Medical Underwriting Policy

Nasoha Ltd is committed to providing fair and transparent medical underwriting for all policyholders. This Medical Underwriting Policy explains how we assess medical conditions, determine eligibility, and set premiums for our health insurance policies.

1. What is Medical Underwriting?

Medical underwriting is the process we use to assess an applicant’s health status, medical history, and risk factors to determine:

  • Eligibility for coverage
  • Premium pricing
  • Coverage exclusions or waiting periods

Our underwriting process ensures that policyholders receive appropriate coverage and fair pricing based on their health profile.

2. Types of Medical Underwriting

We offer different underwriting approaches depending on the policy type:

2.1. Full Medical Underwriting (FMU)

  • Applicants provide a detailed medical history during the application process.
  • We assess pre-existing conditions and may apply exclusions or premium adjustments.
  • Policyholders receive certainty about what is covered and excluded before purchasing a policy.

2.2. Moratorium Underwriting

  • Applicants do not need to provide a full medical history at the time of application.
  • Pre-existing conditions (typically within the last five years) are excluded unless:
    • The policyholder has been symptom-free for a defined period (usually two years).
  • This option provides faster application processing, but policyholders must check conditions before claiming.

2.3. Medical History Disregarded (MHD)

  • Available only for corporate group policies.
  • No medical underwriting is required; all employees receive full coverage, regardless of pre-existing conditions.
  • Premiums are higher, but coverage is comprehensive.

3. How We Assess Pre-Existing Conditions

A pre-existing medical condition is any illness, injury, or health issue that existed before applying for a policy. This includes:

  • Chronic conditions (e.g., diabetes, heart disease, asthma)
  • Previous surgeries or ongoing treatments
  • Mental health conditions
  • Long-term medications

Based on your medical history, we may:

  • Approve coverage with exclusions (certain conditions not covered)
  • Offer coverage with an increased premium
  • Impose waiting periods before covering specific treatments
  • Decline coverage if the risk is too high

Policyholders will be informed of any exclusions, premium changes, or waiting periods before accepting their policy.

4. Disclosure of Medical Information

  • Applicants must provide accurate and complete medical information during the application process.
  • Failure to disclose relevant medical conditions may result in:
    • Claims being denied
    • Policy cancellation
    • Legal consequences for insurance fraud

If your health changes after purchasing a policy, you must notify us if:

  • You develop a serious medical condition.
  • You are diagnosed with an illness that requires long-term treatment.

5. How Medical Underwriting Affects Premiums

Your premium is based on:

  • Age – Older policyholders typically have higher premiums.
  • Medical history – Pre-existing conditions may lead to exclusions or premium adjustments.
  • Lifestyle factors – Smoking, alcohol consumption, and high-risk activities can impact pricing.
  • Coverage level – Comprehensive policies with fewer exclusions have higher premiums.

We aim to provide affordable coverage while maintaining financial sustainability for all policyholders.

6. Reviewing and Updating Medical Underwriting

  • Policyholders can request a review of exclusions after a specified period (e.g., if a pre-existing condition has been resolved).
  • We may update underwriting criteria in response to changes in medical advancements or regulatory requirements.
  • Any policyholder affected by underwriting changes will be notified in advance.

7. Appeals and Complaints

If you disagree with our underwriting decision, you can:

  • Request a review by providing additional medical evidence.
  • Submit a formal complaint to [email protected].
  • If unresolved, escalate your complaint to the Financial Ombudsman Service (FOS):

Financial Ombudsman Service Contact Details:

  • Website: www.financial-ombudsman.org.uk
  • Phone: 0800 023 4567 (UK) / +44 20 7964 0500 (outside UK)
  • Email: [email protected]
  • Address: Financial Ombudsman Service, Exchange Tower, London, E14 9SR

8. Contact Us

If you have any questions about our Medical Underwriting Policy, please contact us:

Nasoha Ltd
83–85 Baker Street, London W1U 6AG,United Kingdom
Email: [email protected]
Phone: +44 20 8050 3221