With this option your client does not need to complete a health questionnaire. Instead, we automatically exclude any pre-existing conditions which they have:
during the five years immediately before they join the policy.
However, if they do not have any:
those pre-existing conditions, or any directly related conditions, for two continuous years after they join the policy, the automatic exclusion will not apply for those conditions.
For children who are under five when their cover starts, we will take into account all the conditions that they have had from the day they were born until the date their cover starts.
Important: Long term medical conditions, which are likely to continue to need regular or periodic treatment, medication or medical advice will always remain excluded from cover on this policy.
Your client should not delay seeking medical advice or treatment for a pre-existing condition simply to obtain cover for that condition under the policy.
Your client will only be asked to provide basic information about themselves. We will not ask for details of their medical history when they join the policy, but we may need to ask for medical information if they make a claim. If they do not have any symptoms of, advice about, or treatment or medication for a pre-existing condition for a continuous two year period after they join the policy, we will not apply the automatic exclusion.
Each person has to complete a health questionnaire before joining the policy. This will enable us to understand their medical history. It is important that your client considers the questions carefully for each person that they want the policy to cover, and answers them fully. We will assess the information and decide the basis on which we can accept them for cover. If necessary, we may ask your client's doctor for any more information we need to help us do this (your client will have to pay if the doctor charges for this information). If they have a pre-existing condition that may need treatment in the future, we will probably exclude it from cover, and also exclude any conditions related to it. For example, if your client suffers from diabetes, we would not pay for treatment of eye disorders which occur as a result of having diabetes, an example of this would be diabetic retinopathy.
If the policyholder chooses full medical underwriting, we will show any exclusions on the membership certificate.
If we exclude treatment for a pre-existing condition from the time the policy starts we can, in some cases, review the exclusion at a later date if we are asked to do so. It is very important that your client gives full and accurate information in answer to the questions that we ask. If your client does not, it may mean that we cannot cover a claim or even that the policy is void.
If you want to apply for Simply Personal Health for your client using full medical underwriting, please call us on 0800 294 7303. We'll be happy to guide you through the application.
While it takes more time to complete an application, it will be clear whether any conditions are excluded from cover when the policy documentation is received.
For more information on this topic see Appendix 2 in the policy documents below.
If you would like more information please contact us on:
Mon to Fri: 8am to 6pm.
From 1st August Simplyhealth no longer provides continuation quotations for customers leaving company schemes. Please call AXA PPP healthcare, who now provide special continuation terms for these customers.
0800 33 33 11
Mon to Fri: 8am to 8pm
Sat: 9am to 1pm
Or email them