Information update for private medical insurance customers

Information update for private medical insurance customers

The information contained in this bulletin is based on sources that we believe are reliable and should be understood as general risk management and insurance information only. It is not intended to be taken as advice with respect to any specific or individual situation and cannot be relied upon as such. If you wish to discuss your specific requirements, please do not hesitate to contact your usual Towergate Insurance Brokers advisor.

Many people will have seen the media coverage of the agreement between the NHS and private hospitals within the UK, which provides the NHS with access to additional hospital capacity during these unprecedented times. As the NHS and private hospital sector work in partnership to support the country through the current pandemic, it is unavoidable that private hospitals will not be able to offer their normal range of services, and some procedures will need to be deferred until the situation within the NHS begins to stabilise.

People insured under a private medical insurance (PMI) policy are, quite understandably, wondering what this means for them when it comes to making a claim on their policy, and what benefits their policy can provide in the weeks to come. Some customers may even wonder whether they should cancel their policy now and take out a new one when the UK private hospital sector returns to normal ways of working.

Our sister company, Towergate Health and Protection, have pulled together a number of key points that all PMI customers should be mindful of:

Additional benefits and services

As people’s understanding of the importance of health and wellbeing has grown in recent years, including the importance of mental health and the link between mental and physical health, most insurers have expanded the range of benefits and services available within their PMI policies.

These services can include online GP consultations, mental health support services, access to phone or online counselling, remote support for musculoskeletal conditions and nurse-led helplines for the day-to-day management of ongoing medical conditions. With large numbers of people either working from home or confined to home, these services will be as important, or more important, than ever before.

Furthermore, many insurers have now introduced new benefits and services specifically designed to support their customers through the current pandemic, such as enhanced NHS cash benefits and remote access to consultants for outpatient consultations.

Protection of underwriting terms

While many private hospitals will have reduced capacity in the coming weeks, the importance and value of private medical insurance will only increase in the medium term. By December 2019 the proportion of NHS patients waiting over 18 weeks to start elective treatment had reached 16%, the highest figure since 2008*, driven by the increased healthcare needs of an aging population and constrained funding in the wake of the 2008 financial crisis. NHS England has now cancelled all elective surgery for up to three months with effect from 15 April 2020, in order to focus on the fight against Covid-19.

Sadly, but inevitably, this means that as the current pandemic subsides, the pressures on NHS waiting times will be even greater than before.

As with all types of insurance, private medical insurance will generally not cover pre-existing events (in this case medical conditions). Customers who choose to cancel their policy now, with the intent of restarting their policy in future, will likely find any new policy does not cover their recent or ongoing medical conditions, meaning they will not be able to claim for those conditions when the UK private hospital sector resumes normal operations.

Flexibility on cover and cost

Should customers wish to retain their cover and their underwriting terms but reduce their benefits for the coming period and upgrade these again later, there may well be options available depending on who your insurer is.

Most insurers are now offering flexibility on short term premium costs for customers in financial distress, so customers should always check with their broker before making a decision to cancel their policy.

Importantly, within the last week, both Bupa and AXA PPP healthcare have recognised the short term limitations on access to treatment within private hospitals and have publicly committed to rebate to their customers the value of any associated reduction in claims costs, through Bupa’s Rebate Pledge and AXA PPP’s Customer Promise, both of which will be subject to independent audits to ensure these commitments to customers will be met.

At a time when our healthcare sectors, both public and private, face challenges on a scale not seen in our lifetimes, the private healthcare sector is stepping up to that challenge and finding new ways to support its customers in their time of need.


For more information or for a full review of your insurance needs, please continue to contact your 
usual Towergate Insurance Brokers adviser or email