General exclusions
Private medical insurance is designed to help you with short-term, acute medical conditions that arise after you take out your cover. Whilst our range of plans includes several benefits that other insurers don't, there are some things that we, along with most insurers, don't cover. For more detail, please contact our advisors to request a copy of our policy document.
- What isn't covered?
- If you join under our moratorium clause, we will not pay for treatment of any pre-existing medical condition or related condition
- If you transfer from another insurer with a continued moratorium or continued personal exclusions, we will not pay for treatment of any medical condition, that your previous insurer excluded when you joined them
- If you choose to be medically underwritten, we will advise you whether we are able to cover any medical condition that you disclose on your health questionnaire. We will not pay for treatment of any pre-existing medical condition you do not disclose to us
- There are certain conditions that Private Medical Insurers do not usually pay for the treatment of, including:
- The ongoing symptoms of a long term, incurable illness (usually referred to as a chronic condition)
- Alcohol or drug abuse or any related condition
- Deliberate self-inflicted injuries
- AIDS or HIV related treatment
- Learning or behavioural difficulties
- Cosmetic surgery
- Regular renal dialysis
Treatments
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Included:
- Inpatient tests and treatment
- Hospital accommodation
- Hospital Nursing costs
- Included in some of our plans:
- Outpatient tests and specialist consultations
- Cash payments for treatment in an NHS hospital
- Abnormal pregnancy or childbirth benefit
- Overseas medical cover
- Not included:
- Outpatient drugs, dressings and surgical appliances
- Accident and emergency admission
- Services of a GP or dentist
- Eye tests; vaccinations; routine medical treatments, examinations or screening;
- Treatment connected with birth control
- Cosmetic treatment
- Fertility treatment
- Routine dental work, unless you opt for cover that includes Major Dental Cash benefit
- Unproven drug therapy
Please refer to the policy document for other policy rules and exclusions.
The Association of British Insurers (ABI) has a Consumer Guide to Buying Private Medical Insurance that you may also find useful.
Download the ABI consumer brochure (PDF 897k)
