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Legal matters

Can anyone help with Health Insurance policy wording please?

4 replies

moosemama · 11/11/2015 20:29

We are trying to work out whether or not the policy my husband has via his company, is likely to request medical history before agreeing to a specialist appointment for diagnosis/testing.

The wording seems ambiguous to me and having ask HR today, they were either being cagey or didn't know themselves.

The wording the company uses when explaining the policy to employees considering taking up a policy is:

Underwriting
The method of underwriting varies on a 'Medical History Disregarded' (MHD) basis for all current scheme members.

Am I right in thinking this means that it varies whether or not they request a medical history? Dh thinks 'medical disregard' in this case is purely referring to whether or not you will be accepted for a policy, rather than anything to do with individual claims.

We don't have an individual policy, just a 'Membership Handbook, Corporate Health Plan'. We've read through that and there's not much at all about medical history other than saying in some cases the claim form won't be enough for them to assess the eligibility of a claim and they will request additional information from us, which must be given and/or they may request access to your medical records, including medical referral letters.

I know we need to see the GP for them to make the referral, then call the insurers to see if they are happy for us to go ahead but, having read lots of reviews online today, it seems this company has serious form for refusing claims on the basis of spurious 'previous conditions' and there's no way dh and I can fund this ourselves.

I was feeling so relieved that I was finally going to be able to get to the bottom of my health problems, but now I'm thinking, given all the dreadful reviews I've read today, it's probably not going to happen.

Does anyone have experience of medical insurance and can help us fathom this out?

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SpanglesGalloway · 11/11/2015 20:31

For my medical insurance medical history disregard (MHD) Means no matter what you have had in the past its covered in lone with terms and conditions of the policy eg mine doesn't cover chronic conditions. Hope this helps?

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SpanglesGalloway · 11/11/2015 20:35

Moosemama I've inboxed you :)

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moosemama · 11/11/2015 20:41

Thanks Spangles. That's what I thought initially. It's just the use of the word 'varies' that concerns me.

In my case I have had a long-term health problem that's been investigated a couple of times, looking for for different conditions that I turned out not to have. We're now pretty sure we know what has been wrong all along and just need confirmation, but specialists are few and far between (with ridiculously long waiting lists) in the NHS.

Once I'm diagnosed there won't be any long-term care required, so I assume, despite it being a lifelong condition, as we are only asking for diagnosis, in theory, they should be ok to cover the investigations and diagnosis. My only concern is that I have already been investigated for the symptoms, even though it turned out not to be the conditions they were looking for at the time (totally different health field too) which potentially means they could cite pre-existing condition as a reason not to cover me.

I know the cover my Dad had from work covered all my Mum's previous health problems, as she has both rheumatoid and osteo arthritis and they still covered her knee and hip replacements, but then Dad was at a much higher level in his company than dh is in his and I don't know if that's a factor.

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moosemama · 11/11/2015 20:46

Thank you. Have pm'd you back. Smile

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