Health insurance
When you are unwell and need treatment quickly, the thing that matters most is whether your policy pays out without a fight. Here is how UK private cover is set up.
Health insurance companies
10 companies
About Health insurance
Health insurance in the United Kingdom covers private medical treatment, which lets people see a specialist, have a scan or undergo surgery without waiting for an NHS slot. Policies vary in what they pay for, from inpatient and day-patient care to outpatient consultations, diagnostic tests, mental health support and cancer treatment. Some cover is bought individually, while much of it is arranged through employers as a staff benefit or sold to families and older customers on their own account.
The companies in this market are a mix of large established insurers, specialist medical insurers and brokers who arrange cover on behalf of customers from several providers. Most policies reach customers through brokers, employee benefit consultants, affinity schemes and direct sales online, while a smaller share is distributed through banks and retailers. Many insurers work with a network of private hospitals and consultants, and some also offer digital GP services or health assessments as part of their packages.
The sector is regulated by the Financial Conduct Authority, which oversees how firms sell policies and handle claims, and the Prudential Regulation Authority, which supervises the financial strength of insurers. The Association of British Insurers represents many of the largest firms and sets out industry standards on claims and customer care. Private medical insurance sits alongside the NHS, and the Competition and Markets Authority has examined the market in the past to assess how competitive it is for customers.
Questions about Health insurance
What is the difference between a private health insurance policy and an NHS service?
The NHS provides free care at the point of use, funded through general taxation, while private health insurance pays for treatment in private hospitals and clinics so that you can choose your consultant and avoid some NHS waiting times. Private policies do not cover emergency care, A&E, most GP services or long-term conditions, which remain the responsibility of the NHS. Private health insurance is regulated by the Financial Conduct Authority, which sets rules on how insurers and intermediaries must treat customers.
How do I know if a health insurance company is authorised in the UK?
You can check whether a firm is authorised by searching the Financial Services Register on the Financial Conduct Authority website, where each firm's permissions and status are listed. Insurers and brokers that appear on the register are subject to FCA rules on fair treatment, product information and complaints handling. If a firm does not appear on the register, do not pay it money or share bank details, and report the approach to the FCA through its contact services.
What should I compare when choosing a health insurance policy?
Compare the level of cover for inpatient and day-case treatment, outpatient consultations and diagnostic tests, since these vary widely between policies. Check the list of hospitals in the insurer's network, the excess you would pay on each claim, and whether cover applies to pre-existing conditions. Read the policy's exclusions carefully, including limits on mental health, cancer and musculoskeletal treatment, and check how the premium may rise with age or claims history.
What is the difference between full medical underwriting and moratorium cover?
Full medical underwriting requires you to complete a detailed health questionnaire and may lead to certain conditions being excluded from the outset. A moratorium policy does not ask for a full medical history at the start, but excludes any condition you have had symptoms of, treatment for or advice about in the previous five years, until you have gone a continuous period without symptoms or treatment for that condition. Both approaches should be explained clearly before you buy, and you should answer every health question accurately to avoid a claim being refused later.
Do I have to tell the insurer about my medical history when I apply?
Yes, you must answer every question on the application honestly and completely, and failing to disclose relevant information can allow the insurer to refuse a claim or cancel the policy. Under the Consumer Insurance (Disclosure and Representations) Act 2012, the insurer must show that a misrepresentation was careless or deliberate before it can act on it. If you are unsure whether a condition is relevant, disclose it and ask the insurer to confirm how it will be treated.
How do I cancel my health insurance policy?
Most private medical insurance policies can be cancelled by writing to the insurer or your broker, and you should check your policy schedule for the notice period required. Under the Financial Conduct Authority's rules, firms must make cancellation clear and not place unreasonable barriers in your way. If you cancel within the cooling-off period, which is fourteen days from receiving the policy documents, you can obtain a refund of the premium paid, and insurers must give you a clear way of doing so.
Can I cancel my policy in the cooling-off period and get a refund?
Yes, the cooling-off period gives you a right to cancel a new policy and receive a refund of any premium paid, provided you have not made a claim. The period runs from the day you receive your policy documents, and the Financial Conduct Authority expects firms to make this right clear at the point of sale.
How do I make a claim on my health insurance?
Contact the insurer's claims line or use its online portal before treatment, as most policies require prior authorisation from the insurer before you see a consultant or have tests. Your GP referral or consultant's details will be needed to start the process. Once the claim is authorised, the hospital or clinic will settle the bill directly with the insurer, and you will be responsible only for any excess or non-covered items shown on your policy.
What happens if my health insurance claim is refused?
The insurer must give you a written reason for refusing a claim, and you should ask for this in writing if it has not been provided. You can challenge the decision by providing further medical evidence or by pointing to the policy wording that supports your claim. If the insurer does not resolve the matter, you can make a formal complaint and, if it remains unresolved after eight weeks or the insurer's final response, refer it to the Financial Ombudsman Service, which can make binding decisions up to the scheme limit.
How do I make a complaint about an insurer or broker?
Make your complaint first to the firm itself, preferably in writing, describing what went wrong and what outcome you want. The Financial Conduct Authority requires firms to have a complaints procedure and to send a final response within eight weeks, or to tell you why they cannot. If you are not satisfied with the final response or do not receive one within eight weeks, you can refer the complaint to the Financial Ombudsman Service, which is free for consumers and must be contacted within six months of the final response.
What protection do I have if my health insurer goes out of business?
UK insurers are regulated by the Prudential Regulation Authority and the Financial Conduct Authority, and they must hold capital to meet their liabilities. If an insurer fails, the Financial Services Compensation Scheme can pay compensation for valid claims on general insurance and certain other policies, subject to the scheme's eligibility rules and limits.
What should I look for in reviews of health insurance companies?
Read reviews that describe specific experiences with claims, pre-authorisation, premium increases and renewals, since these are where health insurers differ most in practice. Check whether reviewers mention how long claims took to settle and how the insurer handled a refused claim or a complaint. Look at the date of each review and whether the reviewer's situation matches yours, such as age, policy type and whether they made an inpatient or outpatient claim.