THE DIFFERENCE BETWEEN MORATORIUM AND FULL MEDICAL UNDERWRITTING

How to apply moratorium or medical questionnaire?

What is "moratorium underwriting"?

This is a common form of underwriting used by private international health insurance companies. It covers each individual, family, small group under a policy excluding any medical conditions that have been treated with advice, treatment or medication in the five years preceding the date of the insurance. The moratorium is defined as a qualifying period of 24 months for treatment costs attributable to an existing medical condition and its consequences. After a continuous insurance period of 24 months, private health insurance companies will reimburse the eligible expenses incurred for existing medical conditions if the insured person did not suffer any symptoms and did not require treatment, and did not receive or require any medication during this 24-month period of moratorium. If the insured submits a request for reimbursement for care, it will be reviewed by the insurance company. The insurance company will consider whether or not the patient had a medical history and whether the symptoms are before the date of the subscription.

The subscription for an insured is easy with the moratorium. It may even make the purchase online as travel insurance without formalities. This process still requires a special attention. Private insurance companies take advantage of the moratorium to avoid paying claims and bear the burden of proof to the insured. The insured must justify in many cases with medical evidence that he did not have a medical history. The date of subscription is also often a source of conflict. In addition to having no medical history; determining a disease that happens unannounced is very complicated. The insured must be proving his good faith. It may be also difficult for individuals to initiate an action in a court against a company with a head office in countries where consumer’s rights do not exist.
Our advice in this case is to provide with its application medical records with a complete check up. Legal line will be defined.

What is "full medical underwriting" (FMU)?

You must complete a medical questionnaire with your private medical application. Your good faith is important. You can enter inside the expatriate health plan without exclusion if you have a good health or with partial, total exclusion or with loading premium. If they would like pre- existing medical conditions to be included, this will apply above all to the questions concerning the present state of health, past or present illnesses, disorders and symptoms, as well as treatment. This process of accession is longer and more complicated and requires medical records. Each insurance company appreciates its risk. It depends on the ratio of premium /claims by country and area of cover.

You must also negotiate with companies on exclusions and the appreciation of risks and provide some concrete medical evidence. Protection for the consumer is more important if you apply with a medical questionnaire (Fully medical underwriting - FMU)

The Conclusion

There are two different ways of thinking in international health insurances: the moratorium used by English brokers and medical questionnaires used by European brokers. We find that companies are moving more and more towards medical questionnaires and the cancellation of pre-existing & chronic conditions. I think the moratorium is the root of many conflicts if it is not properly explained to the insured. It is very important in this case to give good advice and not to just sell without professionalism.

Sources: Olivier LE FAOUDER, CEO at AOC Insurance Broker.