Business Health Insurance Underwriting: The Types Explained

Last checked: 2 November 2026

Underwriting is how an insurer decides what a business health insurance policy covers for each member, based on their past health. It mainly affects pre-existing conditions: illnesses or symptoms a person had before they joined the scheme. Company schemes in the UK use four main types: moratorium, full medical underwriting, medical history disregarded (MHD) and, when a business moves from one insurer to another, continued personal medical exclusions (CPME). The type is chosen when the scheme is set up, and it applies to the staff who join it.

For an overview of how a company scheme works, see what is business health insurance.

The types at a glance

What is moratorium underwriting?

On policies that offer moratorium underwriting, members usually do not give details of their medical history when they join. Instead, the insurer does not cover treatment for any condition, or related condition, that the member had symptoms of, received treatment or medication for, or saw a doctor about during a set period before the policy started. That period is usually five years.

Because no history is given at the start, the insurer may ask for medical notes when a claim is made, to check whether the condition was pre-existing.

These conditions can become eligible for cover later. There are two kinds of moratorium:

• Rolling moratorium: a pre-existing condition can be covered after a qualifying period, usually two years, in which the member has no treatment, medication or medical consultations for it. If they do, the qualifying period starts again from that date. Some conditions may therefore never be covered, because they always need treatment.
• Fixed moratorium: a pre-existing condition can be covered after a continuous qualifying period of membership, usually two years, whether or not treatment was needed during that time.

What is full medical underwriting?

With full medical underwriting, each member fills in a health questionnaire when they join, giving details of their medical history and current health. The insurer's underwriter then decides, for each person, to:

• give cover on standard terms with no personal exclusions;
• exclude a stated condition and any related conditions; or
• exclude a condition but review that decision at a stated time in the future.

The member knows from the start which conditions are excluded. Some exclusions can be permanent.

What is medical history disregarded (MHD)?

Under medical history disregarded underwriting, the insurer ignores members' past medical history. Pre-existing conditions can be covered, subject to the policy terms, and eligible medical costs that arise after the policy start date are paid in line with the standard terms of the plan.

MHD is usually applied to larger group schemes, and the minimum group size varies by insurer. Because the insurer takes on more risk, it usually costs more than the other types. Standard policy exclusions still apply, so chronic conditions, for example, are generally not covered for ongoing management under any underwriting type.

What happens when a business switches insurer?

When a company moves its scheme from one insurer to another, insurers may offer switch terms, so members can keep their existing underwriting rather than start again:

• Continued personal medical exclusions (CPME): for members who were fully medically underwritten, offered at the new insurer's discretion. The member gives the new insurer their most recent insurance certificate, and the new insurer carries over the personal medical exclusions on it. CPME is also known as "switch", "no worse terms" or "continued medical exclusions".
• Continued moratorium: some insurers also offer this for members on a moratorium. The new insurer treats the moratorium as running from the start of the original policy, rather than from the switch date.

Both usually require that there has been no break in cover since the original underwriting. Terms vary between insurers: some ask a short set of medical questions on a switch, and further exclusions may apply. Only the underwriting carries over. All other benefits, terms and conditions of the new insurer apply, even where they differ from the old policy.

How do new joiners fit in?

Staff who join the business after the scheme starts are usually added on the scheme's underwriting type. On a moratorium scheme, the look-back and qualifying periods for a new member usually run from the date that member joins. On a fully underwritten scheme, the new member fills in a questionnaire.

Getting a quote

Prices, underwriting options and cover differ between insurers and depend on your business and staff. Quotes are not given on this website. The form asks a few short questions, such as how many employees you have and whether you already have a policy, plus your contact details. A business health insurance broker then calls you to talk through the options. Schemes are most common in firms with three or more staff, and smaller firms can also ask for a quote. If you send your details outside office hours, the call may come the next working day.

Sources (checked 2026-11-02):

• Association of Medical Insurance Intermediaries, Health insurance glossary (moratorium, full medical underwriting, medical history disregarded, continued personal medical exclusion): https://amii.org.uk/health-insurance-glossary/