Glossary

• Acute condition — A condition that starts suddenly and is expected to respond to treatment and resolve.
• Chronic condition — A long-term condition needing ongoing management rather than a course of treatment that ends.
• Pre-existing condition — A condition you had, or had symptoms or treatment for, before your policy started.
• Moratorium underwriting — Underwriting that automatically excludes recent medical history for a set period, usually five years.
• Full medical underwriting — Underwriting where you declare your medical history and the insurer decides cover up front.
• Continued personal medical exclusions — Switching insurer while carrying your existing exclusions across, rather than being underwritten afresh.
• Excess — The amount you pay towards a claim before the insurer pays anything.
• Outpatient cover — Cover for consultations, tests and scans where you are not admitted to hospital.
• Inpatient treatment — Treatment where you are admitted to a hospital bed and stay at least one night.
• Hospital list — The set of hospitals your policy will pay for you to be treated at.
• Pre-authorisation — Getting the insurer’s agreement to treatment before it happens.
• Referral — A GP’s letter naming a specialist, which most policies require before they will pay.
• Referral to treatment pathway — The NHS measure of the time from referral to the start of consultant-led treatment.
• Premium — What you pay the insurer, monthly or annually, to keep the policy in force.
• No-claims discount — A reduction in premium that reflects how little you have claimed.
• Policy wording — The full contract document that decides what is and is not covered.
• Insurance product information document — A short standardised summary of what a policy covers and excludes.
• Financial Conduct Authority — The UK regulator responsible for the conduct of insurers and insurance brokers.
• Financial Ombudsman Service — The free, independent service that settles complaints between consumers and financial firms.
• Financial Services Compensation Scheme — The statutory safety net that can pay out if an authorised firm fails.
• Insurance broker — A regulated firm that arranges cover for you, usually paid commission by the insurer.
• Shortfall — The part of a private medical bill your policy does not pay, leaving you to settle it.
• Self-pay — Paying for private treatment directly, without using insurance.
• Waiting period — A set time at the start of a policy before certain benefits can be claimed.
• Cancer cover — The policy benefits and conditions used to assess eligible private cancer care.
• Cancer claim authorisation — The insurer’s written approval for a defined cancer service, provider and claim stage.
• Referral to treatment (RTT) — The NHS measure of the time from a referral to the start of consultant-led treatment.
• NHS patient choice — The right to choose which provider delivers your first outpatient appointment at referral.
• Sum assured — The fixed amount a life insurance policy agrees to pay out on a valid claim.
• Term assurance — Life insurance that pays out only if you die within a fixed period (the term).
• Whole of life insurance — Life insurance with no end date, which pays out whenever you die.
• Decreasing term insurance — Term cover whose pay-out falls over time, usually tracking a repayment mortgage.
• Policy written in trust — A legal arrangement where pay-out money is held by trustees for named beneficiaries.
• Guaranteed acceptance (over-50s plan) — Life cover for over-50s with no medical questions, capped pay-outs and a qualifying period.
• Critical illness cover — Insurance that pays a tax-free lump sum if you are diagnosed with a condition meeting the policy definition.
• Policy definition (critical illness) — The exact medical wording a diagnosis must meet before a critical illness claim is paid.
• Survival period — The short period after diagnosis you must survive before a critical illness claim is paid.
• Partial payment (additional-condition payment) — A smaller pay-out for a less severe condition that does not end the main cover.
• Children’s critical illness cover — Automatic cover for the policyholder’s children, usually included on adult policies at a capped amount.
• Combined life and critical illness cover — One policy covering death and defined serious illness, usually paying out once on the first event.
• Deferred period — The waiting time between stopping work and the first income protection payment.
• Own occupation — The strongest incapacity definition: the policy pays if you cannot do your specific job.
• Benefit period — The maximum length of time an income protection policy pays per claim.
• Incapacity definition — The policy clause that sets the test of being unable to work that a claim must pass.
• Waiver of premium — A feature that stops your premiums while a claim is being paid, so cover continues free.
• Key person — An individual whose death or serious illness would measurably damage a company’s profits.
• Cross-option agreement — An agreement giving surviving owners an option to buy and a departing owner’s estate an option to sell.
• Death in service — A lump sum paid to an employee’s family if they die while employed, funded by the employer.
• Relevant life plan — A single-life death-in-service policy a company arranges on one employee or director, held in trust.
• Free cover limit — The level of group scheme benefit an insurer will cover without individual medical underwriting.
• Loading — An increase to a premium applied because the insurer assesses the risk as higher than standard.
• Postponement — An insurer declining to assess an application yet, and inviting it again after a set period.
• GP report — A medical report an insurer requests from your doctor to support an application or a claim.
• Guided option — A lower premium in return for the insurer choosing your consultant or hospital from its network.