated on each and every claim the discount can prove somewhat insignificant if the policy is well used. As policies have evolved over time, some now look at excesses in a much fairer way, largely by applying it to the claimant only and not the group and some insurers even being able to separate excesses from employees and their dependants… ask your adviser about which would be best to suit your company needs…

As with every type of business, the service you receive will vary considerably. If you have certain expectations from an insurer, we recommend that you discuss this issue with your adviser to avoid disappointment as standards can vary considerably.
The common areas of issue are claims management (being slow, unresponsive and obstructive), administration (often being slow or late, unclear and confusing) or their ability to work with hospitals (in some cases hospitals have requested guarantees or upfront payment from a problematic insurer).
We do not rate or score insurers by such standards, however we will always point out whether we have had a number of complaints or dissatisfied customers with an insurer to enable you to make an informed decision.

Due to improved systems and modern communication methods, some insurers can quite literally build a contract to meet your every need. This means you not only capture the benefits relative to your organisation, but you are not then paying for any unwanted benefits which sometimes get bundled up together.
This option is referred to as being ‘modular’ and is especially useful when you are looking to differentiate between different staff levels (senior and lower management etc).
Traditionally, insurers would put together a range of benefits ‘they’ thought were required and allowed little or no flexibility. In today’s market, you could quite simply choose ‘out-patient’ only cover which in relation would cost a fraction of a full policy.

Ask your adviser about any specific benefits which are of concern to you and we will then build it into your recommendation for you.