Medicinal Insurance - Sorry, you're not secured!

In the UK around 7 million people spend around £3 billion a year on medical insurance. One in seven policies are taken out by individuals with the balance being put in place by their employers. The problem is that Medical Insurance is complex and few policyholders take the time to really study the details of their cover. As a result, many misunderstand what will be covered. If you expect medical insurance to pay every health claim, you're mistaken. 

Medical Insurance is designed to provide protection for curable, short-term health problems and allow policyholders to jump the NHS queues to see consultants, be diagnosed, receive surgery or be treated. That sounds fine, but before you buy you need to appreciate the treatments and situations that fall outside the scope of the cover. 

But first a word of warning. This article does not relate to any specific policy and the terms and conditions issued by individual insurers do vary. So please ensure you also check your policy documents. After reading this article, you'll know what to look out for! 

Sorry - it's a chronic condition 

If a condition can be cured and is not a long-term problem, your insurance company will classify it as acute and should meet the cost. If your problem is incurable or it's a problem that, despite appropriate treatment, will be with you for a long time, then your insurance company will classify it as chronic - and no, you won't be covered. 

But deciding whether a condition is acute or chronic is fraught with problems. It's rarely a black and white decision and this can lead to a major area of conflict between policyholder and insurer. 

It's clear that asthma and diabetes are chronic conditions as you're almost certain to suffer from them for the rest of your life. So those categories of illness are not covered. 

Problems arise when Doctors initially consider a patients' condition to be curable, but the condition later deteriorates and the medical team changes its' mind, it's now become incurable. This can sometimes happen, especially in the treatment of certain types of cancer. 

In these circumstances, the condition is initially defined as acute and is therefore insured, but deteriorates and becomes chronic - and outside the terms of cover. This is possible as insurers retain the right to reclassify a condition from acute to chronic during treatment. 

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