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What is underwriting?


When you apply for an insurance policy (or make changes to your existing policy), the insurance company reviews your personal details, including your medical history. This is called underwriting.

In general, Bupa reviews the following factors during the application process:

  • Age
  • Height and weight
  • Smoking
  • Occupation
  • Place of residence
  • Health/medical conditions

Bupa reviews all insurance applications using our established underwriting guidelines. This makes sure that all applicants are treated fairly, objectively and consistently.

As an applicant, it's important that you provide complete information about your medical conditions to the best of your knowledge. Then your application can be processed more efficiently. If you don’t disclose information on your application, it may affect your insurance cover.

If you’re unsure of what information to disclose on your application, please contact your insurance intermediaries or Bupa directly.

The underwriting process helps an insurance company know more about your health. This includes any treatment you may need or what claims you may make in the future. These factors can help the company decide if they want to insure you.

Underwriting does not always exclude all the medical conditions disclosed on your application. It can also help insurance companies know when certain conditions can be included in your cover, usually for an additional premium.

At Bupa, we use underwriting:

  • To help control the amount of claims paid for all our insurance plans
  • To make sure we treat all our customers fairly

At Bupa, all individual health insurance plans are underwritten. During the application process, customers must complete a health questionnaire and declare their medical history. After that, we may ask for more in-depth health information.

Then our underwriting team will review the customer’s details. Based on our underwriting guidelines, they will decide if the customer can be insured.

Exclusion

Sometimes, our underwriting team will suggest that a customer can be insured with an exclusion. That means the customer’s policy won’t cover specific medical condition(s). If a condition is excluded from the policy, then Bupa won’t pay for any claims and/or expenses related to that condition.

Medical loading (also called premium loading)

In some cases, our underwriting team may suggest that a customer’s medical condition(s), say pre-existing medical condition(s), can be covered under the policy with medical loading. This means the customer will pay an additional fee to cover specific medical condition(s).

The medical loading fee is a fixed percentage based on the total policy premium. This percentage stays the same when the policy is renewed.

If a condition is covered under the policy with medical loading, then Bupa will pay for claims and/or expenses related to that condition.

Bupa’s underwriting team will review your health information in these situations:

  • When you apply for a new policy
  • When you apply to reinstate your policy (i.e. apply to reinstate a lapsed policy)
  • When existing customers
    • add a new family member to their policy
    • add an Optional Benefit to their policy
    • lower their deductible or upgrade their policy

After a policy has been issued, we may re-underwrite it in certain situations:

  • When a customer’s occupation changes
  • When a customer’s place of residence changes

There are several different outcomes after the underwriting process.

Standard

No exclusions or medical loading will be added to the policy.

Decline

The insurance application isn’t successful. Bupa won’t issue you a health insurance policy.

Exclusion

Exclusion(s) for certain medical condition(s) will be added to the policy.

Medical loading (or premium loading)

An additional premium will be charged for the policy based on the medical condition(s). It’s usually a fixed percentage, which will be applied to new and renewed policies.

  1. When you’re completing a health insurance application, please provide as much information about your medical history as you can. That can include diagnosed conditions or symptoms that may need to be checked out.
  2. Underwriting is based on a confirmed diagnosis. We can’t underwrite an application based on a treatment name, type of medication or undiagnosed symptoms. When you’re applying for an insurance policy, it’s best if you know any conditions that you’ve been diagnosed with.
  3. We can’t underwrite an application for customers who have undiagnosed medical conditions or conditions that need to be checked out further.
  4. If you have a medical check or surgery scheduled, we may not be able to underwrite your application.
  5. All the information in your health declaration will be included in your policy records. It will be reviewed during underwriting or claim assessments.
  6. If you don't provide the full details of your medical history, this can be considered "non-disclosure". In case of non-disclosure or misrepresentation of your health status, Bupa may not pay your claims and/or terminate your policy. So it's very important to fully disclose your medical history to the best of your knowledge and without any misrepresentation to make sure your cover isn't affected.

Talk to us

Contact our health management consultant to get details and advice.

2517 5860

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