Getting help to choose health insurance

Private medical insurance pays for private treatment, such as seeing a specialist, tests and hospital stays. Policies differ a great deal, and some people ask a broker or adviser to help them choose.

This page explains what a firm like that must tell you and what to check. This site is not a consultant or a broker. It does not sell insurance, recommend policies or take enquiries.

Who the firm works for

In the rules, brokers and other firms that arrange insurance are called insurance intermediaries. The Financial Conduct Authority (FCA) sets those rules. An intermediary must tell you before you buy whether it is acting for you or for the insurer.

It must also give you its name and address. It must say that it is on the Financial Services Register and how you can check that. And it must explain how to complain, to the firm and to the Financial Ombudsman Service.

Advice or a list of options

Firms work in different ways, and they must tell you which way they work. Some give a personal recommendation based on a fair and personal analysis. Some can only offer policies from one or a few insurers, and must name them. Others offer a range without recommending one, and must name the insurers they deal with.

Whichever kind it is, the firm must work out what you need from the cover. It must give you a statement of those demands and needs before you buy, and the policy it proposes must fit them.

Answering questions about your health

When you apply, the insurer may ask about your health. The law says you must take reasonable care not to give a wrong answer. If an answer turns out to be wrong, an insurer may turn down a claim or change your cover.

Some policies are underwritten for each person. Others exclude every claim linked to a condition you had before the policy began. It is worth asking which kind you are being offered.

Before you have treatment

Treatment usually starts with your GP referring you to a specialist. The Association of British Insurers suggests calling your insurer to check you are covered before you arrange any private treatment. Stay in touch with them at each stage.

Some insurers may not cover conditions you have had recently, even if your current insurer does. That matters if you are thinking of switching.

Checking a firm and complaining

Almost all firms that provide financial services in the UK must be authorised or registered by the FCA. You can check a firm and its permissions with the FCA Firm Checker or the Financial Services Register. Make sure the contact details you were given match the ones on the register, because fraudsters sometimes copy real firms.