Your Health Insurance Rights

Health insurance is a fact of life, a product offered by many companies these days. Its aim isn't to replace the NHS, but to help with acute conditions - a disease, illness or injury that will respond quickly to treatment and return you to the state of health you enjoyed prior to the illness. It allows you to receive treatment promptly, rather than joining a waiting list, often with a choice of doctors and hospitals.

Buying Health Insurance

You can purchase health insurance through a broker, directly from the insurer, or via insurance agents. It can be done face-to-face, over the phone, by post or online. However you do it, if you don't receive full details of the terms of your coverage at the time you buy, you have the right to a 14-day cooling-off period from when you do receive the information in which you can change your mind. During that time you can receive a full refund of any premium paid, unless you've made a claim. After that period, if you decide to cancel your policy, you're not usually entitled to a refund.

There's a wide range of coverage, from the minimal to the extensive. What you choose depends on you and how much you want to spend. You should be aware, though, that your insurance won't cover GP visits (which fall under the NHS), A&E admissions, chronic illnesses (long-term illnesses that can't be cured), and pre-existing conditions. You'll also find that drug abuse, self-inflicted injuries, HIV/AIDS, outpatient drugs and dressings, infertility, pregnancy, dialysis, organ transplants, war risks and injuries from dangerous pursuits are among the other areas not covered by health insurance. You should check the policy carefully to see what is and isn't covered.

Health Details

When you apply for coverage, an insurer will want to know your medical details. This can be through a medical history declaration or a moratorium (all insurers offer the former, but only some offer the latter). With a medical history declaration, also known as a full medical underwriting, you complete a form with all the details of your medical history. If you don't give complete information, a claim may be denied at a later date or your policy cancelled. If you have a medical condition that's likely to return, you can still get a policy, but that condition won't be covered, either indefinitely or for a set time. Insurers will still cover you if you're disabled, but treatment arising from your disability might not be covered.

Under a moratorium, the insurer doesn't cover any condition you've had in the last five years. You can only be covered for them if you have no symptoms, treatment, medication, tests or advice (including GP) for them for a set period of time (usually two years) after coverage begins.

Premiums

There's no guarantee that your premiums won't rise. Indeed, they may rise above the level of inflation, due to the increase in the cost of health care. You can keep your costs down by paying an excess, choosing to receive treat at a specified hospital or at a different grade of hospital accommodation, or paying part of the fee yourself - none of which are ideal answers.

Your premiums will also rise with age, since statistically older people suffer more illnesses.

Regulation And Complaint

Health insurance is covered under the General Insurance Standards Council's rules; this applies as long as the person selling or advising on the insurance is a member of the GISC, so you should check. All insurers must treat your details, especially medical details, with absolute confidentiality.

By law, all insurers or advisers who are members of the GISC must have a complaints procedure in place. If you have a problem or complaint about your coverage, talk to your insurer or adviser. If there's no solution, there must de an independent dispute-resolution procedure, and you must be given details of this when you take out coverage.