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‘Six-week PMI options need health warning’

Six-week option plans sold with private medical insurance should come with a health warning, according to the Association of Medical Insurance Intermediaries.

The options offer a premium discount of around 20 per cent and provide immediate treatment if treatment is not available on the NHS within six weeks.

But AMII chairman Andrew Tripp says: “Where I think these policies are dangerous is that , in the event of somebody having a heart attack or road traffic accident, for example, where treatment is available on the NHS immediately, then PMI customers will not be able to use their cover for any subsequent treatment required for that condition.

“Consumers do not understand the implications of these six-week options and I think that they should come with a health warning.”

PMI Partners managing director Ian Sawyer says: “Six-week options have a role to play but it is not something I recommend. What is the point of buying private healthcare to potentially end up with NHS healthcare instead?”

Providers offering six-week options include Aviva, Axa and Standard Life.

An Axa spokesman says that under the company’s six-week option, policyholders can still claim for eligible private treatments such as outpatient physiotherapy or surgery if they have had NHS treatment.

Aviva senior proposition development manager Kevin Murdoch says six-week options offer customers a cost-effective alternative.

He says: “To ensure that customers are fully aware of the option and its implications, we have worked hard to ensure that our policy documentation is written in clear, concise language and that our advisers fully explain the option at point of sale, renewal and claim stage.”

Aviva states in its pre-sales brochure that six-week options will not cover inpatient or day-patient treatment if it is available on the NHS within six weeks. Outpatient treatment is not affected.

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Comments

There are 3 comments at the moment, we would love to hear your opinion too.

  1. I disagree, I have worked within this industry for 18 years and I believe you have 2 types of people that buy PMI. The ones who never want to see the inside of a NHS hospital (6 week rule not for them), and the ones who want peace of mind. For people who want peace of mind knowing they will not have to wait longer than 6 weeks for treatment this is potentially a great option. This also can make the difference between premiums being affordable and not. As always surely it is case of making sure the cover provided fulfills that clients requirements.

  2. We, at Universal Provident, offer a 90-day product that works in a similar way to 6-week policies apart from the length of the waiting period. I agree with Kevin that these policies are appropriate as long as people are made fully aware of what the policy offers. It is conceptually akin to having a large excess – some claims will not be met but full cover will be provided in a lot of cases. It is just the claims for treatment where NHS treatment is available within (in our case) 90 days that are excluded rather than those which cost less than the excess. For clients with acute but not life-threatening conditions these policies can provide ‘full’ cover for that condition at a significant saving compared to PMI without waiting periods

  3. Totally agree. Aviva make a big thing about how wonderful their cancer care is but they fail to point out ( I wonder why) that the NHS will always deal with you in less than 6 weeks which makes the 6 week option and the policy a complete waste of time and money when you might really need it. You could always not take the six week option but how many people automatically assume that the NHS will always take longer than 6 weeks. NHS best option when you really need medical care.

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