Moratorium clause: what is it exactly about?

Moratorium clause: what is it exactly about?

2 November 2021 Insurance

Private health insurance is meant to cover people against new and unexpected medical conditions. Illnesses, diseases, or injuries that existed prior to joining a health insurance policy (pre-existing medical conditions) may have an impact on your health coverage plan depending on the nature and extent of your medical insurance policy, and how your insurer assesses the risks associated with it. To evaluate such risks prior to offering you a healthcare insurance policy, insurers will need to investigate your health history before underwriting or guaranteeing payment on any policy claims. This is called medical underwriting. It helps the insurer to decide whether an additional premium or exclusion is required. Some insurance companies also offer customers moratorium underwriting.

What is moratorium underwriting?

Moratorium underwriting is a fast and easy way to subscribe to a health insurance policy without having to disclose any information about your own health history. All pre-existing conditions are automatically excluded by default.

In contrast, as far as full medical underwriting is concerned, insurance applicants are required to answer a full set of questions about their health. If you choose the moratorium underwriting option, every single claim you submit will be thoroughly checked by the insurer, who will then decide whether to accept or reject the claim depending on whether your medical condition was a pre-existing one or not.

Moratorium underwriting or full medical underwriting: which offers the best health insurance policy?

In English speaking countries such as the UK, moratorium underwriting is often the preferred option when enrolling in an insurance policy. In most other countries, policyholders mainly choose medical underwriting..

Foyer Global Health explains the pros and cons of each to help you decide which option best suits your needs.

Moratorium underwriting is often the choice of healthy applicants who are in a hurry and who do not wish to disclose information about their health

Insurance applicants opt for the moratorium clause for three main reasons. First, it allows them to purchase an insurance policy very quickly and simply, without having to waste time filling out a full medical questionnaire and waiting to receive a response. This is particularly useful for expatriates who find themselves with little time between their expatriation date and their need to obtain international health cover.

Second, policyholders who prefer moratorium underwriting may not wish to disclose any information about their health condition(s) and history.

Finally, moratorium underwriting may be the preferred option of those who are in good health and have not suffered from any pre-existing illness or medical condition.

Moratorium’s main disadvantages: automatic exclusion of any pre-existing medical condition and the claims procedure may be long and obscure.

If you choose moratorium underwriting, any pre-existing conditions, even minor ones, are automatically excluded for the duration of the moratorium. Before selecting this option, be sure to think carefully about any pre-existing medical conditions for which you have received treatment or had symptoms in the past.

As the insurance company has very little information about your situation without a full medical questionnaire, the claims process is lengthy: the insurer’s medical team will have to examine each claim in detail before deciding the extent of policy coverage.

This type of underwriting may create uncertainty with the policyholder who may experience difficulties in understanding the conditions of reimbursement, the restrictions as well as the scope of the moratorium cover. 

Full Medical Underwriting: what is the added value?

In medical underwriting, the medical questionnaire permits the insurer to decide on the price and conditions of their healthcare cover based on information about the applicant’s medical needs/condition that are known and/or can be anticipated.

While the full medical underwriting process is more time-consuming than moratorium underwriting, it nevertheless allows applicants to obtain health cover that is truly tailored to their medical profile and needs.

During the application process, the insurance company takes the time to study your situation, your pre-existing conditions if any, and offers you a policy that reflects your needs. From the start, everything is clear: you know what is covered or excluded.

In addition, some minor pre-existing medical conditions can be accepted and will not be automatically excluded as is the case with moratorium underwriting. This latter option gives you peace of mind in knowing that pre-existing medical conditions identified by you and accepted by the insurer will be covered.

Specific situation: Cancer patients in remission

For survivors of cancer, full medical underwriting may result in permanent exclusion. If, however, you have no symptoms of your past cancer and you are not being treated/monitored for this disease during the moratorium period, it may be worth considering  moratorium underwriting. After this period, you can be covered if the disease is insured by the standard conditions of your health insurance policy. The only drawback is that if the cancer recurs during the moratorium period, the treatment will not be covered by the insurance company.

What is on offer from Foyer Global Health?

Foyer Global Health offers either full medical underwriting or moratorium underwriting. You are free to choose the option that best suits your needs.

Moratorium Underwriting

Foyer Global Health operates like most other insurers with rolling moratorium underwriting. The enrollment process is fast, and all pre-existing medical conditions of the past five years are excluded from the start date of the insurance policy for a period of usually two years. This moratorium period allows the insurer to limit the risks. Moreover, every claim made during this moratorium period is examined closely to assess whether it is a pre-existing condition or not, and to decide whether the medical fees should be reimbursed.

After this period, the terms of the insurance policy may be reconsidered if you have not undertaken any treatment or medication related to these medical conditions, nor have you experienced any symptoms of the pre-existing conditions.

Anyone up to the age of 55 is eligible to apply for moratorium underwriting.

Full Medical Underwriting

When applying for full medical underwriting, you will need to take the time to answer questions about your medical history (medication, chronic diseases, teeth, eyesight, etc.). Your answers will then be reviewed by Foyer Global Health’s medical staff who will recommend which conditions are to be covered or potentially excluded.

Moratorium clause: what we recommend

It is completely up to you which underwriting policy you prefer as you are the best person to know which option fits your needs.

Nevertheless, considering the many disadvantages outlined above, moratorium underwriting is not an option we particularly recommend to our clients for four key reasons:

  1. Any pre-existing condition, even a minor one, will be automatically excluded from your cover
  2. The Claims process takes much longer compared to full medical underwriting: our experts are required to thoroughly check every single claim.
  3. Without accurate information about your current health status, you run the risk of taking out an insurance policy that is not perfectly suited to your expectations and your needs.
  4. Lack of clarity: you may experience a lot of frustration throughout the reimbursement process as you may not be fully aware of what is reimbursed and what is not. Submitting a claim may thus lead to an increase in your insurance premium or an exclusion.

Still not sure which option to choose? Contact our experts and ask them as many questions as you wish! They will help you make the right decision by choosing the solution that best suits you and your health coverage.

Simple products, huge benefits

We provide great health insurance products based on hundreds of clients’ feedback to make sure you always get reassurance from us that we insure you the best way possible.
Get a quote, with actionable options perfectly matching your needs.